Ethics should guide the design of electronic health records (EHR), and recognized principles of bioethics can play an important role. This approach was adopted recently by a team of informaticists designing and testing a system where patients exert granular control over who views their personal health information. While this method of building ethics in from the start of the design process has significant benefits, questions remain about how useful the application of bioethics principles can be in this process, especially when (...) principles conflict. For instance, while the ethical principle of respect for autonomy supports a robust system of granular control, the principles of beneficence and non-maleficence counsel restraint due to the danger of patients being harmed by restrictions on provider access to data. Conflict between principles has long been recognized by ethicists and has even motivated attacks on approaches that state and apply principles. In this paper we show how using ethical principles can help in the design of EHRs by first, explaining how ethical principles can and should be used generally, and then by, discuss how attention to details in specific cases can show that the tension between principles is not as bad as it initially appeared. We conclude by suggesting further ways in which the application of these (and other) principles can add value to the ongoing discussion of patient involvement in their health care. This is a new approach to linking principles to informatics design that we expect will stimulate further interest. (shrink)

Backdating of stock options is an example of an agency problem. It has emerged despite all the measures (i.e., new regulations and additional corporate governance mechanisms) aimed at addressing such problems? Beyond such negative controlling measures, a more positive empowering approach based on ethics may also be necessary. What ethical measures need to be taken to address the agency problem? What values and norms should guide the board of directors in protecting the shareholders' interests? To examine these issues, we first (...) discuss the role values and norms can play with respect to underlying corporate governance and the proper role of directors, such as transparency, accountability, integrity (which is reflected in proper mechanisms of checks and balances), and public responsibility. Second, we discuss various stakeholder approaches (e.g., government, directors, managers, and shareholders) by which conflicts of interest (i.e., the agency problem) can be addressed. Third, we assess the practice of backdating stock options, as an illustration of the agency problem, in terms of whether the practice is legally acceptable or ethically justifiable. Fourth, we proceed to an analysis of good corporate governance practice involving backdating options based on a series of ethical standards including: (1) trustworthiness; (2) utilitarianism; (3) justice; and (4) Kantianism. We conclude that while executive compensation schemes (e. g., stock options) were originally intended to help remedy the agency problem by tying together the interests of the executives and shareholders, these schemes may have actually become "part of the problem," and that the solution ultimately depends upon whether directors and executives accept that all of their actions must be based on a set of core ethical values. (shrink)

Although there is a growing recognition that older adults and those with extensive comorbid conditions undergo cancer screening too frequently, there is little information about patients’ perceptions regarding cessation of cancer screening. Information on older adults’ views of screening cessation would be helpful both for clinicians and for those designing interventions to reduce overscreening.

On the True Sense of Art collects essays by philosophers responding to John Sallis's Transfigurements: On the True Sense of Art as well as his other works on the philosophy of art, including Force of Imagination and Logic of Imagination. Each of the chapters, by some of the leading thinkers in Continental philosophy, engages Sallis's work on both ancient and new senses of aesthetics--a transfiguration of aesthetics--as a beginning that is always beginning again. With a responsive essay by Sallis himself, (...) On the True Sense of Art forms a critical introduction to the thought of this generation's most important aesthetician. (shrink)

Most people do not know there are different kinds of medical studies; some are conducted on people who already have a disease or medical condition, and others are performed on healthy volunteers who want to help science find answers. No matter what sort of research you are invited to participate in, or whether you are a patient when you are asked, it’s entirely up to you whether or not to do it. This decision is important and may have many implications (...) for your health and well-being, as well as those of other patients now and in the future. Making a good decision – the right one for you – requires you to become educated about topics you may not have thought about before, some of which may be quite complicated. This chapter explains the key issues to help you make a good decision. (shrink)

This paper explores gender barriers to the formation of the female mentor – male protégé relationship. The authors consider both physiological as well as social gender as a way to help understand the scarcity of these relationships. A number of gender-related factors are considered, including organizational demographics, relational demography, sexual liaisons, gender stereotypes, gender behaviors, and power dynamics. The paper concludes with directions for future research that will help provide further insights into the development and success of the female mentor (...) – male protégé relationship. (shrink)

The value of a company’s ethical reputation has become a focal point for management researchers. We seek to join this conversation and extend the research centered on a firm’s ethical reputation. We accomplish this by shifting our focus away from its impact on external stakeholders to its impact on internal stakeholders. To this end, we rely on signaling theory to explain why a firm’s ethical reputation matters to its employees in an effort to bridge the macro–micro research gap. Across two (...) studies, we propose and demonstrate that a firm’s ethical reputation impacts employee subjective career success in form of career opportunities and work–life balance. Given our signaling theory framework, we also identify and explain when two industry-level characteristics operate as boundary conditions that distort a firm’s ethical reputation signaling properties. Specifically, the results demonstrate that a firm’s ethical reputation is positively related to employees’ perceptions of career opportunities and work–life balance. The results of our studies also demonstrate that the relatively high levels of industry competition and industry regulation weaken the positive impact of a firm’s ethical reputation on career opportunities and work–life balance. Theoretical and practical implications are discussed. (shrink)

One cue that may facilitate children's word learning is iconicity, or the correspondence between a word's form and meaning. Some have even proposed that iconicity in the early lexicon may serve to help children learn how to learn words, supporting the acquisition of even noniconic, or arbitrary, word–referent associations. However, this proposal remains untested. Here, we investigate the iconicity of caregivers’ speech to young children during a naturalistic free‐play session with novel stimuli and ask whether the iconicity of caregivers’ speech (...) facilitates children's learning of the noniconic novel names of those stimuli. Thirty‐four 1.5‐2‐year‐olds (19 girls; half monolingual English learners and half bilingual English‐Spanish learners) participated in a naturalistic free‐play task with their caregivers followed by a test of word‐referent retention. We found that caregivers’ use of iconicity, particularly in utterances in which they named the novel stimuli, was associated with the likelihood that children learned that novel name. This result held even when controlling for other factors associated with word learning, such as the concreteness and frequency of words in caregiver speech. Together, the results demonstrate that iconicity not only can serve to help children identify the referent of novel words (as in previous research) but can also support their ability to retain even noniconic word‐referent mappings. (shrink)

Objective: There are benefits and risks of giving patients more granular control of their personal health information in electronic health record (EHR) systems. When designing EHR systems and policies, informaticists and system developers must balance these benefits and risks. Ethical considerations should be an explicit part of this balancing. Our objective was to develop a structured ethics framework to accomplish this. -/- Methods: We reviewed existing literature on the ethical and policy issues, developed an ethics framework called a “Points to (...) Consider” (P2C) document, and convened a national expert panel to review and critique the P2C. -/- Results: We developed the P2C to aid informaticists designing an advanced query tool for an electronic health record (EHR) system in Indianapolis. The P2C consists of six questions (“Points”) that frame important ethical issues, apply accepted principles of bioethics and Fair Information Practices, comment on how questions might be answered, and address implications for patient care. -/- Discussion: The P2C is intended to clarify whatis at stake when designers try to accommodate potentially competing ethical commitments and logistical realities. The P2C was developed to guide informaticists who were designing a query tool in an existing EHR that would permit patient granular control. While consideration of ethical issues is coming to the forefront of medical informatics design and development practices, more reflection is needed to facilitate optimal collaboration between designers and ethicists. This report contributes to that discussion. (shrink)

When a caregiver names objects dominating a child’s view, the association between object and name is unambiguous and children are more likely to learn the object’s name. Children also learn to name things other than solid objects, including nonsolid substances like applesauce. However, it is unknown how caregivers structure linguistic and exploratory experiences with nonsolids to support learning. In this exploratory study of caregivers and children we compare caregiver-child free-play with novel solid objects and novel nonsolid substances to identify the (...) linguistic and exploratory experiences associated with children’s word learning. We found systematic differences in interactions with novel objects, such that children performed more manual actions on solids than nonsolids and caregivers named solids more than nonsolids. Additionally, there was less synchrony between caregivers’ naming and children’s manual and visual exploration of nonsolids than solids. Consistent with prior work, we found that synchronous naming was associated with accurate recognition of solid object names. However, naming synchrony was not associated with recognition of nonsolid substance names or with generalization. Together these findings, though exploratory, suggest the coordination of caregiver-child play can shape what children remember about novel word-object associations for solid objects, but not nonsolid substances. (shrink)

We use screams to explore ideas presented in the target article. Evolving first in animals as a response to predation, screams reveal more complex social use in nonhuman primates and, in humans, uniquely, are associated with a much greater variety of emotional contexts including fear, anger, surprise, and happiness. This expansion, and the potential for manipulation, promotes listener social vigilance.

The Continental tradition has always placed great emphasis on the Logos. The Gift of Logos: Essays in Continental Philosophy celebrates and situates this emphasis in the genre of the gift and its giving. The process of receiving, or giving, of the gift overcomes the existential alienation and separation that is so present in the human condition. To ritualize giving and its gifting is to provide a syntax of solidarity that bespeaks our desire for cohesion and need for identities beyond our (...) own. To give a gift is to befriend. The gift of logos is more than a gift from the gods and goddesses; it is an act of giving for those friends of wisdom for those philosophers who give to each other and to their worlds and receive the blessings of logos from each other. The increasing objectification of human being has mobilized a regressive narcissism that shows the ego's reassertion in the light of the meaningless quantifying forces from without. By not reflecting deeply enough upon its conditions of existence in the modern world and on its orginary moments, philosophy itself has not been immune from this besotted sense of self. Although not an invective against thinking nor against modern and contemporary philosophy's genuine advances, The Gift of Logos portends to shed the delusion that theoretical re-description is somehow the same as transforming who we are. This transformation is our greatest gift to each other. To give it voice is the gift of Logos and what this collection of essays commemorates. (shrink)

Both Jane Addams and John Dewey see human beings as ultimately creative in nature and as radically connected to each other. In this paper I look to these ideas to provide a theoretical model that is able to explain why we are able to extend our care to others outside of our intimate circle of family and friends, and to show us how we can purposefully move to the next higher level of moral reasoning.

Loving Justice, Living Shakespeare asks why love is regarded as the highest human value in some cultural sectorsDLreligion, literature and the artsDL and is not even on the map in othersDLphilosophy, law, and political thought. In the biblical vision, 'love the neighbor' is both the law and the just way to live. And yet, while religious thinkers cannot conceive of justice without love, for political philosophers, justice and love belong in completely different spheres, rational and public vs. emotional and private. (...) This book engages our dominant ideas of justice, including theories of contract, retribution and distribution, showing how they fall short if love is not included. Shakespeare emerges as its hero: part of his endurance is due to the many ways his plays stage how justice must be driven by loveDL no mere private passion, but a vital understanding of care for one another, care that a just world cannot do without. (shrink)

APPENDIX: The data emerging from the clinical and brain studies described above suggest that, in the case of OCD, there are two pertinent brain mechanisms that are distinguishable both in terms of neuro-dynamics and in terms of the conscious experiences that accompany them. These mechanisms can be characterized, on anatomical and perhaps evolutionary grounds, as a lower-level and a higher-level mechanism. The clinical treatment has, when successful, an activating effect on the higher-level mechanism, and a suppressive effect on the lower-level (...) one. (shrink)

Health care professionals who travel from their home countries to participate in humanitarian assistance or development work experience distinctive ethical challenges in providing care and services to populations affected by war, disaster or deprivation. Limited information is available about organizational practices related to preparation and support for health professionals working with non-governmental organizations. In this article, we present one component of the results of a qualitative study conducted with 20 Canadian health care professionals who participated in international aid work. The (...) findings reported here relate to expatriate clinicians’ experiences and perceptions of ethics preparation, training and support. The strategies examined include pre-departure training and preparation, in-field supports and retrospective debriefing of ethical issues. Participants experienced a range of training and supports as beneficial for addressing ethical challenges in humanitarian assistance and development work. Participants also expressed ambivalence or scepticism about the benefits offered by specific modalities. This analysis can contribute to informing discussions of how organizations and individual practitioners can best develop, implement and utilize ethics training and support for international aid work. (shrink)

What might a theory of mental imagery look like, and how might one begin formulating such a theory? These are the central questions addressed in the present paper. The first section outlines the general research direction taken here and provides an overview of the empirical foundations of our theory of image representation and processing. Four issues are considered in succession, and the relevant results of experiments are presented and discussed. The second section begins with a discussion of the proper form (...) for a cognitive theory, and the distinction between a theory and a model is developed. Following this, the present theory and computer simulation model are introduced. This theory specifies the nature of the internal representations (data structures) and the processes that operate on them when one generates, inspects, or transforms mental images. In the third, concluding, section we consider three very different kinds of objections to the present research program, one hinging on the possibility of experimental artifacts in the data, and the others turning on metatheoretical commitments about the form of a cognitive theory. Finally, we discuss how one ought best to evaluate theories and models of the sort developed here. (shrink)

Digital medicine is a medical treatment that combines technology with drug delivery. The promises of this combination are continuous and remote monitoring, better disease management, self-tracking, self-management of diseases, and improved treatment adherence. These devices pose ethical challenges for patients, providers, and the social practice of medicine. For patients, having both informed consent and a user agreement raises questions of understanding for autonomy and informed consent, therapeutic misconception, external influences on decision making, confidentiality and privacy, and device dependability. For providers, (...) digital medicine changes the relationship where trust can be verified, clinicians can be monitored, expectations must be managed, and new liability risks may be assumed. Other ethical questions include direct third-party monitoring of health treatment, affordability, and planning for adverse events in the case of device malfunction. This article seeks to lay out the ethical landscape for the implementation of such devices in patient care. (shrink)

A study was conducted in order to examine the relationship between corporate codes of ethics and behaviour. Fifty-seven interviews of employees, managers, and ethics officers were conducted at four large Canadian companies. The study found that codes of ethics are a potential factor influencing the behaviour of corporate agents. Reasons are provided why codes are violated as well as complied with. A set of eight metaphors are developed which help to explain how codes of ethics influence behaviour.

The data emerging from the clinical and brain studies described above suggest that, in the case of OCD, there are two pertinent brain mechanisms that are distinguishable both in terms of neuro dynamics and in terms of the conscious experiences that accompany them. These mechanisms can be characterized, on anatomical and perhaps evolutionary grounds, as a lower level and a higher level mechanism. The clinical treatment has, when successful, an activating effect on the higher level mechanism, and a suppressive effect (...) on the lower level one. (shrink)

_The Futures of School Reform_ represents the culminating work of a three-year discussion among national education leaders convened by the Harvard Graduate School of Education. Based on the recognition that current education reform efforts have reached their limits, the volume maps out a variety of bold visions that push the boundaries of our current thinking. Taken together, these visions identify the leverage points for generating dramatic change and highlight critical trade-offs among different courses of action. The goal of this book (...) is not to present a menu of options. Rather, it is to surface contrasting assumptions, tensions, constraints, and opportunities, so that together we can better understand—and act on—the choices that lie before us. (shrink)

Neuropsychological research on the neural basis of behaviour generally posits that brain mechanisms will ultimately suffice to explain all psychologically described phenomena. This assumption stems from the idea that the brain is made up entirely of material particles and fields, and that all causal mechanisms relevant to neuroscience can therefore be formulated solely in terms of properties of these elements. Thus, terms having intrinsic mentalistic and/or experiential content (e.g. ‘feeling’, ‘knowing’ and ‘effort’) are not included as primary causal factors. This (...) theoretical restriction is motivated primarily by ideas about the natural world that have been known to be fundamentally incorrect for more than three-quarters of a century. Contemporary basic physical theory differs profoundly from classic physics on the important matter of how the consciousness of human agents enters into the structure of empirical phenomena. The new principles contradict the older idea that local mechanical processes alone can account for the structure of all observed empirical data. Contemporary physical theory brings directly and irreducibly into the overall causal structure certain psychologically described choices made by human agents about how they will act. This key development in basic physical theory is applicable to neuroscience, and it provides neuroscientists and psychologists with an alternative conceptual framework for describing neural processes. Indeed, owing to certain structural features of ion channels critical to synaptic function, contemporary physical theory must in principle be used when analysing human brain dynamics. The new framework, unlike its classic-physics-based predecessor, is erected directly upon, and is compatible with, the prevailing principles of physics. It is able to represent more adequately than classic concepts the neuroplastic mechanisms relevant to the growing number of empirical studies of the capacity of directed attention and mental effort to systematically alter brain function.. (shrink)

Volume 20, Issue 7, July 2020, Page 150-152.

College students from small, medium, and large institutions with either a modified or no honor code were presented with cheating scenarios and asked to rate how dishonest they perceived the behavior to be and the likelihood that they would report it. No main effects were found for institution size or type of honor code. Student–faculty ratio was not correlated with responses to the cheating scenarios. Students from modified honor code schools perceived more severe punishments for cheating and understood the reporting (...) process better than students from non–honor code schools. Implications for modified honor code systems are discussed. (shrink)