Many formerly incarcerated people have civil legal needs that can imperil their successful re-entry to society and, consequently, their health. We categorize these needs and assess their association with cardiovascular disease risk factors in a sample of recently released people. We find that having legal needs related to debt, public benefits, housing, or healthcare access is associated with psychosocial stress, but not uncontrolled high blood pressure or high cholesterol, in the first three months after release.

A general practitioner (GP) recounts events which unfolded after visiting a patient at home. She was found to be suffering from an entirely curable clinical condition which was worsening as a result of refusal to accept effective medical treatment. The effects upon a grown-up son of the patient's refusal, and the increasing burden of care falling upon local district nursing services, were factors which influenced the GP's thinking and decision making.

There are very few medical ethics courses in British medical schools which are a formal part of the clinical curriculum. Such a programme is described in the following, along with the way in which the long-term curriculum committee of the University College and Middlesex Hospital Joint Medical School was persuaded to make it compulsory for first-year students. Pedagogical lessons which have been learned in its planning and implementation are outlined and teaching materials are included concerning student and course assessment which (...) should be useful for others engaged in similar work. Finally, some of the institutional obstacles facing such attempts are discussed, particularly problems concerning timetabling, different types of opposition and the consequent importance of building alliances among clinical teaching staff. (shrink)

The speed and scale of the COVID‐19 pandemic has highlighted the limits of current health systems and the potential promise of non‐establishment research such as “DIY” research. We consider one example of how DIY research is responding to the pandemic, discuss the challenges faced by DIY research more generally, and suggest that a “trust architecture” should be developed now to contribute to successful future DIY efforts.

Disparities in access to, and utilization of, treatment for depression among African-American and Caucasian elderly adults have been well-documented. Less fully explored are the multidimensional factors responsible for these disparities. The intersection of cultural constructs, socioeconomic factors, multiple levels of racism, and stigma attending both mental health issues and older age may help to explain disparities in the treatment of the depressed elderly. Personalized medicine with its promise of developing interventions tailored to an individual's health needs and genetically related response (...) to treatment might seem a promising antidote to the documented underutilization of standard depression treatments by African Americans. However, this paper examines the multidimensional factors associated with disparities in effective treatment of depression among African-American and Caucasian elderly adults and argues the scientific and ethical importance of pursuing various paths to address multiple levels and sources of stigma and mistrust if pharmacogenomics is to help, rather than exacerbate, disparities in depression treatment. Seven recommendations are offered to increase the likelihood that developments in pharmacogenomics will reduce disparities in depression treatment. (shrink)

Personalized medicine with its promise of developing interventions tailored to an individual's health need and genetically related response to treatment might seem a promising antidote to the documented underutilization of standard depression treatments by African Americans. In addition, understanding depression not merely in biochemical terms but also in genetic terms might seem to counter cultural beliefs and stigma that attach to depression when conceived as a mood or behavioral problem under an individual's control. After all, if there is one thing (...) for which a person is not responsible and cannot be blamed, it is her genes. Nevertheless, for multiple reasons, a personalized medical approach to depression treatment, and its attendant conceptualization of depression and treatment response as genetically influenced, present the risk of exacerbating well-documented disparities in access to, and utilization of, treatment for depression among African-American and Caucasian elderly adults. (shrink)

The representational distortion (RD) approach to similarity (e.g., Hahn, Chater, & Richardson, 2003) proposes that similarity is computed using the transformation distance between two entities. We argue that researchers who adopt this approach need to be concerned with how representational transformations can be determined a priori. We discuss several roadblocks to using this approach. Specifically we demonstrate the difficulties inherent in determining what transformations are psychologically salient and the importance of considering the directionality of transformations.

Using a queer theory and disrupting heteronormativity framework, we applied a model lesson in the elementary methods course to understand preservice teachers’ experiences with LGBTQ individuals and families and their beliefs about utilizing children׳s literature portraying LGBTQ families in the elementary classroom. Participants reported a range of personal experiences with LGBTQ individuals and families and relatively positive responses to the family text set presented but wavered on LGBTQ themed books due to perceived conflict, religious beliefs, and ideas about what is (...) appropriate content for young learners. A discussion of the findings also includes preservice teachers’ intentions for future teaching related to LGBTQ topics. Implications for teacher education and social studies education are explored. (shrink)

Employing the National Institute of Mental Health-funded Prevention of Suicide in Primary Care Elderly Collaborative Trial as a case study, we discuss 2 sets of ethical issues: obtaining informed consent for a clinic-based intervention study and using treatment as usual (TAU) as the control condition. We then address these ethical issues in the context of the debate about the quality improvement efforts of health care organizations. Our analysis reveals the tension between ethics and scientific integrity involved with using TAU as (...) a control condition and the difficulty in designing high-quality research in a community-based setting. (shrink)

Scientific peer reviewers play an integral role in the grant selection process, yet very little has been reported on the levels of participation or the motivations of scientists to take part in peer review. The American Institute of Biological Sciences developed a comprehensive peer review survey that examined the motivations and levels of participation of grant reviewers. The survey was disseminated to 13,091 scientists in AIBS’s proprietary database. Of the 874 respondents, 76% indicated they had reviewed grant applications in the (...) last 3 years; however, the number of reviews was unevenly distributed across this sample. Higher review loads were associated with respondents who had submitted more grant proposals over this time period, some of whom were likely to be study section members for large funding agencies. The most prevalent reason to participate in a review was to give back to the scientific community and the most common reason to decline an invitation to review was lack of time. Interestingly, few suggested that expectation from the funding agency was a motivation to review. Most felt that review participation positively influenced their careers through improving grantsmanship and exposure to new scientific ideas. Of those who reviewed, respondents reported dedicating 2–5% of their total annual work time to grant review and, based on their self-reported maximum review loads, it is estimated they are participating at 56–87% of their capacity, which may have important implications regarding the sustainability of the system. Overall, it is clear that participation in peer review is uneven and in some cases near capacity, and more needs to be done to create new motivations and incentives to increase the future pool of reviewers. (shrink)

One winter morning, the two of us—both postdoctoral fellows in medical humanities and bioethics—gathered with a handful of reproductive science graduate students in the lab to watch a demonstration on making alginate beads. Due to their three-dimensional nature, the beads are capable of holding ovarian follicles—the beads act as though they were a small ovary. The scientists in the lab have managed to mature the follicles maintained in the beads into eggs, fertilize these eggs, and produce the birth of live (...) mice. This research was begun in an effort to develop a means of gathering ovarian follicles from young human cancer patients before they commence cancer treatment that may result in their infertility, thus .. (shrink)

BackgroundFunding agencies have long used panel discussion in the peer review of research grant proposals as a way to utilize a set of expertise and perspectives in making funding decisions. Little research has examined the quality of panel discussions and how effectively they are facilitated.MethodsHere, we present a mixed-method analysis of data from a survey of reviewers focused on their perceptions of the quality, effectiveness, and influence of panel discussion from their last peer review experience.ResultsReviewers indicated that panel discussions were (...) viewed favorably in terms of participation, clarifying differing opinions, informing unassigned reviewers, and chair facilitation. However, some reviewers mentioned issues with panel discussions, including an uneven focus, limited participation from unassigned reviewers, and short discussion times. Most reviewers felt the discussions affected the review outcome, helped in choosing the best science, and were generally fair and balanced. However, those who felt the discussion did not affect the outcome were also more likely to evaluate panel communication negatively, and several reviewers mentioned potential sources of bias related to the discussion. While respondents strongly acknowledged the importance of the chair in ensuring appropriate facilitation of the discussion to influence scoring and to limit the influence of potential sources of bias from the discussion on scoring, nearly a third of respondents did not find the chair of their most recent panel to have performed these roles effectively.ConclusionsIt is likely that improving chair training in the management of discussion as well as creating review procedures that are informed by the science of leadership and team communication would improve review processes and proposal review reliability. (shrink)

The Repugnant Conclusion served an important purpose in catalyzing and inspiring the pioneering stage of population ethics research. We believe, however, that the Repugnant Conclusion now receives too much focus. Avoiding the Repugnant Conclusion should no longer be the central goal driving population ethics research, despite its importance to the fundamental accomplishments of the existing literature.

In contrast to the views put forth by Stein & Glasier, we support the use of inbred strains of rodents in studies of the immunobiology of neural transplants. Inbred strains demonstrate homology of the major histocompatibility complex (MHC). Virtually all experimental work in transplantation immunology is performed using inbred strains, yet very few published studies of immune rejection in intracerebral grafts have used inbred animals.

Interventions to decrease acquisition and transmission of sexually transmitted diseases among African American women using text messages versus small-group delivery modalities pose distinct research risks and benefits. Determining the relative risk–benefit ratio of studies using these different modalities has relied on the expertise of investigators and their institutional review boards. In this study, African American women participated in focus groups and surveys to elicit and compare risks and benefits inherent in these two intervention delivery modalities, focusing on issues such as (...) convenience, privacy, and stigma of participation. Some risk/benefit variables were implicated in willingness to participate the two intervention modalities. (shrink)

Tests of economic theory often focus on choice outcomes and find significant individual differences in these outcomes. This variability may mask universal psychological processes that lead to different choices because of differences across cultures in the information people have available when making decisions. On this view, decision making research within and across cultures must focus on the processes underlying choice.

Pothos suggests dispensing with the distinction between rules and similarity, without defining what is meant by either term. We agree that there are problems with the distinction between rules and similarity, but believe these will be solved only by exploring the representations and processes underlying cases purported to involve rules and similarity.

Employing the National Institute of Mental Health-funded Prevention of Suicide in Primary Care Elderly Collaborative Trial as a case study, we discuss 2 sets of ethical issues: obtaining informed consent for a clinic-based intervention study and using treatment as usual (TAU) as the control condition. We then address these ethical issues in the context of the debate about the quality improvement efforts of health care organizations. Our analysis reveals the tension between ethics and scientific integrity involved with using TAU as (...) a control condition and the difficulty in designing high-quality research in a community-based setting. (shrink)

In their article, De Bie et al. (2023) provide a scoping review of the ethical and socio-legal issues arising from research into, and the potential, maybe even likely deployment of, artificial womb...

Investors with a pro-social or sustainability agenda increasingly attempt to influence firm managers to adopt socially responsible behavior, either through positive/reward tactics or negative/punishment tactics. This paper considers how investors can use each approach to differentially influence managers to make more CSR investments. The paper uses game theory with an all-pay contest structure to model how a large institutional investor could reward firms for CSR activities by creating a socially responsible investment fund (reward contest) or punish firms via shareholder activism (...) (punishment contest). We identify conditions under which the punishment contest induces a higher level of CSR activity among firms compared to the reward contest. Managers bearing substantial private costs stemming from the activism is one such condition. Spillover effects are seen as the other managers in the economy engage in CSR to avoid being punished by the investor’s activism. This level of engagement is not the case when rewards are used—only those managers with an expectation of being rewarded increase their CSR activity in that scenario. This suggests, for example, that incorporating thresholds or tiers (e.g. gold, silver, and bronze-level winners) can increase the effectiveness of reward contests. Implications for designing both positive and negative CSR inducements are explored. We also identify the ethical dilemmas that relate to such influence attempts. (shrink)

Different aspects of people's interactions with money are best conceptualized using the drug and tool theories. The key question is when these models of money are most likely to guide behavior. We suggest that the Drug Theory characterizes motivationally active uses of money and that the Tool Theory characterizes behavior in motivationally cool situations. (Published Online April 5 2006).

Pickering & Garrod (P&G) suggest that communicators synchronize their processing at a number of linguistic levels. Whereas their explanation suggests that representations are being compared across individuals, there must be some representation of all conversation participants in each participant's head. At the level of the situation model, it is important to maintain separate representations for each participant. At other levels, it seems less crucial to have a separate representation for each participant. This analysis suggests that different mechanisms may synchronize representations (...) at different linguistic levels. (shrink)

Implementation of guidelines regarding breaches of electronic health information requires an anticipatory stance and physician and patient education regarding security and monitoring measures and methods of redress. Adopting a preventive ethics, rather than a crisis management, model may also increase physician awareness of how the information they choose to include and privilege within the health record may expose patients to added harms if not done mindfully.

When one thinks about organ transplantation, the organs that usually come to mind are the heart, or possibly the kidney, the most commonly transplanted organ (UNOS 2008). Transplantations are generally regarded as necessary to the life of the person receiving the transplant or to physiologically improving that life: the transplant is seen as making the recipient “whole” once more (Lederer 2008). While many have commented on the various ethical issues brought forth by the clinical practice of organ transplantation, here we (...) are concerned with the idea of becoming whole from organ transplantation. The idea of wholeness that a transplant renders can extend beyond the physiological to the individual, the familial, and .. (shrink)