The informed consent process for genetic testing does not commonly address preferences regarding disclosure of results in the event of the patient's death. Adults being tested for familial colorectal cancer were asked whether they want their exome sequencing results disclosed to another person in the event of their death prior to receiving the results. Of 78 participants, 92% designated an individual and 8% declined to. Further research will help refine practices for informed consent.

In September 2008, 10 years after the untimely death of Pere Alberch (1954–1998), the 20th Altenberg Workshop in Theoretical Biology gathered a group of Pere’s students, col- laborators, and colleagues (Figure 1) to celebrate his contribu- tions to the origins of EvoDevo. Hosted by the Konrad Lorenz Institute for Evolution and Cognition Research (KLI) outside Vienna, the group met for two days of discussion. The meeting was organized in tandem with a congress held in May 2008 at the Cavanilles Institute (...) for Biodiversity and Evolutionary Biology (ICBiBE) in Valencia, Spain. The talks at the KLI were equal parts: nostalgic remembrance, excitement over new ways of thinking about old problems, and an unrepressed vitriol against the resurgence of reductionist thinking in EvoDevo. Here we highlight some of the key aspects of Pere’s life and work that informed and infused the talks. (shrink)

In this essay, we suggest practical ways to shift the framing of crisis standards of care toward disability justice. We elaborate on the vision statement provided in the 2010 Institute of Medicine (National Academy of Medicine) “Summary of Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations,” which emphasizes fairness; equitable processes; community and provider engagement, education, and communication; and the rule of law. We argue that interpreting these elements through disability justice entails a commitment to both (...) distributive and recognitive justice. The disability rights movement's demand “Nothing about us, without us” requires substantive inclusion of disabled people in decision‐making related to their interests, including in crisis planning before, during, and after a pandemic like Covid‐19. (shrink)

Extensive research has demonstrated that rs1360780, a common single nucleotide polymorphism within the FKBP5 gene, interacts with early-life stress in predicting psychopathology. Previous results suggest that carriers of the TT genotype of rs1360780 who were exposed to child abuse show differences in structure and functional activation of emotion-processing brain areas belonging to the salience network. Extending these findings on intermediate phenotypes of psychopathology, we examined if the interaction between rs1360780 and child abuse predicts resting-state functional connectivity (rsFC) between the amygdala (...) and other areas of the salience network. We analyzed data of young European adults from the general population (N = 774; mean age = 18.76 years) who took part in the IMAGEN study. In the absence of main effects of genotype and abuse, a significant interaction effect was observed for rsFC between the right centromedial amygdala and right posterior insula (p <.025, FWE-corrected), which was driven by stronger rsFC in TT allele carriers with a history of abuse. Our results suggest that the TT genotype of rs1360780 may render individuals with a history of abuse more vulnerable to functional changes in communication between brain areas processing emotions and bodily sensations, which could underlie or increase the risk for psychopathology. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Notes and Fragments WEISKEL'S SUBLIME AND THE IMPASSE OF KNOWLEDGE by Laura Quinney Since the publication of Thomas Weiskel's The Romantic Sublime in 1976, scholars of the sublime, in America at any rate, have taken their cue from the demystifying character ofWeiskel's analysis.1 Before Weiskel the most ambitious twentieth-century account of the sublime was Samuel Monk's largely descriptive work The Sublime: A Study of Critical Theories inEighteenth-CenturyEngland.2 With (...) the advent ofsemiotic and psychoanalytic approaches in the late sixties and early seventies, studies of the sublime shifted into a more critical mode. Neil Hertz had taken a skeptical tack in his early essay "A Reading of Longinus," but it was with Weiskel's book that the possibilities of demystifying die sublime were first explored fully.3 Weiskel's treatment is comprehensive, covering all the English Romantic poets as well as Burke and Kant. His thinking is sophisticated, incisive, and often inspired; though The Romantic Sublime was published nearly twenty years ago, it remains an admirable and influential work. In some respects it has never been superseded. Most major American scholars of the sublime—de Man, Knapp, and de Bolla, among others—have adopted the skeptical mode of Weiskel and Hertz.4 But die demystifying approach Weiskel's book helped to pioneer, while it has led to powerful argument, has certain limitations. Weiskel's precocious effort to "desublimate" the sublime shows diese limitations clearly, and it is die purpose of this essay to explore them. In die course of exposing the sublime as a mystified notion, and separating the naive believers from the canny skeptics, Weiskel also Philosophy and Literature, © 1994, 18: 309-319 310Philosophy and Literature separates intellectual insight from aesthetic capacity, and thus he uncritically reiterates die old Romantic dialectic of knowledge and power. The figure of Wordsworth plays a central role in establishing these oppositions. Weiskel portrays Wordsworth as the most successful poet of the sublime—the most successful, and tiierefore the most beguiled. In his remarkable concluding chapter, Weiskel locates the source of Wordsworth's powerful "liminal sublime" in a kind of intellectual regression. Wordswortii refuses the whole Symbolic order, the ghastly product of the Oedipus complex, for that order spells die deatii or disappearance of the signified, and die end of an imaginatively fruitful narcissism. Wordswortii retreats from the Symbolic to the Imaginary radier than endure tiiis threat to poetic life. And he is well rewarded for his dodge, since as a consequence the images of his memory thrill with the fascination of the ineffable. The Prelude gains its momentum from the project of memory; but the rich opacity and mysterious beckoning of memory's images are in a sense contrived. They spring out of a sublimation, the images colored widi the intensity of the signification Wordswortii has repudiated. Wordswortii sacrifices insight and intellectual progress for imaginative power. This is a strictly ambivalent exchange, as Weiskel makes clear in his conclusion; Wordsworth's rejection of the Oedipus complex and of the descent into the Symbolic Order, is "purely illusory, a fiction," but "the fiction is a necessary and saving one; it founds die self and secures the possibility—the chance for a self-conviction—of originality" (p. 203). Wordswortii's poetic success arises from his acceptance of an illusion, a "saving fiction" both enviable and degraded. This selfdelusion is essential to the poetic flourishing of the sublime, and only Wordsworth had the odd insensitivity to maintain it. Weiskel contrasts faith in the efficacy and excellence of sublimation with skeptical insight into its origin and end—its origin in mystification, and its end in alienation from the phenomenal world. The faith of Wordswortii's egotistical sublime is that imaginative perception provides die highest and paradoxically truest form of perception. It is easy enough to see how such a faith could provide hope and energy, and tiius could be compromised by wish-fulfillment in its generation, and direatened by extinction in its analysis. But what lies behind Weiskel's opposition of faith and insight is the old dichotomy—or series of interrelated dichotomies—that date back at least to Romanticism. Weiskel admits that his opposition of fruitful illusion and dessicating realism... (shrink)

This study examined individual difference characteristics as predictors of business students' attitudes toward sustainable business practices. Three types of predictors were considered: personal values, individualism—collectivism, and leadership styles. Data were collected from 248 business students attending a mid-sized university in western United States using self-reported questionnaires. Few gender differences were present.Hierarchical regression analyses, controlling for personal demographic characteristics, indicated that business students scoring higher on Rokeach's social value scale, collectivism, and transformational leadership also reported more positive attitudes toward sustainable business (...) practices.Implications for research and practice are discussed. (shrink)

This study examined individual difference characteristics as predictors of business students’ attitudes toward sustainable business practices. Three types of predictors were considered: personal values, individualism–collectivism, and leadership styles. Data were collected from 248 business students attending a mid-sized university in western United States using self-reported questionnaires. Few gender differences were present. Hierarchical regression analyses, controlling for personal demographic characteristics, indicated that business students scoring higher on Rokeach’s social value scale, collectivism, and transformational leadership also reported more positive attitudes toward sustainable (...) business practices. Implications for research and practice are discussed. (shrink)

Recent revisions in child support and paternity establishment legislation enacted under the 1996 welfare reform act, the Personal Responsibility and Work Opportunity Reconciliation Act, significantly alter the American welfare state's relationship to men's fathering. Through a critical review of prior research and social service literature, the authors argue that PRWORA actively constructs fatherhood not only through state policies that maintain males as “breadwinners” but also through state-sponsored social service programs that seek to influence men's identities as fathers. PRWORA's policies and (...) their accompanying discourses simultaneously reproduce and undermine gender hierarchy yet tacitly maintain structural race and class inequalities. (shrink)

Here, we describe how Casas Grandes Medio period (AD 1200 to 1450) shamanic practices of the North American Southwest used tobacco shamanism, a ritual stance called the Tennessee Diviner (TD) posture, and cultural expectations to generate trance experiences of soul flight and divination. We introduce a conceptual model that holds that specific trance experiences are the emergent result of human minds interacting with additional factors including entheogens, cultural expectations, physiological states, postures/movement, and sound/stimulation. Experimental and ethnographic evidence indicates initiating trance (...) with either tobacco intoxication or the TD posture accompanied with a rapidly beating drum or rattle corresponds with perceptions of soul flight, transformation, and divination/information acquisition. Both have similar results but pairing them together as they were during the Medio period likely helped ensure the culturally desired trance experiences. This practice of mutually reinforcing factors was likely part of tobacco‐based shamanism found in other New World cultures as well. We suggest our general model can be applied to other contexts to examine how various aspects of trance induction interact to produce the cultural patterns (and resulting cosmological and spiritual frameworks) anthropologists have documented in other cultures. (shrink)

Spontaneous inferences are unconscious, automatic, and apparently ubiquitous. Research has documented their variety (particularly in the social domain) and impact on memory and judgment. They are good candidates for Mercier and Sperber's (M&S's) Forming spontaneous inferences is highly context sensitive, varying with the perceiver's conscious and unconscious goals, and implicit and explicit theories about the domain in question.

¿Cómo se forma un sujeto político? En la herencia más antigua de la interrogación filosófica esta pregunta busca recuperar una actitud de asombro suscitada por prácticas diversas de relación consigo y con los otros en las que personas comunes y corrientes ponen en cuestión experiencias sedimentadas sobre el cuerpo y el género, así como fronteras establecidas entre lo natural y lo artificial, lo humano y lo animal, lo común y lo propio. Los artículos aquí reunidos apuntan a mostrar que para (...) pensar estas formas de agencia política es preciso atender a una dimensión amplia de la estética que se refiere al modo en que la materialidad sensorial de la experiencia compartida se ha conformado históricamente y a cómo esta, dada su contingencia, puede reconfigurarse desde ciertas prácticas cotidianas: prácticas de elaboración de sí y de organización colectiva que crean otros escenarios y otras maneras de aparición de los cuerpos, y con esto estrategias de confrontación y antagonismo que atraviesan y afectan lo social. Así, ¿Cómo se forma un sujeto político? es un esfuerzo colectivo de franca resistencia contra la estrechez desde el cual se nos tiende a hacer pensar la política: bien sea desde una política consensual liberal que acaba por neutralizar las diferencias más intratables de nuestra pluralidad, bien sea desde el realismo de una política conflictual y guerrera que funciona desde la polaridad amigo-enemigo. El lector podrá explorar y profundizar, desde otro ángulo, las apuestas epistemológicas, éticas y políticas que resuenan en estas prácticas artísticas y de acción colectiva que nos enseñan hoy, más allá de los paradigmas del "ciudadano" o del "actor racional", cómo se hace un sujeto político. (shrink)

Previous research has demonstrated that trait self-control is related to a range of positive romantic relationship processes, suggesting that trait self-control should be positively and robustly linked to relationship satisfaction in both partners in a romantic relationship. However, the existing empirical evidence is limited and mixed, especially regarding partner effects. With three datasets of heterosexual couples, the present pre-registered studies examined: the dyadic associations between trait self-control and relationship satisfaction both cross-sectionally and longitudinally, and whether these effects hold when controlling (...) for both partners’ relationship commitment. The results indicated a cross-sectional positive actor effect, some support for a positive cross-sectional partner effect, and only little support for a longitudinal actor effect. After controlling for relationship commitment, all effects of trait self-control on satisfaction diminished except for a longitudinal actor effect among women in Study 2. Potential explanations for the current results, and implications for theory and practice, are discussed. (shrink)

ABSTRACTEmotion differentiation, the ability to describe and label our own emotions in a differentiated and specific manner, has been repeatedly associated with well-being. However, it is unclear exactly what type of differentiation is most strongly related to well-being: the ability to make fine-grained distinctions between emotions that are relatively closely related, the ability to make larger distinctions between very distinct emotions, or the combination of both. To determine which type of differentiation is most predictive of well-being, we performed a comprehensive (...) meta-analysis across six datasets. We examined the correlations between these three types of differentiation and several indicators of well-being. Results showed that individuals differentiated most between very distinct emotions and least between more related emotions, and that an index computed across emotions from both the same and di... (shrink)

This investigation examined whether speakers produce reliable prosodic correlates to meaning across semantic domains and whether listeners use these cues to derive word meaning from novel words. Speakers were asked to produce phrases in infant‐directed speech in which novel words were used to convey one of two meanings from a set of antonym pairs (e.g., big/small). Acoustic analyses revealed that some acoustic features were correlated with overall valence of the meaning. However, each word meaning also displayed a unique acoustic signature, (...) and semantically related meanings elicited similar acoustic profiles. In two perceptual tests, listeners either attempted to identify the novel words with a matching meaning dimension (picture pair) or with mismatched meaning dimensions. Listeners inferred the meaning of the novel words significantly more often when prosody matched the word meaning choices than when prosody mismatched. These findings suggest that speech contains reliable prosodic markers to word meaning and that listeners use these prosodic cues to differentiate meanings. That prosody is semantic suggests a reconceptualization of traditional distinctions between linguistic and nonlinguistic properties of spoken language. (shrink)

In caring for pediatric patients, a multifaceted approach in decision-making is utilized. The role of the medical team in complementary and alternative medicine is controversial. In cases of conventional treatment refusal by parents in pursuit of complementary and alternative medicine, there must be balanced decision-making, autonomy, and the best interest of the child. This report highlights two illustrative cases of patients with brain tumor, whereby parents refused postoperative conventional therapy involving chemoradiotherapy, in pursuit of complementary and alternative medicine alone. Parental (...) decision-making in complementary and alternative medicine, in lieu of medical recommendations, poses an ethical and legal dilemma that may impede care of the pediatric patient and compromise outcome of oncological care. (shrink)

Investigating the causes of unethical behaviors in academia, such as scientific misconduct, has become a highly important research subject. The current performance measurement practices (e.g., equating research performance with the number of publications in top-tier journals) are frequently referred to as being responsible for scientists’ unethical behaviors. We conducted qualitative semi-structured interviews with different stakeholders of the higher education system (e.g., professors and policy makers; N = 43) to analyze the influence of performance measurement on scientists’ behavior. We followed a (...) three-step coding procedure and found (1) that the participants described a variety of positive behavioral consequences (e.g., higher productivity) but mainly negative behavioral consequences (e.g., questionable publishing practices) of current performance measurement practices in academia; (2) that scientists’ behavior can be described as gaming performance measurement (i.e., achieving performance goals by reducing performance quality and focusing on those tasks that are measured); and (3) that gaming performance measurement shares the same characteristics as deviant workplace behavior (i.e., a voluntary violation of organizational norms that harms the university). We discuss that gaming performance measurement has not been considered as a type of deviant workplace behavior in the previous literature. Furthermore, we draw from research on deviant workplace behavior and goal setting to discuss psychological processes that may underlie gaming performance measurement. Our results indicate the importance of connecting literature on deviant workplace behavior and goal setting to advance our understanding of gaming performance measurement. (shrink)

Neither the range of potential results from genomic research that might be returned to participants nor future uses of stored data and biospecimens can be fully predicted at the outset of a study. Informed consent procedures require clear explanations about how and by whom decisions are made and what principles and criteria apply. To ensure trustworthy research governance, there is also a need for empirical studies incorporating public input to evaluate and strengthen these processes.

Over the last decade, our appreciation of the importance of the nucleolus for cellular function has progressed from the ordinary to the extraordinary. We no longer think of the nucleolus as simply the site of ribosome production, or a dynamic subnuclear body noted by pathologists for its changes in size and shape with malignancy. Instead, the nucleolus has emerged as a key controller of many cellular processes that are fundamental to normal cell homeostasis and the target for dysregulation in many (...) human diseases; in some cases, independent of its functions in ribosome biogenesis. These extra‐nucleolar or new functions, which we term “non‐canonical” to distinguish them from the more traditional role of the nucleolus in ribosome synthesis, are the focus of this review. In particular, we explore how these non‐canonical functions may provide novel insights into human disease and in some cases new targets for therapeutic development. (shrink)

The goal of this study was to assess the relationships between computational approaches to analyzing constructed responses made during reading and individual differences in the foundational skills of reading in college readers. We also explored if these relationships were consistent across texts and samples collected at different institutions and texts. The study made use of archival data that involved college participants who produced typed constructed responses under thinking aloud instructions reading history and science texts. They also took assessments of vocabulary (...) knowledge and proficiency in comprehension. The protocols were analyzed to assess two different ways to determine their cohesion. One approach involved assessing how readers established connections with themselves. The other approach involved assessing connections between the constructed responses and the texts that were read. Additionally, the comparisons were made by assessing both lexical and semantic comparisons. The result showed that both approaches for analyzing cohesion and making the comparisons were correlated with vocabulary knowledge and comprehension proficiency. The implications of the results for theory and practice are discussed. (shrink)

Metaphors for describing the introduction, impacts, and management of non-native species are numerous and often quite outspoken. Policy-makers have adopted increasingly disputed metaphorical terms from scientific discourse. We performed a critical analysis of the use of strong metaphors in reporting scientific findings to policy-makers. Our analysis shows that perceptions of harm, invasiveness or nativeness are dynamic and inevitably display multiple narratives in science, policy or management. Improving our awareness of multiple expert and stakeholder narratives that exist in the context of (...) non-native species management, as well as metaphorical alternatives, is critical. (shrink)

This target article draws together two groups of experimental studies on the control of human movement through peripheral feedback and centrally generated signals of motor commands. First, during natural movement, feedback from muscle, joint, and cutaneous afferents changes; in human subjects these changes have reflex and kinesthetic consequences. Recent psychophysical and microneurographic evidence suggests that joint and even cutaneous afferents may have a proprioceptive role. Second, the role of centrally generated motor commands in the control of normal movements and movements (...) following acute and chronic deafferentation is reviewed. There is increasing evidence that subjects can perceive their motor commands under various conditions, but that this is inadequate for normal movement; deficits in motor performance arise when the reliance on proprioceptive feedback is abolished either experimentally or because of pathology. During natural movement, the CNS appears to have access to functionally useful input from a range of peripheral receptors as well as from internally generated command signals. The unanswered questions that remain suggest a number of avenues for further research. (shrink)

Feminist therapy is more than a prescription of technique; it is a unique philosophy of psychotherapy. While much has been written on feminism and therapy, this bold book breaks new ground by making explicit and coherent the theoretical underpinnings of feminist therapy.Building on the revolutionary work of feminist scholars who have described how women employ strategies of knowing the world in a manner distinct from men, Laura S. Brown, noted for her pioneering work in the field of ethics and (...) boundaries, shows how these insights should reshape the very nature of the therapeutic encounter. With meticulous care, the author examines key features of the therapeutic encounter with a feminist lens: the power of the therapist; assessment and diagnosis; the nature of change; the ethics of practice; and differences in race, class, and sexual identity. She constructs a vision of therapy that helps the client develop a sense of entitlement to satisfying and equal relationships outside the therapist's office. This powerful vision of feminist therapy is grounded throughout with case examples that illustrate how a dialogue between therapist and client can be healing, subversive, and transformative all at once. (shrink)

The debate over the propriety of cognitive enhancement evokes both enthusiasm and worry. To gain further insight into the reasons that people may have for endorsing or eschewing pharmacological enhancement, we used empirical tools to explore public attitudes towards PE of twelve cognitive, affective, and social domains. Participants from Canada and the United States were recruited using Mechanical Turk and were randomly assigned to read one vignette that described an individual who uses a pill to enhance a single domain. After (...) reading the vignette, participants were asked how comfortable they were with the individual using the enhancement. People were significantly more comfortable when they read about enhancement of certain CAS domains than others. We found a modest negative correlation between comfort level and the degree to which the PE was perceived as changing core features of the person. We also found a modest correlation between comfort level and the degree to which the PE was perceived as improving success in life. Finally, using a sequential mixed method technique, we found that participants who felt uncomfortable about PE use overwhelmingly focused on a lack of need and, to a lesser degree, expressed concerns about safety; those who felt comfortable about PE use most frequently mentioned the safety of the pill and its ability to provide a positive outcome. The data provide novel insights into public enthusiasms and concerns over the use of PE. (shrink)

The OpenNotes (ON) mandate in the 21st Century Cures Act requires that patients or their legally authorized representatives be able to access their medical information in their electronic medical record (EMR) in real time. Ethics notes fall under the domain of this policy. We argue that ethics notes are unique from other clinical documentation in a number of ways: they lack best-practice guidelines, are written in the context of common misconceptions surrounding the purpose of ethics consultation, and often answer questions (...) of a different nature than other documentation. Thus, we believe the clinical ethics community would benefit from clarification on when the withholding of ethics notes is justified. We provide recommendations for excluding information from ethics documentation based on the likelihood and magnitude of harm that may occur with particular disclosures and suggest approaches to decrease the potential harms that may occur. We define and explain six types of reasons to exclude information from ethics notes based on significant harms that are not addressed in the ON policy: (1) harmful revelations from a protected chart note; (2) negative emotional effects on patients or families; (3) the purpose of the consultation is undermined by harmful consequences; (4) avoidable negative impact on interpersonal dynamics; (5) inappropriate labeling or disclosure of medical, social, or financial information; and (6) inclusion of biasing or otherwise unfair information. We also suggest approaches to mitigate harm when excluding, including, reframing, or delaying release of information that is perceived to be relevant to an ethics case. Overall, we hope our analysis and recommendations will initiate a much-needed discussion about the impact of the ON mandate on clinical ethics documentation. (shrink)

Most aspects of agriculture in Cuba prior to 1989 were comparable to California: a high energy input, conventional agriculture (based on what the Cubans now call the “classical model”) in which little was done to protect the nation's soils from erosion, loss of fertility, salinization, and other forms of degradation. In stark contrast the new “Alternative Model,” which has been rapidly replacing the previous model since 1989, emphasizes soil conservation and rehabilitation and the general improvement of the nation's soils as (...) the key to sustaining low-input production and attainment of food security. One of the first steps in implementing the new model was the launching of an ambitious program to reclassify, evaluate, and map the nation's soils in great detail, and to interpret the maps for management of sustainable production. A main feature of this program is coordinated fertility trials to determine, for each combination of crop and soil, the minimum quantity of plant nutrients needed to produce the crop. The build up and maintenance of soil fertility and productivity is being accomplished with various organic and mineral amendments and biofertilizers, produced or mined within the country (locally, where possible) and through rational management utilizing cover crops, green manures, crop successions (intercropping and rotations), and other appropriate technologies. Rehabilitation of degraded soils, tillage reduction, reforestation, vermiculture, vermicomposting, and other forms of waste cycling are other features of the new model that are important to soil conservation and maintenance for sustainable production. (shrink)

The health care needs of rural populations often differ from those of their urban counterparts. And the ethical dilemmas that caregivers face are distinctively shaped in rural settings, not only by resource constraints, but by the nature of life in small, close-knit communities as well.

The inconsistency between pro-environmental attitudes and behaviours, known as the “attitude-behaviour” gap, is exceptionally pronounced in scenarios associated with “green” choice. The current literature offers numerous explanations for the reasons behind the “attitude-behaviour” gap, however, the generalisability of these explanations is complex. In addition, the answer to the question of whether the gap occurs between attitudes and intentions, or intentions and behaviours is also unknown. In this study, we propose the moral dimension as a generalisable driver of the “attitude-behaviour” gap (...) and investigate its effectiveness in predicting attitudes, pro-environmental intentions and subsequent behaviours. We do so by using Hunt–Vitell’s moral philosophy-based framework of ethical decision-making, which conceptualises morality as the central decision-making parameter. The results from 557 US MTurk participants revealed that the manipulation of moral dimensions, specifically deontology and teleology, impacted ethical evaluation of presented dilemmas, however, failed to translate into subsequent intentions and behaviours. This finding suggests (i) that the moral dimension has an effect in shaping attitudes toward environmental issues, and (ii) that gap occurs between attitudes and intentions rather than intentions and behaviours. Further investigation of what strengthens and/or overrides the effects of the moral dimension would help understand the reasons why moral attitudes do not always translate into subsequent intentions and behaviours in the pro-environmental domain. (shrink)

The ambiguity regarding whether a given intervention is perceived as enhancement or as therapy might contribute to the angst that the public expresses with respect to endorsement of enhancement. We set out to develop empirical data that explored this. We used Amazon Mechanical Turk to recruit participants from Canada and the United States. Each individual was randomly assigned to read one vignette describing the use of a pill to enhance one of 12 cognitive, affective or social domains. The vignettes described (...) a situation in which an individual was using a pill to enhance the relevant domain under one of two possible enhancement conditions, one perceived as enhancing above the norm, what most people recognize as a clear case of enhancement, whereas the other perceived as enhancing towards the norm, with the individual using the enhancement having a modest, but subclinical deficit. Participants were asked how comfortable they were with the individual using the enhancement and about the impact the enhancement might have had in the individuals’ success in life. We found that irrespective of the domain to be enhanced, participants felt significantly more comfortable with ETN than with EAN, and they regarded the enhancement intervention as contributing to greater success in life with ETN rather than EAN. These data demonstrate that the therapy enhancement distinction is morally salient to the public, and that this distinction contributes to the angst that people feel when considering the propriety of CAS enhancement. (shrink)