To what extent does payment method (managed care vs. out of pocket) influence the likelihood that an independent practitioner will assign a Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994) diagnosis to a client? When a practitioner does diagnose, how does payment method influence the specific choice of a diagnostic category? Independent practitioners responded to a vignette describing a fictitious client with symptoms of depression or anxiety. In half of the vignettes, the fictitious client intended to pay (...) via managed care; in the other half, the fictitious client intended to pay out of pocket. Payment method had a very significant impact on diagnosis such that relative to out-of-pocket clients, managed care clients were much more likely to receive diagnoses and more likely to receive adjustment disorder diagnoses in particular. We discuss implications involving informed consent and other ethical issues. (shrink)

Psychologists are ethically obligated to obtain informed consent to psychotherapy "as early as is feasible" (American Psychological Association, 2002, p. 1072). However, the range of topics to be addressed includes both information that may be immediately and uniformly applicable to most clients via policy or rule, as well as information that is not immediately presentable because it varies widely across clients or emerges over time. In this study, licensed psychologists were surveyed regarding the earliest feasible point at which they could (...) provide information regarding specific aspects of psychotherapy. Results indicate that, although psychologists believe that they are capable of presenting some information, such as payment and confidentiality policies, at the outset, they believe that a discussion of more substantive issues, such as psychotherapy duration, goals, orientation, and activities, can take place only after some therapy has transpired. Implications are discussed regarding the process and event models of informed consent. (shrink)

Are psychotherapy clients who pay via health insurance more likely to receive Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV], American Psychiatric Association, 1994) diagnoses than identical clients who pay out of pocket? Previous research (Kielbasa, Pomerantz, Krohn, & Sullivan, 2004) indicates that when psychologists consider a mildly depressed or anxious client, payment method significantly influences diagnostic decisions. This study extends the scope of the previous study to include clients whose symptoms are even less severe. Independent practitioners (...) responded to vignettes of clients whose profiles deliberately included subclinical impairment and a high level of functioning. Half of the participants were told that the clients would pay via managed care; the other half were told that the clients would pay out of pocket. As in the earlier study, payment method had a highly significant impact on diagnosis such that relative to out-of-pocket clients, managed care clients were much more likely to be assigned DSM-IV diagnoses. In addition, a noteworthy percentage of participants assigned diagnoses regardless of payment method. Ethical implications are discussed. (shrink)

Modal responses to items from a recent survey of independent practitioners regarding the impact of managed care on their practices and ethics were presented to participants as the responses of a hypothetical independent practitioner. Participants were asked to consider seeing this hypothetical practitioner both before and after being informed of the practitioner's responses to the managed care survey. Results indicate that when participants were informed of the practitioner's views toward managed care, their own attitudes toward therapy changed significantly. Specifically, compared (...) to uninformed participants, informed participants were significantly more likely to believe that managed care would have a negative impact on treatment and significantly less likely to see an independent practitioner, use insurance benefits, expect to benefit from treatment, expect to form a strong working relationship, and trust that the practitioner would work in their best interest. Implications regarding ethics and informed consent are discussed. (shrink)

Previous research (Kielbasa, Pomerantz, Krohn, & Sullivan, 2004; Pomerantz & Segrist, 2006) indicates that when psychologists consider a client with symptoms of depression or anxiety, payment method significantly influences diagnostic decisions. This study extends the scope of the previous research to consider clients with symptoms of social phobia and attention deficit hyperactivity disorder (ADHD). Psychologists in independent practice responded to vignettes of clients whose descriptions deliberately included subclinical impairment. Half of the participants were told that the clients would (...) pay via managed care; the other half were told that the clients would pay out-of-pocket. Confirming previous studies, payment method had a highly significant impact on diagnosis such that compared to out-of-pocket clients, managed care clients were much more likely to be assigned Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) diagnoses. Ethical implications relate to informed consent, accuracy and truthfulness in diagnosis, and psychologists' integrity. (shrink)

The present study examined nonprofessionals' perceptions of culturally based and noncultural ethical violations. One hundred seventy-four undergraduates students read 12 vignettes depicting situations in which a clinician committed either a culturally based violation (e.g., sexist or ageist behavior) or a noncultural violation (e.g., breeching confidentiality or multiple relationship). Results indicated that participants were more likely to have unfavorable views of clinicians who had committed culturally based violations. In addition, results suggested that participants would be more likely to report a clinician (...) who had committed a culturally based violation to a supervisor or ethics board. (shrink)

Research on multiple relationships by practicing psychologists has typically presumed the presence of a professional relationship and focused on the ethicality of subsequent, nonprofessional relationships. Instead, this study focused on the question of what, exactly, constitutes the professional relationship in the first place. Practicing psychologists and undergraduates responded to vignettes portraying various early stages of interaction between a therapist and a prospective client. Participants' responses indicated that determinations of professional relationship establishment, and the ethicality of subsequent nonprofessional relationships, depended upon (...) the degree of engagement. Some differences emerged between perceptions by professionals and nonprofessionals. Ethical and professional implications are discussed. (shrink)

Although psychologist impairment has received attention from researchers, there is a paucity of empirical data aimed at determining the point at which such impairment necessitates action. The purpose of this study was to provide such empirical data. Members of Division 42 ( n = 285) responded to vignettes describing a psychologist whose symptoms of either depression or substance abuse varied across five levels of severity. Results identified specific levels of impairment at which psychologists were deemed too impaired to practice psychotherapy, (...) as well as significant differences between ratings of increasingly severe impairment. Practical and ethical implications of these results are discussed. (shrink)

© 2015, Springer-Verlag Berlin Heidelberg.Genetic studies have identified single nucleotide polymorphisms associated with the risk of prostate cancer. It remains unclear whether such genetic variants are associated with disease aggressiveness. The NCI-SPORE Genetics Working Group retrospectively collected clinicopathologic information and genotype data for 36 SNPs which at the time had been validated to be associated with PC risk from 25,674 cases with PC. Cases were grouped according to race, Gleason score and aggressiveness. Statistical analyses were used to compare the frequency (...) of the SNPs between different disease cohorts. After adjusting for multiple testing, only PC-risk SNP rs2735839 was significantly and inversely associated with aggressive and high-grade disease in European men. Similar associations with aggressive and high-grade disease were documented in African-American subjects. The G allele of rs2735839 was associated with disease aggressiveness even at low PSA levels in both European and African-American men. Our results provide further support that a PC-risk SNP rs2735839 near the KLK3 gene on chromosome 19q13 may be associated with aggressive and high-grade PC. Future prospectively designed, case-case GWAS are needed to identify additional SNPs associated with PC aggressiveness. (shrink)

In their target article, Nelson, Lushkov, Pomerantz, and Weeks demonstrate that there has been a lack of discussion on rural bioethics issues in published, or at least indexed, literature. They con...

Our thinking is still the captive of the dichotomy “national/ international.” The reaction to nationalism takes the form of an abstract internationalism, and reaction to internationalism leads to the rebirth of nationalism. However, this dichotomy was only true (and that relatively) in 19th century Europe, or at the latest, at the beginning of the twentieth century, when subnational cultures seemed on the way to disappearing, and everything European was considered “universal” (two hypotheses that the facts prove to be untrue). As (...) H. Frey observes, “Today, the decline or decadence of the West is part of the contemporary view of the world, like the electron or the dinosaur.” The linear outline of progress, with Europe at the head, did not withstand the test of the First World War. The year 1918 marked the beginning of the end of Europeanism. Since then, we have begun to speak of “areas of civilization” (Splengler), “civilizations” (Toynbee), “cultural coalitions” (Lévi-Strauss). The existence of “areas of civilization” (regions) is commonly admitted today; it has entered journalistic language and even the structure of regional commissions and agencies of the United Nations (Europe, Near East, Southern Asia, South-east Asia, and the Far East). New communities have inserted themselves between nations and humanity. What do they represent? Are they something unique, or are they divided into a certain number of types in opposition to each other because of some characteristic? And in what way have they modified our view of universal history? (shrink)

The unique context of the rural setting provides special challenges to furnishing ethical healthcare to its approximately 62 million inhabitants. Although rural communities are widely diverse, most have the following common features: limited economic resources, shared values, reduced health status, limited availability of and accessibility to healthcare services, overlapping professional–patient relationships and care giver stress. These rural features shape common healthcare ethical issues, including threats to confidentiality, boundary issues, professional–patient relationship and allocation of resources. To date, there exists a limited (...) focus on rural healthcare ethics shown by the scarcity of rural healthcare ethics literature, rural ethics committees, rural focused ethics training and research on rural ethics issues. An interdisciplinary group of rural healthcare ethicists with backgrounds in medicine, nursing and philosophy was convened to explore the need for a rural healthcare ethics agenda. At the meeting, the Coalition for Rural Health Care Ethics agreed to a definition of rural healthcare ethics and a broad-ranging rural ethics agenda with the ultimate goal of enhancing the quality of patient care in rural America. The proposed agenda calls for increasing awareness and understanding of rural healthcare ethics through the development of evidence—informed, rural-attuned research, scholarship and education in collaboration with rural healthcare professionals, healthcare institutions and the diverse rural population. (shrink)

To better understand the available publications addressing ethical issues in rural health care we sought to identify the ethics literature that specifically focuses on rural America. We wanted to determine the extent to which the rural ethics literature was distributed between general commentaries, descriptive summaries of research, and original research publications. We identified 55 publications that specifically and substantively addressed rural health care ethics, published between 1966 and 2004. Only 7 (13%) of these publications were original research articles while (12) (...) 22% were descriptive summaries of research and 36 (65%) were general commentaries. The majority of publications examined (55%) were clinically focused while 27% addressed organizational ethics and 18% addressed ethical ramifications of rural health care policy at a national or community level. Our findings indicate that there are a limited number of publications focusing on rural health care ethics, suggesting a need for scholars and researchers to more rigorously address rural ethics issues. (shrink)

How do teenage girls articulate sexism in an era where gender injustice has been constructed as a thing of the past? Our article addresses this question by qualitatively exploring Canadian girls’ experiences of being caught between the postfeminist belief that gender equality has been achieved and the realities of their lives in school, which include incidents of sexism in their classrooms, their social worlds, and their projected futures. This analysis takes place in relation to two celebratory postfeminist narratives: Girl Power, (...) where girls are told they can do, be, and have anything they want, and Successful Girls, where girls are told they are surpassing boys in schools and workplaces. We argue that these postfeminist narratives have made naming sexism in schools difficult for girls because they are now seen to “have it all.” Utilizing Foucault’s law of the tactical polyvalence of discourse, this article analyzes girls’ contradictory engagement with postfeminism in order to both show its importance in girls’ lives, and its instability as a narrative that can adequately explain gender injustice. (shrink)

When physicians take readings of health indices such as temperature or blood pressure, the practices that physicians and patients employ in discussing the readings both reflect and propose a set of expectations regarding the level of technical medical information the patients should acquire and understand. In this article we demonstrate how physicians’ reporting practices reflect and propose the roles of paternalism or independent expertise and how patients’ responding practices either ratify or contest the roles cast by the physicians’ practices. In (...) contrast to the usual assumption that roles are relatively stable for individuals over the course of encounters, we treat role enactments as matters that are negotiated turn by turn in interaction. Physicians’ practices for reporting test results implicate various sets of expectations about the knowledge, interest, and responsibility state of each participant; patients employ responding practices that ratify or contest the expectations implicated by the physicians’ prior report. In each subsequent turn within the information exchange sequence, a speaker indicates whether the level and kind of information being exchanged is appropriate/inappropriate and sufficient/insufficient for the participants. (shrink)

This paper has described three uses of Extreme Case formulationsto assert the strongest case in anticipation of non-sympathetic hearingsto propose the cause of a phenomenonto speak for the rightness (wrongness) of a practice.The interactants in the illustrations were engaged in several types of activities, among which were complaining, accusing, justifying, and defending. As concluding remarks, a few comments will be made about why participants use Extreme Case formulations in these activities.Part of the business of complaining involves portraying a situation as (...) a legitimate complainable. This may take the form of protraying the offense committed and/or the suffering endured in a way such that it would not be dismissed as minor. So as to legitimize a complaint and portray the complainable situation as worthy of the complaint, a speaker may portray the offense and/or the suffering with Extreme Case formulations. In both accusing and defending, participants ofyen present their strongest cases, including specifying Extreme Cases of their claims.Part of justifying a course of actions may involve portraying the precipitating circumstance as necessitating the action. The precipitating circumstance may be a problem circumstance which is portrayed as unfair, immoral, embarrassing, uncomfortable, or in some other way undesirable and/or intolerable. There is a shared assumption that the worse the problem, the more necessary it is to do something about it. In justifying, speakers use Extreme Case formulations to portray the circumstances that precipitated their actions as demanding their actions.A problem that participants have when engaged in, or reflecting on, conflicts, complaints, criticism, compliments, praise, etc. is to attribute the cause of the phenomenon. Who or what is responsible for the conflictual, complainable, praise-worthy state of affairs? One method that is used to determine what or who is responsible, i.e. to make an attribution, involves comparing the case in question to other similar cases. Through this procedure, persons determine that they are (are not) responsible for the state of affairsin questions. Extreme Case proportional formulations (‘everyone,’ ‘all,’ ‘every time’) are used to indicate that any individual member of that category is not responsible for the state of affairs; that responsibility is to be attributed elsewhere.The social order essentially is a moral order (Garfinkel, 1967). One of the ways of knowing what is acceptable and right is by finding out how people behave. There often is a shared assumption operating (one that is called into question on occasion): how people behave tells us what is the right way to behave. Proportional measures reporting the frequency or prevalence of practices are used to propose and substantiate the rightness and wrongness of those practices. Extreme Case formulations (‘all the time,’ ‘everybody,’ ‘no one’) propose behaviors are acceptable and right or unacceptable and wrong. (shrink)

The analysis in this article considers how dispatchers in a 911 wireless call center direct callers’ orientations from one possible trajectory of action to keeping the caller engaged and prepared to speak with a second dispatcher. We describe how dispatchers deploy two distinct actions, a directing action and an informing action, timed at a precise moment to execute successful transfers. The analysis presents largely unexplored features of the call transfer environment, including dispatchers’ management of callers’ expectations and how the transfer (...) phase contributes to a reshaping of the overall structural organization of a 911 call. (shrink)

In the medieval Islamic world, eloquent expression was an important skill for statesmen to acquire, such that many of the leading viziers were often prominent belletrists. Among the most well known of these literary figures was the Būyid vizier Ibn ʿAbbād. Drawing from a wide range of historical and literary sources, this article compiles and corroborates the many accounts relating to Ibn ʿAbbād’s political career, beginning with his family background and early education as a scribe, to his experiences in the (...) Būyid courts of Baghdad, Iṣfahān, and Rayy and his two decades as vizier to the Būyids Muʾayyid al-Dawla and Fakhr al-Dawla in western Iran. (shrink)

In response to an article by Waring, Creider, Tarpey and Black, the author argues that the nature of the analytic aims of a research project determines whether or not participants’ reported goals and motives are relevant and useful. Her position is that for traditional conversation analytic studies aimed at explicating culturally shared methods for producing conversational actions and for interpreting interactional behavior, participants’ reports of their goals and motives are irrelevant. She differentiates between explanations based on participants’ reports of their (...) goals and motives and conversation analytic explanations consisting of preferences or principles to which members of a culture orient while interacting. (shrink)

La Pensée d’Ibn al-Muqaffaʿ: Un «agent double» dans le monde persan et arabe. By István T. Kristó-Nagy. Studia Arabica, vol. 19. Paris: Éditions de Paris, 2013. Pp. 605. €34.

Writing from a scientifically and philosophically informed perspective, the authors provide a critical overview of the conceptual difficulties encountered in many current neuroscientific and psychological theories.

A long-standing theme in discussion of perception and thought has been that our primary cognitive contact with individual objects and events in the world derives from our perceptual contact with them. When I look at a duck in front of me, I am not merely presented with the fact that there is at least one duck in the area, rather I seem to be presented withthisthing (as one might put it from my perspective) in front of me, which looks to (...) me to be a duck. Furthermore, such a perception would seem to put me in a position not merely to make the existential judgment that there is some duck or other present, but rather to make a singular, demonstrative judgment, that that is a duck. My grounds for an existential judgment in this case derives from my apprehension of the demonstrative thought and not vice versa. (shrink)

This book defends antitheodicism, arguing that theodicies, seeking to excuse God for evil and suffering in the world, fail to ethically acknowledge the victims of suffering. The authors argue for this view using literary and philosophical resources, commencing with Immanuel Kant's 1791 "Theodicy Essay" and its reading of the Book of Job. Three important twentieth century antitheodicist positions are explored, including "Jewish" post-Holocaust ethical antitheodicism, Wittgensteinian antitheodicism exemplified by D.Z. Phillips and pragmatist antitheodicism defended by William James. The authors argue (...) that these approaches to evil and suffering are fundamentally Kantian. Literary works such as Franz Kafka'sThe Trial, Samuel Beckett's Waiting for Godot, and George Orwell's Nineteen Eighty-Four, are examined in order to crucially advance the philosophical case for antitheodicism. (shrink)

Temporal Logic: From Ancient Ideas to Artificial Intelligence deals with the history of temporal logic as well as the crucial systematic questions within the field. The book studies the rich contributions from ancient and medieval philosophy up to the downfall of temporal logic in the Renaissance. The modern rediscovery of the subject, which is especially due to the work of A. N. Prior, is described, leading into a thorough discussion of the use of temporal logic in computer science and the (...) understanding of natural language. Temporal Logic: From Ancient Ideas to Artificial Intelligence thus interweaves linguistic, philosophical and computational aspects into an informative and inspiring whole. (shrink)

In his last book, David Armstrong sets out his metaphysical system in a set of concise and lively chapters each dealing with one aspect of the world. He begins with the assumption that all that exists is the physical world of space-time. On this foundation he constructs a coherent metaphysical scheme that gives plausible answers to many of the great problems of metaphysics. He gives accounts of properties, relations, and particulars; laws of nature; modality; abstract objects such as numbers; and (...) time and mind. (shrink)

Is consciousness a purely physical phenomenon? Most contemporary philosophers and theorists hold that it is, and take this to be supported by modern science. But a significant minority endorse non-physicalist theories such as dualism, idealism and panpsychism, among other reasons because it may seem impossible to fully explain consciousness, or capture what it's like to be in conscious states (such as seeing red, or being in pain), in physical terms. This Element will introduce the main non-physicalist theories of consciousness and (...) explain the most important arguments for them, and consider how they each respond to the scientific and other arguments in support of physicalism. This title is also available as Open Access on Cambridge Core. (shrink)

Western democracy is now at a critical juncture. Some worry that power has been wrested from the people and placed in the hands of a small political elite. Others argue that the democratic system gives too much power to a populace that is largely ill-informed and easily swayed by demagogues. This classic study of democratic principles is thus now more relevant than ever. A renowned historian of antiquity and political philosophy, Sir M.I. Finley offers a comparative analysis of Greek and (...) modern conceptions of democracy. As he puts the ancient Greeks in dialogue with their contemporary counterparts, Finley tackles some of the most pressing issues of our day, including public apathy, partisanship, consensus politics, distrust of professional politicians, and the limits of free speech. Including three lectures that Finley delivered at Rutgers University, plus two additional essays that further illuminate his thinking, _Democracy Ancient and Modern _explores the dramatic differences between the close-knit civil society of the ancient Greeks and our own atomized mass societies. By mapping out democracy’s past and its present manifestations, this book helps us plot a course for democracy’s future. (shrink)

The ideal introduction for students of semantics, Lexical Meaning fills the gap left by more general semantics textbooks, providing the teacher and the student with insights into word meaning beyond the traditional overviews of lexical relations. The book explores the relationship between word meanings and syntax and semantics more generally. It provides a balanced overview of the main theoretical approaches, along with a lucid explanation of their relative strengths and weaknesses. After covering the main topics in lexical meaning, such as (...) polysemy and sense relations, the textbook surveys the types of meanings represented by different word classes. It explains abstract concepts in clear language, using a wide range of examples, and includes linguistic puzzles in each chapter to encourage the student to practise using the concepts. 'Adopt-a-Word' exercises give students the chance to research a particular word, building a portfolio of specialist work on a single word. (shrink)

The concept of the receptive field, first articulated by Hartline, is central to visual neuroscience. The receptive field of a neuron encompasses the spatial and temporal properties of stimuli that activate the neuron, and, as Hubel and Wiesel conceived of it, a neuron’s receptive field is static. This makes it possible to build models of neural circuits and to build up more complex receptive fields out of simpler ones. Recent work in visual neurophysiology is providing evidence that the classical receptive (...) field is an inaccurate picture. The receptive field seems to be a dynamic feature of the neuron. In particular, the receptive field of neurons in V1 seems to be dependent on the properties of the stimulus. In this paper, we review the history of the concept of the receptive field and the problematic data. We then consider a number of possible theoretical responses to these data. (shrink)

The phenomenal powers view claims that phenomenal properties metaphysically necessitate their effects in virtue of how they feel, and thereby constitute non-Humean causal powers. For example, pain necessitates that subjects who experience it try to avoid it in virtue of feeling bad. I argue for this view based on the inconceivability of certain phenomenal properties necessitating different effects than their actual ones, their ability to predict their effects without induction, and their ability to explain their effects without appeal to laws (...) or regularities. I also offer a harmony argument according to which the view offers the best explanation for otherwise seemingly fortunate psychophysical regularities. I then outline the view’s main implications for the metaphysics of causation and philosophy of mind. (shrink)

This book presents a collection of essays on institutional theory written by the German sociologist and Weber-expert M. Rainer Lepsius. Based on Weber's work, the author develops concepts of institutional theory, which he subsequently applies to topics such as National Socialism, democratization processes, German unification, and the institutionalization of the European Union. By showing how charismatic leadership can under certain circumstances threaten democratic structures and curtail individual freedoms, and by analyzing the structural and cultural conditions under which people develop trust (...) in political and social structures and ultimately come to support and comply with them, the author provides a sound analytical understanding of the development of democratic institutions and a democratic political culture. This collection of essays was edited, translated and commented on by Claus Wendt. (shrink)

The Ismaili Imam and Imamat -- Ethical foundations -- Tradition and modernity -- The ethos of modernism -- Pluralism and cosmopolitan ethics -- Cohesion within the Umma -- Islam and the West -- Cultivating and enabling environment -- Living the ethics of Islam -- Global convergence.