Although psychologist impairment has received attention from researchers, there is a paucity of empirical data aimed at determining the point at which such impairment necessitates action. The purpose of this study was to provide such empirical data. Members of Division 42 ( n = 285) responded to vignettes describing a psychologist whose symptoms of either depression or substance abuse varied across five levels of severity. Results identified specific levels of impairment at which psychologists were deemed too impaired to practice psychotherapy, (...) as well as significant differences between ratings of increasingly severe impairment. Practical and ethical implications of these results are discussed. (shrink)

Are psychotherapy clients who pay via health insurance more likely to receive Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV], American Psychiatric Association, 1994) diagnoses than identical clients who pay out of pocket? Previous research (Kielbasa, Pomerantz, Krohn, & Sullivan, 2004) indicates that when psychologists consider a mildly depressed or anxious client, payment method significantly influences diagnostic decisions. This study extends the scope of the previous study to include clients whose symptoms are even less severe. Independent practitioners (...) responded to vignettes of clients whose profiles deliberately included subclinical impairment and a high level of functioning. Half of the participants were told that the clients would pay via managed care; the other half were told that the clients would pay out of pocket. As in the earlier study, payment method had a highly significant impact on diagnosis such that relative to out-of-pocket clients, managed care clients were much more likely to be assigned DSM-IV diagnoses. In addition, a noteworthy percentage of participants assigned diagnoses regardless of payment method. Ethical implications are discussed. (shrink)

Research on multiple relationships by practicing psychologists has typically presumed the presence of a professional relationship and focused on the ethicality of subsequent, nonprofessional relationships. Instead, this study focused on the question of what, exactly, constitutes the professional relationship in the first place. Practicing psychologists and undergraduates responded to vignettes portraying various early stages of interaction between a therapist and a prospective client. Participants' responses indicated that determinations of professional relationship establishment, and the ethicality of subsequent nonprofessional relationships, depended upon (...) the degree of engagement. Some differences emerged between perceptions by professionals and nonprofessionals. Ethical and professional implications are discussed. (shrink)

To what extent does payment method (managed care vs. out of pocket) influence the likelihood that an independent practitioner will assign a Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994) diagnosis to a client? When a practitioner does diagnose, how does payment method influence the specific choice of a diagnostic category? Independent practitioners responded to a vignette describing a fictitious client with symptoms of depression or anxiety. In half of the vignettes, the fictitious client intended to pay (...) via managed care; in the other half, the fictitious client intended to pay out of pocket. Payment method had a very significant impact on diagnosis such that relative to out-of-pocket clients, managed care clients were much more likely to receive diagnoses and more likely to receive adjustment disorder diagnoses in particular. We discuss implications involving informed consent and other ethical issues. (shrink)

© 2015, Springer-Verlag Berlin Heidelberg.Genetic studies have identified single nucleotide polymorphisms associated with the risk of prostate cancer. It remains unclear whether such genetic variants are associated with disease aggressiveness. The NCI-SPORE Genetics Working Group retrospectively collected clinicopathologic information and genotype data for 36 SNPs which at the time had been validated to be associated with PC risk from 25,674 cases with PC. Cases were grouped according to race, Gleason score and aggressiveness. Statistical analyses were used to compare the frequency (...) of the SNPs between different disease cohorts. After adjusting for multiple testing, only PC-risk SNP rs2735839 was significantly and inversely associated with aggressive and high-grade disease in European men. Similar associations with aggressive and high-grade disease were documented in African-American subjects. The G allele of rs2735839 was associated with disease aggressiveness even at low PSA levels in both European and African-American men. Our results provide further support that a PC-risk SNP rs2735839 near the KLK3 gene on chromosome 19q13 may be associated with aggressive and high-grade PC. Future prospectively designed, case-case GWAS are needed to identify additional SNPs associated with PC aggressiveness. (shrink)

Our thinking is still the captive of the dichotomy “national/ international.” The reaction to nationalism takes the form of an abstract internationalism, and reaction to internationalism leads to the rebirth of nationalism. However, this dichotomy was only true (and that relatively) in 19th century Europe, or at the latest, at the beginning of the twentieth century, when subnational cultures seemed on the way to disappearing, and everything European was considered “universal” (two hypotheses that the facts prove to be untrue). As (...) H. Frey observes, “Today, the decline or decadence of the West is part of the contemporary view of the world, like the electron or the dinosaur.” The linear outline of progress, with Europe at the head, did not withstand the test of the First World War. The year 1918 marked the beginning of the end of Europeanism. Since then, we have begun to speak of “areas of civilization” (Splengler), “civilizations” (Toynbee), “cultural coalitions” (Lévi-Strauss). The existence of “areas of civilization” (regions) is commonly admitted today; it has entered journalistic language and even the structure of regional commissions and agencies of the United Nations (Europe, Near East, Southern Asia, South-east Asia, and the Far East). New communities have inserted themselves between nations and humanity. What do they represent? Are they something unique, or are they divided into a certain number of types in opposition to each other because of some characteristic? And in what way have they modified our view of universal history? (shrink)

The unique context of the rural setting provides special challenges to furnishing ethical healthcare to its approximately 62 million inhabitants. Although rural communities are widely diverse, most have the following common features: limited economic resources, shared values, reduced health status, limited availability of and accessibility to healthcare services, overlapping professional–patient relationships and care giver stress. These rural features shape common healthcare ethical issues, including threats to confidentiality, boundary issues, professional–patient relationship and allocation of resources. To date, there exists a limited (...) focus on rural healthcare ethics shown by the scarcity of rural healthcare ethics literature, rural ethics committees, rural focused ethics training and research on rural ethics issues. An interdisciplinary group of rural healthcare ethicists with backgrounds in medicine, nursing and philosophy was convened to explore the need for a rural healthcare ethics agenda. At the meeting, the Coalition for Rural Health Care Ethics agreed to a definition of rural healthcare ethics and a broad-ranging rural ethics agenda with the ultimate goal of enhancing the quality of patient care in rural America. The proposed agenda calls for increasing awareness and understanding of rural healthcare ethics through the development of evidence—informed, rural-attuned research, scholarship and education in collaboration with rural healthcare professionals, healthcare institutions and the diverse rural population. (shrink)

To better understand the available publications addressing ethical issues in rural health care we sought to identify the ethics literature that specifically focuses on rural America. We wanted to determine the extent to which the rural ethics literature was distributed between general commentaries, descriptive summaries of research, and original research publications. We identified 55 publications that specifically and substantively addressed rural health care ethics, published between 1966 and 2004. Only 7 (13%) of these publications were original research articles while (12) (...) 22% were descriptive summaries of research and 36 (65%) were general commentaries. The majority of publications examined (55%) were clinically focused while 27% addressed organizational ethics and 18% addressed ethical ramifications of rural health care policy at a national or community level. Our findings indicate that there are a limited number of publications focusing on rural health care ethics, suggesting a need for scholars and researchers to more rigorously address rural ethics issues. (shrink)

How do teenage girls articulate sexism in an era where gender injustice has been constructed as a thing of the past? Our article addresses this question by qualitatively exploring Canadian girls’ experiences of being caught between the postfeminist belief that gender equality has been achieved and the realities of their lives in school, which include incidents of sexism in their classrooms, their social worlds, and their projected futures. This analysis takes place in relation to two celebratory postfeminist narratives: Girl Power, (...) where girls are told they can do, be, and have anything they want, and Successful Girls, where girls are told they are surpassing boys in schools and workplaces. We argue that these postfeminist narratives have made naming sexism in schools difficult for girls because they are now seen to “have it all.” Utilizing Foucault’s law of the tactical polyvalence of discourse, this article analyzes girls’ contradictory engagement with postfeminism in order to both show its importance in girls’ lives, and its instability as a narrative that can adequately explain gender injustice. (shrink)

Previous research (Kielbasa, Pomerantz, Krohn, & Sullivan, 2004; Pomerantz & Segrist, 2006) indicates that when psychologists consider a client with symptoms of depression or anxiety, payment method significantly influences diagnostic decisions. This study extends the scope of the previous research to consider clients with symptoms of social phobia and attention deficit hyperactivity disorder (ADHD). Psychologists in independent practice responded to vignettes of clients whose descriptions deliberately included subclinical impairment. Half of the participants were told that the clients would (...) pay via managed care; the other half were told that the clients would pay out-of-pocket. Confirming previous studies, payment method had a highly significant impact on diagnosis such that compared to out-of-pocket clients, managed care clients were much more likely to be assigned Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) diagnoses. Ethical implications relate to informed consent, accuracy and truthfulness in diagnosis, and psychologists' integrity. (shrink)

The present study examined nonprofessionals' perceptions of culturally based and noncultural ethical violations. One hundred seventy-four undergraduates students read 12 vignettes depicting situations in which a clinician committed either a culturally based violation (e.g., sexist or ageist behavior) or a noncultural violation (e.g., breeching confidentiality or multiple relationship). Results indicated that participants were more likely to have unfavorable views of clinicians who had committed culturally based violations. In addition, results suggested that participants would be more likely to report a clinician (...) who had committed a culturally based violation to a supervisor or ethics board. (shrink)

When physicians take readings of health indices such as temperature or blood pressure, the practices that physicians and patients employ in discussing the readings both reflect and propose a set of expectations regarding the level of technical medical information the patients should acquire and understand. In this article we demonstrate how physicians’ reporting practices reflect and propose the roles of paternalism or independent expertise and how patients’ responding practices either ratify or contest the roles cast by the physicians’ practices. In (...) contrast to the usual assumption that roles are relatively stable for individuals over the course of encounters, we treat role enactments as matters that are negotiated turn by turn in interaction. Physicians’ practices for reporting test results implicate various sets of expectations about the knowledge, interest, and responsibility state of each participant; patients employ responding practices that ratify or contest the expectations implicated by the physicians’ prior report. In each subsequent turn within the information exchange sequence, a speaker indicates whether the level and kind of information being exchanged is appropriate/inappropriate and sufficient/insufficient for the participants. (shrink)

This paper has described three uses of Extreme Case formulationsto assert the strongest case in anticipation of non-sympathetic hearingsto propose the cause of a phenomenonto speak for the rightness (wrongness) of a practice.The interactants in the illustrations were engaged in several types of activities, among which were complaining, accusing, justifying, and defending. As concluding remarks, a few comments will be made about why participants use Extreme Case formulations in these activities.Part of the business of complaining involves portraying a situation as (...) a legitimate complainable. This may take the form of protraying the offense committed and/or the suffering endured in a way such that it would not be dismissed as minor. So as to legitimize a complaint and portray the complainable situation as worthy of the complaint, a speaker may portray the offense and/or the suffering with Extreme Case formulations. In both accusing and defending, participants ofyen present their strongest cases, including specifying Extreme Cases of their claims.Part of justifying a course of actions may involve portraying the precipitating circumstance as necessitating the action. The precipitating circumstance may be a problem circumstance which is portrayed as unfair, immoral, embarrassing, uncomfortable, or in some other way undesirable and/or intolerable. There is a shared assumption that the worse the problem, the more necessary it is to do something about it. In justifying, speakers use Extreme Case formulations to portray the circumstances that precipitated their actions as demanding their actions.A problem that participants have when engaged in, or reflecting on, conflicts, complaints, criticism, compliments, praise, etc. is to attribute the cause of the phenomenon. Who or what is responsible for the conflictual, complainable, praise-worthy state of affairs? One method that is used to determine what or who is responsible, i.e. to make an attribution, involves comparing the case in question to other similar cases. Through this procedure, persons determine that they are (are not) responsible for the state of affairsin questions. Extreme Case proportional formulations (‘everyone,’ ‘all,’ ‘every time’) are used to indicate that any individual member of that category is not responsible for the state of affairs; that responsibility is to be attributed elsewhere.The social order essentially is a moral order (Garfinkel, 1967). One of the ways of knowing what is acceptable and right is by finding out how people behave. There often is a shared assumption operating (one that is called into question on occasion): how people behave tells us what is the right way to behave. Proportional measures reporting the frequency or prevalence of practices are used to propose and substantiate the rightness and wrongness of those practices. Extreme Case formulations (‘all the time,’ ‘everybody,’ ‘no one’) propose behaviors are acceptable and right or unacceptable and wrong. (shrink)

The analysis in this article considers how dispatchers in a 911 wireless call center direct callers’ orientations from one possible trajectory of action to keeping the caller engaged and prepared to speak with a second dispatcher. We describe how dispatchers deploy two distinct actions, a directing action and an informing action, timed at a precise moment to execute successful transfers. The analysis presents largely unexplored features of the call transfer environment, including dispatchers’ management of callers’ expectations and how the transfer (...) phase contributes to a reshaping of the overall structural organization of a 911 call. (shrink)

Psychologists are ethically obligated to obtain informed consent to psychotherapy "as early as is feasible" (American Psychological Association, 2002, p. 1072). However, the range of topics to be addressed includes both information that may be immediately and uniformly applicable to most clients via policy or rule, as well as information that is not immediately presentable because it varies widely across clients or emerges over time. In this study, licensed psychologists were surveyed regarding the earliest feasible point at which they could (...) provide information regarding specific aspects of psychotherapy. Results indicate that, although psychologists believe that they are capable of presenting some information, such as payment and confidentiality policies, at the outset, they believe that a discussion of more substantive issues, such as psychotherapy duration, goals, orientation, and activities, can take place only after some therapy has transpired. Implications are discussed regarding the process and event models of informed consent. (shrink)

In the medieval Islamic world, eloquent expression was an important skill for statesmen to acquire, such that many of the leading viziers were often prominent belletrists. Among the most well known of these literary figures was the Būyid vizier Ibn ʿAbbād. Drawing from a wide range of historical and literary sources, this article compiles and corroborates the many accounts relating to Ibn ʿAbbād’s political career, beginning with his family background and early education as a scribe, to his experiences in the (...) Būyid courts of Baghdad, Iṣfahān, and Rayy and his two decades as vizier to the Būyids Muʾayyid al-Dawla and Fakhr al-Dawla in western Iran. (shrink)

In response to an article by Waring, Creider, Tarpey and Black, the author argues that the nature of the analytic aims of a research project determines whether or not participants’ reported goals and motives are relevant and useful. Her position is that for traditional conversation analytic studies aimed at explicating culturally shared methods for producing conversational actions and for interpreting interactional behavior, participants’ reports of their goals and motives are irrelevant. She differentiates between explanations based on participants’ reports of their (...) goals and motives and conversation analytic explanations consisting of preferences or principles to which members of a culture orient while interacting. (shrink)

La Pensée d’Ibn al-Muqaffaʿ: Un «agent double» dans le monde persan et arabe. By István T. Kristó-Nagy. Studia Arabica, vol. 19. Paris: Éditions de Paris, 2013. Pp. 605. €34.

Modal responses to items from a recent survey of independent practitioners regarding the impact of managed care on their practices and ethics were presented to participants as the responses of a hypothetical independent practitioner. Participants were asked to consider seeing this hypothetical practitioner both before and after being informed of the practitioner's responses to the managed care survey. Results indicate that when participants were informed of the practitioner's views toward managed care, their own attitudes toward therapy changed significantly. Specifically, compared (...) to uninformed participants, informed participants were significantly more likely to believe that managed care would have a negative impact on treatment and significantly less likely to see an independent practitioner, use insurance benefits, expect to benefit from treatment, expect to form a strong working relationship, and trust that the practitioner would work in their best interest. Implications regarding ethics and informed consent are discussed. (shrink)

Consequence is at the heart of logic, and an account of consequence offers a vital tool in the evaluation of arguments. This text presents what the authors term as 'logical pluralism' arguing that the notion of logical consequence doesn't pin down one deductive consequence relation; it allows for many of them.

Providing an original and systematic treatment of foundational issues in philosophy of religion, J. L. Schellenberg's new book addresses the structure of..

What happens when someone acts? A familiar answer goes like this. There is something that the agent wants, and there is an action that he believes conducive to its attainment. His desire for the end, and his belief in the action as a means, justify taking the action, and they jointly cause an intention to take it, which in turn causes the corresponding movements of the agent's body. I think that the standard story is flawed in several respects. The flaw (...) that will concern me in this paper is that the story fails to include an agent-or, more precisely, fails to cast the agent in his proper role. (shrink)

Abstract I argue that meaning in life is importantly influenced by bioloical ties. More specifically, I maintain that knowing one's relatives and especially one's parents provides a kind of self-knowledge that is of irreplaceable value in the life-task of identity formation. These claims lead me to the conclusion that it is immoral to create children with the intention that they be alienated from their bioloical relatives?for example, by donor conception.

Retributive theories of punishment argue that punishing a criminal for a crime she committed is sufficient reason for a justified and morally permissible punishment. But what about when the state gets lucky in its decision to punish? I argue that retributive theories of punishment are subject to “Gettier” style cases from epistemology. Such cases demonstrate that the state needs more than to just get lucky, and as these retributive theories of punishment stand, there is no anti-luck condition. I’ll argue that (...) Gettier-style cases demonstrate an impermissible instance of punishment, even though they meet the conditions of retributive theories of punishment. Retributive theories are, therefore, too weak. The safety condition from epistemology provides the anti-luck condition needed for permissible punishment. I argue that two forms of retributivism, rights-forfeiture and what I call standard retributivism, are both subject to Gettier-style cases. Unlike the literature on standards of proof, this paper argues that safety is a condition on punishment itself, i.e., in all nearby possible worlds, the accuser must correctly accuse the convicted for the crime they actually committed. (shrink)

Supervaluationism is often described as the most popular semantic treatment of indeterminacy. There’s little consensus, however, about how to fill out the bare-bones idea to include a characterization of logical consequence. The paper explores one methodology for choosing between the logics: pick a logic thatnorms beliefas classical consequence is standardly thought to do. The main focus of the paper considers a variant of standard supervaluational, on which we can characterizedegrees of determinacy. It applies the methodology above to focus ondegree logic. (...) This is developed first in a basic, single-premise case; and then extended to the multipremise case, and to allowdegreesof consequence. The metatheoretic properties of degree logic are set out. On the positive side, the logic is supraclassical—all classical valid sequents are degree logic valid. Strikingly, metarules such as cut and conjunction introduction fail. (shrink)

J.L. Schellenberg offers a path to a new kind of religious outlook. Reflection on our early stage in the evolutionary process leads to skepticism about religion, but also offers a new answer to the problem of faith and reason, and the possibility of a new, evolutionary form of religion.

v. 1. Nicomachean ethics. Politics. The Athenian Constitution. Rhetoric. On Poetics.--v. 2. Logic.--v. 3. Physics. Metaphysics. On the soul. Short physical treaties.--v. 4. On the heavens. On generation and corruption. Meteorology. Biological treatises.

The aim of this paper is to elaborate on the phenomenological approach to expertise as proposed by Dreyfus and Dreyfus and to give an account of the extent to which their approach may contribute to a better understanding of how athletes may use their cognitive capacities during high-level skill execution. Dreyfus and Dreyfus's non-representational view of experience-based expertise implies that, given enough relevant experience, the skill learner, when expert, will respond intuitively to immediate situations with no recourse to deliberate actions (...) or mental representations. The paper will subsequently outline some implications and consequences of such an approach and will also examine to what extent Dreyfus and Dreyfus's skill model is capable to resist different attacks that have been made against their view, and in particular regarding the practical application of their approach to the skill domain of competitive sport. (shrink)

This paper offers an alternate explanation of cases from the doxastic wronging literature. These cases violate what I call the degree of inquiry right—a novel account of zetetic obligations to inquire when interests are at stake. The degree of inquiry right is a moral right against other epistemic agents to inquire to a certain threshold when a belief undermines one’s interests. Thus, the agents are sometimes obligated to leave inquiry open. I argue that we have relevant interests in reputation, relationships, (...) and the well-being of our social groups. These interests generate obligations against others to “do their homework” before closing inquiry. This alternate account makes better sense of puzzles that accounts of doxastic wronging fall prey to. (shrink)

This volume provides discussions of both the concept of responsibility and of punishment, and of both individual and collective responsibility. It provides in-depth Socratic and Kantian bases for a new version of retributivism, and defends that version against the main criticisms that have been raised against retributivism in general. It includes chapters on criminal recidivism and capital punishment, as well as one on forgiveness, apology and punishment that is congruent with the basic precepts of the new retributivism defended therein. Finally, (...) chapters on corporate responsibility and punishment are included, with a closing chapter on holding the U.S. accountable for its most recent invasion and occupation of Iraq. The book is well-focused but also presents the widest ranging set of topics of any book of its kind as it demonstrates how the concepts of responsibility and punishment apply to some of the most important problems of our time. “This is one of the best books on punishment, and the Fourth Edition continues its tradition of excellence. The book connects punishment importantly to moral responsibility and desert, and it is comprehensive in its scope, both addressing abstract, theoretical issues and applied issues as well. The topics treated include collective responsibility, apology, forgiveness, capital punishment, and war crimes. Highly recommended.”—John Martin Fischer, Distinguished Professor of Philosophy, University of California, Riverside. (shrink)

A common objection to Sosa’s epistemology is that it countenances, in an objectionable way, unsafe knowledge. This objection, under closer inspection, turns out to be in far worse shape than Sosa’s critics have realised. Sosa and his defenders have offered two central response types to the idea that allowing unsafe knowledge is problematic: one response type adverts to the animal/reflective knowledge distinction that is characteristic of bi-level virtue epistemology. The other less-discussed response type appeals to the threat of dream scepticism, (...) and in particular, to the idea that many of our everyday perceptual beliefs are unsafe through the nearness of the dream possibility. The latter dreaming response to the safety objection to Sosa’s virtue epistemology has largely flown under the radar in contemporary discussions of safety and knowledge. We think that, suitably articulated in view of research in the philosophy and science of dreaming, it has much more going for it than has been appreciated. This paper further develops, beyond what Sosa does himself, the dreaming argument in response to those who think safety (as traditionally understood) is a condition on knowledge and who object to Sosa’s account on the grounds that it fails this condition. The payoffs of further developing this argument will be not only a better understanding of the importance of insights about dreaming against safety as a condition on knowledge, but also some reason to think a weaker safety condition, one that is relativised to SSS (i.e., skill/shape/situation) conditions for competence exercise, gets better results all things considered as an anti-luck codicil on knowledge. (shrink)