Patient consent has been formulated in terms of radical individualism rather than shared benefits. Medical education relies on the provision of patient consent to provide medical students with the training and experience to become competent doctors. Pelvic examination represents an extreme case in which patients may legitimately seek to avoid contact with inexperienced medical students particularly where these are male. However, using this extreme case, this paper will examine practices of framing and obtaining consent as perceived by medical students. This (...) paper reports findings of an exploratory qualitative study of medical students and junior doctors. Participants described a number of barriers to obtaining informed consent. These related to misunderstandings concerning student roles and experiences and insufficient information on the nature of the examination. Participants reported perceptions of the negative framing of decisions on consent by nursing staff where the student was male. Potentially coercive practices of framing of the decision by senior doctors were also reported. Participants outlined strategies they adopted to circumvent patients’ reasons for refusal. Practices of framing the information used by students, nurses and senior doctors to enable patients to decide about consent are discussed in the context of good ethical practice. In the absence of a clear ethical model, coercion appears likely. We argue for an expanded model of autonomy in which the potential tension between respecting patients’ autonomy and ensuring the societal benefit of well-trained doctors is recognised. Practical recommendations are made concerning information provision and clear delineations of student and patient roles and expectations. (shrink)

The requirements of the UK Equality Act 2010 and some high profile criticism for using a potentially ageist methodology have prompted the National Institute for Health and Clinical Excellence (NICE) to assess the processes and methodology it uses to make appraisal decisions. This paper argues that NICE has established rigorous systems to protect against ageist decisions, has no track record of ageism and is well placed to meet the requirements of new UK equality legislation.

In this study, we sought to obtain detailed opinion on some of the practical issues that might arise should physician-assisted suicide (PAS) ever be legalized in the UK. We carried out an anonymous postal questionnaire of medical students, junior and senior doctors working at an acute hospital trust, over a three-week period. A total of 435 questionnaires were distributed and we had an overall return rate of 34%. We found that opinions changed very little as doctors progressed from medical school (...) through to senior clinical positions. Overall, there was neutral opinion on whether PAS should be legalized. There was strong support for a multidisciplinary approach to the process and the involvement of the coroner. An opt-out clause for physicians who did not want to be involved in assisted suicide also received strong support. (shrink)

1 Adaptationism is a research strategy that seeks to identify adaptations and the specific selective forces that drove their evolution in past environments. Since the mid-1970s, paleontologist Stephen J. Gould and geneticist Richard Lewontin have been critical of adaptationism, especially as applied toward understanding human behavior and cognition. Perhaps the most prominent criticism they made was that adaptationist explanations were analogous to Rudyard Kipling's Just So Stories. Since storytelling is an inherent part of science, the criticism refers to the acceptance (...) of stories without sufficient empirical evidence. In particular, Gould, Lewontin, and their colleagues argue that adaptationists often use inappropriate evidentiary standards for identifying adaptations and their functions, and that they often fail to consider alternative hypotheses to adaptation. Playing prominently in both of these criticisms are the concepts of constraint, spandrel, and exaptation. In this article we discuss the standards of evidence that could be used to identify adaptations and when and how they may be appropriately used. Moreover, building an empirical case that certain features of a trait are best explained by exaptation, spandrel, or constraint requires demonstrating that the trait's features cannot be better accounted for by adaptationist hypotheses. Thus, we argue that the testing of alternatives requires the consideration, testing, and systematic rejection of adaptationist hypotheses. Where possible, we illustrate our points with examples taken from human behavior and cognition. Key Words: adaptation; ADHD; brain allometry; constraint; epistemology; evolutionary psychology; exaptation; female orgasm ; optimization; special design; waist-hip ratio. Footnotes1 The authors contributed equally to this paper. Order of authorship was determined alphabetically. Correspondence may be addressed to any of the authors. (shrink)

This timely anthology gathers forty historical and contemporary readings edited for accessibility. Short introductions precede each reading and a general introduction increase student comprehension across the spectrum of readings. The volume is ideal for all levels of students in civics, political theory, and philosophy courses.

The most inclusive anthology of its kind, Exploring Moral Problems covers both classic issues and often-neglected topics including the meaning of life, prostitution, organ sales, pornography, drug legalization, gun control, immigration, reparations, racism, sexism, sex and consent, sexual harassment, and climate change. The readings have been carefully edited to make them understandable to every reader. Each selection is accompanied by an introduction and study questions that help students comprehend the material. Reflecting the major role of women in philosophy today, more (...) than 1/3 of the contemporary essays are authored by women. (shrink)

Foundations of Moral Philosophy: Readings in Metaethics is a comprehensive collection of fifty-six contemporary readings and historical sources on major issues in metaethics. It focuses on the meaning of moral terms, the nature of moral psychology, whether we can know moral truths (if there are any), and the role of moral reasons. The book features unparalleled representation of women philosophers, with one-third of the contemporary articles authored or coauthored by women. Wherever appropriate, the articles have been carefully edited to ensure (...) that they will be exceptionally clear and understandable to undergraduate students. The volume is enhanced by a general introduction, introductions and study questions for each selection, and a detailed glossary. (shrink)

In the classroom, philosophers face not only the perennial problems of philosophy, but the problems of _teaching_ philosophy, and specifically the problems of teaching philosophy today: how to make philosophy interesting and relevant to students who are resistant to, or unfamiliar with, the discipline; how to bring classic texts to life within our current socio-cultural context; how to serve all students regardless of their abilities, backgrounds, or declared majors; how to sustain our discipline in light of support for more "vocational" (...) pursuits. In these essays, 24 of our most celebrated professors of philosophy offer perspectives on and solutions to these questions and more. Selected and introduced by three leaders in the world of philosophical education, the insights contained in this inspiring collection illuminate the challenges and possibilities of teaching the academy’s oldest discipline. (shrink)

Observing averted eye gaze results in the automatic allocation of attention to the gazed-at location. The role of the orientation of the face that produces the gaze cue was investigated. The eyes in the face could look left or right in a head-centred frame, but the face itself could be oriented 90 degrees clockwise or anticlockwise such that the eyes were gazing up or down. Significant cueing effects to targets presented to the left or right of the screen were found (...) in these head orientation conditions. This suggests that attention was directed to the side to which the eyes would have been looking towards, had the face been presented upright. This finding provides evidence that head orientation can affect gaze following, even when the head orientation alone is not a social cue. It also shows that the mechanism responsible for the allocation of attention following a gaze cue can be influenced by intrinsic object-based (i.e. head-centred) properties of the task-irrelevant cue. (shrink)

Design patterns are generalized solutions to frequently recurring problems. They were initially developed by architects and computer scientists to create a higher level of abstraction for their designs. Here, we extend these concepts to cell biology to lend a new perspective on the evolved designs of cells' underlying reaction networks. We present a catalog of 21 design patterns divided into three categories: creational patterns describe processes that build the cell, structural patterns describe the layouts of reaction networks, and behavioral patterns (...) describe reaction network function. Applying this pattern language to the E. coli central metabolic reaction network, the yeast pheromone response signaling network, and other examples lends new insights into these systems. (shrink)

Despite the importance of extrapair copulation (EPC) in human evolution, almost nothing is known about the design features of EPC detection mechanisms. We tested for sex differences in EPC inference-making mechanisms in a sample of 203 young couples. Men made more accurate inferences (φmen = 0.66, φwomen = 0.46), and the ratio of positive errors to negative errors was higher for men than for women (1.22 vs. 0.18). Since some may have been reluctant to admit EPC behavior, we modeled how (...) underreporting could have influenced these results. These analyses indicated that it would take highly sex-differentiated levels of underreporting by subjects with trusting partners for there to be no real sex difference. Further analyses indicated that men may be less willing to harbor unresolved suspicions about their partners’ EPC behavior, which may explain the sex difference in accuracy. Finally, we estimated that women underreported their own EPC behavior (10%) more than men (0%). (shrink)

In our target article, we discussed the standards of evidence that could be used to identify adaptations, and argued that building an empirical case that certain features of a trait are best explained by exaptation, spandrel, or constraint requires the consideration, testing, and rejection of adaptationist hypotheses. We are grateful to the 31 commentators for their thoughtful insights. They raised important issues, including the meaning of “exaptation”; whether Gould and Lewontin's critique of adaptationism was primarily epistemological or ontological; the necessity, (...) sufficiency, or utility of design evidence, phylogenetic analyses, homology, and molecular genetics in distinguishing exaptations from adaptations; whether adaptationists accept adaptationist hypotheses too quickly; and the real utility of adaptationism to human behavioral science. We organize our response along the major points of the target article, in some situations defending our original claims and in others modifying them. While debate on these issues will undoubtedly continue, we are cautiously optimistic that the main points of the target article (as modified by our response) will help move the debate in a positive direction. (shrink)

This article describes research to build an embodied conversational agent as an interface to a question-and-answer system about a National Science Foundation program. We call this ECA the LifeLike Avatar, and it can interact with its users in spoken natural language to answer general as well as specific questions about specific topics. In an idealized case, the LifeLike Avatar could conceivably provide a user with a level of interaction such that he or she would not be certain as to whether (...) he or she is talking to the actual person via video teleconference. This could be considered a extended version of the seminal Turing test. Although passing such a test is still far off, our work moves the science in that direction. The Uncanny Valley notwithstanding, applications of such lifelike interfaces could include those where specific instructors/caregivers could be represented as stand-ins for the actual person in situations where personal representation is important. Possible areas that come to mind that might benefit from these lifelike ECAs include health-care support for elderly/disabled patients in extended home care, education/training, and knowledge preservation. Another more personal application would be to posthumously preserve elements of the persona of a loved one by family members. We apply this approach to a Q/a system for knowledge preservation and dissemination, where the specific individual who had this knowledge was to retire from the US National Science Foundation. The system is described in detail, and evaluations were performed to determine how well the system was perceived by users. (shrink)

What can well-meaning people do about terror and genocide? The more we fight against systems of violence, the further we seem to sink into them. This book explores the lives and letters of ordinary and intellectual Germans who faced the ethical challenges of the Third Reich. Trained in history, literary criticism, philosophy, and theology, its four authors look at the role of myths, lies, non-conformity, irony, and modeling in cultivating a self. They explain how we might use these ordinary strategies (...) of selfhood to bear the burden of historical responsibility and be happy doing so.". (shrink)

This article reviews research into the attention mechanisms underlying a critical behavior in social interactions. It discusses findings from studies that investigate social gaze as a cue to attention and considers the perceptual mechanisms that may underlie these effects and their possible social functions. There is still debate as to whether gaze stimuli are “special” in terms of the attention processes engaged. However, there is evidence for the distinctive nature of gaze cues in their involvement in other aspects of social (...) perception such as person identity and emotional expression perception. Further, the sensitivity to another person's gaze direction varies across individuals within normal populations and in clinical populations, and these individual differences provide further insights into the key role of gaze cues in social cognition. (shrink)

A research project by the Schools of Theology and Psychology of Australia’s Charles Sturt University surveyed a large sample of Salvation Army officers. This article considers survey responses to two questions relating to end-of-life care: the use of pain medications that may shorten life, and the cessation of fluid and food intake. The results of the analyses are evaluated in terms of Michael Banner’s proposal that moral theology should more assiduously converse with ‘patient ethnographic study’, which the survey instantiates to (...) some extent. Banner’s proposal and the results of the survey are contrasted to Peter Singer’s analytical moral philosophical dictums on end-of-life care. The results are also compared to a metastudy by Andrea Rodríguez-Prat and Evert van Leeuwen of 14 ethnographic studies of those who wish to hasten death at the end of life. We conclude that respondents exemplify a form of moral reasoning that is embedded within Christian spirituality; counters the assumptions of Singer’s approach; contrasts the diminishment of ‘meaning’ at the end of life, as seen in Rodríguez-Prat and van Leeuwen; and deserves further respectful ethnographic study. (shrink)

We consider measurements, described by a positive-operator-valued measure (POVM), whose outcome probabilities determine an arbitrary pure state of a D-dimensional quantum system. We call such a measurement a pure-state informationally complete (PS I-complete) POVM. We show that a measurement with 2D−1 outcomes cannot be PS I-complete, and then we construct a POVM with 2D outcomes that suffices, thus showing that a minimal PS I-complete POVM has 2D outcomes. We also consider PS I-complete POVMs that have only rank-one POVM elements and (...) construct an example with 3D−2 outcomes, which is a generalization of the tetrahedral measurement for a qubit. The question of the minimal number of elements in a rank-one PS I-complete POVM is left open. (shrink)

Principles of Moral Philosophy: Classic and Contemporary Approaches covers all the major theories in normative ethics--relativism, egoism, divine command theory, natural law, Kantian ethics, consequentialism, pluralism, social contract theory, virtue ethics, the ethics of care, and particularism--and also includes sections on applied ethics and metaethics. It provides students with a balanced introduction to an array of approaches to topics in normative ethics, offering traditional theories alongside criticisms of them. The readings are enhanced by a variety of pedagogical features including a (...) general introduction, an introduction to each reading, study questions after each reading, and a glossary of key terms. -/- With one-third of its contemporary readings authored by women, Principles of Moral Philosophy is the most inclusive and balanced normative ethics reader available. (shrink)

People tend to prefer fluently processed over harder to process information. In this study we examine two issues concerning fluency and preference. First, previous research has pre-selected fluent and non-fluent materials. We did not take this approach yet show that the fluency of individuals’ idiosyncratic on-line interactions with a given stimulus can influence preference formation. Second, while processing fluency influences preference, the opposite also may be true: preferred stimuli could be processed more fluently than non-preferred. Participants performed a visual search (...) task either before or after indicating their preferred images from an array of either paintings by Kandinsky or decorated coffee mugs. Preferred stimuli were associated with fluent processing, reflected in facilitated search times. Critically, this was only the case for participants who gave their preferences after completing the visual search task, not for those stating preferences prior to the visual search task. Our results suggest that the spontaneous and idiosyncratic experience of processing fluency plays a role in forming preference judgments and conversely that our first impressions of preference do not drive response fluency. (shrink)

The American Academy of Pediatrics Task Force on Circumcision published its policy statement and technical report on newborn circumcision in September 2012.1 ,2 Since that time, some individuals and groups have voiced objections to the work of the Task Force, while others have conveyed their support. The AAP task force is pleased that the policy statement and technical reports on circumcision have stimulated debate on this topic and welcomes respectful discussion and dialogue about the scientific and ethical issues that surround (...) neonatal circumcision. We believe this is a complex issue that does not lend itself to simplistic solutions. The Task Force encourages those of all viewpoints to contribute to a vibrant, thoughtful and respectful evidence-based dialogue. We appreciate that the free exchange of competing ideas is a necessary component of scientific discovery. We also recognise that all clinical decisions carry ethical dimensions and that a respectful and thoughtful dialogue about these issues is important. However, the Task Force also feels strongly that this debate and the academic literature are demeaned when those with an ideological agenda disseminate inaccurate information, misapply scientific principles, make accusations that are unsupported, communicate in a vitriolic tone, and attempt to discredit and mischaracterise alternative views and those who hold them. Healthy debate and …. (shrink)