A guide to the everyday decisions about right and wrong faced by physical scientists and research engineers. This book offers the first comprehensive guide to ethics for physical scientists and engineers who conduct research. Written by a distinguished professor of chemistry and chemical engineering, the book focuses on the everyday decisions about right and wrong faced by scientists as they do research, interact with other people, and work within society. The goal is to nurture readers' ethical intelligence so that they (...) know an ethical issue when they see one, and to give them a way to think about ethical problems. After introductions to the philosophy of ethics and the philosophy of science, the book discusses research integrity, with a unique emphasis on how scientists make mistakes and how they can avoid them. It goes on to cover personal interactions among scientists, including authorship, collaborators, predecessors, reviewers, grantees, mentors, and whistle-blowers. It considers underrepresented groups in science as an ethical issue that matters not only to those groups but also to the development of science, and it examines human participants and animal subjects. Finally, the book examines scientifically relevant social issues, including public policy, weapons research, conflicts of interest, and intellectual property. Each chapter ends with discussion questions and case studies to encourage debate and further exploration of topics. The book can be used in classes and seminars in research ethics and will be an essential reference for scientists in academia, government, and industry. (shrink)

The technology for the digitized text creates fluid meaning, representing its culture in transition from the dominance of the single-authored text with its hierarchically ordered system. This new architecture for the digitized word has been making explicit the shift from human consciousness reflecting the interiority of the self to a human consciousness reflecting self in relation to others. Educators using the technology of networked writing environments need to understand how the technology functions and intervenes for pedagogical processes during models of (...) asynchronous and synchronous collaborative writing. Both models support a constructivist view of learning; however, for each, educators need to consider the ethos of the writer as inhabiting a negotiated, shared space with readers during text production. As a consequence, cocognition may occur when writers share ideas and engage in the process of collaboration. (shrink)

This study explored the nature of patient advocacy among 40 institutionally employed registered nurses, nurse managers, clinical nurse specialists and nursing administrators. Participants were asked to define patient advocacy, to discuss their experiences with advocacy in institutions and their perceptions of risk associated with advocacy in institutional settings, and to identify one concept central to patient advocacy. The results delineated conceptual definitions of advocacy and numerous factors that influence nurses' decisions about acting as patient advocates in institutions. Additionally, they showed (...) striking similarities between conceptual terms used to define advocacy and terms used to define caring. Cet article est basé sur une enquête auprés de quarante infirmiers/ères, directeurs/ directrices, infirmiers/ères spécialisé(e)s et administrateurs employés dans des institu tions. On a demandé aux participants de définir la défense des malades, de discuter de leurs expériences concernant cette activité dans les institutions, de leurs perceptions des risques courus au cours de la défense et d'identifier un principe central à la défense des malades. Les résultats de l'enquête présentaient des définitions conceptuels de la défense ainsi que de nombreux éléments qui influencent les décisions prises par les infirmiers/ères qui assument la défence des malades dans les institutions. En plus, les résultats montraient de grandes ressemblances entre les expressions conceptuelles utilisées pour définir cette défense et les expressions utilisées pour définir les soins. In dieser Studie wird untersucht, was vierzig in Insitutionen angestellte Pflegende, Man ager, und andere Pflegeexperten unter Fürsprache verstehen, wie sie sie definieren, und was ihre Erfahrung mit Fürsprache am Arbeitsort ist. Die Beteiligten wurden gefragt, wie sie die Risiken der Fürsprache in Institutionen einschätzen, und sie wurden aufgefordert, ein allgemein gültiges Konzept für Patientenfürsprache zu identifizieren. Das Resultat zeigt begriffliche Definitionen der Fürsprache sowei verschiedene Faktoren, die die Entscheidungen des Pflegepersonals beeinflussen, wenn sie als Fürsprecher der Patienten handeln. Zugleich zeigte diese Studie auch grosse Aehnlichkeiten zwischen Begriffen der Fürsprache und der Pflege. (shrink)

Comprehensive regulatory changes brought on by recent corporate governance reforms have broadly redefined and re-emphasized the roles and responsibilities of all the participants in a public company’s financial reporting process. Most notably, these reforms have intensified scrutiny of corporate audit committees, whose role as protectors of investors’ interests now attracts substantially higher visibility and expectations. As a result, audit committees face the formidable challenge of effectively overseeing the company’s financial reporting process in a dramatically changed – and highly charged – (...) corporate governance environment. This paper discusses the new expectations of audit committee responsibilities and effectiveness in the wake of corporate governance reforms, key challenges, “whistleblower” provisions and shortcomings, and provides some directions for future research. (shrink)

Although canine identification of body odor (BO) has been widely used as forensic evidence, the concept of nosewitness identification by human observers was only recently put to the test. The results indicated that BOs associated with male characters in authentic crime videos could later be identified in BO lineup tests well above chance. To further evaluate nosewitness memory, we assessed the effects of lineup size (Experiment 1) and retention interval (Experiment 2), using a forced-choice memory test. The results showed that (...) nosewitness identification works for all lineup sizes (3, 5, and 8 BOs), but that larger lineups compromise identification performance in similarity to observations from eye- and earwitness studies. Also in line with previous eye- and earwitness studies, but in disagreement with some studies on odor memory, Experiment 2 showed significant forgetting between shorter retention intervals (15 min) and longer retention intervals (1-week) using lineups of five BOs. Altogether this study shows that identification of BO in a forensic setting is possible and has limits and characteristics in line with witness identification through other sensory modalities. (shrink)

The use of robots had already been proven to encourage the promotion of social interaction and skills lacking in children with Autism Spectrum Disorders, who typically have difficulties in recognizing facial expressions and emotions. The main goal of this research is to study the influence of a humanoid robot to develop socio-emotional skills in children with ASD. The children’s performance in game scenarios aiming to develop facial expressions recognition skills is presented. Along the sessions, children who performed the game scenarios (...) with the robot and the experimenter had a significantly better performance than the children who performed the game scenarios without the robot. The main conclusions of this research support that a humanoid robot is a useful tool to develop socio-emotional skills in the intervention of children with ASD, due to the engagement and positive learning outcome observed. (shrink)

Anxiety shifts visual attention and perceptual mechanisms, preparing oneself to detect potentially threatening information more rapidly. Despite being demonstrated for threat‐related social stimuli, such as fearful expressions, it remains unexplored if these effects encompass other social cues of danger, such as aggressive gestures/actions. To this end, we recruited a total of 65 participants and asked them to identify, as quickly and accurately as possible, potentially aggressive actions depicted by an agent. By introducing and manipulating the occurrence of electric shocks, we (...) induced safe and threatening conditions. In addition, the association between electric shocks and aggression was also manipulated. Our result showed that participants have improved sensitivity, with no changes to criterion, when detecting aggressive gestures during threat compared to safe conditions. Furthermore, drift diffusion model analysis showed that under threat participants exhibited faster evidence accumulation toward the correct perceptual decision. Lastly, the relationship between threat source and aggression appeared to not impact any of the effects described above. Overall, our results indicate that the benefits gained from states of anxiety, such as increased sensitivity toward threat and greater evidence accumulation, are transposable to social stimuli capable of signaling danger other than facial expressions. (shrink)

Recently, approach-avoidance tendencies and visual perception biases have been increasingly studied using bistable point-light walkers (PLWs). Prior studies have found a facing-the-viewer bias when one is primed with general threat stimuli (e.g. angry faces), explained by the “error management theory”, as failing to detect a threat as approaching is riskier than the opposite. Importantly, no study has explored how disease threat – linked to the behavioural immune system – might affect this bias. This study aimed to explore whether disease-signalling cues (...) can alter how we perceive the motion direction of ambiguous PLWs. Throughout 3 experiments, participants indicated the motion direction of a bistable PLW previously primed with a control or disease-signalling stimuli – that is, face with a surgical mask (Experiment 1), sickness sound (Experiment 2), or face with a disease cue (Experiment 3). Results showed that sickness cues do not significantly modulate the perception of approach-avoidance behaviours. However, a pattern emerged in Experiments 2 and 3, suggesting that sickness stimuli led to more facing away percepts. Unlike other types of threat, this implies that disease-related threat stimuli might trigger a distinct perceptual bias, indicating a preference to avoid a possible infection source. Nonetheless, this finding warrants future investigations. (shrink)

DUREY A, WYNADEN D, THOMPSON SC, DAVIDSON PM, BESSARAB D and KATZENELLENBOGEN JM. Nursing Inquiry 2012; 19: 144–152 [Epub ahead of print]Owning solutions: a collaborative model to improve quality in hospital care for Aboriginal AustraliansWell‐documented health disparities between Aboriginal and Torres Strait Islander (hereafter referred to as Aboriginal) and non‐Aboriginal Australians are underpinned by complex historical and social factors. The effects of colonisation including racism continue to impact negatively on Aboriginal health outcomes, despite being under‐recognised and under‐reported. Many Aboriginal people (...) find hospitals unwelcoming and are reluctant to attend for diagnosis and treatment, particularly with few Aboriginal health professionals employed on these facilities. In this paper, scientific literature and reports on Aboriginal health‐care, methodology and cross‐cultural education are reviewed to inform a collaborative model of hospital‐based organisational change. The paper proposes a collaborative model of care to improve health service delivery by building capacity in Aboriginal and non‐Aboriginal personnel by recruiting more Aboriginal health professionals, increasing knowledge and skills to establish good relationships between non‐Aboriginal care providers and Aboriginal patients and their families, delivering quality care that is respectful of culture and improving Aboriginal health outcomes. A key element of model design, implementation and evaluation is critical reflection on barriers and facilitators to providing respectful and culturally safe quality care at systemic, interpersonal and patient/family‐centred levels. Nurses are central to addressing the current state of inequity and are pivotal change agents within the proposed model. (shrink)

ZusammenfassungSystemmedizinische Ansätze zeichnen sich durch die Integration großer Datenmengen aus vielfältigen Datenquellen aus und führen systembiologische und medizinische Forschungsansätze mit informationswissenschaftlichen Methoden und prädiktiven Verfahren mathematischer Modellierung zusammen. Hieraus resultiert eine enge Kooperation von Ärzten und Naturwissenschaftlern, wobei insbesondere die Expertise nicht-ärztlicher Forscher zunehmend an Bedeutung für die Datenaufbereitung und -interpretation gewinnt. Aus ethischer Perspektive wirft diese Entwicklung Fragen nach der konkreten Gestaltung einer systemmedizinischen Zusammenarbeit sowie möglichen Rollenveränderungen und neuen Verantwortungszuschreibungen an Ärzte und nicht-ärztliche Forscher auf. Um diese Fragen (...) mit Blick auf die Erfahrungen und Perspektiven der beteiligten Akteursgruppen zu beleuchten, führten wir eine qualitative Interviewstudie mit Ärzten und nicht-ärztlichen Forschern aus unterschiedlichen systemmedizinischen Kontexten durch. Aus dem Interviewmaterial ließen sich zwei Konzeptionen von Systemmedizin rekonstruieren. Die erste ist durch eine eindeutige arbeitsteilige Rollentrennung zwischen Ärzten und Forschern charakterisiert: Der Forscher fungiert als Dienstleister, der Arzt als translationaler, interdisziplinär ausgerichteter Mediziner. Die zweite zeichnet sich durch eine weitreichende Aufhebung der Rollentrennung von Ärzten und Forschern aus: Die Berufsgruppen agieren als interdisziplinäres Team mit einer engen wechselseitigen inhaltlichen und methodischen Zusammenarbeit der Akteure. In beiden Konzeptionen werden Rollenkonflikte von Ärzten und Forschern deutlich, die insbesondere auf die Diskrepanz zwischen dem Arzt- und Forscherethos und die mit ihnen je verknüpften spezifischen Handlungsnormen und Ziele zurückzuführen sind. Ferner besteht mit Blick auf die dem Arzt und Forscher jeweils zukommende Verantwortung gegenüber Patienten vielfältiger normativer Klärungsbedarf, insbesondere hinsichtlich der Frage, welche Verantwortung den Akteursgruppen gerechtfertigter Weise zugeschrieben werden kann. Diesbezüglich erscheint eine Differenzierung von versorgungsnäheren und grundlagenforschungsorientierten Arbeitsfeldern angeraten. (shrink)

Background Achieving meaningful consent can be challenging, particularly in contexts of diminished literacy, yet is a vital part of participant protection in global health research. Method We explored the challenges and potential solutions of achieving meaningful consent through a qualitative study in a predominantly hill tribe ethnic minority population in northern Thailand, a culturally distinctive population with low literacy. Semi-structured interviews were conducted with 37 respondents who had participated in scrub typhus clinical research, their family members, researchers and other key (...) informants. A thematic analysis was conducted. Results Our analysis identified four interrelated themes surrounding participants’ ability to give consent: varying degrees of research understanding, limitations of using informal translators, issues impacting decisions to join research, and voluntariness of consent. Suggestions for achieving more meaningful consent included the use of formal translators and community engagement with research populations. Conclusions Participant’s agency in decision making to join research should be supported, but research information needs to be communicated to potential participants in a way that they can understand. We found that improved understanding about the study and its potential benefits and harms goes beyond literacy or translation and requires attention to social and cultural factors. (shrink)

When researchers encounter preexisting psychological distress in participants, ethical codes provide little guidance on how to balance issues of beneficence and autonomy. Although researchers may inform participants what will occur given responses indicating distress, this information may lead to biased self-reports. This important issue was addressed in this study by manipulating consent form information regarding the type of psychopathology to be assessed and various levels of possible follow-up. In comparing responses on self-report measures of anxiety, depression, and general psychological distress, (...) men who believed depression was the focus of the study reported fewer symptoms of depression and less trait anxiety as intrusiveness of experimenter follow-up increased. These results are discussed within the framework of socialization theory. Given that half of the sample did not correctly answer questions regarding information contained in the consent form, guidelines to improve consent form comprehension are offered. (shrink)

The concept of organizational justice is important to understanding and predicting organizational behavior. A significant development in the research literature has been the separation of distributive and procedural justice. While much of the research has focused on negative outcomes, this research attempted to verify the presence of both forms of justice in the context of positive outcomes. Subjects completed an instrument designed to measure their perceptions of distributive and procedural justice. The subjects also reported their satisfaction and sense of fairness (...) with their salary increases, their belief that the procedures to award the increases had been followed, and their level of information and agreement regarding the salary program. These measures, along with size of salary increase and gender were examined to determine their impact on the subjects' perceived level of justice. The data support the existence of the two distinct forms of justice, but suggest that procedural justice may, in turn, branch out into two aspects. One category involves being informed, and a second appears to deal with acceptance of procedures. A series of relationships are then considered. Significant gender effects were non-existent. (shrink)

The rising demographic of older adults worldwide has led to an increase in dementia cases. In order to ensure the proper allocation of care and resources to this clinical group, it is necessary to correctly distinguish between simulated versus bona-fide cognitive deficits typical of dementia. Performance Validity Tests are specifically designed to assess a lack of effort and the possible simulation of cognitive impairment. Previous research demonstrates that PVTs may be sensitive to dementia, thus inaccurately classifying real memory impairment as (...) simulation. Here, we analyzed the sensitivity of PVTs in discriminating between dementia and simulation using receiver operating characteristic curve analyses. Further, we examined the potential need for adjusting cut-off scores for three stand-alone and one embedded PVT for Portuguese older adults with dementia. The results showed that all measures, except for the Coin in Hand— Extended version, were sensitive to one or more sociodemographic and/or cognitive variables, and it was necessary to adjust cut-off points for all measures. Additionally, the Rey-15 Item Memory Test did not demonstrate sufficient discriminating capacity for dementia. These results present important implications for clinical practice and the daily life of patients, as the use of incorrect cut-off points could impede patients from getting the resources they need. (shrink)

The ease with which genotyping technologies generate tremendous amounts of data on research participants has been well chronicled, a feat that continues to become both faster and cheaper to perform. In parallel to these advances come additional ethical considerations and debates, one of which centers on providing individual research results and incidental findings back to research participants taking part in genetic research efforts. In 2006 the Industry Pharmacogenomics Working Group offered some ‘Points-to-Consider’ on this topic within the context of the (...) drug development process from those who are affiliated to pharmaceutical companies. Today many of these points remain applicable to the discussion but will be expanded upon in this updated viewpoint from the I-PWG. The exploratory nature of pharmacogenomic work in the pharmaceutical industry is discussed to provide context for why these results typically are not best suited for return. Operational challenges unique to this industry which cause barriers to returning this information are also explained. (shrink)

It is proposed in this writing to deal whith the theme of the possible links between scientifíc investigation and ethical refíection. In approaching this question, we propose to backtrack as far as Greek line of thought, and stop at the precise moment when something similar to scientifíc "truth" first becomes observable, and starts thus to make part of what is "sayable". We are referring to this inaugural instant when historical reflection, medical knowledge, and juridical research have simultaneously appeard. We shall (...) try and demonstrate that, whithin this context, the concern whith truth, far from being alien to ethical reñection, was considered to be the most efficient resource, that which could best contribute in the effort to reach a life worth being lived.Este escrito se propone tematizar los vínculos existentes entre la investigación científica y la reflexión ética. Con la finalidad de abordar esa cuestión nos proponemos aquí retrotraernos hasta el pensamiento griego, y detenernos en ese momento preciso en que algo semejante a la "verdad científica" emerge por primera vez, pasando así a formar parte de lo "decible". Nos referimos a ese instante inaugural en el que surgieron, casi al mismo tiempo, la reflexión histórica, el saber médico y la investigación jurídica. Intentaremos mostrar que, en ese contexto, la preocupación por la verdad lejos de ser ajena a la reflexión ética fue considerada como el recurso mas eficaz, aquel que mejor podía contribuir, con el intento de alcanzar una vida digna de ser vivida. (shrink)

We identify a normative paradox of responsible management education. Business educators aim to promote social values and develop ethical habits and socially responsible mindsets through education, but they attempt to do so with theories that have normative underpinnings and create actual normative effects that counteract their intentions. We identify a limited conceptualization of freedom in economic theorizing as a cause of the paradox. Economic theory emphasizes individual freedom and understands this as the freedom to choose from available options. However, conceptualizing (...) individuals as profit-maximizing actors neglects their freedom to reflect on the purposes and goals of their actions. We build on the work of pragmatist philosopher John Dewey, who distinguishes between habitualized and creative problem-solving behaviors, conceptualizes knowledge construction as a process of interdependent scientific social inquiry, and understands actors as having the freedom to determine what kind of people they wish to be. We apply pragmatist theory to business education and suggest equipping students with a plurality of theories, supplementing neoclassical economics with other economic perspectives and views from other disciplines on economic behavior. Moreover, we suggest putting students into learning situations that require practical problem solution through interdependent social inquiry, encouraging ethical reflection. In doing so, we contribute by linking the problematic conceptions of freedom identified in economic theorizing to the debate on responsible management education. We conceptualize a pragmatist approach to management education that explicitly re-integrates the freedom to discursively reflect on the individual and societal purpose of business activity and thereby makes existing tools and pedagogies useful for bringing potential freedom back into business. (shrink)

An important area of business ethics research focuses on how otherwise normal and law-abiding individuals can engage in acts of corruption. Key in this literature is the concept of rationalization. This is where individuals attempt to justify past and future corrupt deeds to themselves and others. In this article, we argue that rationalization often entails a process of overcompensation whereby the justification forwarded is excessive in relation to the actual act. Such over-rationalization provides an impetus for further and more serious (...) acts of illegality. Using a number of high profile cases, it is argued that this dynamic gap between the act and excessive rationalization can explain why corruption often escalates in severity and scope in the organization. (shrink)

C. I. Lewis was one of the most important thinkers of his generation. In this book, Sandra B. Rosenthal explores Lewis’s philosophical vision, and links his thought to the traditions of classical American pragmatism. Tracing Lewis’s influences, she explains the central concepts informing his thinking and how he developed a unique and practical vision of the human experience. She shows how Lewis contributed to the enrichment and expansion of pragmatism, opening new paths of constructive dialogue with other traditions. This (...) book will become a standard reference for readers who want to know more about one of American philosophy’s most distinguished minds. (shrink)

RESUMEN Las investigaciones en el campo de la teoría de la comunicación apuntan a que en la actualidad el proceso es, desde lo social, una vía para el logro de las relaciones interpersonales y posee sus potencialidades estratégicas para la construcción social y cultural del hombre. Se realizó una revisión bibliográfica para el acercamiento inicial al estudio de las temáticas de la comunicación social en salud y la prevención de enfermedades en la comunidad. Por ello el objetivo del presente trabajo (...) estriba en establecer los fundamentos teóricos que sustentan el estudio de las relaciones entre la comunicación en salud y la concreción del trabajo preventivo desde la comunidad. Se defiende que la comunicación social en salud promueve el diálogo y el intercambio de información y es un componente imprescindible de todos los servicios de salud. ABSTRACT Research on the theoretical basis of communication point to the fact that nowadays, the process is, from a social point of view, a means of achieving interpersonal relationships and it has strategic potential toward men’s social and cultural construction. A bibliographic review was carried out in order to approach the study of subject matters related to social communication in health and disease prevention in the community. Therefore, this paper aims at stablishing the theoretical basis that support the study of the relationship between communication in health and the implementation of precautionary work from the community. It is defended that social communication in health promotes dialogue and information exchange and it is an essential element in all health services. (shrink)

Rhythm is key to language acquisition. Across languages, rhythmic features highlight fundamental linguistic elements of the sound stream and structural relations among them. A sensitivity to rhythmic features, which begins in utero, is evident at birth. What is less clear is whether rhythm supports infants' earliest links between language and cognition. Prior evidence has documented that for infants as young as 3 and 4 months, listening to their native language supports the core cognitive capacity of object categorization. This precocious link (...) is initially part of a broader template: listening to a non-native language from the same rhythmic class as and to vocalizations of non-human primates provide English-acquiring infants the same cognitive advantage as does listening to their native language. Here, we implement a machine-learning approach to ask whether there are acoustic properties, available on the surface of these vocalizations, that permit infants' to identify which vocalizations are candidate links to cognition. We provided the model with a robust sample of vocalizations that, from the vantage point of English-acquiring 4-month-olds, either support object categorization or fail to do so. We assess whether supervised ML classification models can distinguish those vocalizations that support cognition from those that do not, and which class of acoustic features best support that classification. Our analysis reveals that principal components derived from rhythm-relevant acoustic features were among the most robust in supporting the classification. Classifications performed using temporal envelope components were also robust. These new findings provide in principle evidence that infants' earliest links between vocalizations and cognition may be subserved by their perceptual sensitivity to rhythmic and spectral elements available on the surface of these vocalizations, and that these may guide infants' identification of candidate links to cognition. (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)

To find more information about Rowman and Littlefield titles, please visit www.rowmanlittlefield.com.

Bioethics at the Movies explores the ways in which popular films engage basic bioethical concepts and concerns. Twenty philosophically grounded essays use cinematic tools such as character and plot development, scene-setting, and narrative-framing to demonstrate a range of principles and topics in contemporary medical ethics. The first section plumbs popular and bioethical thought on birth, abortion, genetic selection, and personhood through several films, including The Cider House Rules, Citizen Ruth, Gattaca, and I, Robot. In the second section, the contributors examine (...) medical practice and troubling questions about the quality and commodification of life by way of Dirty Pretty Things, Eternal Sunshine of the Spotless Mind, and other movies. The third section's essays use Million Dollar Baby, Critical Care, Big Fish, and Soylent Green to show how the medical profession and society at large view issues related to aging, death, and dying. A final section makes use of Extreme Measures and select Spanish and Japanese films to discuss two foundational matters in bioethics: the role of theories and principles in medicine and the importance of cultural context in devising care. Structured to mirror bioethics and cinema classes, this innovative work includes end-of-chapter questions for further consideration and contributions from scholars from the United States, Canada, the United Kingdom, Israel, Spain, and Australia. Contributors: Robert Arp, Ph.D., Michael C. Brannigan, Ph.D., Matthew Burstein, Ph.D., Antonio Casado da Rocha, Ph.D., Stephen Coleman, Ph.D., Jason T. Eberl, Ph.D., Paul J. Ford, Ph.D., Helen Frowe, M.A., Colin Gavaghan, Ph.D., Richard Hanley, Ph.D., Nancy Hansen, Ph.D., Al-Yasha Ilhaam, Ph.D., Troy Jollimore, Ph.D., Amy Kind, Ph.D., Zana Marie Lutfiyya, Ph.D., Terrance McConnell, Ph.D., Andy Miah, Ph.D., Nathan Norbis, Ph.D., Kenneth Richman, Ph.D., Karen D. Schwartz, LL.B., M.A., Sandra Shapshay, Ph.D., Daniel Sperling, LL.M., S.J.D., Becky Cox White, R.N., Ph.D., Clark Wolf, Ph.D. (shrink)

Background Scientific and technological advancements in mapping and understanding the interrelated pathways through which biological and environmental exposures affect disease development create new possibilities for detecting disease risk factors. Early detection of such risk factors may help prevent disease onset or moderate the disease course, thereby decreasing associated disease burden, morbidity, and mortality. However, the ethical implications of screening for disease risk factors are unclear and the current literature provides a fragmented and case-by-case picture. Methods To identify key ethical considerations (...) arising from the early detection of disease risk factors, we performed a systematic scoping review. The Scopus, Embase, and Philosopher’s Index databases were searched for peer-reviewed, academic records, which were included if they were written in English or Dutch and concerned the ethics of (1) early detection of (2) disease risk factors for (3) disease caused by environmental factors or gene-environment interactions. All records were reviewed independently by at least two researchers. Results After screening 2034 titles and abstracts, and 112 full papers, 55 articles were included in the thematic synthesis of the results. We identified eight common ethical themes: (1) Reliability and uncertainty in early detection, (2) autonomy, (3) privacy, (4) beneficence and non-maleficence, (5) downstream burdens on others, (6) responsibility, (7) justice, and (8) medicalization and conceptual disruption. We identified several gaps in the literature, including a relative scarcity of research on ethical considerations associated with environmental preventive health interventions, a dearth of practical suggestions on how to address expressed concerns about overestimating health capacities, and a lack of insights into preventing undue attribution of health responsibility to individuals. Conclusions The ethical concerns arising with the early detection of risk factors are often interrelated and complex. Comprehensive ethical analyses are needed that are better embedded in normative frameworks and also assess and weigh the expected benefits of early risk factor detection. Such research is necessary for developing and implementing responsible and fair preventive health policies. (shrink)