Historically, patients have deferred to physicians′ judgments about appropriate medical care, thereby limiting patient participation in treatment decisions. In this model of medical decision making, physicians typically decided upon the treatment plan. Communication with patients focused on securing their cooperation in accepting a treatment decision that essentially had already been made.

Cesario claims that all bias research tells us is that people “end up using the information they have come to learn as being probabilistically accurate in their daily lives”. We expose Cesario's flawed assumptions about the relationship between accuracy and bias. Through statistical simulations and empirical work, we show that even probabilistically accurate responses are regularly accompanied by bias.

Our objective is to test an optimality model of human fertility that specifies the behavioral requirements for fitness maximization in order (a) to determine whether current behavior does maximize fitness and, if not, (b) to use the specific nature of the behavioral deviations from fitness maximization towards the development of models of evolved proximate mechanisms that may have maximized fitness in the past but lead to deviations under present conditions. To test the model we use data from a representative sample (...) of 7,107 men living in Albuquerque, New Mexico, between 1990 and 1993. The model we test proposes that low fertility in modern settings maximizes number of grandchildren as a result of a trade-off between parental fertility and next generation fertility. Results do not show the optimization, although the data do reveal a trade-off between parental fertility and offspring education and income.We propose that two characteristics of modern economies have led to a period of sustained fertility reduction and to a corresponding lack of association between income and fertility. The first is the direct link between costs of investment and wage rates due to the forces of supply and demand for labor in competitive economies. The second is the increasing emphasis on cumulative knowledge, skills, and technologies in the production of resources. Together they produce historically novel conditions. These two features of modern economies may interact with evolved psychological and physiological mechanisms governing fertility and parental investment to produce behavior that maximizes the economic productivity of lineages at the expense of fitness. If cognitive processes evolved to track diminishing returns to parental investment and if physiological processes evolved to regulate fertility in response to nutritional state and patterns of breast feeding, we might expect non-adaptive responses when returns from parental investment do not diminish until extremely high levels are reached. With high economic payoffs from parental investment, people have begun to exercise cognitive regulation of fertility through contraception and family planning practices. Those cognitive processes maynot have evolved to handle fitness trade-offs between fertility and parental investment. (shrink)

Management plays an important role in reinforcing ethics in organizations. To support this aim, managers must use incentive and goal programs in ethical ways. This study examines experimentally the potential ethical costs associated with incentive-driven and goal-induced employee behavior from a managerial perspective. In a quasi-experimental setting, 243 MBA students with significant professional work experience evaluated a hypothetical employee’s ethical behavior under incentive pay systems modeled on a business case. In the role of the employee’s manager, participants evaluated the ethicality (...) of the employee’s incentive-driven and goal-induced ethical/unethical behavior and the outcomes of behavior, with consequences that were either favorable or unfavorable to the organization. The results indicated that participants discounted the ethical considerations of incentive-driven and goal-induced behavior when consequences were favorable to the organization. Participants’ morals and outcome orientations were also significantly related to their ethical judgments and intentions to intervene. The implications of these findings for research and practice are discussed. (shrink)

Music-based interventions (MBI) have become increasingly widely adopted for dementia and related disorders. Previous research shows that music engages reward-related regions through functional connectivity with the auditory system, but evidence for the effectiveness of MBI is mixed in older adults with mild cognitive impairment (MCI) and Alzheimer’s disease (AD). This underscores the need for a unified mechanistic understanding to motivate MBIs. The main objective of the present study is to characterize the intrinsic connectivity of the auditory and reward systems in (...) healthy aging individuals with MCI, and those with AD. Using resting-state fMRI data from the Alzheimer’s Database Neuroimaging Initiative, we tested resting-state functional connectivity within and between auditory and reward systems in older adults with MCI, AD, and age-matched healthy controls (N = 105). Seed-based correlations were assessed from regions of interest (ROIs) in the auditory network (i.e., anterior superior temporal gyrus, posterior superior temporal gyrus, Heschl’s Gyrus), and the reward network (i.e., nucleus accumbens, caudate, putamen, and orbitofrontal cortex). AD individuals were lower in both within-network and between-network functional connectivity in the auditory network and reward networks compared to MCI and controls. Furthermore, graph theory analyses showed that the MCI group had higher clustering and local efficiency than both AD and control groups, whereas AD individuals had lo... (shrink)

Flawed clinical practice guidelines may compromise patient care. Commercial conflicts of interest on panels that write treatment guidelines are particularly problematic, because panelists may have conflicting agendas that influence guideline recommendations. Historically, there has been no legal remedy for conflicts of interest on guidelines panels. However, in May 2008, the Attorney General of Connecticut concluded a ground-breaking antitrust investigation into the development of Lyme disease treatment guidelines by one of the largest medical societies in the United States, the Infectious Diseases (...) Society of America (IDSA). Although the investigation found significant flaws in the IDSA guidelines development process, the subsequent review of the guidelines mandated by the settlement was compromised by a lack of impartiality at various stages of the IDSA review process. This article will examine the interplay between the recent calls for guidelines reform, the ethical canons of medicine, and due process considerations under antitrust laws as they apply to the formulation of the IDSA Lyme disease treatment guidelines. The article will also discuss pitfalls in the implementation of the IDSA antitrust settlement that should be avoided in the future. (shrink)

Knowledge of mechanisms is critical for causal reasoning. We contrasted two possible organizations of causal knowledge—an interconnected causal network, where events are causally connected without any boundaries delineating discrete mechanisms; or a set of disparate mechanisms—causal islands—such that events in different mechanisms are not thought to be related even when they belong to the same causal chain. To distinguish these possibilities, we tested whether people make transitive judgments about causal chains by inferring, given A causes B and B causes C, (...) that A causes C. Specifically, causal chains schematized as one chunk or mechanism in semantic memory led to transitive causal judgments. On the other hand, chains schematized as multiple chunks led to intransitive judgments despite strong intermediate links. Normative accounts of causal intransitivity could not explain these intransitive judgments. (shrink)

An interruption. Rethinking the first three chapters of this book, I have come to suspect that, not unlike Iris Murdoch and Emmanuel Levinas, the way I imagine ‘ethics’ floats on an idea that any ethical substantive position or ethical theory is always shaped through our existential condition and our embodied encounter with others. To Murdoch, existence is the disposition for our responses to the ways in which we perceive reality, and yet, although these responses are always part of who we (...) are, they are not always part of what we do, and so, we set ourselves ethical tasks when we desire to act ethically. As scholar Bridget Clarke argues, “to attend to something [for Murdoch] is to approach it with a just and loving eye, and therewith to perceive it in its unbounded particularity and complexity, and so, as it truly is.” Or as I argue, to attend to the other ‘justly and lovingly’, Murdoch would instruct, is not merely to accurately collect details about the other and then arrive at an approximation of its being, but also to apprehend the other as ‘distinctly singular’ and ‘distinctly foreign’ from oneself–which at once forgoes any assimilation of the other into oneself, incidentally. The recognition of the other as ‘one who embodies human otherness and dignity’ becomes the condition for and coherent way of imagining and accessing moral reality. Moreover, for Diane Davis, this “being-for-the-other names a pre-originary obligation to respond to the other [and] it is in this response that both the self and the other emerge as existents” whose ethical projects are each challenged by the markedly different and infinitely other being. This obligation, Levinas might also say, is an ‘authority’ that is experienced like the effect of the other upon me, so that I am subsequently motivated to enact ethical task-making. I am not, therefore, “pulling everything other into the same, the known, the comprehended,” nor am I looking to any normative theories as authoritative templates from which I act ethically. And so, unlike Husserl, I am not “joining the philosophical tradition in its fundamental disrespect for all things other,” but instead, by dispositioning myself between these theories in responsible Levinasian fashion, I will be tracking them in response to their confronting me, and not as normative theories that are applicable to real and lived experiences. (shrink)

To Aaron Pacitti and Michael Cauvel–whose journal article, “Rent-Seeking Behavior and Economic Justice: A Classroom Exercise” broadly argues that “understanding the [complexities] of rent-seeking behavior helps fill the gap between economics and politics”–the varieties of rent are wide and, therefore, can only be described in their category-specific positions. I will discuss three of these categories in more detail below, but for now, I propose that a useful working grasp of economic rent involves “the amount paid to the owner of a (...) factor of production over the cost that is to be necessarily incurred on utilizing such elements in the production process.” In math terms, ‘economic rent’ equals the agreed-upon-amount paid by the consumer (when that amount far exceeds the market value of the product) minus the cost spent by the producer to make the product (when that cost is far below the typical amount to produce the product). Originally, the concept of economic rent concerned land ownership and the production of natural goods. Two major economists, Adam Smith and David Ricardo, offered insights into the general makeup and logic of what they called, the rent of land and simply rent, respectively. (shrink)

This study investigated the proficiency of CPAs in recognizing and evaluating ethical and unethical situations. In addition, CPAs provided attitudes on ethics education. Respondents were asked to evaluate the ethical acceptability of CPA behavior as presented in six vignettes involving a variety of ethical dilemmas from questions of conflict of interest to questions of personal honor. The results tend to signify that CPAs can, to a degree, distinguish ethical and unethical behaviors. It appears that ethical behaviors and very specific unethical (...) behaviors were more easily identified by practitioners. This may reveal uncertainty and apprehension as to exactly what constitutes unethical behavior since, in many circumstances, this resolution is made on a case-specific basis rather that via a universal rule. In addition, it is interesting to note that CPAs tend to picture themselves as more ethically-oriented than their peers.With respect to ethics education, the CPAs indicated that instruction in ethical concepts and literacy was important and should definitely be embodied in the accounting curriculum as well as at all educational levels. However, the CPAs were remarkably uncertain and ambivalent as to the qualifications of university faculty to provide this instruction and guidance. (shrink)

Chater & Loewenstein have done a service to the field by raising the fundamental issue of how the political process distorts well-intentioned efforts at behavioral public policy. We connect this argument to broader research on government failure, particularly public choice theory in economics. We further suggest ways that behavioral research can help identify and mitigate such failures.

© 2017. The American Astronomical Society. All rights reserved.We present new observations of the low-mass companion to HD 984 taken with the Gemini Planet Imager as a part of the GPI Exoplanet Survey campaign. Images of HD 984 B were obtained in the J and H bands. Combined with archival epochs from 2012 and 2014, we fit the first orbit to the companion to find an 18 au orbit with a 68% confidence interval between 14 and 28 au, an eccentricity (...) of 0.18 with a 68% confidence interval between 0.05 and 0.47, and an inclination of 119°with a 68% confidence interval between 114°and 125°. To address the considerable spectral covariance in both spectra, we present a method of splitting the spectra into low and high frequencies to analyze the spectral structure at different spatial frequencies with the proper spectral noise correlation. Using the split spectra, we compare them to known spectral types using field brown dwarf and low-mass star spectra and find a best-fit match of a field gravity M6.5 ±1.5 spectral type with a corresponding temperature of K. Photometry of the companion yields a luminosity of log=2.88 ± 0.07 dex with DUSTY models. Mass estimates, again from DUSTY models, find an age-dependent mass of 34 ±1 to 95 ±4 M Jup. These results are consistent with previous measurements of the object. (shrink)

ABSTRACT:Despite widespread attention to corruption and organizational change in the literature, to our knowledge, no research has attempted to understand the linkages between these two powerful organizational phenomena. Accordingly, we draw on major theories in ethics, sociology, and management to develop a theoretical framework for understanding how organizational change can sometimes generate corruption. We extend anomie theory and ethical climate theory to articulate the deinstitutionalization of the normative control system and argue that, through this deinstitutionalization, organizations have the potential to (...) become incubators for corruption. We qualify this process by proposing conditions more ripe for anomie and under which this deinstitutionalization is more likely to occur, propounding moderating relationships that influence organizational reconfiguration. Examples of turbulence in the contemporary business environment that can trigger change highlight our discussion. We conclude with managerial implications, offering means by which the deleterious effects of corruption may be arrested or controlled. (shrink)

Management plays an important role in reinforcing ethics in organizations. To support this aim, managers must use incentive and goal programs in ethical ways. This study examines experimentally the potential ethical costs associated with incentive-driven and goal-induced employee behavior from a managerial perspective. In a quasi-experimental setting, 243 MBA students with significant professional work experience evaluated a hypothetical employee’s ethical behavior under incentive pay systems modeled on a business case. In the role of the employee’s manager, participants evaluated the ethicality (...) of the employee’s incentive-driven and goal-induced ethical/unethical behavior and the outcomes of behavior, with consequences that were either favorable or unfavorable to the organization. The results indicated that participants discounted the ethical considerations of incentive-driven and goal-induced behavior when consequences were favorable to the organization. Participants’ morals and outcome orientations were also significantly related to their ethical judgments and intentions to intervene. The implications of these findings for research and practice are discussed. (shrink)

Conviction Narrative Theory (CNT) is a theory of choice underradical uncertainty– situations where outcomes cannot be enumerated and probabilities cannot be assigned. Whereas most theories of choice assume that people rely on (potentially biased) probabilistic judgments, such theories cannot account for adaptive decision-making when probabilities cannot be assigned. CNT proposes that people usenarratives– structured representations of causal, temporal, analogical, and valence relationships – rather than probabilities, as the currency of thought that unifies our sense-making and decision-making faculties. According to CNT, (...) narratives arise from the interplay between individual cognition and the social environment, with reasoners adopting a narrative that feels “right” to explain the available data; using that narrative to imagine plausible futures; and affectively evaluating those imagined futures to make a choice. Evidence from many areas of the cognitive, behavioral, and social sciences supports this basic model, including lab experiments, interview studies, and econometric analyses. We identify 12 propositions to explain how the mental representations (narratives) interact with four inter-related processes (explanation, simulation, affective evaluation, and communication), examining the theoretical and empirical basis for each. We conclude by discussing how CNT can provide a common vocabulary for researchers studying everyday choices across areas of the decision sciences. (shrink)

The 2010 Quinnipiac cheerleading case raises interesting questions about the nature of both cheerleading and sport, as well as about the moral character of each. In this paper we explore some of those questions, and argue that no form of college cheerleading currently in existence deserves, from a moral point of view, to be recognized as a sport for Title IX purposes. To reach that conclusion, we evaluate cheerleading using a quasi-legal argument based on the NCAA’s definition of sport and (...) conclude that cheerleading fails to qualify as a legitimate sport. A philosophical argument leads to the same conclusion, primarily because of the essential entertainment-aspect of cheerleading. We then examine a consequentialist moral case for making cheerleading an intercollegiate sport and argue that the balance of moral reasons is against doing so. Finally, we look at cheerleading’s newest offspring – Acrobatics and Tumbling, and STUNT – and express our moral reservations about their current claims to be worthy of Title IX recognition. While we would not claim that any single one of our arguments is decisive, we are convinced that the cumulative weight of the arguments against granting intercollegiate sport status to any of the forms of cheerleading or its derivatives is, at present, irresistible. (shrink)

Lyme disease is one of the most controversial illnesses in the history of medicine. In 2006 the Connecticut Attorney General launched an antitrust investigation into the Lyme guidelines development process of the Infectious Diseases Society of America (IDSA). In a recent settlement with IDSA, the Attorney General noted important commercial conflicts of interest and suppression of scientific evidence that had tainted the guidelines process. This paper explores two broad ethical themes that influenced the IDSA investigation. The first is the growing (...) problem of conflicts of interest among guidelines developers, and the second is the increasing centralisation of medical decisions by insurance companies, which use treatment guidelines as a means of controlling the practices of individual doctors and denying treatment for patients. The implications of the first-ever antitrust investigation of medical guidelines and the proposed model to remediate the tainted IDSA guidelines process are also discussed. (shrink)

In the coming weeks and months SARS-CoV-2 may ravage countries with weak health systems and populations disproportionately affected by HIV, tuberculosis, and other infectious diseases. Without safeguards and proper attention to global health equity and justice, the effects of this pandemic are likely to exacerbate existing health and socio-economic inequalities. This paper argues that achieving global health equity in the context of COVID-19 will require that notions of reciprocity and relational equity are introduced to the response.

The promises of precision medicine are often heralded in the medical and lay literature, but routine integration of genomics in clinical practice is still limited. While the “last mile” infrastructure to bring genomics to the bedside has been demonstrated in some healthcare settings, a number of challenges remain — both in the receptivity of today's health system and in its technical and educational readiness to respond to this evolution in care. To improve the impact of genomics on health and disease (...) management, we will need to integrate both new knowledge and new care processes into existing workflows. This change will be onerous and time-consuming, but hopefully valuable to the provision of high quality, economically feasible care worldwide. (shrink)

Although the target article emphasizes the important role of prediction in language use, prediction may well also play a key role in the initial formation of linguistic representations, that is, in language development. We outline the role of prediction in three relevant language-learning domains: transitional probabilities, statistical preemption, and construction learning.

The psychedelic psilocybin has shown promise both as treatment for psychiatric conditions and as a means of improving well-being in healthy individuals. In some jurisdictions (e.g., Oregon, USA), psilocybin use for both purposes is or will soon be allowed and yet, public attitudes toward this shift are understudied. We asked a nationally representative sample of 795 US Americans to evaluate the moral status of psilocybin use in an appropriately licensed setting for either treatment of a psychiatric condition or well-being enhancement. (...) Showing strong bipartisan support, participants rated the individual’s decision as morally positive in both contexts. These results can inform effective policy-making decisions around supervised psilocybin use, given robust public attitudes as elicited in the context of an innovative regulatory model. We did not explore attitudes to psilocybin use in unsupervised or non-licensed community or social settings. (shrink)