Notwithstanding the question of whether abortion is generally or exceptionally a legitimate means of family planning, it is basically agreed that abortion is not justifiable without free and informed consent of the pregnant woman. However, if abortion is held by the legislature to be a ground of justification (i.e., a far-reaching exception to criminal liability), is it true that abortion may also be carried out for the benefit of a pregnant woman who is not able to give free and informed (...) consent? Should a substituted-judgment approach be applied in cases where the woman is incompetent to decide? Or should the pregnant womans relatives interests be taken into account exclusively? The author tries to answer these questions, which were tackled by the Austrian Supreme Court in a recent case. (shrink)
It is argued that philosophers can contribute indirectly to the cure of psychopathology by helping to resolve problems that impede the development of effective treatments. Two such problems are discussed. The first arises because different schools of therapy use conflicting criteria in evaluating therapeutic outcomes. A theory of Defective Desires is developed to deal with this problem. The second issue, which divides the field of psychotherapy, concerns the need for experiments, especially in validating claims of therapeutic efficacy. An epistemological foundation (...) is developed to support the need for experiments. (shrink)
The application of neuroimaging technology to the study of the injured brain has transformed how neuroscientists understand disorders of consciousness, such as the vegetative and minimally conscious states, and deepened our understanding of mechanisms of recovery. This scientific progress, and its potential clinical translation, provides an opportunity for ethical reflection. It was against this scientific backdrop that we convened a conference of leading investigators in neuroimaging, disorders of consciousness and neuroethics. Our goal was to develop an ethical frame to move (...) these investigative techniques into mature clinical tools. This paper presents the recommendations and analysis of a Working Meeting on Ethics, Neuroimaging and Limited States of Consciousness held at Stanford University during June 2007. It represents an interdisciplinary approach to the challenges posed by the emerging use of neuroimaging technologies to describe and characterize disorders of consciousness. (shrink)
Some psychologists have recently tried to develop new approaches to psychology incompatible with both natural-science views of the discipline and basic tenets of postmodernism. In her new book on psychology’s interpretative turn, Barbara Held refers to these thinkers as "middleground theorists" or MGTs. Most of the MGTs reject psychological laws, defend free choice and agency, stress the role of values in psychological inquiry, and argue for a hermeneutical methodology. Some reject scientific realism and embrace epistemological relativism. Both Held and I (...) express doubts about some of these views. (shrink)
In this commentary, I agree with Chow's treatment of null hypothesis significance testing as a noninferential procedure. However, I dispute his reconstruction of the logic of theory corroboration. I also challenge recent criticisms of NHSTP based on power analysis and meta-analysis.
tries to elucidate some of the rational considerations that determine the standing and value of psychoanalysis. He is sceptical about much of the positive evidence, but he also tries to provide some support for Freudian doctrines. I examine his supporting arguments and try to show that they have serious weaknesses.
In the care of patients with disorders of consciousness (DOC), some ethical difficulties stem from the challenges of accurate diagnosis and the uncertainty of prognosis. Current neuroimaging research on these disorders could eventually improve the accuracy of diagnoses and prognoses and therefore change the context of end-of-life decision making. However, the perspective of healthcare professionals on these disorders remains poorly understood and may constitute an obstacle to the integration of research. We conducted a qualitative study involving healthcare professionals from an (...) acute care university medical center. A short questionnaire captured demographic data as well as the experience of participants with DOC patients. A semi-structured interview was used to explore attitudes toward ethical issues identified in a previous literature review. Qualitative content analysis of interviews was conducted with the NVivo software. Accurate diagnosis among DOC is often regarded as a challenge, but this was generally not the case for our participants because most reported high confidence in DOC diagnoses. However, participants reported struggling with prognosis, especially because of its essential role for end-of-life decision making and communication with families. Variability of opinion between healthcare professionals was reported and identified by some as a minor issue while others stressed how families struggle with different medical opinions. End-of-life decision making encompassed a large proportion of ethical challenges in these patients, and the removal of artificial nutrition and hydration created significant discomfort in a minority of participants. The concept of futility was subject to wide-ranging understandings with both favorable and unfavorable opinions. Our data suggest that to ensure the incorporation of new evidence-based advances, attention should be directed to the real-world practices and challenges of accurate diagnosis and prognosis. Given pervasive challenges in end-of-life care, we recommend improved training of healthcare professionals in the care of patients with DOC, particularly in end-of life care, understanding the context of decision making, and determining how to optimally integrate new neuroscience research on the care of patients with DOC. (shrink)
The distribution of organisms in morphologic space is clumpy. Cats are like felids, dogs are like canids and snails are (mostly) like gastropods. But cats are not like dogs and snails are not like clams. This clumpy distribution of morphology has long posed one of the greatest challenges to evolutionary biologists. Does it represent the extinction and disappearance of a oncecontinuous distribution of morphologies, clades perched on the summits of persistent selective peaks ala Sewell Wright, or a primary signature of (...) the evolutionary processes? And if the latter, what processes are responsible for generating it? Although often couched in discussions of the origin of higher taxa, such taxa are but proxies for this clumpy distribution, and ultimately the latter is the critical issue for macroevolution and for Stephen Jay Gould’s opus. Underneath all the controversies over whether species constitute individuals, whether speciation serves to divide intra-speciﬁc adaptation driven by natural selection from a set of inter- and supra-speciﬁc evolutionary processes, and over the impact of catastrophic mass extinctions on evolutionary trends, the fundamental issue is simply one of clumpiness (or, if you prefer, the inhomogeneous distribution of morphologies). Iurii Filipchenko, a Russian geneticist and the mentor of Theodosius Dobzhansky, introduced the term macroevolution in 1927 because he believed that the origin of the characters associated with higher taxa (those beyond the species level) required a different process of evolution. Filipchenko believed macroevolution was driven by cytoplasmic inheritance, but his general argument was consistent with other saltationists and macro-mutationists of the time, including the paleontologist Henry Fairﬁeld Osborne and the geneticist Richard Goldschmidt. These evolutionary biologists shared the.. (shrink)
The distinction between the "permanent" (will not reverse) and "irreversible" (cannot reverse) cessation of functions is critical to understand the meaning of a determination of death using circulatory–respiratory tests. Physicians determining death test only for the permanent cessation of circulation and respiration because they know that irreversible cessation follows rapidly and inevitably once circulation no longer will restore itself spontaneously and will not be restored medically. Although most statutes of death stipulate irreversible cessation of circulatory and respiratory functions, the accepted (...) medical standard is their permanent cessation because permanence is a perfect surrogate indicator for irreversibility, and using it permits a more timely declaration. Therefore, patients properly declared dead in donation after circulatory death (DCD) protocols satisfy the requirements of death statutes and do not violate the dead donor rule. The acronym DCD should represent organ "donation after circulatory death" to clarify that the death standard is the permanent cessation of circulation, not heartbeat. Heart donation in DCD does not retroactively negate the donor's death determination because circulation has ceased permanently. (shrink)
Dr. Lacewing’s paper is a very interesting one. We agree in part, but only in part. Lacewing (2012) rejects the general thesis that “causal inferences must always be justified on the basis of Mill’s canons” (p. 199). I agree, but so does his target, Adolf Grünbaum, as we shall see in a moment. But first there is a question about Grünbaum’s alleged reliance on Mill’s Methods of Agreement and Difference. This interpretation may not make a difference to Lacewing’s arguments, but (...) it is worth correcting, given that some philosophers criticize both methods and yet their criticisms have no direct bearing on any of Grünbaum’s arguments. When Grünbaum speaks of “Millian methods,” he is not necessarily talking .. (shrink)
John Greenwood (this issue) claims that neglect of an important methodological distinction has contributed directly to the "epistemic impoverishment" of empirical studies of all forms of professional psychotherapy. I challenge this claim, as well as other important claims he makes about the efficacy of psychoanalysis and other forms of psychotherapy.
Obtaining informed consent is a cornerstone of biomedical research, yet participants comprehension of presented information is often low. The most effective interventions to improve understanding rates have not been identified.
Corporate codes of conduct are a practical corporate social responsibility (CSR) instrument commonly used to govern employee behavior and establish a socially responsible organizational culture. The effectiveness of these codes has been widely discussed on theoretical grounds and empirically tested in numerous previous reports that directly compare companies with and without codes of conduct. Empirical research has yielded inconsistent results that may be explained by multiple ancillary factors, including the quality of code content and implementation, which are excluded from analyses (...) based solely on the presence or absence of codes.This study investigated the importance of code content in determining code effectiveness by examining the relationship between code of conduct quality and ethical performance. Companies maintaining high quality codes of conduct were significantly more represented among top CSR ranking systems for corporate citizenship, sustainability, ethical behavior, and public perception. Further, a significant relationship was observed between code quality and CSR performance, across a full range of ethical rankings. These findings suggest code quality may play a crucial role in the effectiveness of codes of conduct and their ability to transform organizational cultures.Future research efforts should transcend traditional comparisons based on the presence or absence of ethical codes and begin to examine the essential factors leading to the effective establishment of CSR policies and sustainable business practices in corporate culture. (shrink)