In 15 insightful essays, Jacques Derrida and an international group of scholars of religion explore postmodern thinking about God and consider the nature of forgiveness in relation to the paradoxes of the gift. Among the themes addressed by contributors are the possibilities of imagining God as unthinkable, imagining God as non-patriarchal, imagining a return to Augustine, and imagining an age in which praise is far more important than narrative. Questioning God moves readers beyond the parameters of metaphysical reason and modernist (...) rationality as it attempts to think the questions of God and forgiveness in a postmodernist context. Contributors include John D. Caputo, Jacques Derrida, Mark Dooley, Francis Schüssler Fiorenza, Robert Gibbs, Jean Greisch, Kevin Hart, Richard Kearney, Cleo McNelly Kearns, John Milbank, Regina M. Schwartz, Michael J. Scanlon, and Graham Ward. Indiana Series in the Philosophy of Religion—Merold Westphal, general editor. (shrink)

Research has shown that adults can engage in cognitive offloading, whereby internal processes are offloaded onto the environment to help task performance. Here, we investigate an application of this approach with children, in particular children with poor working memory. Participants were required to remember and recall sequences of colors by placing colored blocks in the correct serial order. In one condition the blocks were arranged to facilitate cognitive offloading (i.e., grouped by color), whereas in the other condition they were arranged (...) randomly. Across two experiments (total N = 166) the ordered condition improved task performance for children with low working memory ability. In addition, participants in Experiment 2 rated the difficulty of the two arrangements and performed a further condition in which they were given an opportunity to freely arrange the blocks before completing the task. Despite performing better in the ordered condition, children with low working memory ability did not rate the ordered arrangement as easier, nor did they choose an ordered arrangement when given the opportunity to do so. This research shows that cognitive offloading can also be a useful process in populations other than typical adults, and the implications of this work for supporting children with poor working memory are discussed. (shrink)

The literature on affective determinants of physical activity is growing rapidly. The present paper aims to provide greater clarity regarding the definition and distinctions among the various affect-related constructs that have been examined in relation to PA. Affective constructs are organized according to the Affect and Health Behavior Framework, including: affective response to PA; incidental affect; affect processing; and affectively charged motivational states. After defining each category of affective construct, we provide examples of relevant research showing how each construct may (...) relate to PA behavior. We conclude each section with a discussion of future directions for research. (shrink)

Drawing on a landscape analysis of existing data-sharing initiatives, in-depth interviews with expert stakeholders, and public deliberations with community advisory panels across the U.S., we describe features of the evolving medical information commons. We identify participant-centricity and trustworthiness as the most important features of an MIC and discuss the implications for those seeking to create a sustainable, useful, and widely available collection of linked resources for research and other purposes.

Emotion Review, Volume 14, Issue 2, Page 132-160, April 2022. Autonomic nervous system activity is a fundamental component of emotional responding. It is not clear, however, whether positive emotional states are associated with differential ANS reactivity. To address this issue, we conducted a meta-analytic review of 120 articles, measuring ANS activity during 11 elicited positive emotions, namely amusement, attachment love, awe, contentment, craving, excitement, gratitude, joy, nurturant love, pride, and sexual desire. We identified a widely dispersed collection of studies. Univariate (...) results indicated that positive emotions produce no or weak and highly variable increases in ANS reactivity. However, the limitations of work to date – which we discuss – mean that our conclusions should be treated as empirically grounded hypotheses that future research should validate. (shrink)

Dolphins exhibit both action-level imitation (ALI) and program-level imitation (PLI). Dolphins may use ALI primarily for social cohesion, whereas PLI seems more likely to occur in goal-directed, problem-solving contexts. Both PLI and insightful problem solving require a recognition of the functional relations between actions and outcomes. Insightful problem solving, however, involves the creation of a program in the absence of a model, and therefore requires a higher order appreciation and application of the relations between actions and outcomes.

The undoing hypothesis proposes that positive emotions serve to undo sympathetic arousal related to negative emotions and stress. However, a recent qualitative review challenged the undoing effect by presenting conflicting results. To address this issue quantitatively, we conducted a meta-analytic review of 16 studies ( N = 1,220; 72 effect sizes) measuring sympathetic recovery during elicited positive emotions and neutral conditions. Findings indicated that in most cases, positive emotions did not speed sympathetic recovery compared to neutral conditions. However, when a (...) composite index of cardiovascular reactivity was used, undoing effects were evident. Our findings suggest the need for further work on the functions of positive emotions. (shrink)

Presumably it is common ground that this verb has in addition to the basic sense ‘recognize’ the derivative sense ‘oread’, and that one must judge from the context whether reading to one or more other people, or private reading, is meant. The reading of the text of a law to a jury at an orator's request is marked by the circumstances themselves as public reading; so is the reading of the Athenian decree to the Mitylenaeans in Thucydides. When Theaetetus answers (...) in the affirmative the question whether he has read the book of Protagoras which contains the statement that man is the measure of all things (); or when it is asked ‘Why is it that some people, if they begin to read, are overcome by sleep even against their will, whereas others wishing to be overcome by sleep are kept awake by taking up a book?’ Evidently what is intended is reading in the privacy of one's own room. When Socrates in the Phaedo says that he heard a person reading from Anaxagoras and eagerly took the book home to read , both senses are found within a few pages. (shrink)

Presumably it is common ground that this verb has in addition to the basic sense ‘recognize’ the derivative sense ‘oread’, and that one must judge from the context whether reading to one or more other people, or private reading, is meant. The reading of the text of a law to a jury at an orator's request is marked by the circumstances themselves as public reading; so is the reading of the Athenian decree to the Mitylenaeans in Thucydides. When Theaetetus answers (...) in the affirmative the question whether he has read the book of Protagoras which contains the statement that man is the measure of all things (); or when it is asked ‘Why is it that some people, if they begin to read, are overcome by sleep even against their will, whereas others wishing to be overcome by sleep are kept awake by taking up a book?’ Evidently what is intended is reading in the privacy of one's own room. When Socrates in the Phaedo says that he heard a person reading from Anaxagoras and eagerly took the book home to read, both senses are found within a few pages. (shrink)

I argue that there is a flaw in the way that response-dependence has been formulated in the literature, and this flawed formulation has been correctly attacked by Mark Johnston’s Missing Explanation Argument (1993, 1998). Moving to a better formulation, which is analogous to the move from behaviourism to functionalism, avoids the Missing Explanation Argument.

Humans think and communicate in very flexible and schematic ways, and a Spatial Data Infrastructure (SDI) for the Amazon and associated information system ontologies should reflect this flexibility and the adaptive nature of human cognition in order to achieve semantic interoperability. In this paper I offer a conceptual investigation of SDI and explore the nature of cultural schemas as expressions of indigenous ontologies and the challenges of semantic interoperability across cultures. Cultural schemas are, in essence, our ontologies, but they are (...) markedly different than classical formal ontologies. They shape our ontological commitments to what exists in the world as well as the ways in which we approach and engage the world. And while they help structure our understanding of the world in which we are embedded, they are associative and flexible. They help to focus our attention to particular details of our experiences and give them salience, yet they cannot be simply reduced to a series of extracted features. They allow us to make meaning of the contextualized, cultural experience in which we are always immersed. An SDI is a shared social-technological-informational structure that, if it is to be useful and successful for sustainability in the Amazon, must incorporate and use indigenous cultural schemas. Indigenous communities must have the ability to contribute to the collection of geospatial data and their contributions recognized as legitimate forms of knowledge. In order for the SDI to work, it must recognize the larger cultural landscape to which cultural schemas can connect to the ready-to-hand elements of salient cultural experiences. (shrink)

Marsh borrows Richard McKeon's methodological notion of the "problematic" approach to intellectual history. Concentrating on their dialectical character, English criticism from 1650-1800 is explored in the writings of the third Earl of Shaftesbury, Mark Akenside, David Hartley, and James Harris.—D. J. B.

This is a splendid study for anyone interested in the minutiae of the authorship and sources of John's Gospel. Bultmann argued for five sources: 1) revelation discourses used in the prologue and elsewhere; 2) a semeia or sign source for the miracle stories; 3) a source underlying the Johannine passion narrative but also incorporating elements of the resurrection tradition; 4) the ecclesiastical redactor who added material and gave the gospel its traditional order; 5) the work of the evangelist himself. Smith (...) scrupulously develops Bultmann's own position and summarizes all of the scholarly reaction and controversy on each point. Smith concludes that while Bultmann's contentions are brilliant and important, they are highly debatable and often relatively untenable. Smith, in contrast, weakly suggests that John's Gospel may have "been left to us in an unfinished state" and ends by wondering whether Bultmann has not overstepped the genuine theological mark by so much rearranging.—D. J. B. (shrink)

During periods of scarcity, or the fear of it, many health systems create or adopt triage protocols to determine how to best allocate limited resources. Interest in such protocols has become acute...

This is a splendid study for anyone interested in the minutiae of the authorship and sources of John's Gospel. Bultmann argued for five sources: 1) revelation discourses used in the prologue and elsewhere; 2) a semeia or sign source for the miracle stories; 3) a source underlying the Johannine passion narrative but also incorporating elements of the resurrection tradition; 4) the ecclesiastical redactor who added material and gave the gospel its traditional order; 5) the work of the evangelist himself. Smith (...) scrupulously develops Bultmann's own position and summarizes all of the scholarly reaction and controversy on each point. Smith concludes that while Bultmann's contentions are brilliant and important, they are highly debatable and often relatively untenable. Smith, in contrast, weakly suggests that John's Gospel may have "been left to us in an unfinished state" and ends by wondering whether Bultmann has not overstepped the genuine theological mark by so much rearranging.—D. J. B. (shrink)

The American Institute of Certified Public Accountants monitors the misconduct of its members using the AICPA Code of Professional Conduct. To accomplish this task, the AICPA relies on various stakeholders to report known violations of its CPC. We examine the full population of sanctions imposed by the AICPA on its members under its CPC from 2008–2013 to identify recent trends in the misconduct of accounting professionals. While we find that multiple stakeholders identify and report violations, we also find that the (...) most common types of violations remain consistent with those reported in the 1990s. Further, we develop a taxonomy based on prior accounting literature to determine whether the AICPA CPC is being enforced to defend the public interest and/or the private interests of the accounting profession. In contrast to prior studies, our results suggest that as the accounting profession emerges from a recession and period of intense public scrutiny, the AICPA CPC is largely being enforced to defend the public interest. This public interest focus was most pronounced during the recessionary years of 2008–2010, as evident from misconduct reported by parties such as the Internal Revenue Service, Securities and Exchange Commission, Public Company Accounting Oversight Board, and state boards of accountancy. Although key stakeholders have recently focused on reporting misconduct that threatens the public interest, we believe there are still areas in need of improvement, especially around the level of detail provided in the AICPA’s sanction records. We propose some possible solutions to improve public transparency. (shrink)

Mandating psychiatric evaluation for patients who request physician‐assisted suicide may not offer the clearcut protection from possible coercion or other abuse that proponents assert. Competence itself is a complex concept and determinations of decisionmaking capacity are not straightforward, nor is the relationship between mental illness and decisionmaking capacity in dying patients clearly understood. And casting psychiatrists as gatekeepers in end‐of‐life decisions poses risks to the profession itself.

Marsh borrows Richard McKeon's methodological notion of the "problematic" approach to intellectual history. Concentrating on their dialectical character, English criticism from 1650-1800 is explored in the writings of the third Earl of Shaftesbury, Mark Akenside, David Hartley, and James Harris.—D. J. B.

A study was undertaken of the views of users of two genitourinary medicine (GUM) clinics in England on unlinked anonymous testing (UAT) for HIV. The UAT programme measures the prevalence of HIV in the population, including undiagnosed prevalence, by testing residual blood (from samples taken for clinical purposes) which is anonymised and irreversibly unlinked from the source. 424 clinic users completed an anonymous questionnaire about their knowledge of, and attitudes towards, UAT. Only 1/7 (14%) were aware that blood left over (...) from clinical testing may be tested anonymously for HIV. A large majority (89%) said they would agree to their blood being tested, although 74% wanted the opportunity to consent. These findings indicate broad support for UAT of blood in a group of patients whose samples are included in the HIV surveillance programme. The findings suggest the need for greater attention to be given to the provision of information and, if replicated in a larger survey, may justify a reappraisal of UK policy on UAT. (shrink)

We perceive color everywhere and on everything that we encounter in daily life. Color science has progressed to the point where a great deal is known about the mechanics, evolution, and development of color vision, but less is known about the relation between color vision and psychology. However, color psychology is now a burgeoning, exciting area and this Handbook provides comprehensive coverage of emerging theory and research. Top scholars in the field provide rigorous overviews of work on color categorization, color (...) symbolism and association, color preference, reciprocal relations between color perception and psychological functioning, and variations and deficiencies in color perception. The Handbook of Color Psychology seeks to facilitate cross-fertilization among researchers, both within and across disciplines and areas of research, and is an essential resource for anyone interested in color psychology in both theoretical and applied areas of study. (shrink)

Coral bleaching has impacted reefs worldwide and the predictions of near‐annual bleaching from over two decades ago have now been realized. While technology currently provides the means to predict large‐scale bleaching, predicting reef‐scale and within‐reef patterns in real‐time for all reef users is limited. In 2020, heat stress across the Great Barrier Reef underpinned the region's third bleaching event in 5 years. Here we review the heterogeneous emergence of bleaching across Heron Island reef habitats and discuss the oceanographic drivers that (...) underpinned variable bleaching emergence. We do so as a case study to highlight how reef end‐user groups who engage with coral reefs in different ways require targeted guidance for how, and when, to alter their use of coral reefs in response to bleaching events. Our case study of coral bleaching emergence demonstrates how within‐reef scale nowcasting of coral bleaching could aid the development of accessible and equitable bleaching response strategies on coral reefs. Also see the video abstract here: https://youtu.be/N9Tgb8N-vN0. (shrink)

Although workplace bullying is common and has universally harmful effects on employees’ outcomes, little is known about workplace bullies. To address this gap in knowledge, we draw from the tenets of social exchange and displaced aggression theories in order to develop and test a model of workplace bullying that incorporates the effects of employees’ individual differences, perceptions of their work environments, and perceptions of supervisory treatment on their tendencies to bully coworkers. The results of mediated moderation analyses that examine responses (...) from two samples of working adults support our hypotheses. Specifically, we find evidence of an indirect relationship between entitlement and coworker bullying through perceptions of abusive supervision that is stronger for employees who report lower levels of felt accountability than employees who report higher levels of felt accountability. This study makes important theoretical and practical contributions to abusive supervision research, bullying research, and organizational efforts to promote ethical work environments devoid of interpersonal mistreatment by providing novel insight into how employees’ entitlement and felt accountability combine to influence their tendencies to perceive themselves as victims of abusive supervision and culprits of coworker bullying. (shrink)

In response to recent calls to extend the underlying theories used in the literature :375–413, 2005; Craft in J Bus Ethics 117:221–259, 2013), we review the usefulness of social norm theory in empirical business ethics research. We begin by identifying the seeds of social norm theory in Adam Smith’s The Theory of Moral Sentiments, the Glasgow Edition, Oxford University Press, Oxford, 1759/1790) seminal work, The Theory of Moral Sentiments. Next, we introduce recent theory in social norm activation by Bicchieri and (...) compare the new theory to two theoretical frameworks found in the literature: Kohlberg’s Handbook of socialization theory and research, Rand McNally, Chicago, IL, 1969; in: Lickona Moral development and behavior, Holt, Rinehart & Winston, New York, 1976) theory of moral development and Cialdini and Trost’s The handbook of social psychology, Oxford University Press, Boston, 1998) taxonomy of social norms. We argue that the new theory provides useful insights by emphasizing the ability of situational cues and information to generate common expectations for social/moral norms. The theory is particularly useful for empirical research in business ethics because it gives both organizational and individual factors a role in motivating norm-based behavior. To demonstrate this usefulness, we present examples where the theory has been effectively applied in experimental accounting research to generate new insights. We conclude by citing specific examples where the theory may prove useful in empirical business ethics research. (shrink)

The proliferation of personal data collection practices fundamentally reshapes how society is ordered and commercialized, and demands reconsideration of the possibilities for a just and equitable s...

We assert that audit quality can be improved to the extent that social norms for honesty and responsibility are activated in the auditor. To test this assertion, we use an experimental audit market setting found in the literature and manipulate factors expected to activate honesty and responsibility norms in the auditor. We find that auditor misreporting is reduced when the investor is another participant in the experiment rather than computer simulated, and thus, the interests of third-party investors are salient to (...) the auditor. We also find that auditor misreporting is reduced when the auditor is required to sign-off on the audit report, but only when the investor is another participant in the experiment. Consistent with our underlying theory, we find that pre-experimental measures of sensitivity to honesty and responsibility norms help explain the effects of our manipulated variables. Finally, we find that these measures of social norm sensitivity are associated with the moral judgment that auditor misreporting is unethical. Our study helps explain previous anomalous findings in the literature and answers the call in Blay et al. (J Bus Ethics 2017. doi:10.1007/s10551-016-3286-4) for empirical researchers to use social norm theory to develop stronger tests of moral reasoning in the market for auditing services. (shrink)

Understanding individual differences in cognitive performance is an important part of understanding how variations in underlying cognitive processes can result in variations in task performance. However, the exploration of individual differences in the components of the decision process—such as cognitive processing speed, response caution, and motor execution speed—in previous research has been limited. Here, we assess the heritability of the components of the decision process, with heritability having been a common aspect of individual differences research within other areas of cognition. (...) Importantly, a limitation of previous work on cognitive heritability is the underlying assumption that variability in response times solely reflects variability in the speed of cognitive processing. This assumption has been problematic in other domains, due to the confounding effects of caution and motor execution speed on observed response times. We extend a cognitive model of decision‐making to account for relatedness structure in a twin study paradigm. This approach can separately quantify different contributions to the heritability of response time. Using data from the Human Connectome Project, we find strong evidence for the heritability of response caution, and more ambiguous evidence for the heritability of cognitive processing speed and motor execution speed. Our study suggests that the assumption made in previous studies—that the heritability of cognitive ability is based on cognitive processing speed—may be incorrect. More generally, our methodology provides a useful avenue for future research in complex data that aims to analyze cognitive traits across different sources of related data, whether the relation is between people, tasks, experimental phases, or methods of measurement. (shrink)

We assert that audit quality can be improved to the extent that social norms for honesty and responsibility are activated in the auditor. To test this assertion, we use an experimental audit market setting found in the literature and manipulate factors expected to activate honesty and responsibility norms in the auditor. We find that auditor misreporting is reduced when the investor is another participant in the experiment rather than computer simulated, and thus, the interests of third-party investors are salient to (...) the auditor. We also find that auditor misreporting is reduced when the auditor is required to sign-off on the audit report, but only when the investor is another participant in the experiment. Consistent with our underlying theory, we find that pre-experimental measures of sensitivity to honesty and responsibility norms help explain the effects of our manipulated variables. Finally, we find that these measures of social norm sensitivity are associated with the moral judgment that auditor misreporting is unethical. Our study helps explain previous anomalous findings in the literature and answers the call in Blay et al. for empirical researchers to use social norm theory to develop stronger tests of moral reasoning in the market for auditing services. (shrink)

In the age of surveillance capitalism, the prevailing business model underlying the use of social media applications (“apps”) foresees the exchange of personal data for the allowance to use an online service. Such a data business model comes with many potential negative side effects ranging from violation of privacy issues to election manipulation. Therefore, it is of utmost importance to think of alternatives to the current data business model. The present study investigated how strong the support would be for a (...) monetary payment model among a sample of 210 participants. Participants were asked about their willingness to pay for social media, if in turn their data would be private and other problems concerning social media use would be tackled. Only one-fifth of participants (21.43%) supported such a model. From the Big Five Personality traits, Agreeableness was positively associated with support of such a model. Finally, data are also provided on how much participants would be willing to pay for social media on a monthly basis. The present study’s findings are of a preliminary nature and will contribute to the start of an important discussion. (shrink)

BackgroundCentral to ethically justified clinical trial design is the need for an informed consent process responsive to how potential subjects actually comprehend study participation, especially study goals, risks, and potential benefits. This will be particularly challenging when studying deep brain stimulation and whether it impedes symptom progression in Parkinson’s disease, since potential subjects will be Parkinson’s patients for whom deep brain stimulation will likely have therapeutic value in the future as their disease progresses.MethodAs part of an expanded informed consent process (...) for a pilot Phase I study of deep brain stimulation in early stage Parkinson’s disease, an ethics questionnaire composed of 13 open-ended questions was distributed to potential subjects. The questionnaire was designed to guide potential subjects in thinking about their potential participation.ResultsWhile the purpose of the study (safety and tolerability) was extensively presented during the informed consent process, in returned responses 70 percent focused on effectiveness and 91 percent included personal benefit as potential benefit from enrolling. However, 91 percent also indicated helping other Parkinson’s patients as motivation when considering whether or not to enroll.ConclusionsThis combination of responses highlights two issues to which investigators need to pay close attention in future trial designs: (1) how, and in what ways, informed consent processes reinforce potential subjects’ preconceived understandings of benefit, and (2) that potential subjects see themselves as part of a community of Parkinson’s sufferers with responsibilities extending beyond self-interest. More importantly, it invites speculation that a different paradigm for informed consent may be needed. (shrink)

A recent American Academy of Pediatrics (AAP) clinical report states that it is an acceptable option for pediatric care clinicians to dismiss families who refuse vaccines. This is a clear shift in guidance from the AAP, which previously advised clinicians to “endeavor not to discharge” patients solely because of parental vaccine refusal. While this new policy might be interpreted as encouraging or recommending dismissal of vaccine-refusing families, it instead expresses tolerance for diverse professional approaches. This is unlike the earlier guidance, (...) which promoted a unified response to vaccine refusal. In fact, the resolution (which was presented at the AAP’s Annual Leadership Forum) that led to this clinical report also calls on the AAP “to continue to support pediatricians who continue to provide health care to children of parents who refuse to immunize their children.” However, the shift toward embracing dismissal as an acceptable response to vaccine refusal may erode professional solidarity. Pediatricians are clearly divided on this question; most do not dismiss vaccine-refusing families. By declaring that dismissal is an acceptable option, the AAP has sanctioned a practice that may be unfair to the many clinicians who do not dismiss these families. Clinicians who adopt a policy of dismissal toward families who refuse vaccines might impose burdens on colleagues who remain willing to offer care to those families, and their actions might show insufficient commitment to the efforts of their profession to promote health for all children. (shrink)

Despite the prevalence of beliefs across religions regarding repentance and divine forgiveness and their recognition in theoretical and religious studies, these constructs are relatively understudied phenomena in the social sciences. Furthermore, in recent years, multiple scholars have argued for the need for research to systematically study and highlight the experience and processes of repentance and divine forgiveness. Subsequently, this study explored processes of repentance, antecedents and motivations of repentance, resources to aid in repentance, and outcomes of repentance that should be (...) further examined. This analysis was done using in-depth qualitative interviews with 15 emerging adult religious exemplars identifying with the Church of Jesus Christ of Latter-day Saints. The authors used NVivo 12 and team-based qualitative coding processes to identify themes. Repentance processes included personal change, took various lengths of time, were a part of participants’ religious identity, were recurrent processes, and were influenced by participants’ view of God. Antecedents and motivations included religious practices and rituals, emotions, interpersonal interactions, and their relationship with God. Resources that aided in repentance included religious practices and rituals, interpersonal relationships, and a relationship with God. Finally, participants reported experiencing personal changes in their behavior and character, positive emotions (including feelings of divine forgiveness), improved interpersonal relationships, and a better relationship with God. These processes align with some previously discovered and theorized findings on repentance, contribute a number of novel findings, and offer future direction regarding the motivations, resources, and transformative experiences that participants reported in their personal repentance and experience of forgiveness. (shrink)

Liver transplantation is the treatment of choice for many forms of liver disease. Unfortunately, the scarcity of cadaveric donor livers limits the availability of this technique. To improve the availability of liver transplantation, surgeons have developed the capability of removing a portion of liver from a live donor and transplanting it into a recipient. A few liver transplants using living donors have been performed worldwide.Our purpose was to analyze the ethics of liver transplants using living donors and to propose guidelines (...) for the procedure before it was introduced in the United States. We used a process of research ethics consultation that involves a collaboration between clinical investigators and clinical ethicists. We concluded that it was ethically appropriate to perform liver transplantation using living donors in a small series of patients on a trial basis, and we published our ethical guidelines in a medical journal before the procedure was introduced. We recommend this prospective, public approach for the introduction of other innovative therapies in medicine and surgery. (shrink)

Subcortical substrates for behavioural integration include the fore/midbrain nuclei of the basal ganglia and the hindbrain medial reticular formation. The midbrain superior colliculus requires basal ganglia disinhibition in order to generate orienting movements. The colliculus should therefore be seen as one of many competitors vying for control of the body's effector systems with the basal ganglia acting as the key arbiter. (Published Online May 1 2007).

Marshall and O’Leary’s thoughtful response to our article suggests that dismissal policies are ethically justifiable because they might induce parents to immunize their children. This outcome is conceivable, but we have only anecdotes about how often it occurs. Such evidence became the thin reed on which the American Academy of Pediatrics rested its new policy of tolerating the practice of dismissing vaccine-hesitant parents. It seems likely that relatively few parents would agree to vaccinate because they were threatened with dismissal. Other (...) heavy-handed interventions have failed to move most such parents. When Washington state made nonmedical exemptions more difficult to obtain, nearly two-thirds of vaccine refusers were unmoved and their children remained unvaccinated. Even if dismissal threats led some parents to accept vaccines, this alone would not justify a dismissal policy. The benefits would still have to be weighed against the risks of dismissing those families who do not change their minds. (shrink)