Implicit biases involve associations outside conscious awareness that lead to a negative evaluation of a person on the basis of irrelevant characteristics such as race or gender. This review examines the evidence that healthcare professionals display implicit biases towards patients. PubMed, PsychINFO, PsychARTICLE and CINAHL were searched for peer-reviewed articles published between 1st March 2003 and 31st March 2013. Two reviewers assessed the eligibility of the identified papers based on precise content and quality criteria. The references of eligible papers were (...) examined to identify further eligible studies. Forty two articles were identified as eligible. Seventeen used an implicit measure, to test the biases of healthcare professionals. Twenty five articles employed a between-subjects design, using vignettes to examine the influence of patient characteristics on healthcare professionals’ attitudes, diagnoses, and treatment decisions. The second method was included although it does not isolate implicit attitudes because it is recognised by psychologists who specialise in implicit cognition as a way of detecting the possible presence of implicit bias. Twenty seven studies examined racial/ethnic biases; ten other biases were investigated, including gender, age and weight. Thirty five articles found evidence of implicit bias in healthcare professionals; all the studies that investigated correlations found a significant positive relationship between level of implicit bias and lower quality of care. The evidence indicates that healthcare professionals exhibit the same levels of implicit bias as the wider population. The interactions between multiple patient characteristics and between healthcare professional and patient characteristics reveal the complexity of the phenomenon of implicit bias and its influence on clinician-patient interaction. The most convincing studies from our review are those that combine the IAT and a method measuring the quality of treatment in the actual world. Correlational evidence indicates that biases are likely to influence diagnosis and treatment decisions and levels of care in some circumstances and need to be further investigated. Our review also indicates that there may sometimes be a gap between the norm of impartiality and the extent to which it is embraced by healthcare professionals for some of the tested characteristics. Our findings highlight the need for the healthcare profession to address the role of implicit biases in disparities in healthcare. More research in actual care settings and a greater homogeneity in methods employed to test implicit biases in healthcare is needed. (shrink)

Background Implicit biases are present in the general population and among professionals in various domains, where they can lead to discrimination. Many interventions are used to reduce implicit bias. However, uncertainties remain as to their effectiveness. -/- Methods We conducted a systematic review by searching ERIC, PUBMED and PSYCHINFO for peer-reviewed studies conducted on adults between May 2005 and April 2015, testing interventions designed to reduce implicit bias, with results measured using the Implicit Association Test (IAT) or sufficiently similar methods. (...) -/- Results 30 articles were identified as eligible. Some techniques, such as engaging with others’ perspective, appear unfruitful, at least in short term implicit bias reduction, while other techniques, such as exposure to counterstereotypical exemplars, are more promising. Robust data is lacking for many of these interventions. -/- Conclusions Caution is thus advised when it comes to programs aiming at reducing biases. This does not weaken the case for implementing widespread structural and institutional changes that are multiply justified. (shrink)

An overview of the philosophical and bioethics literature on conscientious refusals by health care professionals to provide abortion and contraceptive services.

The conception of conscience that dominates discussions in bioethics focuses narrowly on private regulation of behaviour resulting from explicit attitudes. It neglects to mention implicit attitudes and the role of social feedback in becoming aware of one's implicit attitudes. But if conscience is a way of ensuring that a person's behaviour is in line with her moral values, it must be responsive to all aspects of the mind that influence behaviour. There is a wealth of recent psychological work demonstrating the (...) influence of implicit attitudes on behaviour. A necessary part of having a well-functioning conscience must thus be awareness and regulation of one's implicit attitudes in addition to one's explicit attitudes; this cannot be done by an individual in isolation. On my revised conception of conscience, heeding social feedback, being emotionally self-aware and engaging in self-monitoring are important for the possession of a well-functioning conscience. Health professionals may need specific training to help them develop and maintain a well-functioning conscience, which should involve cultivation of awareness of implicit attitudes, emphasis on social feedback and techniques to enable better control over them. (shrink)

Despite the widespread use of the notion of moral intuition, its psychological features remain a matter of debate and it is unclear why the capacity to experience moral intuitions evolved in humans. We first survey standard accounts of moral intuition, pointing out their interesting and problematic aspects. Drawing lessons from this analysis, we propose a novel account of moral intuitions which captures their phenomenological, mechanistic, and evolutionary features. Moral intuitions are composed of two elements: an evaluative mental state and a (...) feeling of rightness (FOR). We illustrate the phenomenology of the FOR with examples of non-moral and moral cases, and provide a biological and mechanistic account: the emergence of human reasoning capacities created a need for the co-evolution of a psychological system producing the feeling of rightness (the FORs). This system is triggered when we experience conflicting evaluations. The FORs renders evaluations resulting from rational deliberation less compelling than the evaluations produced by simple evolved systems. It thus facilitates optimal decision-making, preventing excessive interference by rational deliberation. Our account sheds light on why moral intuitions are so frequently experienced and why they are so compelling and resistant to argument. In addition, the account fuels interesting speculations about common metaethical intuitions. (shrink)

BackgroundImplicit prejudice can lead to disparities in treatment. The effects of specialty and experience on implicit obesity and mental illness prejudice had not been explored. The main objective was to examine how specializing in psychiatry/general medicine and years of experience moderated implicit obesity and mental illness prejudice among Swiss physicians. Secondary outcomes included examining the malleability of implicit bias via two video interventions and a condition of cognitive load, correlations of implicit bias with responses to a clinical vignette, and correlations (...) with explicit prejudice. MethodsIn stage 1, participants completed an online questionnaire including a clinical vignette. In stage 2, implicit prejudice pre- and post- intervention was tested using a 4 × 4 between-subject design including a control group. In stage 3, explicit prejudice was tested with feeling thermometers and participants were debriefed. Participants were 133 psychiatrists and internists working in Geneva, hospital-based and private practice. Implicit prejudice was assessed using a Weight IAT and a Mental Illness IAT. Explicit feelings towards the obese and the mentally ill were measured using Feeling Thermometers. A clinical vignette assessed the level of concern felt for a fictional patient under four conditions: control, obese, depression, obese and depression. Linear regression was conducted to test for association of gender, experience, and specialty with responses to vignettes, pre-intervention IATs and explicit attitudes, and to test for association of interventions with post-intervention IATs and explicit attitudes. Reported effect sizes were computed using Cohen’s d. Two-tailed p < 0.05 was selected as the significance threshold. ResultsCompared to internists, psychiatrists showed significantly less implicit bias against mentally vs. physically ill people than internists and warmer explicit feelings towards the mentally ill. More experienced physicians displayed warmer explicit feelings towards the mentally ill and a greater level of concern for the fictional patients in the vignette than the less experienced, except when the patient was described as obese. ConclusionsSpecialty moderates both implicit and explicit mental illness prejudice. Experience moderates explicit mental illness bias and concern for patients. The effect of specialty on implicit prejudice seems to be based principally on self-selection. (shrink)

AbstractMichel Foucault is well known as a theorist of power who provided forceful critiques of institutions of confinement such as the psychiatric asylum and the prison. Although the invention of factory farms and industrial slaughterhouses, like prisons and psychiatric hospitals, can be considered emblematic moments in a history of modernity, and although the modern farm is an institution of confinement comparable to the prison, Foucault never addressed these institutions, the politics of animal agriculture, or power relationships between humans and other (...) animals more generally. The few times that Foucault discussed animality or human–animal relations, animals and animality remained metaphors for humans and human experiences. Despite Foucault's failure to analyze human–nonhuman animal relations, a significant body of Critical Animal Studies literature has mobilized Foucault's work over the last decade. In particular, a number of scholars have taken up Foucault's writings to consider how relations between humans and nonhuman animals in agriculture might be conceptualized as instances of sovereign power, biopower, disciplinary power, and pastoral power, as well as why we may not think that these are power relations at all. This essay provides an overview of Foucault's accounts of power and of the Foucauldian scholarship that applies these accounts to human–nonhuman animal relations in animal agriculture. (shrink)

Albert of Saxony was one of the great logicians of the Middle Ages, on a par with William Ockham and John Buridan. The Twenty-Five Disputed Questions on Logic treat of central issues in logic, both then and now, such as the nature of meaning, of universals, of truth, and of tense and modality; and the quality and quantity of propositions, the role of negation, and the relations of contradiction and equivalence between them. Dr. Fitzgerald has studied Albert's work extensively, (...) and previously edited the Twenty-Five Disputed Questions from the original manuscripts. This translation makes available for the first time in English this careful and exemplary examination of logical notions by an outstanding medieval thinker.-Stephen Read, University of St. Andrews. (shrink)

Au cours de la guerre froide, les organisations internationales, notamment celles du système de l’ONU, sont des tribunes instrumentalisées par les deux superpuissances pour se mettre en valeur. C’est le cas de l’UNESCO. Le discours de la cosmonaute soviétique Valentina Terechkova en 1966 est la première prise de parole d’une femme soviétique dans cette enceinte. Terechkova, qui a été la première femme au monde à effectuer, en 1963, un vol dans l’espace, utilise la tribune de l’UNESCO pour introduire des enjeux (...) de genre dans le cadre des relations internationales marquées par le contexte de guerre froide. Au-delà des rapports de force entre États marqués par la bipolarisation du monde, elle tente d’exprimer des arguments à prétention universaliste en faveur des droits des femmes et du développement, tout en produisant un discours à rhétorique typiquement soviétique. (shrink)

This paper begins with a recognition that questions of climate change, environmental degradation, and our relations to the natural world are increasingly significant and requiring of a response not only as philosophers of education but also as citizens of the planet. As such the paper explores five of the key journals in philosophy of education in order to identify the extent, range, and content of current discussions related to the environment. It then organizes and summaries the articles that were located (...) while seeking to identify the extent, possibilities, and limitations of current discussions relating to the environment in the philosophy of education community. The hope is that ultimately this work is an invitation to anyone, regardless of tradition, orientation, and expertise, to contribute to the expansion and deepening of both theory and practice in the face of this most serious of challenges. (shrink)

Bioethics scholarship considering the possibility of gestating an embryo to full term in an artificial womb (ectogenesis) often overstates the capacities of current technologies and underestimates the barriers to the development of full ectogenesis. Moreover, this debate causes harm by (1) neglecting more immediate problems in the development of artificial wombs, (2) treating abortion as a “problem with a technological solution,” bolstering anti-abortion rhetoric, and (3) presuming the stability of women’s reproductive rights. The ectogenesis conversation must consider anticipated uses of (...) the technology (neonatal intensive care) and acknowledge the immediate context (recognizing abortion as essential healthcare and existing reproductive inequities). (shrink)

Building Abolition: Decarceration and Social Justice explores the intersections of the carceral in projects of oppression, while at the same time providing intellectual, pragmatic, and undetermined paths toward abolition. Prison abolition is at once about the institution of the prison, and a broad, intersectional political project calling for the end of the social structured by settler colonialism, anti-black racism, and related oppressions. Beyond this, prison abolition is a constructive project that imagines and strives for a transformed world in which justice (...) is not equated with punishment, and accountability is not equated with caging. Composed of sixteen chapters by an international team of scholars and activists, with a Foreword by Perry Zurn and an Afterword by Justin Piché, the book is divided into four themes: - Prisons and Racism - Prisons and Settler Colonialism - Anti-Carceral Feminisms - Multispecies Carceralities. This book will be of interest to undergraduate and postgraduate students, activists, and scholars working in the areas of Critical Prison Studies, Critical Criminology, Native Studies, Postcolonial Studies, Black Studies, Critical Race Studies, Gender and Sexuality Studies, and Critical Animal Studies, with particular chapters being of interest to scholars and students in other fields, such as, Feminist Legal Studies, Animal Law, Critical Disability Studies, Queer Theory, and Transnational Feminisms. (shrink)

There has long been interest in why languages are shaped the way they are, and in the relationship between sign language and gesture. In sign languages, entity classifiers are handshapes that encode how objects move, how they are located relative to one another, and how multiple objects of the same type are distributed in space. Previous studies have shown that hearing adults who are asked to use only manual gestures to describe how objects move in space will use gestures that (...) bear some similarities to classifiers. We investigated how accurately hearing adults, who had been learning British Sign Language for 1–3 years, produce and comprehend classifiers in locative and distributive constructions. In a production task, learners of BSL knew that they could use their hands to represent objects, but they had difficulty choosing the same, conventionalized, handshapes as native signers. They were, however, highly accurate at encoding location and orientation information. Learners therefore show the same pattern found in sign-naïve gesturers. In contrast, handshape, orientation, and location were comprehended with equal accuracy, and testing a group of sign-naïve adults showed that they too were able to understand classifiers with higher than chance accuracy. We conclude that adult learners of BSL bring their visuo-spatial knowledge and gestural abilities to the tasks of understanding and producing constructions that contain entity classifiers. We speculate that investigating the time course of adult sign language acquisition might shed light on how gesture became conventionalized during the genesis of sign languages. (shrink)

Ethical issues arise in the world’s first population-level treatment of severe lead poisoning caused by small-scale mining for gold in rural Nigeria. Emergency medical intervention and environmental cleanup have reduced the mortality in children younger than 5 years from lead poisoning from over 40 to 2.5 per cent leaving little evidence of the harms caused by lead poisoning. In the absence of obvious sequelae, family adherence to long-term intensive therapy to remove accumulated lead reservoirs in children wanes and some community (...) miners challenge safer mining interventions to prevent recontamination of the environment with lead. This letter raises questions regarding community versus individual rights in public health interventions and patient autonomy. (shrink)

This paper examines the reasons why peasant migrants in Chinese cities, a long exploited but silent working class, recently started to voice out claims for better protection of their legal rights. As legal consciousness develops among migrant workers, who slowly learn how to mobilize the law in an effort to resist an oppressive system, so does the awareness of the regime's failings and of the need for alternative forms of representation. However, the migrants' attempts to achieve more autonomy have so (...) far been hijacked by the Party_state and hardly give rise to society empowerment. mobilization of the grassroots, how to guide the new civil rights movement towards a nonviolent and legal form of expression; how to limit the negative developments caused by the reform through political reform, protect society’s rights and constrain officials’ rights in order to establish a political system that respects human rights—these are the challenges confronting the Chinese Communist regime if it wants to appease the wrath of the people. (shrink)

The Routledge Companion to Gender and Animals is the first fully comprehensive reference volume to examine the intersections of gender studies and critical animal studies, and is an essential reference for students in Gender Studies, Sexuality Studies, Cultural Studies, Sociology, Geography and Environmental Studies.

Although the philosophical systems of G. W. Leibniz and David Lewis both feature possible worlds, the ways in which their systems are similar and dissimilar are ultimately surprising. At first glance, Leibniz’s modal metaphysics might strike us as one of the most contemporarily relevant aspects of his system. But I clarify in this paper major interpretive problems that result from understanding Leibniz’s system in terms of contemporary views (like Lewis’s, for instance). Specifically, I argue that Leibniz rejects the inference that (...) if something is possible, it therefore occurs in some possible world. This discussion highlights how Leibniz’s account of individual substance (with his strict notion of identity) constrains his modal theorizing and produces fatalistic threats. I then make an unexpected connection between Leibniz’s and Lewis’s systems by showing that Leibniz’s treatment of fatalism bears similarities to the response Lewis gives to the fatalist when considering the paradoxes of time travel. (shrink)

In this short note we prove that a definable set X over is superstable only if.

Pour appréhender le costume en archéologie protohistorique européenne, il faut le plus souvent se satisfaire des accessoires vestimentaires métalliques conservés dans les sépultures, tels que les fibules et les éléments de ceinture. Cette nature instable des vestiges limite notre compréhension de l’implication du costume dans la construction sociale des différences entre les individus des ensembles funéraires. Néanmoins, l’examen des éléments métalliques de ceinture permet d’avoir une image dynamique de l’emploi de ces objets dans la représentation et la création de ces (...) différences, qui ne reposent pas nécessairement sur une dualité entre des ensembles sépulcraux dits « masculins » ou « féminins ». La ceinture doit être investie d’une signification symbolique particulière pour devenir un objet participant à la structuration des différences entre les genres. (shrink)

This commentary argues the case for developmental psychopathology in understanding social learning. Informed by work on “epistemic disruption,” we have described difficulties with social learning associated with many forms of psychopathology. Epistemic disruption manifests in an inability to move between innovation and conformity, and arises from poor mentalizing, which generates difficulties in identifying social cues that trigger the correct stance.

Brette presents arguments that query the existence of the neural code. However, he has neglected certain evidence that could be viewed as proof that a neural code operates in the brain. Albeit these proofs show a link between neural activity and cognition, we discuss why they fail to demonstrate the existence of an invariant neural code.

L’anticipation est généralement conçue comme un phénomène qui, d’un point de vue temporel et logique, est antérieur à une action ou une situation donnée. Dans cet article, nous proposons d’interroger cette conception en nous intéressant en détail à ce que l’anticipation fait à l’action qu’elle anticipe. En détail c’est-à-dire, très littéralement, en observant dans des situations d’interactions ordinaires les effets que peut produire le fait d’anticiper une action. En l’occurrence, dans des situations d’apprentissage entre hommes et chiens comme celles que (...) nous examinons, anticiper une action en l’évaluant avant qu’elle n’ait eu lieu contribue en grande part à la configurer. Cette avancée nous conduit à développer une vision proprement pragmatiste de l’action, conçue comme un procès façonné de manière émergente et collaborative par l’ensemble des participants qui l’accomplissent. (shrink)