The online version of the original article can be found under doi:10.1007/s11948-007-9045-2.

There has been relatively little empirical research into the causes of research misconduct. To begin to address this void, the authors collected data from closed case files of the Office of Research Integrity (ORI). These data were in the form of statements extracted from ORI file documents including transcripts, investigative reports, witness statements, and correspondence. Researchers assigned these statements to 44 different concepts. These concepts were then analyzed using multidimensional scaling and cluster analysis. The authors chose a solution consisting of (...) seven clusters: (1) personal and professional stressors, (2) organizational climate, (3) job insecurities, (4) rationalizations A, (5) personal inhibitions, (6) rationalizations B and, (7) personality factors. The authors discuss the implications of their findings for policy and for future research. (shrink)

The physical distancing measures necessitated by COVID-19 have resulted in a severe withdrawal from the patterns of daily life, necessitating significantly reduced contact with other people. To many, such withdrawal can be a major cause of distress. But, to some, this sort of withdrawal is an integral part of growth, a pathway to a more enriching life. The present study uses a sequential explanatory QUAN-qual design to investigate whether people who felt that their lives had changed for the better after (...) being forced to engage in physical distancing, what factors predicted such well-being, and how they spent their time to generate this sense of well-being. We invited 614 participants who reported closely following physical distancing recommendations to complete a survey exploring this topic. Our analyses, after controlling for all other variables in the regression model, found a greater positive association between presence of meaning in life, coping style, and self-transcendent wisdom and residualized current well-being accounting for retrospective assessments of well-being prior to physical distancing. An extreme-case content analysis of participants' personal projects found that participants with low self-transcendent wisdom reported more survival-oriented projects (e.g., acquiring groceries or engaging in distracting entertainments), while participants reporting high self-transcendent wisdom reported more projects involving deepening interactions with other people, especially family. Our findings suggest a more nuanced pathway from adversity to a deeper sense of well-being by showing the importance of not merely coping with adversity, but truly transcending it. (shrink)

We report in this paper the result of three experiments on risk, ambiguity and time attitude. The first two differed by the population considered (students vs. general population) while the third one used a different protocol and concerned students and portfolio managers. We find quite a lot of heterogeneity at the individual level. Of principal interest was the elicitation of risk, time and ambiguity attitudes and the relationship among these (model free) measures. We find that on the student population, there (...) is essentially no correlation. A non negligible fraction of the population behaves in an extremely cautious manner in the risk and ambiguity domain. When we drop this population from the sample, the correlation between our measures is also non significant. We also raise three questions linked to measurement of ambiguity attitudes that come out from our data sets. (shrink)

The aim of the paper is to propose a preferences representation model under risk where risk perception can be past experience dependent. A first step consists in considering a one period decision problem where individual preferences are no more defined only on decisions but on pairs (decision, past experience). The obtained criterion is used in the construction of a dynamic choice model under risk. The paper ends with an illustrative example concerning insurance demand. It appears that our model allows to (...) explain modifications in the insurance demand behavior over time observed on the insurance markets for catastrophic risk and difficult to justify with standard models. (shrink)

The existing literature on savings, insurance, and portfolio choices under risk has revealed that quite often comparative statics results depend, among other things, upon the values of the coefficients of relative risk aversion and relative prudence. More specifically the benchmark values for these coefficients are, respectively, one and two. Recently, several papers investigated constraints on the higher degree extensions of the coefficients of relative risk aversion and of relative prudence. The present work provides a unified approach to this question based (...) on the concept of elementary correlation increasing transformations, allowing for a better understanding of changes in risk in the multiplicative case. (shrink)

In this paper, we consider the composition of an optimal portfolio made of two dependent risky assets. The investor is first assumed to be a risk-averse expected utility maximizer, and we recover the existing conditions under which all these investors hold at least some percentage of their portfolio in one of the assets. Then, we assume that the decision maker is not only risk-averse, but also prudent and we obtain new minimum demand conditions as well as intuitively appealing interpretations for (...) them. Finally, we consider the general case of investor’s preferences exhibiting risk apportionment of any order and we derive the corresponding minimum demand conditions. As a byproduct, we obtain conditions such that an investor holds either a positive quantity of one of the assets or a proportion greater than 50 %. (shrink)

This paper reviews common advertising claims by egg freezing companies and evaluates the medical evidence behind those claims. It then surveys legal standards for truth in advertising, including FTC and FDA regulations and the First Amendment right to free speech. Professional standards for medical advertising, such as guidelines published by the American Society for Reproductive Medicine, the American College of Obstetricians and Gynecologists, and the American Medical Association, are also summarized. A number of claims, many of which relate to the (...) targeting of younger women for eOC, are found to breach legal and ethical standards for truth in advertising. The ethical implications of misleading advertising claims are also discussed, and the central narrative woven by OC ads — that egg freezing is empowering to women — is examined. The paper concludes that a more balanced approach to the risks and benefits of OC is necessary to truly respect women's autonomy. Moreover, justice requires us to look beyond a medical procedure accessible only to a minority of women in order to address inequities in the workplace. (shrink)

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)

In this paper we argue that transparency of machine learning algorithms, just as explanation, can be defined at different levels of abstraction. We criticize recent attempts to identify the explanation of black box algorithms with making their decisions (post-hoc) interpretable, focusing our discussion on counterfactual explanations. These approaches to explanation simplify the real nature of the black boxes and risk misleading the public about the normative features of a model. We propose a new form of algorithmic transparency, that consists in (...) explaining algorithms as an intentional product, that serves a particular goal, or multiple goals (Daniel Dennet’s design stance) in a given domain of applicability, and that provides a measure of the extent to which such a goal is achieved, and evidence about the way that measure has been reached. We call such idea of algorithmic transparency “design publicity.” We argue that design publicity can be more easily linked with the justification of the use and of the design of the algorithm, and of each individual decision following from it. In comparison to post-hoc explanations of individual algorithmic decisions, design publicity meets a different demand (the demand for impersonal justification) of the explainee. Finally, we argue that when models that pursue justifiable goals (which may include fairness as avoidance of bias towards specific groups) to a justifiable degree are used consistently, the resulting decisions are all justified even if some of them are (unavoidably) based on incorrect predictions. For this argument, we rely on John Rawls’s idea of procedural justice applied to algorithms conceived as institutions. (shrink)

Research on human genetic variation can present collective risks to all members of a socially identifiable group. Research that associates race or ethnicity with a genetic disposition to disease, for example, presents risks of group discrimination and stigmatization. To better protect against these risks, some have proposed supplemental community-based reviews of research on genetic differences between populations. The assumption behind these appeals is that involving members of study populations in the review process can help to identify and minimize collective risks (...) that otherwise could go unnoticed. In contrast to this position, critics have argued that supplemental community-based reviews are unnecessary, impractical, and morally problematic. This paper is our attempt to advance this debate by distinguishing the various goals of community review and the forms that it can take. (shrink)

Fishburn and Vickson showed that, when applied to random alternatives with an equal mean, 3rd-degree and decreasing absolute risk aversion stochastic dominances represent equivalent rules. The present paper generalizes this result to higher degrees. Specifically, higher-degree stochastic dominance rules and common preference by all decision makers with decreasing higher-order absolute risk aversion are shown to coincide under appropriate constraints on the respective moments of the random variables to be compared.

Research on human genetic variation can present collective risks to all members of a socially identifiable group. Research that associates race or ethnicity with a genetic disposition to disease, for example, presents risks of group discrimination and stigmatization. To better protect against these risks, some have proposed supplemental community-based reviews of research on genetic differences between populations. The assumption behind these appeals is that involving members of study populations in the review process can help to identify and minimize collective risks (...) that otherwise could go unnoticed. In contrast to this position, critics have argued that supplemental community-based reviews are unnecessary, impractical, and morally problematic. This paper is our attempt to advance this debate by distinguishing the various goals of community review and the forms that it can take. (shrink)

The present note first discusses the concept of s-convex pain functions in decision theory. Then, the economic behavior of an agent with such a pain function is represented through the comparison of some recursive lotteries.

International documents on ethical conduct in clinical research have in common the principle that potential harms to research participants must be proportional to anticipated benefits. The anticipated benefits that can justify human research consist of direct benefits to the research participant, and societal benefits, also called social value. In first-in-human research, no direct benefits are expected and the benefit component of the risks-benefit assessment thus merely exists in social value. The concept social value is ambiguous by nature and is used (...) in numerous ways in the research ethics literature. Because social value justifies involving human participants, especially in early human trials, this is problematic. (shrink)

Here, we provide an ethical analysis of discrimination in private insurance to guide the application of non-discriminatory algorithms for risk prediction in the insurance context. This addresses the need for ethical guidance of data-science experts, business managers, and regulators, proposing a framework of moral reasoning behind the choice of fairness goals for prediction-based decisions in the insurance domain. The reference to private insurance as a business practice is essential in our approach, because the consequences of discrimination and predictive inaccuracy in (...) underwriting are different from those of using predictive algorithms in other sectors. Here we focus on the trade-off in the extent to which one can pursue indirect non-discrimination versus predictive accuracy. The moral assessment of this trade-off is related to the context of application—to the consequences of inaccurate risk predictions in the insurance domain. (shrink)

In Complicity and the Rwandan Genocide ( 2010b ), Larry May argues that complicity can be the basis for criminal liability if two conditions are met: First, the person’s actions or inactions must contribute to the harm in question, and secondly, the person must know that his actions or inactions risk contributing to this harm. May also states that the threshold for guilt for criminal liability is higher than for moral responsibility. I agree with this latter claim, but I think (...) that it casts doubt on May’s account of criminal liability, particular in so-called performance cases in which low-level participants merely fail to help. This is because it is far from clear that passive non-helpers are morally responsible for their participation in widespread harms. Situationism purports to show that passive bystanders typically are not morally responsible for their role in such harms, because they were behaving reasonably subject to the constraints they faced. In this paper, I assess this claim, and defend it on the basis of O. W. Holmes’ standard of the reasonable person as a guide to judging criminal complicity. Finally, I provide a situationist account of the Rwandan genocide, which focuses on the systemic causes and primary perpetrators of the genocide, rather than low-level participants. (shrink)

In recent decades, the digital age and the Third Industrial Revolution have attracted significant attention in terms of their benefits and risks. Scholars have explored the impact of these changes on autonomy, freedom, human interactions, cognition, and knowledge sharing. However, the influence of the digital communicative environment on civic interactions and public deliberation processes has received limited attention from virtue theorists. This paper aims to address this gap. First, we discuss the challenges posed by the digital communicative environment, and we (...) present recent attempts to revive civility within this context. Then, we propose a twofold account of civility as consisting in the two virtues of civic benevolence and civil deliberation. Finally, we focus on the epistemic side of civility, civil deliberation, and we conduct the first empirical studies on two of its components. (shrink)

Research on human cadavers is an important mechanism of scientific progress and comprises a large industry in the United States. However, despite its importance and influence, there is little ethical or regulatory oversight of cadaver-based research. This lack of transparency raises important ethical questions. Thus, this paper serves as a call for ethicists and regulators to pay increased attention to cadaver research. I argue that cadaver research ought to be considered a subset of human subjects research and held accountable to (...) higher ethical standards. After describing current practices, I argue that oversight of cadaver research as a form of human subjects research is appropriate because cadaver research is similar to other types of human research, participants in cadaver research incur risks of harm, and a current lack of oversight has allowed the cadaver industry to entice research participation through ethically questionable practices. This paper urges greater dialogue among human subjects research ethicists and regulators about what constitutes appropriate protections for participants in cadaver research. (shrink)

Prenatal screening can significantly benefit parents and the community. However, it has created a dilemma for women as it requires them to quickly decide whether to continue a pregnancy or terminate it should the test indicate a foetal abnormality. This can be psychologically traumatic for women torn between their connection to an unborn child with all its possible imperfections, and a desire to prevent its suffering as a disabled child in later life. A woman must also consider her own and (...) her family's future welfare. Extensive research into the physical aspects of prenatal screening has not explored the meaning of the experience for women or whether termination is the most appropriate option. This article examines recent qualitative studies, concluding that women who terminate a pregnancy following prenatal screening may experience an acute grief reaction or be plagued by guilt and fear that can precipitate marital breakdown. Additionally, there is a risk that through striving to eradicate congenital disability, a community risks promoting a cult of perfectionism that may have discriminatory effects on disabled people. (shrink)

The purpose of this study was to determine whether certain self-discrepancies predicted the extent to which individuals experienced suicidal ideation. The Selves Questionnaire (an idiographic measure of self-beliefs) was administered to 152 undergraduate participants, who also completed measures of hopelessness, depression, and suicidal ideation. Three kinds of self-discrepancies were associated with suicidal ideation: actual:ideal, actual:ought, and actual:ideal:future. Covariance structure analyses indicated a best-fitting model suggesting that, actual:ideal and actual:ideal:future self-discrepancies contribute to hopelessness, which in turn contributes to depression and suicidal (...) ideation. The findings suggest that self-discrepancy, as a form of negative self-evaluation, may contribute to an individual's risk for suicidal ideation. Moreover, the findings point to an integration of self-discrepancy theory with hopelessness theory. (shrink)

Strategies for protecting historically disadvantaged groups have been extensively debated in the context of genetic variation research, making this a useful starting point in examining the protection of social groups from harm resulting from biomedical research. We analyze research practices developed in response to concerns about the involvement of indigenous communities in studies of genetic variation and consider their potential application in other contexts. We highlight several conceptual ambiguities and practical challenges associated with the protection of group interests and argue (...) that protectionist strategies developed in the context of genetic research will not be easily adapted to other types of research in which social groups are placed at risk. We suggest that it is this set of conceptual and practical issues that philosophers, ethicists, and others should focus on in their efforts to protect identifiable social groups from harm resulting from biomedical research. (shrink)

Violence in psychiatric clinics has been a consistent problem since the birth of modern psychiatry. In this paper, I examine current efforts to understand and reduce both violence and coercive responses to violence in psychiatry, arguing that these efforts are destined to fall short. By and large, scholarship on psychiatric violence reduction has focused on identifying discrete factors that are statistically associated with violence, such as patient demographics and clinical qualities, in an effort to quantify risk and predict violent acts (...) before they happen. Using the work of Horkheimer and Adorno, I characterize the theoretical orientation of such efforts as identity thinking. I then argue that these approaches lead to epistemic imperceptiveness and a subtle form of conceptual restraint on patients. I suggest a reorientation in psychiatric research, away from identity thinking and toward a more productive and just approach to the problem of violence in psychiatric clinics. (shrink)

(2013). Herding, social influence and expert opinion. Journal of Economic Methodology: Vol. 20, Methodology, Systemic Risk, and the Economics Profession, pp. 35-44. doi: 10.1080/1350178X.2013.774845.

Clients may feel trapped into sharing their private digital data with insurance companies to get a desired insurance product or premium. However, private insurance must collect some data to offer products and premiums appropriate to the client’s level of risk. This situation creates tension between the value of privacy and common insurance business practice. We argue for three main claims: first, coercion to share private data with insurers is pro tanto wrong because it violates the autonomous choice of a privacy-valuing (...) client. Second, we maintain that irrespective of being coerced, the choice of accepting digital surveillance by insurers makes it harder for the client to protect his or her autonomy. The violation of autonomy also makes coercing customers into digital surveillance pro tanto morally wrong. Third, having identified an economically plausible process involving no direct coercion by insurers, leading to the adoption of digital surveillance, we argue that such an outcome generates further threats against autonomy. This threat provides individuals with a pro tanto reason to prevent this process. We highlight the freedom dilemma faced by regulators who aim to prevent this outcome by constraining market freedoms and argue for the need for further moral and empirical research on this question. (shrink)

In this consensus report by a diverse group of academics who conduct and/or are concerned about social and behavioral genomics (SBG) research, the authors recount the often‐ugly history of scientific attempts to understand the genetic contributions to human behaviors and social outcomes. They then describe what the current science—including genomewide association studies and polygenic indexes—can and cannot tell us, as well as its risks and potential benefits. They conclude with a discussion of responsible behavior in the context of SBG research. (...) SBG research that compares individuals within a group according to a “sensitive” phenotype requires extra attention to responsible conduct and to responsible communication about the research and its findings. SBG research (1) on sensitive phenotypes that (2) compares two or more groups defined by (a) race, (b) ethnicity, or (c) genetic ancestry (where genetic ancestry could easily be misunderstood as race or ethnicity) requires a compelling justification to be conducted, funded, or published. All authors agree that this justification at least requires a convincing argument that a study's design could yield scientifically valid results; some authors would additionally require the study to have a socially favorable risk‐benefit profile. (shrink)

What Kyselo calls the “body-social problem” concerns whether to individuate the human self in terms of its bodily aspects or social aspects. In her view, either approach risks privileging one dimension while reducing the other to a mere contextual element. However, she proposes that principles from enactivism can help us to find a middle ground and solve the body-social problem. Here Kyselo looks to the notions of “needful freedom” and "individuation through and from a world" and extends them from the (...) realm of biological individuation to an individuation in terms of social interactions. However, I will argue that because Kyselo’s solution to the body-social problem downplays the role of the living body, it actually is in tension with the enactivist framework. First, while enactivism places the living body at the center of selfhood and subjectivity, Kyselo’s account treats the living body as mere means and mediator. Second, her claim that the self is socially enacted and individuated is in tension with the enactivist conception of autonomous agency, which centers on the autonomous organization of the living body. However, suppose we grant Kyselo’s claim that we are necessarily social beings, but claim that the mind of a minded human animal constitutively extends to the limits of its living organismic body, but no further. My proposed “life shaping” thesis says that the self is not just essentially embodied, but also partially causally determined or shaped by social interactions, and thoroughly influenced by social norms and values. The life shaping thesis can explain how the self is individuated biologically, in terms of the autonomous organization of the living body, but nonetheless deeply embedded in the social world. (shrink)

This paper weakens the expectation dependence concept due to Wright and its higher-order extensions proposed by Li to conform with the preferences generating the almost stochastic dominance rules introduced in Leshno and Levy. A new dependence concept, called excess dependence is introduced and studied in addition to expectation dependence. This new concept coincides with expectation dependence at first-degree but provides distinct higher-order extensions. Three applications, to portfolio diversification, to the determination of the sign of the equity premium in the consumption-based (...) CAPM, and to optimal investment in the presence of a background risk, illustrate the usefulness of the approach proposed in the present paper. (shrink)

PurposeTo examine the contribution of “values-based reasoning” in evaluating older adults’ capacity to make medical decisions.Design and MethodsOlder men with schizophrenia (n=20) or dementia (n=20), and a primary care comparison group (n=19), completed cognitive and psychiatric screening and an interview to determine their capacity to make medical decisions, which included a component on values. All of the participants were receiving treatment at Veterans Administration (VA) outpatient clinics.ResultsParticipants varied widely in the activities and relationships they most valued, the extent to which (...) religious beliefs would influence healthcare decisions, and in ratings of the importance of preserving quality versus length of life. Most participants preferred shared decision making with doctor, family, or both. Individuals with schizophrenia or dementia performed worse than a primary care comparison group in reasoning measured by the ability to list risks and benefits and compare choices. Individuals with dementia performed comparably to the primary care group in reasoning measured by the ability to justify choices in terms of valued abilities or activities, whereas individuals with schizophrenia performed relatively worse compared to the other two groups. Compared to primary care patients, participants with schizophrenia and with dementia were impaired on the ability to explain treatment choices in terms of valued relationships.ConclusionMedical decision making may be influenced by strongly held values and beliefs, emotions, and long life experience. To date, these issues have not been explicitly included in structured evaluations of medical decision-making capacity. This study demonstrated that it is possible to inquire of and elicit a range of healthcare related values and preferences from older adults with dementia or schizophrenia, and individuals with mild to moderate dementia may be able to discuss healthcare options in relation to their values. However, how best to incorporate a values assessment into a structured capacity evaluation deserves further research attention. (shrink)

This paper describes and critically reflects on a participatory policy process which resulted in a government decision not to introduce genetically modified cotton in farmers’ fields in Mali. In January 2006, 45 Malian farmers gathered in Sikasso to deliberate on GM cotton and the future of farming in Mali. As an invited policy space convened by the government of Sikasso region, this first-time farmers' jury was unique in West Africa. It was known as l’ECID—Espace Citoyen d’Interpellation Démocratique —and it had (...) an unprecedented impact on the region. In this Deliberative and Inclusive Process, the ECID combined the citizens’ jury method with indigenous methods for debate and dialogue, including the traditional African palaver. The ECID brought together male and female producers representing every district in the Sikasso region of southern Mali, specialist witnesses from various continents and a panel of independent observers, as well as resource persons and members of the national and international press and media. As an experiment in deliberative democracy, the ECID of Sikasso aimed to give men and women farmers the opportunity to share knowledge on the benefits and risks of GM cotton, and make policy recommendations on the future of GM technology in Malian agriculture. Designed as a bottom-up and participatory process, the ECID’s outcomes significantly changed national policy on the release of GM technology and have had an enduring influence in Mali. In this paper, we describe our positionality as action researchers and co-organisers of the ECID. We explain the methodology used for the ECID of Sikasso and critically reflect on the safeguards that were put in place to ensure a balanced and trustworthy deliberative process. The ECID and its key outcomes are discussed in the context of the political economy of GM cotton in West Africa. Last, we briefly highlight the relevance of the ECID for current international debates on racism in the theory and practice deliberative democracy; the production of post-normal transdisciplinary knowledge for technology risk-assessments; and the politics of knowledge in participatory policy-making for food and agriculture. (shrink)

Violence confronts us increasingly, everywhere: how are we to make sense of it? Its ubiquity begs the question of analytical differentiation. This article seeks to open the field by suggesting a fivefold typology: violence as loss of meaning; violence as non-sense; violence as cruelty; fundamental violence; and founding violence. The idea of analytically differentiating between types of violence cannot avoid the fact that sometimes victims are also perpetrators in other ways, and that even violent activity is not conducted only by (...) essentially violent subjects. Violence needs to be connected to modernity and to problems of identity formation and not only to personal or collective risk. (shrink)

Algorithmic predictions are promising for insurance companies to develop personalized risk models for determining premiums. In this context, issues of fairness, discrimination, and social injustice might arise: Algorithms for estimating the risk based on personal data may be biased towards specific social groups, leading to systematic disadvantages for those groups. Personalized premiums may thus lead to discrimination and social injustice. It is well known from many application fields that such biases occur frequently and naturally when prediction models are applied to (...) people unless special efforts are made to avoid them. Insurance is no exception. In this paper, we provide a thorough analysis of algorithmic fairness in the case of insurance premiums. We ask what “fairness” might mean in this context and how the fairness of a premium system can be measured. For this, we apply the established fairness frameworks of the fair machine learning literature to the case of insurance premiums and show which of the existing fairness criteria can be applied to assess the fairness of insurance premiums. We argue that two of the often-discussed group fairness criteria, independence (also called statistical parity or demographic parity) and separation (also known as equalized odds), are not normatively appropriate for insurance premiums. Instead, we propose the sufficiency criterion (also known as well-calibration) as a morally defensible alternative that allows us to test for systematic biases in premiums towards certain groups based on the risk they bring to the pool. In addition, we clarify the connection between group fairness and different degrees of personalization. Our findings enable insurers to assess the fairness properties of their risk models, helping them avoid reputation damage resulting from potentially unfair and discriminatory premium systems. (shrink)

While we consider directive teaching to be detrimental to the Community of Inquiry, we nonetheless find ourselves in qualified agreement with Hand as he challenges certain norms of practice that support the common presumption in favour of nondirective teaching in the moral CoI. We agree with Hand that it is possible for teachers to impart their own moral beliefs without indoctrinating students, yet we argue that the risk of indoctrination remains present in the many realistic scenarios in which teachers misjudge (...) controversial standards as uncontroversial or in which teachers’ arguments bypass students’ reason. We agree with Hand that substantively closed questions can generate satisfying inquiries, with the caveat that in the absence of open inquiry there is a chronic risk of eroding the ethos of trust in a CoI. Similarly, we find qualified agreement with Hand regarding teachers’ philosophical self-effacement. We accept that teachers may judiciously suspend neutrality in order to ensure that sound arguments and objections are aired and understood, yet we caution teachers against endorsing any particular justification or rebuttal. We further raise three distinct concerns about Hand’s theory. Firstly, we argue that Hand’s theory is insensitive to the varieties of moral controversy that emerge within the CoI. We maintain that a nondirective approach is required for a proper exploration of controversy over conflicting justifications for shared moral standards grounded in diverse normative ethical theories, where the conative power of particular justifications may differ among individuals; controversy over the meaning, scope and significance of moral concepts; and controversy over the application of moral standards and concepts to actual cases. Secondly, we argue that in light of teachers’ susceptibility to motivated reasoning and myside bias, Hand’s theory places undue demands on teachers to exercise objective judgement. Where teachers unwittingly transmit biases to students, we are not assured that Hand’s proposal can safeguard against indoctrination. Thirdly, we do not share Hand’s conception of moral inquiry as concerned exclusively with argument over the content and justification of moral standards. The narrowness of this conception, together with available evidence that moral argument alone has little effect on moral behaviour, leads us to question Hand’s claim that a fundamental reason for engaging students in moral inquiry is to reinforce their moral formation. We suggest that the scope of the moral CoI should not be limited to argument over the content and justification of moral standards, but should also include the cultivation of virtues and dispositions that prepare students for complex moral decision-making, as well as the investigation of Aristotelian questions concerning what is worthwhile in human life. Given our broader conception of the CoI as both moral and ethical, and our emphasis on students having both the freedom and the responsibility to judge reasonableness for themselves, we conclude that nondirective teaching remains a beneficial regulatory principle for CoI practice. (shrink)

Sexually dimorphic mate selection strategies were examined in 200 university students reporting their willingness to engage in casual sexual encounters with hypothetical individuals of the opposite sex. Using a questionnaire format, the possibility of forming a long-term relationship was manipulated, while risk of disease, pregnancy, and detection was eliminated across all conditions. In addition, potential partners varied in level of attractiveness, and in personality and behavioral characteristics. As expected, men reported a greater anticipated willingness to engage in sexual intercourse across (...) all conditions compared with women. The possibility of forming a long-term relationship elevated women’s, but not men’s, willingness for sexual intercourse. While a potential partner’s attractiveness had a significant positive overall effect on responses, reducing their relative attractiveness had a greater negative impact on men’s responses. Reference to the parental qualities of a potential partner significantly increased women’s, but not men’s, anticipated willingness for sexual intercourse. Describing a hypothetical partner as non-aggressive marginally increased women’s willingness and did not affect men’s responses. The wording of items relevant to this condition may have resulted in the potential partner sounding "wimpy" rather than nonaggressive, and this may have reduced the expected effect of this manipulation. The possibility that women may trade off personality and behavioral characteristics with attractiveness to a greater degree than men when assessing potential mates is considered. (shrink)

Background: Treatment of psychotic disorders in pregnancy is often ethically and clinically challenging, especially when psychotic symptoms impair decision-making capacity. There are several competing ethical obligations to consider: the ethical obligation to maternal autonomy, the maternal and fetal beneficence-based obligations to treat peripartum psychosis, and the fetal beneficence-based obligation to minimize teratogenic exposure. Objective: This article outlines an ethical framework for clinical decision-making for the management of chronic psychosis in pregnancy, with an emphasis on special considerations in the previable and (...) periviable period. Case Presentation: A 31-year-old gravida 2, para 1 with intrauterine pregnancy at 12 weeks and 4 days gestation was brought to the emergency department by her husband seven months after delivering her first child, due to sudden onset of behavioral changes that included self-isolation, not eating, and not taking care of her child. Her past medical history included hypothyroidism and inflammatory bowel disease, but no prior psychiatric illness. After being admitted to the psychiatric hospital, she continued to have poor oral intake and weight loss despite initial inpatient treatment with antipsychotics, levothyroxine, and discontinuation of corticosteroids. Her pregnancy was also complicated by the diagnosis of multiple fetal anomalies at 20 weeks gestation, when the fetus was periviable. Conclusions: For previable or periviable pregnancies, the patient and/or surrogate should decide whether to pursue prenatal genetic screening and invasive diagnostic testing, as well as whether to continue or terminate the pregnancy. When the choice is made to continue the pregnancy, initiation of long-term psychiatric treatment (including medications with potential adverse fetal effects) should be based on shared decision-making between the physician and the patient and/or surrogate. Although some pharmacologic interventions may have potential adverse effects on the developing fetus, the use of psychotropic medications can be ethically justified, even if the patient herself does not have the capacity to consent and requires a surrogate, when the goal is to restore maternal autonomy and minimize the risks of maternal and fetal harm from untreated psychiatric illness. (shrink)

A deontological approach to surgical ethics advocates that patients have the right to receive the best care that can be provided. The ‘learning curve’ in surgical skill is an observable and measurable phenomenon. Surgical training may therefore carry risk to patients. This can occur directly, through inadvertent harm, or indirectly through theatre inefficiency and associated costs. Trainee surgeon operating, however, is necessary from a utilitarian perspective, with potential risk balanced by the greater societal need to train future independent surgeons.New technology (...) means that the surgical learning curve could take place, at least in part, outside of the operating theatre. Simulation-based deliberate practice could be used to obtain a predetermined level of proficiency in a safe environment, followed by simulation-based assessment of operative competence. Such an approach would require an overhaul of the current training paradigm and significant investment in simulator technology. This may increasingly be viewed as necessary in light of well-discussed pressures on surgical trainees and trainers.This article discusses the obligations to trainees, trainers and training bodies raised by simulation technology, and outlines the current arguments both against and in favour of a simulation-based training-to-proficiency model in surgery. The significant changes to the current training paradigm that would be required to implement such a model are also discussed. (shrink)

In order to show how Michel Serres’s work diverges from traditional Western philosophy, this article explores a multitude of texts and contexts against which Serres might be better understood. Most starkly, Serres’s work diverges from the eighteenth and nineteenth century Germanic tradition of Bildung, meaning cultivation through introspection, apolitical thought and character building through education. Serres’s moves away from ego-centric thought to eco-centric thought more akin to what Gregory Bateson called an ecology of mind. That is, Serres’s integrates—in a more (...) ecological fashion—poetry, science, the arts, ecology and politics to raise philosophical questions. Further, this author suggests that Serres’s reference to the nineteenth century poem Pierrot Lunaire ) serves as a trope for Serres’s over-arching philosophy. Pierrot is an artist, a sage, an outlier, a Hermes-like figure who breaks with tradition. Arnold Schoenberg’s atonal performance piece, spoken and sung, shattered the boundaries of classical music. Like Schoenberg’s work, Serres’s work, both in style and content, shatters the boundaries of traditional philosophy. Serres’s breaks open a new paradigm in philosophy. (shrink)

Quality health care relies upon communication in a patient's preferred language. Language access in health care occurs when individuals are: Welcomed by providers regardless of language ability; and Offered quality language services as part of their care. Federal law generally requires access to health care and quality language services for deaf and Limited English Proficient patients in health care settings, but these patients still find it hard to access health care and quality language services.Meanwhile, several states are implementing Medicaid Accountable (...) Care Organization initiatives to reduce health care costs and improve health care quality. Alternative payment methods used in these initiatives can give Accountable Care Organizations more flexibility to design linguistically accessible care, but they can also put ACOs at increased financial risk for the cost of care. If these new payment methods do not account for differences in patient language needs, ACO initiatives could have the unintended consequence of rewarding ACOs who do not reach out to deaf and LEP communities or offer quality language services.We reviewed public documents related to Medicaid ACO initiatives in six states. Some of these documents address language access. More could be done, however, to pay for language access efforts. This article describes Medicaid ACO initiatives and explores how different payment tools could be leveraged to reward ACOs for increased access to care and quality language services. We find that a combination of payment tools might be helpful to encourage both access and quality. (shrink)

I think "schizo-culture" here is being used rather in a special sense. Not referring to clinical schizophrenia, but to the fact that the culture is divided up into all sorts of classes and groups, etc., and that some of the old lines are breaking down. And that this is a healthy sign. -- William Burroughs, from _Schizo-Culture_ The legendary 1975 "Schizo-Culture" conference, conceived by the early Semiotext collective, began as an attempt to introduce the then-unknown radical philosophies of post-'68 France (...) to the American avant-garde. The event featured a series of seminal papers, from Deleuze's first presentation of the concept of the "rhizome" to Foucault's introduction of his _History of Sexuality_ project. The conference was equally important on a political level, and brought together a diverse group of activists, thinkers, patients, and ex-cons in order to address the challenge of penal and psychiatric institutions. The combination proved to be explosive, but amid the fighting and confusion "Schizo-Culture" revealed deep ruptures in left politics, French thought, and American culture. The "Schizo-Culture" issue of the Semiotext journal came three years later. Designed by a group of artists and filmmakers including Kathryn Bigelow and Denise Green, it documented the chaotic creativity of an emerging downtown New York scene, and offered interviews with artists, theorists, writers, and No Wave and pre-punk musicians together with new texts from Deleuze, Foucault, R. D. Laing, and other conference participants. This slip-cased edition includes _The Book: 1978_, a facsimile reproduction of the original Schizo-Culture publication; and _The Event: 1975_, a previously unpublished and comprehensive record of the conference that set it all off. It assembles many previously unpublished texts, including a detailed selection of interviews reconstructing the events, and features Félix Guattari, William Burroughs, Kathy Acker, Michel Foucault, Sylvère Lotringer, Guy Hocquenghem, Gilles Deleuze, John Rajchman, Robert Wilson, Joel Kovel, Jack Smith, Jean-François Lyotard, Ti-Grace Atkinson, François Peraldi, and John Cage. (shrink)

Intellectual property in biotechnology invention provides important incentives for research and development leading to advances in genetic tests and treatments. However, there have been numerous concerns raised regarding the negative effect patents on gene sequences and their practical applications may have on clinical research and the availability of new medical tests and procedures. One concern is that licensing policies attempting to capture for the benefit of the licensor valuable rights to downstream research results and products may increase the financial risks (...) and cliniinish potential payoffs of — and therefore motivation for — performing downstream research and development. In addition, very broad patent claims allowed by the U.S. Patent and Trademark Office, the sheer growth in patents claiming genetic sequences, and threats of overlapping patents create a veritable minefield for researchers in both academia and industry. The concern is that research may be stifled because of the high cost and hassle of negotiating access. (shrink)

Intellectual property in biotechnology invention provides important incentives for research and development leading to advances in genetic tests and treatments. However, there have been numerous concerns raised regarding the negative effect patents on gene sequences and their practical applications may have on clinical research and the availability of new medical tests and procedures. One concern is that licensing policies attempting to capture for the benefit of the licensor valuable rights to downstream research results and products may increase the financial risks (...) and cliniinish potential payoffs of — and therefore motivation for — performing downstream research and development. In addition, very broad patent claims allowed by the U.S. Patent and Trademark Office, the sheer growth in patents claiming genetic sequences, and threats of overlapping patents create a veritable minefield for researchers in both academia and industry. The concern is that research may be stifled because of the high cost and hassle of negotiating access. (shrink)

While innovations have fostered the mass production of food at low costs, there are externalities or side effects associated with high-volume food processing. We focus on foodborne illness linked to two commodities: ground beef and bagged salad greens. In our analysis, we draw from the concepts of risk, reflexive modernization, and techniques of ethical neutralization. For each commodity, we find that systems organized for industrial goals overlook how production models foster cross-contamination and widespread outbreaks. Responses to outbreaks tend to rely (...) on technological fixes, which do not constitute the reflexive change needed to holistically and effectively address foodborne illness in the long term. We contend that powerful anti-reflexivity movements resist calls for reform and successfully maintain industrial goals and organization. Actions that thwart changes in agrifood systems to better protect consumers are unethical, yet they continue to be successful. We argue that specific techniques of ethical neutralization play an important part in their success. Research on anti-reflexivity and techniques of neutralization will serve to further expose the ethical issues associated with the industrial agrifood system and foster new guiding principles and organizational designs for food production. (shrink)