This article proposes and empirically tests a theoretical framework incorporating Reidenbach and Robin’s (J Bus Ethics 10(4):273–284, 1991 ) conceptual model of corporate moral development. The framework is used to examine the relation between governance and business ethics, as proxied by diversity management (DM), and financial reporting quality, as proxied by the magnitude of earnings management (EM). The level of DM and governance quality are measured in accordance with the ratings of Jantzi Research (JR), a leading provider of social and (...) governance research for institutional investors. This DM score is part of an index developed by JR that investment managers use to integrate DM criteria into their investment decisions. As expected, a negative relation between corporate DM development and financial reporting quality is found while controlling for other factors known in the literatures on governance and accounting choices to affect earnings quality. Despite some caveats presented in conclusion, this study contributes to the ethics, governance, and financial reporting literatures by studying the dynamics between governance and ethics in the prevention of EM. (shrink)

This article examines whether and how the participation of women in the firm’s board of directors and senior management enhances financial performance. We use the Fama and French (1992, 1993) valuation framework to take the level of risk into consideration, when comparing firm performances, whereas previous studies used either raw stock returns or accounting ratios. Our results indicate that firms operating in complex environments do generate positive and significant abnormal returns when they have a high proportion of women officers. Although (...) the participation of women as directors does not seem to make a difference in this regard, firms with a high proportion of women in both their management and governance systems generate enough value to keep up with normal stock-market returns. These findings tend to support the policies currently being discussed or implemented in some countries and organizations to foster the advancement of women in business. (shrink)

Companies that are serious about corporate governance and business ethics are turning their attention to gender diversity at the most senior levels of business . Board gender diversity has been the subject of several studies carried out by international organizations such as Catalyst , the World Economic Forum , and the European Board Diversity Analysis . They all lead to reports confirming the overall relatively low proportion of women on boards and the slow pace at which more women are being (...) appointed. Furthermore, the proportion of women on corporate boards varies much across countries. Based on institutional theory, this study hypothesizes and tests whether this variation can be attributed to differences in cultural settings across countries. Our analysis of the representation of women on boards for 32 countries during 2010 reveals that two cultural characteristics are indeed associated with the observed differences. We use the cultural dimensions proposed by Hofstede to measure this construct. Results show that countries which have the greatest tolerance for inequalities in the distribution of power and those that tend to value the role of men generally exhibit lower representations of women on boards. (shrink)

Anti-vascular endothelial growth factor therapy has revolutionised the treatment of a variety of ophthalmic conditions and has become the first-line therapy for a range of retinal diseases. Bevacizumab, a VEGF inhibitor first approved for the treatment of colorectal cancer, has been shown to be nearly or virtually as effective and safe as other anti-VEGF therapies in the treatment of certain retinal diseases but is not approved or registered by the Food and Drug Administration or European Medicines Agency. While other anti-VEGF (...) options are approved and registered, they are generally more expensive and less accessible. Accordingly, despite its off-label status, bevacizumab is frequently used for a variety of disabling retinal diseases. Indeed, bevacizumab is included on the World Health Organization’s list of essential medicines. However, its use in some parts of the world remains restricted due to its off-label status. How, then, should healthcare authorities approach this situation? What are the ethical and societal implications of adhering to a standard and generally effective evaluation and approval system while restricting access to a potentially cost-saving therapy? In countries where its use is not restricted, how should providers approach off-label treatment with bevacizumab? By examining the evidence behind bevacizumab’s efficacy and safety and evaluating the individual and societal implications of off-label use and restriction, this paper illustrates the ethical factors providers and policy makers must consider in the off-label use of bevacizumab and ultimately argues for increased access to bevacizumab in the treatment of retinal disease. (shrink)

Can Covid-19 vaccines be used off-label? Should they be? These were questions on the minds of parents, pediatricians, and the media when the FDA fully approved the Pfizer-BioNTech Covid-19 vaccine for people aged 16 and up. Yet the American Academy of Pediatrics cautioned against pediatric off-label use of the vaccine, and the CDC Covid-19 Vaccine Provider Agreement appears to prohibit it. After briefly contextualizing ethical and legal precedents regarding off-label use, we offer an analysis of the ethical (...) permissibility of and considerations for pediatric off-label Covid-19 vaccination based on individual benefits, risks, and available alternatives. Our analysis challenges the ethics of a blanket prohibition on off-label pediatric Covid-19 vaccination, as it limits clinician ability to provide care they may determine to be clinically and ethically appropriate. At the same time, our analysis acknowledges that Covid-19 creates population-level ethical considerations that are at times in tension with individual health interests. (shrink)

Unter Off-Label-Use versteht man den zulassungsüberschreitenden Einsatz eines Arzneimittels außerhalb der von Zulassungsbehörden genehmigten Anwendungsgebiete. Er ist in der medizinischen Praxis weit verbreitet und fächerübergreifend zu beobachten. Der Beitrag gibt eine Einschätzung der Off-Label-Anwendung aus ethischer Sicht. Dazu wird die Off- Label-Anwendung zunächst von anderen, sachlich verwandten Anwendungsweisen abgegrenzt. Danach wird über die aktuelle Verbreitung des Off-Label- Use informiert. Sodann wird gezeigt, dass sich bekannte Problemlagen aus der Medizinethik bei der Off-Label-Anwendung in spezifischer Weise verschärfen. (...) Schließlich wird diskutiert, wie eine ethisch akzeptable Off-Label-Anwendung von Arzneimitteln ausgestaltet werden könnte und auf welchen Ebenen sie ansetzen müsste. (shrink)

We wish to point out an additional consequence of the Catch-22 described by Andreae and colleagues (Andreae et al. 2016). The decades-long research gridlock of controlled drugs has unintentionally...

Sustainable labels are considered the best way for consumers to identify brands with environmental or social attributes on the shelves, and therefore promoted as a means to develop the so-called “ethical markets”. However, little is known about how consumers use these brands. This paper tries to offer complementary theoretical insights on the determinants of sustainable label use by drawing on the economic model of information search; in particular, it examines the influence of two factors on the purchase of such (...) labels: motivation and knowledge. Information was gathered through a structured questionnaire in personal interviews with 289 primary buyers. The study found that education influences directly knowledge, while Motivation influences Label use both directly and indirectly, via Label knowledge. This study concludes that Motivation is the most powerful factor to explain Label use; knowledge is a necessary but not sufficient condition. Even more, consumers may not have a good understanding of sustainable labels and still use them in their purchasing decisions. This suggests that there is a dual processing mode of sustainable labels, both systematic and heuristic. (shrink)

Previous research conducted in 1999 highlighted ethical concerns behind challenge studies inducing psychosis with ketamine and made recommendations to enhance ethical standards. Recently, a plethora of clinical trials have evaluated the efficacy of ketamine to treat mood disorders, which lead to complex ethical issues. Pharmaceutical companies and researchers hope to profit by developing patentable variations on ketamine for treating depression. Media have labeled ketamine as a “miracle” antidepressant. Some clinics offer expensive off-label use of ketamine to treat mood disorders. (...) This article examines the ecological validity of ketamine trials, measures to protect patients, informed consent procedures, financial inducements to participants and conflict of interest of researchers, therapeutic misconception, concealment, and deception. Further recommendations are purposed to improve ethical standard of clinical research involving ketamine. (shrink)

Coronavirus disease 2019 is a fast-developing viral pandemic spreading across the globe. Due to lack of availability of proven medicines against COVID-19, physicians have resorted to treatments through large trials of investigational drugs with poor evidence or those used for similar diseases. Large trials randomize 100–500+ patients at multiple hospitals in different countries to either receive these drugs or standard treatment. In order to expedite the process, some regulatory agencies had also given permission to use drugs approved for other diseases, (...) despite a lack of evidence of efficacy in COVID-19. In this review, we highlight the potential ethical issues that should be addressed during the use of investigational drugs with little prior evidence as a treatment options during a pandemic. We discuss the impact of design of randomized clinical trials using LOTUS trial as an example and that of off-label use of drugs like chloroquine/hydroxychloroquine on the safety of patients during COVID-19. We conclude that the adaptive randomized clinical trial designs offer a flexible and efficient approach, enabling patients to quickly switch to successful treatments, while minimizing the number of patients on standard of care. Randomized clinical trial design should consider blinding of investigators and only representative patients who can provide consent should be included. We also conclude the emergency approvals of drugs should be carefully issued and off-label use should be restricted in pandemics. Streamlined regulatory guidelines for emergency drug use in a pandemic can also help in providing benefit and minimizing harm to patients in the future. (shrink)

People have a love/hate relationship with rapidly changing healthcare technology. While consumer demand for medical apps continues to grow as rapidly as does supply, healthcare professionals and safety experts worry about the impact of these apps on the health consumer. In response to the rapidly growing mobile healthcare sector, the Food and Drug Administration has put forth guidelines to regulate ‘mobile medical apps’, those health-related apps that are designated as medical devices. In this article, I argue that this decision, to (...) only regulate apps that bill themselves as medical devices, will create a market for ‘off-label’ app use. Further, I will talk about the oft used analogy between off-label apps and off-label pharmaceuticals, showing that off-labeling apps will provide patients none of the benefits that come with a physician prescribing a drug off-label, while exposing the mobile healthcare consumer to significant risks that go significantly beyond those that we know of from prescription drugs. Recognizing that the Food and Drug Administration is not going to be able to significantly change its policies on oversight, I will suggest specific actions to at least mitigate some of the risks associated with off-label app use. (shrink)

Volume 19, Issue 6, June 2019, Page 22-25.

This paper studies the uses of proper names within a communication-theoretic setting, looking at both the conditions that govern the use of a name by a speaker and those involved in the correct interpretation of the name by her audience. The setting in which these conditions are investigated is provided by an extension of Discourse Representation Theory, MSDRT, in which mental states are represented as combinations of propositional attitudes and entity representations . The first half of the paper presents the (...) features of this framework that are needed to understand its application to the account of names that follows. N-labelled entity representations, where N is a proper name, play a pivotal part in this account: A speaker must have an N-labelled ER in order to be in a position to use a name N, and the interpreter must either have such a representation, or else construct one as part of his interpretation. The paper distinguishes different types of name uses in terms of what they presuppose about the role of N-labelled ERs on the side of the interpreter. (shrink)

The term “off-label drug use” refers to drugs that have not yet acquired “approved” status or drugs that have acquired “approved” status but are used with a different dosage, route, or administration method other than that for which the drug has been approved. In New Zealand, the Medicines Act 1981 specifically allows for off-label drug use. However, this authority is limited by the Health and Disability Commissioner Regulations 1996 and the common law, which require that off-label drug (...) use is of an acceptable standard, that the patient should be fully informed, and that the patient should give informed consent. Off-label drug use is an important issue because the current law provides medical practitioners very wide discretionary power, without providing clarification for what is required of the practitioner in exercising his or her discretion in prescribing off-label. This paper discusses possible solutions to this issue, for example, establishing protocol for off-label use, an electronic database of off-label use, and the amendment of legal provisions. (shrink)

Food labels legislated by the U.S. government have been designed to provide information to consumers. It has been asserted that the simple disclosures “produced using genetic engineering” on newly legislated U.S. food labels will send a signal that influences individual preferences rather than providing information. Vermont is the only US state to have experienced mandatory labeling of foods produced using genetic engineering via simple disclosures. Using a representative sample of adults who experienced Vermont’s mandatory GE labeling policy, we examined whether (...) GE labels were seen by consumers and whether the labels provided information or influenced preferences. Nearly one-third of respondents reported seeing a label. Higher income, younger consumers who search for information about GE were more likely to report seeing a label. We also estimated whether labels served as information cues that helped reveal consumer preferences through purchases, or whether labels served as a signal that influenced preferences and purchases. For 50.5% of consumers who saw a label, the label served as an information cue that revealed their preferences. For 13% of those who saw the label, the label influenced preferences and behavior. Overall, for 4% of the total sample, simple GE disclosures influenced preferences. For a slight majority of consumers who used a GE label, simple disclosures were an information signal and not a preference signal. Searching for GE information, classifying as female, older age and opposing GE in food production significantly increased the probability that GE labels served as an information source. Providing such disclosures to consumers may be the least complex and most transparent option for mandatory GE labeling. (shrink)

Prescribing drugs for uses that the FDA has not approved — off-label drug use — can sometimes be justified but is typically not supported by substantial evidence of effectiveness. At the root of inappropriate off-label drug use lie perverse incentives for pharmaceutical firms and flawed oversight of prescribing physicians. Typical reform proposals such as increased sanctions for manufacturers might reduce the incidence of unjustified off-label use, but they do not remove the source of the problem. Public policy (...) should address the cause and control the practice. To manage inappropriate off-label drug use, off-label prescriptions must be tracked in order to monitor the risks and benefits and the manufacturers’ conduct. Even more important, reimbursement rules should be changed so that manufacturers cannot profit from off-label sales. When off-label sales pass a critical threshold, manufacturers should also be required to pay for independent testing of the safety and effectiveness of off-label drug uses and for the FDA to review the evidence. Manufacturers should also finance, under FDA supervision, programs designed to warn physicians and the public about the risks of off-label drug use. (shrink)

Under current U.S. law, physicians may prescribe drugs and devices in situations not covered on the label approved by the Food and Drug Administration. Those supporting this system say that requiring FDA approval for off-label uses would unnecessarily impede the delivery of benefits to patients. Patients do benefit from off-label prescribing that is supported by sound scientific and medical evidence. In the absence of such evidence, however, off-label prescribing can expose patients to risky and ineffective treatments. (...) The medical community and federal authorities should more actively promote patients' interests in receiving beneficial off-label treatments. To exercise responsible self-regulation, members of the medical community must determine whether available evidence justifies specific off-label uses and must promote information-gathering when the evidence is inadequate. Physicians should also discuss with patients the uncertainties accompanying off-label uses. Federal authorities should more closely monitor the effects of off-label prescribing and adopt other measures to reduce harm and enhance benefits produced by off-label prescribing. (shrink)

Off-label prescribing is an integral part of contemporary medicine. Many patients benefit when they receive drugs or devices under circumstances not specified on the label approved by the Food and Drug Administration. An off-label use may provide the best available intervention for a patient, as well as the standard of care for a particular health problem. In oncology, pediatrics, geriatrics, obstetrics, and other practice areas, patient care could not proceed without off-label prescribing. When scientific and medical (...) evidence justify off-label uses, physicians promote patients’ interests by prescribing products off label.Off-label prescribing can also harm patients, however. The potential for harm is greatest when an offlabel use lacks a solid evidentiary basis. A 2006 study examining prescribing practices for 169 commonly prescribed drugs found high rates of off-label use with little or no scientific support. Researchers examining off-label use in U.S. children’s hospitals concluded, “[W]e still have incomplete knowledge about the safety and efficacy of many medications commonly used to treat children across a range of drug classes and clinical diagnoses.”. (shrink)

The Food and Drug Administration authorizes the marketing of a drug only for uses that the manufacturer has demonstrated to be safe and effective, based on evidence from at least two clinical trials. However, the FDA does not regulate the practice of medicine, so physicians may prescribe drugs in any manner they choose. Prescribing drugs in ways that deviate from the uses specified in the FDA-approved drug label, package insert, and marketing authorization is referred to as off-label prescribing. (...) This occurs when physicians prescribe a drug for a therapeutic purpose other than the one approved by the FDA; treat patients in a different age cohort or gender than the population on which it was tested; or prescribe a different dose, for a different duration of use, or a different mode of administration than indicated on the label. (shrink)

This thesis introduces the "method of structural refinement", which serves as a means of transforming the relational semantics of a modal and/or constructive logic into an 'economical' proof system by connecting two proof-theoretic paradigms: labelled and nested sequent calculi. The formalism of labelled sequents has been successful in that cut-free calculi in possession of desirable proof-theoretic properties can be automatically generated for large classes of logics. Despite these qualities, labelled systems make use of a complicated syntax that explicitly incorporates the (...) semantics of the associated logic, and such systems typically violate the subformula property to a high degree. By contrast, nested sequent calculi employ a simpler syntax and adhere to a strict reading of the subformula property, making such systems useful in the design of automated reasoning algorithms. However, the downside of the nested sequent paradigm is that a general theory concerning the automated construction of such calculi (as in the labelled setting) is essentially absent, meaning that the construction of nested systems and the confirmation of their properties is usually done on a case-by-case basis. The refinement method connects both paradigms in a fruitful way, by transforming labelled systems into nested (or, refined labelled) systems with the properties of the former preserved throughout the transformation process. To demonstrate the method of refinement and some of its applications, we consider grammar logics, first-order intuitionistic logics, and deontic STIT logics. The introduced refined labelled calculi will be used to provide the first proof-search algorithms for deontic STIT logics. Furthermore, we employ our refined labelled calculi for grammar logics to show that every logic in the class possesses the effective Lyndon interpolation property. (shrink)

In attempting to explain or deal with negative workplace behaviours such as workplace bullying, the notion of ‘workplace psychopaths’ has recently received much attention. Focusing on individual aspects of negative workplace behaviour is at odds with more systemic approaches that recognise the contribution of individual, organisational and societal influences, without seeking to blame a person(s) for their behaviour or personality disorder. Regarding a coworker as a psychopath is highly stigmatising, and given the relatively low prevalence of psychopathy in the community, (...) is likely to be incorrect. Sources promoting the notion of workplace psychopathy provide lists of diagnostic criteria and appear to encourage the perception that it is common. This research examines how lay persons use behavioural criteria consistent with psychopathy and the label ‘psychopath’ in relation to a coworker. 307 Australian workers completed an online survey concerning their experience of workplace bullying, which also asked them to rate a coworker’s behaviour on a range of scales to assess perceptions of psychopathy. Rates of psychopathy, when using labels and behavioural criteria, were found to be much higher than scientific estimates of prevalence, for both participants who had been bullied and those who had not. A higher proportion of non-bullied participants classified a coworker as a psychopath when using the label ‘psychopath’, compared to when using behavioural criteria. The notion that there are psychopaths in every workplace should be treated with caution to ensure that the potential for ‘misdiagnosis’ and stigmatisation do not cause further harm in situations of unacceptable workplace behaviours. (shrink)

Affiliation is both an antecedent and a consequence of emotional mimicry (i.e. imitating a counterpart’s emotional expression). Thus, interacting with a disliked partner can decrease emotional mimicry, which in turn can further decrease liking. This perpetuating circle has not been investigated in the context of mental health stigma yet. The present study tested the influence of the label “schizophrenia” on liking, interpersonal closeness, and emotional mimicry. In an online experiment (n = 201), participants recruited from the general population saw (...) several videos of actors displaying emotional expressions. Actors were described with one of four labels: “schizophrenia”, “healthy”, “diabetes”, and a negative adjective (e.g. “hot-tempered”). Emotional mimicry was measured using OpenFace 2.2. Liking and interpersonal closeness were assessed with questionnaires. Overall, compared to other labels, participants reported less liking and interpersonal closeness to the actor with the schizophrenia label. However, no effect on emotional mimicry was found. The decreased liking of the schizophrenia actors was explained by a lack of knowledge about schizophrenia and the explicit stigma of schizophrenia. Our study contributes to the literature by highlighting the need to reduce the stigma of schizophrenia. (shrink)

We present a labelled version of Lambek Calculus without unit, and we use it to prove a completeness theorem for Lambek Calculus with respect to some relational semantics.

Background Thorough information of the patient is an integral part of the process of shared decision making. We aimed to investigate if detailed information about medication may induce nocebo effects. Methods We conducted a randomized, single-blind, pilot-study including n = 51 psychiatric in-patients aged between 18 and 80 years with a depressive disorder and accompanying sleeping disorders. In the intervention group we provided thorough information about adverse effects, while the control group received only a simple consent procedure. In both groups, (...) patients received an open-label placebo pill instead of their sleeping medication. Results No statistically significant differences between the intervention group and the control group were found regarding the main outcome parameter. Conclusion In this study, we were not able detect an effect of informed consent vs. simple consent on the emergence of placebo or nocebo effects. This finding is contrary to most assumptions and publications about this topic. Trial registration Trial registration number: DRKS00017653, registered August 30th 2018. Retrosprectively registered. (shrink)

In this paper a uniform methodology to perform natural\ndeduction over the family of linear, relevance and intuitionistic\nlogics is proposed. The methodology follows the Labelled\nDeductive Systems (LDS) discipline, where the deductive process\nmanipulates {\em declarative units} -- formulas {\em labelled}\naccording to a {\em labelling algebra}. In the system described\nhere, labels are either ground terms or variables of a given {\em\nlabelling language} and inference rules manipulate formulas and\nlabels simultaneously, generating (whenever necessary)\nconstraints on the labels used in the rules. A set of natural\ndeduction style (...) inference rules is given, and the notion of a\n{\em derivation} is defined which associates a labelled natural\ndeduction style ``structural derivation'' with a set of generated\nconstraints. Algorithmic procedures, based on a technique called\n{\em resource abduction\/}, are defined to solve the constraints\ngenerated within a structural derivation, and their termination\nconditions discussed. A natural deduction derivation is then\ndefined to be {\em correct} with respect to a given substructural\nlogic, if, under the condition that the algorithmic procedures\nterminate, the associated set of constraints is satisfied with\nrespect to the underlying labelling algebra. Finally, soundness\nand completeness of the natural deduction system are proved with\nrespect to the LKE tableaux system \cite{daga:LAD}.\footnote{Full\nversion of a paper presented at the {\em 3rd Workshop on Logic,\nLanguage, Information and Computation\/} ({\em WoLLIC'96\/}), May\n8--10, Salvador (Bahia), Brazil, organised by Univ.\ Federal de\nPernambuco (UFPE) and Univ.\ Federal da Bahia (UFBA), and\nsponsored by IGPL, FoLLI, and ASL.}. (shrink)

We argue that the universal recommendations against “off-label” pediatric use of approved COVID-19 issued by the FDA, CDC, and AAP are overbroad. Especially for higher-risk children, vaccination can be ethically justified even before FDA authorization or approval – and similar reasoning is relevant for even younger patients. Legal risks can also be managed, although the FDA, CDC, and Department of Health and Human Services (HHS) should move quickly to provide clarity.

In recent years, the postulation that deception is necessary for placebos to have an effect on pain relief or increased well-being has come into question. Latest studies have shown that an openly administered mock drug works just as well as a deceptively administered placebo on certain complaints. This open-label placebo effect has primarily been used in the area of pain treatment so far. This study is the first to examine the effect of such placebos on healthy individuals with the (...) use of drinking water. In two experiments, participants were required to use certain specified water bottles for their daily drinking water consumption. At the beginning of Experiment 1, all participants received one bottle of water, which they were asked to refill themselves each day during a 2-week intervention period. In Experiment 2, participants received a new sealed water bottle every day. In both experiments, participants were randomly assigned to one of four groups: no treatment, open-label placebo without rationale, open-label placebo with rationale, and open-label placebo with additional rationale in a suggested relaxed state. We conducted baseline and post-treatment measurements of the subjective perceived physical and mental well-being of the participants. In Experiment 1, only the OPR++ group reported enhanced vitality at the post-treatment level compared to the other groups. In Experiment 2, post-treatment measurements showed improvements for the OPR++ group in the Physical Performance Capability, Mental Performance Capability, Emotional Balance, Overall Recovery, Negative Emotional State, and Overall Stress categories compared to the other groups. Our results support the idea that placebos with an additional rationale in a suggestive relaxed state are more effective than with just a rationale in a normal state. Furthermore, our study shows the tendency that OLP++ in the form of water with health claims may be more effective when the water is given in several sealed bottles separately than in one sealed but refillable bottle. (shrink)

A substantial body of experimental evidence has demonstrated that labels have an impact on infant categorization processes. Yet little is known regarding the nature of the mechanisms by which this effect is achieved. We distinguish between two competing accounts: supervised name‐based categorization and unsupervised feature‐based categorization. We describe a neurocomputational model of infant visual categorization, based on self‐organizing maps, that implements the unsupervised feature‐based approach. The model successfully reproduces experiments demonstrating the impact of labeling on infant visual categorization reported in (...) Plunkett, Hu, and Cohen (2008). It mimics infant behavior in both the familiarization and testing phases of the procedure, using a training regime that involves only single presentations of each stimulus and using just 24 participant networks per experiment. The model predicts that the observed behavior in infants is due to a transient form of learning that might lead to the emergence of hierarchically organized categorical structure and that the impact of labels on categorization is influenced by the perceived similarity and the sequence in which the objects are presented. The results suggest that early in development, say before 12 months old, labels need not act as invitations to form categories nor highlight the commonalities between objects, but they may play a more mundane but nevertheless powerful role as additional features that are processed in the same fashion as other features that characterize objects and object categories. (shrink)

From a marketing point of view, front labels play a crucial role in the consumers' relatively quick decisionmaking process when buying wine in retail stores. The aim of this paper was to reveal which semiotic code systems, in particular, colors, visual representations, and designs, as well as verbal representations, Austrian wine producers use on the front labels of their red wine bottles. For that purpose, the method of content analysis was applied on a representative corpus of red wine labels. Our (...) empirical study showed that the wine labels analyzed especially appeal to price sensitive customers through the employment of light colors. In addition, wine producers do not seem to apply the “visualtotaste lexicon” as the labels rarely show the color “red.” Furthermore, in a large number of cases the wine producers use their family names as brand names of their wines. Moreover, both the depiction of crests and landscapes and the application of indexical brand names, emphasize the Austrian origin of wines. Finally, the extensive use of English brand names appears to connect wines to the social stereotypes of modernity, prestige, and progress. (shrink)

Until recently, the medical community assumed that placebos required either concealment in randomized controlled trials or deception in clinical practice to elicit placebo effects. Henry Beecher emphasized this orthodoxy, when he stated that placebo pills only work "as long as it is not detected as a placebo by the subject or the observer" and therefore, patients "believe it [is a drug] and consequently the expected results occurs". The time was ripe for such ideas: Norman Vincent Peale's The Power of Positive (...) Thinking was already in its fourth year on the bestseller list when Beecher published his landmark paper. As time went on, the use of placebo pills became trapped in an... (shrink)

The Italian government recently criticized the UK’s “traffic light” food labelling system for unfairly discriminating against some traditional Italian foods such as mozzarella, Parma ham, and Parmesan cheese . This type of labelling highlights the percentages of fat, saturated fat, salt, sugar, and calories of each food and classifies them by using red, amber, and green colors depending on the level of each nutrient. While it is true that some Italian foods do contain a high level of fat or salt (...) , the Italian government pointed out that traffic light labelling sometimes privileges certain processed foods or fizzy drinks with artificial sweeteners over .. (shrink)

BackgroundDepressive disorders are a common form of psychiatric illness and cause significant disability. Regulation authorities, the medical profession and the public require high safety standards for antidepressants to protect vulnerable psychiatric patients. Ketamine is a dissociative anaesthetic and a derivative of a hallucinogen. Its abuse is a major worldwide public health problem. Ketamine is a scheduled drug and its usage is restricted due to its abuse liability. Recent clinical trials have reported that ketamine use led to rapid antidepressant effects in (...) patients suffering from treatment-resistant depression. However, various flaws in study designs, and possible biased reporting of results, may have influenced those findings. Further analyses of ketamine use are needed to ensure patient safety.DiscussionThe use of ketamine in research and treatment of depressive disorders is controversial. Recently, mental health professionals raised ethical concerns about an ongoing ketamine trial in the UK. Also, a Canadian agency reviewed the existing evidence and did not recommend prescribing ketamine to treat depressive disorders. Findings obtained from tightly controlled research settings cannot be easily translated to clinical practice as substance abuse is commonly comorbid with depressive disorders. An effective antidepressant should reduce severity of depressive symptoms without liability problems. Although the US FDA has not approved the use of ketamine to treat depressive disorders, some psychiatrists offer off-label repeat prescription of ketamine. Prescribing ketamine for treating depressive disorders requires substantial empirical evidence. Clinicians should also consider research findings on ketamine abuse. Depressive disorders can be chronic conditions and the current evidence does not rule out the risk of substance abuse after repeat prescription of ketamine. Off-label ketamine use in treating depressive disorders may breach ethical and moral standards, especially in countries seriously affected by ketamine abuse. This article presents two real-world clinical vignettes which highlight ethical principles and theories, including autonomy, nonmaleficience, fidelity and consequentialism, as related to off-label ketamine use.ConclusionWe urge clinicians to minimise the risk of harming patients by considering the empirical evidence on ketamine properties and attempting all standard antidepressant therapies before considering the off-label use of ketamine. (shrink)

Learning in natural environments is often characterized by a degree of inconsistency from an input. These inconsistencies occur, for example, when learning from more than one source, or when the presence of environmental noise distorts incoming information; as a result, the task faced by the learner becomes ambiguous. In this study, we investigate how learners handle such situations. We focus on the setting where a learner receives and processes a sequence of utterances to master associations between objects and their labels, (...) where the source is inconsistent by design: It uses both “correct” and “incorrect” object‐label pairings. We hypothesize that depending on the order of presentation, the result of the learning may be different. To this end, we consider two types of symbolic learning procedures: the Object‐Label (OL) and the Label‐Object (LO) process. In the OL process, the learner is first exposed to the object, and then the label. In the LO process, this order is reversed. We perform experiments with human subjects, and also construct a computational model that is based on a nonlinear stochastic reinforcement learning algorithm. It is observed experimentally that OL learners are generally better at processing inconsistent input compared to LO learners. We show that the patterns observed in the learning experiments can be reproduced in the simulations if the model includes (a) an ability to regularize the input (and also to do the opposite, i.e., undermatch) and (b) an ability to take account of implicit negative evidence (i.e., interactions among different objects/labels). The model suggests that while both types of learners utilize implicit negative evidence in a similar way, there is a difference in regularization patterns: OL learners regularize the input, whereas LO learners undermatch. As a result, OL learners are able to form a more consistent system of image‐utterance associations, despite the ambiguous learning task. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Titles, Labels, and Names:A House of MirrorsGreg Petersen (bio)An EducationAmong the harshest critiques ever received during my doctoral coursework came from a professor who was noticeably perturbed that I had researched and written a paper on an artwork without considering the title in the interpretation and analysis of the work. The professor insisted that the title is necessary to understand the piece. As a diligent student, the lesson was (...) learned, and the following semester I wrote a different paper for a different professor including the title as part of the interpretation and analysis. The professor's response asserted that the sections of the paper discussing the title should be deleted to improve the paper because a title is a name only—a linguistic referent to speak and write about the work that has no other relationship to the work. The discussions that followed with the two professors evolved into a permanent interest in the relationship between appellations and the works they represent. The debate of whether titles are or are not important is not a two-sided argument but rather a maze. This article is not a specialized theoretical argument but an explication of this maze of disjointed relationships among images, their appellations, and the theories espoused by various artists, art critics, art historians, and philosophers. Nevertheless, the clearest exits from the maze are found by treating the appellations as literature and applying literary theory to them.Between Text and ImageMuch of the world we live in is visual and linguistic in nature: visual to the extent that seeing is associated with knowing, and linguistic to the extent that we can communicate through the use of words and letters. For thousands [End Page 29] of years there has been a close relationship between images and language. Both are commonly represented through the use of pigments on a two-dimensional surface. While we know of no literary relationships in early paintings, it is extremely rare today to find paintings without a literary appellation attached. Today we study paintings through words, but only on the most elementary levels do we study words through paintings. It appears that literate cultures give dominance to textual symbols over those in paintings, while illiterate cultures reverse these relationships. The problem is that words have culturally agreed upon meanings, often more so than visual images. We read and listen and then write and speak about those things we have read and heard. Historically, it may be that the relationship between language and images has reversed itself, and perhaps even reverses itself in our own educational process as we begin teaching children letters and words through the use of pictures. After all, which came first: image or language?There has been little written on the use of word associations with iconographic images during the Middle Ages. Nevertheless, it is clear that identification characteristics other than linguistic ones existed. Hazard Adams is one of the few to raise this issue in his essay on titles: "Before I turn to literary titles it might be well to ask whether... I am correct in assuming that there has never been a nonverbal title of a literary work or of anything else for that matter, the word-objects relation of a title being irreversible. There are certainly nonverbal labels like coats of arms and crowns that imply title in a related sense."1 It may be true that titles are typically thought of as word associations identifying objects, but it may also be possible that medieval imagery was at least as communicatively accurate as our present textual system. For example, a man with arrows fixed in his flesh would still be recognized by a medieval illiterate as St. Sebastian, yet most of the depictions of this Catholic saint are simply titled St. Sebastian. Would hanging the text St. Sebastian next to these depictions have created more meaning or a deeper understanding to a medieval Catholic? Often sacred personages and other important visual images have their own identifying characteristics that make a correlative text unnecessary. These identifying characteristics, to those familiar with them, remain very effective nonverbal symbols that conjure the stories they represent.Furthermore, during the medieval... (shrink)

Resolution is an effective deduction procedure for classical logic. There is no similar "resolution" system for non-classical logics (though there are various automated deduction systems). The paper presents resolution systems for intuistionistic predicate logic as well as for modal and temporal logics within the framework of labelled deductive systems. Whereas in classical predicate logic resolution is applied to literals, in our system resolution is applied to L(abelled) R(epresentation) S(tructures). Proofs are discovered by a refutation procedure defined on LRSs, that imposes (...) a hierarchy on clause sets of such structures together with an inheritance discipline. This is a form of Theory Resolution. For intuitionistic logic these structures are called I(ntuitionistic) R(epresentation) S(tructures). Their hierarchical structure allows the restriction of unification of individual variables and/or constants without using Skolem functions. This structures must therefore be preserved when we consider other (non-modal) logics. Variations between different logics are captured by fine tuning of the inheritance properties of the hierarchy. For modal and temporal logics IRS's are extended to structures that represent worlds and/or times. This enables us to consider all kinds of combined logics. (shrink)

We propose a family of Labelled Deductive Conditional Logic systems by defining a Labelled Deductive formalisation for the propositional conditional logics of normality proposed by Boutilier and Lamarre. By making use of the Compilation approach to Labelled Deductive Systems we define natural deduction rules for conditional logics and prove that our formalisation is a generalisation of the conditional logics of normality.

The doctor-patient relationship is built on an implicit covenant of trust, yet it was not until the post-World War Two era that respect for patient autonomy emerged as an article of mainstream medical ethics. Unlike their medical forebears, physicians today are expected to furnish patients with adequate information about diagnoses, prognoses and treatments. Against these dicta there has been ongoing debate over whether placebos pose a threat to patient autonomy. A key premise underlying medical ethics discussion is the notion that (...) the placebo effect necessitates patient deception. Indeed, the American Medical Association guidelines imply that placebo treatment necessary entails a form of deception. As a consequence of this assumption, the fulcrum of debate on the use of placebo treatment has hinged on whether that deception is ever justified. Recently performed experiments with open-label transparently prescribed placebos have begun to challenge the notion that deception is necessary in eliciting the placebo effect and such effects necessarily involve a binary distinction between autonomy and beneficence. In this article we focus on the content of disclosures in distinctive open-label, transparently disclosed placebo studies and inquire whether they might be said to invoke deception in clinical contexts, and if so, whether the deception is unethical. We find that open placebos may be said to involve equivocation over how placebos work. However, drawing on surveys of patient attitudes we suggest that this equivocation appears to be acceptable to patients. We conclude that open placebos fulfil current American Medical Association guidelines for placebo use, and propose future research directions for harnessing the placebo effect ethically. (shrink)