Recent experiments have been used to “edit” genomes of various plant, animal and other species, including humans, with unprecedented precision. Furthermore, editing the Cas9 endonuclease gene with a gene encoding the desired guide RNA into an organism, adjacent to an altered gene, could create a “gene drive” that could spread a trait through an entire population of organisms. These experiments represent advances along a spectrum of technological abilities that genetic engineers have been working on since the advent of recombinant DNA (...) techniques. The scientific and bioethics communities have built substantial literatures about the ethical and policy implications of genetic engineering, especially in the age of bioterrorism. However, recent CRISPr/Cas experiments have triggered a rehashing of previous policy discussions, suggesting that the scientific community requires guidance on how to think about social responsibility. We propose a framework to enable analysis of social responsibility, using two example.. (shrink)

The US National Institute of Health’s Human Microbiome Project aims to use genomic techniques to understand the microbial communities that live on the human body. The emergent field of microbiome science brought together diverse disciplinary perspectives and technologies, thus facilitating the negotiation of differing values. Here, we describe how values are conceptualized and negotiated within microbiome research. Analyzing discussions from a series of interdisciplinary workshops conducted with microbiome researchers, we argue that negotiations of epistemic, social, and institutional values were inextricable (...) from the reflective and strategic category work that defined and organized the microbiome as an object of study and a potential future site of biomedical intervention. Negotiating the divergence or tension between emerging scientific and regulatory classifications also activated “values levers” and opened up reflective discussions of how classifications embody values and how these values might differ across domains. These data suggest that scholars at the intersections of science and technology studies, ethics, and policy could leverage such openings to identify and intervene in the ways that ethical/regulatory and scientific/technical practices are coproduced within unfolding research. (shrink)

ABSTRACTHIV/AIDS harms the viability and competitiveness of African businesses. As a consequence, companies increasingly subscribe to the view that taking a proactive role to combat HIV/AIDS is not simply a question of compassion and good corporate citizenship. Rather, these firms see assertive action against HIV as critical to their long‐term profitability, and some have concluded that it is cost effective even in the short term. The article discusses how South African companies are taking action against HIV in ways that set (...) new benchmarks, enhance the effectiveness of international AIDS advocacy efforts, and spur businesses across Africa and beyond to strengthen their corporate responses to HIV/AIDS. (shrink)

The Drosophila salivary gland has emerged as an outstanding model system for the process of organ formation. Many of the component steps, from initial regional specification through cell specialization and morphogenesis, are known and many of the genes required for these different processes have been identified. The salivary gland is a relatively simple organ; the entire gland comprises of only two major cell types, which derive from a single contiguous primordium. Salivary cells cease dividing once they are specified, and organ (...) growth is achieved simply by an increase in size of individual cells, thus eliminating concerns about the potential unequal distribution of determinants during mitosis. Drosophila salivary glands form by the same cellular mechanisms as organs in higher organisms, including regulated cell shape changes, cell intercalation and directed cell migration. Thus, learning how these events are coordinated for tissue morphogenesis in an organism for which the genetic and molecular tools are unsurpassed should provide excellent paradigms for dissecting related processes in the more intricate organs of more complicated species. BioEssays 23:901–911, 2001. © 2001 John Wiley & Sons, Inc. (shrink)

Concerns regarding corporate ethics have grown steadily throughout the past decade. In order to remain competitive, many organizational leaders are faced with the challenge of creating an ethical environment within their organization. A model is presented showing the process and elements necessary for the institutionalization of organizational ethics. The transformational leadership style lends itself well to the creation of an ethical environment and is suggested as a means to facilitate the institutionalization of corporate ethics. Finally, the benefits of using transformational (...) leadership are demonstrated through the components of a psychological contract, organizational commitment, and ethical culture to institutionalize organizational ethics. (shrink)

Past research has demonstrated that employees’ perceptions of abusive supervision are positively associated with the enactment of bullying behaviors. However, an investigation of the factors influencing employees’ decision to bully others at work has yet to be completed. In this study, we propose that the relationship between perceptions of abusive supervision and the enactment of bullying behaviors is mediated by state self-regulation, and that active coping moderates the relationship between state self-regulation and bullying. Further, we analyze how the situational context (...) affects employees’ levels of self-regulatory resource depletion and ultimately, the extent to which they engage in bullying behaviors. A moderated mediation analysis using time-separated data provided support for our hypotheses, suggesting that employees’ state self-regulation helps explain why abusive supervision is associated with bullying and that active coping helps to reduce bullying behaviors. Further, the results suggest that negative environments are associated with more bullying. Contributions, practical implications, and future research directions are discussed. (shrink)

Many patients experience aspects of treatment and care as dehumanizing because the body is considered separate from the self and its life context. An attempt to transcend viewing persons in dualistic terms is posed by phenomenologists who focus not on “the body” as such but on what it means to be “embodied.” In this paper, we review the relevance of the phenomenology of the body for health care and report the results of comparing Sally Gadow’s phenomenological insights about body-self unity (...) with a qualitative analysis of patients’ accounts of satisfaction with the outcome of hand surgery. We illustrate the ways in which our findings were and were not congruent with Gadow’s conceptualization of embodiment and highlight aspects that are ambiguous. We conclude that the body-self dialectical relationship should be recast as a body-self-society trialectic and discuss the implications of this new conceptualization for clinical practices. (shrink)

Background Machine learning (ML) is utilized increasingly in health care, and can pose harms to patients, clinicians, health systems, and the public. In response, regulators have proposed an approach that would shift more responsibility to ML developers for mitigating potential harms. To be effective, this approach requires ML developers to recognize, accept, and act on responsibility for mitigating harms. However, little is known regarding the perspectives of developers themselves regarding their obligations to mitigate harms.Methods We conducted 40 semi-structured interviews with (...) developers of ML predictive analytics applications for health care in the United States.Results Participants varied widely in their perspectives on personal responsibility and included examples of both moral engagement and disengagement, albeit in a variety of forms. While most (70%) of participants made a statement indicative of moral engagement, most of these statements reflected an awareness of moral issues, while only a subset of these included additional elements of engagement such as recognizing responsibility, alignment with personal values, addressing conflicts of interests, and opportunities for action. Further, we identified eight distinct categories of moral disengagement reflecting efforts to minimize potential harms or deflect personal responsibility for preventing or mitigating harms.Conclusions These findings suggest possible facilitators and barriers to the development of ethical ML that could act by encouraging moral engagement or discouraging moral disengagement. Regulatory approaches that depend on the ability of ML developers to recognize, accept, and act on responsibility for mitigating harms might have limited success without education and guidance for ML developers about the extent of their responsibilities and how to implement them. (shrink)

Caring for critically ill and dying patients often triggers both professional and personal growth for physician trainees. In pediatrics, the neonatal intensive care unit is among the most distressing settings for trainees. We used longitudinal narrative writing to gain insight into how physician trainees are challenged by and make sense of repetitive, ongoing conflicts experienced as part of caring for very sick and dying babies. The study took place in a 45-bed, university-based NICU in an urban setting in the United (...) States. From November 2009 to June 2010 we enrolled pediatric residents and neonatology fellows at the beginning of their NICU rotations. Participants were asked to engage in individual, longitudinal narrative writing about their “experience in the NICU.” Thematic narrative analysis was performed. Thirty-seven physician trainees participated in the study. The mean number of narratives per trainee was 12; a total of 441 narratives were available for analysis. Conflict was the most pervasive theme in the narratives. Trainees experienced conflicts with families and conflicts with other clinicians. Trainees also described multiple conflicts of identity as members of the neonatology team, as members of the medical profession, as members of their own families, and as members of society. Physician trainees experience significant conflict and distress while learning to care for critically ill and dying infants. These conflicts often led them to question their own morals and their role in the medical profession. Physician trainees should be educated to expect various types of distress during intensive care rotations, encouraged to identify their own sources of distress, and supported in mitigating their effects. (shrink)

When there have been substantial failures by institutional leadership in their oversight responsibility to protect research integrity, the public should demand that these be recognized and addressed by the institution itself, or the funding bodies. This commentary discusses a case of research failures in developing genomic predictors for cancer risk assessment and treatment at a leading university. In its review of this case, the Office of Research Integrity, an agency within the US Department of Health and Human Services, focused their (...) report entirely on one individual faculty member and made no comment on the institution’s responsibility and its failure to provide adequate oversight and investigation. These actions missed an important opportunity to emphasize the institution’s critical responsibilities in oversight of research integrity and the importance of institutional transparency and accountability. (shrink)

Conscientious objections (CO) can be disruptive in a variety of ways and may disadvantage patients and colleagues who must step-in to assume care. Nevertheless, nurses have a right and responsibility to object to participation in interventions that would seriously harm their sense of integrity. This is an ethical problem of balancing risks and responsibilities related to patient care. Here we explore the problem and propose a nonlinear framework for exploring the authenticity of a claim of CO from the perspective of (...) the nurse and of those who must evaluate such claims. We synthesized the framework using Rest’s Four Component Model of moral reasoning along with tenets of the International Council of Nursing’s (ICN) Code of Ethics for Nurses and insights from relevant ethics and nursing ethics literature. The resulting framework facilitates evaluating potential consequences of a given CO for all involved. We propose that the framework can also serve as an aid for nurse educators as they prepare students for practice. Gaining clarity about the sense in which the concept of conscience provides a defensible foundation for objecting to legally, or otherwise ethically, permissible actions, in any given case is critical to arriving at an ethical and reasonable plan of action. (shrink)

This article analyzes Wittgenstein’s position on the grammatical incorrigibility of psychological self-ascriptions and shows how introspective statements can be of use to philosophers. In Wittgenstein On Rules and Private Language, Kripke notes Wittgenstein’s puzzling ambivalence toward introspection. On the one hand Wittgenstein repudiates introspection and on the other he uses it in his own philosophical investigations. To resolve the paradox, this paper distinguishes between introspective methodology in psychological and philosophical investigations. Wittgenstein’s arguments against introspection are specifically directed at introspective methodology (...) in psychology. He argues that the use of introspection to discover “inner causes” commits one to a conception of “direct inner awareness”. On that conception, psychological self-ascriptions are considered highly reliable due to the superiority of the subjective vantage point in ascertaining one’s own mental contents. As an alternative, Wittgenstein maintains that this reliability stems from the grammar of the ascription. The paper places Wittgenstein’s alternative conception of incorrigibility into the context of his argument against the use of introspection in psychology. (shrink)

This article analyzes Wittgenstein’s position on the grammatical incorrigibility of psychological self-ascriptions and shows how introspective statements can be of use to philosophers. In Wittgenstein On Rules and Private Language, Kripke notes Wittgenstein’s puzzling ambivalence toward introspection. On the one hand Wittgenstein repudiates introspection and on the other he uses it in his own philosophical investigations. To resolve the paradox, this paper distinguishes between introspective methodology in psychological and philosophical investigations. Wittgenstein’s arguments against introspection are specifically directed at introspective methodology (...) in psychology. He argues that the use of introspection to discover “inner causes” commits one to a conception of “direct inner awareness”. On that conception, psychological self-ascriptions are considered highly reliable due to the superiority of the subjective vantage point in ascertaining one’s own mental contents. As an alternative, Wittgenstein maintains that this reliability stems from the grammar of the ascription. The paper places Wittgenstein’s alternative conception of incorrigibility into the context of his argument against the use of introspection in psychology. (shrink)

This paper presents Freud’s argument that the clinical process of psychoanalysis must continually combat the patient’s resistance to the analyst’s interpretations. It also presents systematically Wittgenstein’s counterargument. Wittgenstein contends that psychoanalytic interpretations are enormously attractive and that their “charm” predisposes the patient to accept them. He traces their charm to six sources, each of which is discussed.

This paper presents Freud’s argument that the clinical process of psychoanalysis must continually combat the patient’s resistance to the analyst’s interpretations. It also presents systematically Wittgenstein’s counterargument. Wittgenstein contends that psychoanalytic interpretations are enormously attractive and that their “charm” predisposes the patient to accept them. He traces their charm to six sources, each of which is discussed.

This paper presents Freud’s argument that the clinical process of psychoanalysis must continually combat the patient’s resistance to the analyst’s interpretations. It also presents systematically Wittgenstein’s counterargument. Wittgenstein contends that psychoanalytic interpretations are enormously attractive and that their “charm” predisposes the patient to accept them. He traces their charm to six sources, each of which is discussed.

This volume contains an array of essays that reflect, and reflect upon, the recent revival of scholarly interest in the self and consciousness. Various relevant issues are addressed in conceptually challenging ways, such as how consciousness and different forms of self-relevant experience develop in infancy and childhood and are related to the acquisition of skill; the role of the self in social development; the phenomenology of being conscious and its metapsychological implications; and the cultural foundations of conceptualizations of consciousness. Written (...) by notable scholars in several areas of psychology, philosophy, cognitive neuroscience, and anthropology, the essays are of interest to readers from a variety of disciplines concerned with central, substantive questions in contemporary social science, and the humanities. (shrink)

Introduction: the Study of Argumentation Although our overall organization of the readings suggests one way of dividing our selected literature, ...

Doctoral programs at U.S. universities play a critical role in the development of human resources both in the United States and abroad. This volume reports the results of an extensive study of U.S. research-doctorate programs in five broad fields: physical sciences and mathematics, engineering, social and behavioral sciences, biological sciences, and the humanities. Research-Doctorate Programs in the United States documents changes that have taken place in the size, structure, and quality of doctoral education since the widely used 1982 editions. This (...) update provides selected information on nearly 4,000 doctoral programs in 41 subdisciplines at 274 doctorate-granting institutions. This volume also reports the results of the National Survey of Graduate Faculty, which polled a sample of faculty for their views on the scholarly quality of program faculty and the effectiveness of doctoral programs in preparing research scholars/scientists. This much-anticipated update of such an essential reference will be useful to education administrators, university faculty, and students seeking authoritative information on doctoral programs. (shrink)

For focal neurodegenerative diseases or brain tumors, localized delivery of protein or genetic vectors may be sufficient to alleviate symptoms, halt disease progression, or even cure the disease. One may circumvent the limitation imposed by the blood-brain barrier by transplantation of genetically altered cell grafts or focal inoculation of virus or protein. However, permanent gene replacement therapy for diseases affecting the entire brain will require global delivery of genetic vectors. The neurotoxicity of currently available viral vectors and the transient nature (...) of transgene expression invivomust be overcome before their use in human gene therapy becomes clinically applicable. (shrink)

In 2018-2019, at the Keck School of Medicine of the University of Southern California, we developed and piloted a narrative-based health systems science intervention for patients living with HIV and medical students in which medical students co-wrote patients’ life narratives for inclusion in the electronic health record. The pilot study aimed to assess the acceptability of the “life narrative protocol” from multiple stakeholder positions and characterize participants’ experiences of the clinical and pedagogical implications of the LNP. Students were recruited from (...) KSOM. Patients and staff were recruited from the Maternal, Child, and Adolescent/Adult Center for Infectious Disease and Virology at Los Angeles County+USC Medical Center. Ten patients, seventeen students, and ten MCA staff participated in the pilot study. Qualitative methods were used to gather data from students’, patients’, and staff’s perspectives. Three themes emerged from the thematic analysis: patients’ life narratives conveyed their unique life experiences and voices; the protocol could result in wide-ranging effects on HIV care; the LNP enabled students to contribute value to patients’ healthcare. Across groups, participants considered the LNP an acceptable intervention. The LNP, its limitations, and implications for HIV care, narrative medicine, and health information technology are presented. (shrink)

This article is an ethnographic analysis of the mutuality that is possible in relationships between caregivers and women with intellectual disabilities who live together in L'Arche homes. Creating mutuality through which both parties grow and exercise agency requires that caregivers learn to negotiate delicate power relations connected to the physics of care and to reframe dominant stereotypes of disability. This helps them to support the women with intellectual disabilities to name and achieve their desires.