Among bioethicists and members of the public, genetics is often regarded as unique in its ethical challenges. As medical researchers and clinicians increasingly combine genetic information with a range of non-genetic information in the study and clinical management of patients with common diseases, the unique ethical challenges attributed to genetics must be re-examined. A process of genetic routinisation that will have implications for research and clinical ethics, as well as for public conceptions of genetic information, is constituted by the emergence (...) of new forms of genetic medicine, in which genetic information is interpreted in a multifactorial frame of reference. Although the integration of genetics in medical research and treatment may be a helpful corrective to the mistaken assumptions of genetic essentialism or determinism, the routinisation of genetics may have unintended consequences for the protection of genetic information, perceptions of non-genetic information and the loss of genetic research as a laboratory for exploring issues in research and clinical ethics. Consequently, new ethical challenges are presented by the increasing routinisation of genetic information in both biomedical and public spheres. (shrink)
The author regards faith as a restless quest for that which can save man from his self-destructive tendencies and allow him to actualize most completely his constructive potentialities. Wieman critically examines several answers to this quest of faith, including those of Dewey, Tillich, and Barth. In contrast he develops the view of "liberal religion," which finds the answer in a divine creativity fostered by communication, and is productive of fresh insights which transform human ideals.--J. M. W.
There are differences in caregivers’ literacy and health literacy levels that may affect their ability to consent to children participating in clinical research trials. This study aimed to explore the effectiveness, and caregivers’ understandings, of the process of informed consent that accompanied their child’s participation in a dental randomized control trial. Telephone interviews were conducted with a convenience sample of ten caregivers who each had a child participating in the RCT. Pre-tested closed and open-ended questions were used, and the findings (...) were produced from an inductive analysis of the latter and a descriptive analysis of the former. Participants had limited understanding of the purpose of the RCT and rated the readability of the consent form more highly than they rated their understanding of the research. All felt that informed consent was vital, but some caregivers had not read the consent documents. Some caregivers enrolled their child in the RCT because they trusted the researchers, and the majority wanted to improve dental care for children. The informed consent process was not always effective despite high readability of the informed consent documents. Researchers must consider the health literacy of the study group, and actively engaging with caregivers to achieve meaningful informed consent may be challenging. Future research could explore participants’ perspectives of informed consent in populations with low health literacy and assess whether an underlying expectation not to comprehend health-related information may be a barrier to informed consent. (shrink)
This book is a collection of secondary essays on America's most important philosophic thinkers—statesmen, judges, writers, educators, and activists—from the colonial period to the present. Each essay is a comprehensive introduction to the thought of a noted American on the fundamental meaning of the American regime.
We provide a short review on the recent and near-future developments of computational processing of emotion in the voice, highlighting self-learning of representations moving continuously away from traditional expert-crafted or brute-forced feature representations to end-to-end learning, a movement towards the coupling of analysis and synthesis of emotional voices to foster better mutual understanding, weakly supervised learning at a large scale, transfer learning from related domains such as speech recognition or cross-modal transfer learning, and reinforced learning through interactive applications at (...) a large scale. For each of these trends, we shortly explain their implications and potential use such as for interpretation in psychological studies and usage in digital health and digital psychology applications. We also discuss further potential development. (shrink)
BackgroundClinical Ethics Support services are offered to support healthcare professionals in dealing with ethically difficult situations. Evaluation of CES is important to understand if it is indeed a supportive service in order to inform and improve future implementation of CES. Yet, methods to measure outcomes of CES are scarce. In 2014, the European Moral Case Deliberation Outcomes Instrument was developed to measure outcomes of Moral Case Deliberation. To further validate the instrument, we tested it in field studies and revised it. (...) This paper presents the Euro-MCD 2.0 and describes the revision process.MethodsThe revision process comprised an iterative dialogue among the authors as Euro-MCD-project team, including empirical findings from six Euro-MCD field-studies and input from European experts in CES and theory. Empirical findings contained perceptions and experiences of MCD outcomes among healthcare professionals who participated in MCDs in various settings in Norway, Sweden and the Netherlands. Theoretical viewpoints on CES, literature on goals of CES and MCD and ethics theory guided the interpretation of the empirical findings and final selection of MCD outcomes.ResultsThe Euro-MCD 2.0 Instrument includes three domains: Moral Competence, Moral Teamwork and Moral Action. Moral Competence consists of items about moral sensitivity, analytical skills and virtuous attitude. Moral Teamwork includes open dialogue and supportive relationships and Moral Action refers to moral decision-making and responsible care. During the revision process, we made decisions about adding and reformulating items as well as decreasing the number from 26 to 15 items. We also altered the sentence structure of items to assess the current status of outcomes instead of an assumed improvement over time and we omitted the question about perceived importance.ConclusionsThe Euro-MCD 2.0 is shorter, less complex and more strongly substantiated by an integration of empirical findings, theoretical reflections and dialogues with participants and experts. Use of the Euro-MCD 2.0 will facilitate evaluation of MCD and can thereby monitor and foster implementation and quality of MCD. The Euro-MCD 2.0 will strengthen future research on evaluation of outcomes of MCD. (shrink)
Throughout the biological and biomedical sciences there is a growing need for, prescriptive ‘minimum information’ (MI) checklists specifying the key information to include when reporting experimental results are beginning to find favor with experimentalists, analysts, publishers and funders alike. Such checklists aim to ensure that methods, data, analyses and results are described to a level sufficient to support the unambiguous interpretation, sophisticated search, reanalysis and experimental corroboration and reuse of data sets, facilitating the extraction of maximum value from data sets (...) them. However, such ‘minimum information’ MI checklists are usually developed independently by groups working within representatives of particular biologically- or technologically-delineated domains. Consequently, an overview of the full range of checklists can be difficult to establish without intensive searching, and even tracking thetheir individual evolution of single checklists may be a non-trivial exercise. Checklists are also inevitably partially redundant when measured one against another, and where they overlap is far from straightforward. Furthermore, conflicts in scope and arbitrary decisions on wording and sub-structuring make integration difficult. This presents inhibit their use in combination. Overall, these issues present significant difficulties for the users of checklists, especially those in areas such as systems biology, who routinely combine information from multiple biological domains and technology platforms. To address all of the above, we present MIBBI (Minimum Information for Biological and Biomedical Investigations); a web-based communal resource for such checklists, designed to act as a ‘one-stop shop’ for those exploring the range of extant checklist projects, and to foster collaborative, integrative development and ultimately promote gradual integration of checklists. (shrink)
Stress and anxiety can both influence risk-taking in decision-making. While stress typically increases risk-taking, anxiety often leads to risk-averse choices. Few studies have examined both stress and anxiety in a single paradigm to assess risk-averse choices. We therefore set out to examine emotional decision-making under stress in socially anxious participants. In our study, individuals high or low in social anxiety completed an expanded variation of the Balloon Analogue Risk Task. While inflating a balloon to a larger degree is rewarded, a (...) possible explosion leads to a loss of money and it is followed by an emotional picture. To induce stress before this task, participants were told that they would have to deliver a speech. We operationalized risk-taking by the number of pumps during inflation and its functionality by the amount of monetary gain. In addition, response times were recorded as an index of decisional conflict. Without the stressor, high socially anxious compared to low socially anxious participants did not differ in any of the dependent variables. However, under stress, the low socially anxious group took more risk and earned more money, while high socially anxious individuals remained more cautious and did not change their risk-taking under social stress. Overall, high socially anxious individuals made their decisions more hesitantly compared to low socially anxious individuals. Unexpectedly, there were no main effects or interactions with the valence of the emotional faces. This data shows that stress affects socially anxious individuals differently: in low socially anxious individuals stress fosters risk-taking, whereas high socially anxious individuals did not alter their behavior and remained risk-averse. The novel eBART is a promising research tool to examine the specific factors that influence decision-making. (shrink)
OrientationThis study employed a second stage moderated mediation analysis to investigate the influence of authentic leadership on employee flourishing via trust in the leader and job overload.Research PurposeTo explore the relationship between authentic leadership and flourishing by considering the indirect effect of trust in the leader as potentially moderated by job overload.Motivation for the StudyAn authentic leadership style, trust in the leader, and job overload may impact employee flourishing. A deeper understanding of the potential interaction effect of trust in the (...) leader and job overload in the relationship between authentic leadership and flourishing may improve individual and organizational productivity.Research Approach/Design and MethodThis study used a quantitative, cross-sectional survey design and PROCESS for moderated mediation. The sample consisted of 314 employees in a prominent steel manufacturing organization in South Africa. The Authentic Leadership Inventory, Workplace Trust Survey, Flourishing-at-Work Scale, and the Job Demands-Resources Scale were utilized.Main FindingsThe study found that authentic leadership was a significant predictor of flourishing through trust in the leader. Job overload did not moderate the relationship between trust in the leader and employee flourishing.Practical/Managerial ImplicationsThis study emphasizes the potential role of authentic leadership in fostering a trustful relationship between employees and their leaders. It might result in the increased flourishing of employees. The non-significant influence of job overload on trusting relationships in precarious work contexts was also illuminated.Contribution/Value-AddThrough the analysis of these relations, organizations may be favorably equipped to optimize the resources required to improve performance. Moreover, the investigation into trust in the leader combined with job overload increases our understanding of supporting and promoting employee flourishing at work. (shrink)
Adverse events that harm patients can also have a harmful impact on health care workers. A few health care organizations have begun to provide psychological support to these Second Victims, but there is uncertainty over whether these discussions are admissible as evidence in malpractice litigation or disciplinary proceedings. We examined the laws governing the admissibility of these communications in 5 states, and address how the laws might affect participation in programs designed to support health care workers involved in adverse events. (...) We found that privilege is uneven from stateto- state, and also unclear. Ambiguity alone could have a chilling effect on Second Victim programs. We propose legislation to protect volunteer and health care worker communications provided by peer counselors, or failing this, updating of statutory provisions to explicitly include these communications within the ambit of existing protections. Enhancing protections could help to foster an environment of healing for both patients and caregivers. (shrink)
The theory of personal identity should illuminate and be illuminated by the theory of personality, of which it is a part. I believe that Locke's theory succeeds in this more than that of any other great philosopher, and the modifications which it may need are not fundamental ones. The problems raised by Butler and Flew can be made to disappear.
Precision Medicine has become a common label for data-intensive and patient-driven biomedical research. Its intended future is reflected in endeavours such as the Precision Medicine Initiative in the USA. This article addresses the question whether it is possible to discern a new ‘medical cosmology’ in Precision Medicine, a concept that was developed by Nicholas Jewson to describe comprehensive transformations involving various dimensions of biomedical knowledge and practice, such as vocabularies, the roles of patients and physicians and the conceptualisation of disease. (...) Subsequently, I will elaborate my assessment of the features of Precision Medicine with the help of Michel Foucault, by exploring how precision medicine involves a transformation along three axes: the axis of biomedical knowledge, of biomedical power and of the patient as a self. Patients are encouraged to become the managers of their own health status, while the medical domain is reframed as a data-sharing community, characterised by changing power relationships between providers and patients, producers and consumers. While the emerging Precision Medicine cosmology may surpass existing knowledge frameworks; it obscures previous traditions and reduces research-subjects to mere data. This in turn, means that the individual is both subjected to the neoliberal demand to share personal information, and at the same time has acquired the positive ‘right’ to become a member of the data-sharing community. The subject has to constantly negotiate the meaning of his or her data, which can either enable self-expression, or function as a commanding Superego. (shrink)
Biotechnology is one of the fastest-growing areas of scientific, technical and industrial innovation and one of the most controversial. As developments have occurred such as genetic test therapies and the breeding of genetically modified food crops, so the public debates have become more heated and grave concerns have been expressed about access to genetic information, labelling of genetically modified foods and human and animal cloning. Across Europe, public opinion has become a crucial factor in the ability of governments and biotech (...) industries to exploit the new technology. This 2002 book presents the results of a unique cross-national and cross-disciplinary study of the relationship between the development of new biotechnology and public perception, media coverage and policy formulation. It outlines a conceptual framework for understanding these issues and contains a number of empirical studies including studies of the international controversies surrounding the cloning of Dolly the sheep and GM Soya. (shrink)
A modern form of narrative, comic books are used to communicate, discuss, and critique issues in business ethics and social issues in management. A description of comic books as a legitimate medium is followed by a discussion of the pedagogical uses of comic books and assessment techniques. The strengths of the pedagogy include crossing cultural barriers, understanding the complexity of individual decision-making and organizational influences, and the universality of dilemmas and values. We provide an initial source for educators on the (...) topics, comic books, plotlines, and other commentary for consideration of use in the classroom from high school to graduate business ethics and social issues in management courses. (shrink)
After presenting a variety of arguments in support of the idea that ordinary names are indexical, I respond to John Perry's recent arguments against the indexicality of names. I conclude by indicating some connections between the theory of names defended here and Wittgenstein's observations on naming, and suggest that the latter may have been misconstrued in the literature.