Unable to answer the call of our patients: mental health nurses’ experience of moral distress When health practitioners’ moral choices and actions are thwarted by constraints, they may respond with feelings of moral distress. In a Canadian hermeneutic phenomenological study, physicians, nurses, psychologists and non‐professional aides were asked to identify care situations that they found morally distressing, and to elaborate on how moral concerns regarding the care of patients were raised and resolved. In this paper, we describe the experience of (...) moral distress related by nurses working in mental healthcare settings who believed that lack of resources (such as time and staff) leads to dispiritedness, lack of respect, and absence of recognition (for both patients and staff) which severely diminished their ability to provide quality care. The metaphors of flashlight and hammer are used to elaborate nurses’ possible responses to intolerable situations. (shrink)

This paper draws on findings from qualitative interviews with queer and trans patients and with physicians providing care to queer and trans patients in Halifax, Nova Scotia, Canada, to explore how routine practices of health care can perpetuate or challenge the marginalization of queers. One of the most common “measures” of improved cultural competence in health care practice is self-reported increases in confidence and comfort, though it seems unlikely that an increase in physician comfort levels with queer and trans patients (...) will necessarily mean better health care for queers. More attention to current felt discomfort in patient–provider encounters is required. Policies and practices that avoid discomfort at all costs are not always helpful for care, and experiences of shared discomfort in queer health contexts are not always harmful. (shrink)

Phenomenological interviews with queer women in rural Nova Scotia reveal significant forms of trauma experienced during labour and birth. Situating the accounts of participants within both phenomenological and intersectional analyses reveals harms enabled by structurally embedded heteronormative and homophobic healthcare practices and policies. Our account illustrates the breadth and depth of harm experienced and outlines how these violate core ethical principles and values in healthcare.

In this article, the theme of introductory engagement is developed through the conversational interviews and participatory observations I carried out with perinatal nurses and birthing women in the context of a feminist phenomenological methodology. Positioned against the landscape of hierarchical health care practices embedded with power dynamics and disembodied practices, this research explored the ways in which perinatal nurses related to birthing women in the context of relational care. The focus of attention in this article is to describe the theme (...) of introductory engagement by way of a storied phenomenological text. (shrink)

An understanding of autonomy has important significance in North American health care. Although a respect for autonomy is necessary to protect the self-determination and agency of birthing women in hospital settings, I suggest that enactments of autonomy that are independent of relationships offer only an incomplete interpretation of such a vital concept. In this article I explore an understanding of autonomy situated within the context of a relational birthing narrative. In so doing, autonomy becomes conceptualized as contextual and concrete, giving (...) rise to an embodied view of the birthing woman. (shrink)

Aims and objectives. Participant narratives from a feminist and queer phe- nomenological study aim to broaden current understandings of trauma. Examin- ing structural marginalisation within perinatal care relationships provides insights into the impact of dominant models of care on queer birthing women. More specifically, validation of queer experience as a key finding from the study offers trauma-informed strategies that reconstruct formerly disempowering perinatal relationships. Background. Heteronormativity governs birthing spaces and presents considerable challenges for queer birthing women who may also have (...) an increased risk of trauma due to structurally marginalising processes that create and maintain socially constructed differences. Design. Analysis of the qualitative data was guided by feminist and queer phe- nomenology. This was well suited to understanding queer women’s storied narra- tives of trauma, including disempowering processes of structural marginalisation. Methods. Semistructured and conversational interviews were conducted with a purposeful sample of thirteen queer-identified women who had experiences of birthing in rural Nova Scotia, Canada. Results. Validation was identified as meaningful for queer women in the context of perinatal care in rural Nova Scotia. Offering new perspectives on traditional models of assessment provide strategies to create a context of care that recon- structs the birthing space insofar as women at risk do not have to come out as queer in opposition to the expectation of heterosexuality. Conclusions. Normative practices were found to further the effects of structural marginalisation suggesting that perinatal care providers, including nurses, can challenge dominant models of care and reconstruct the relationality between queer women and formerly disempowering expectations of heteronormativity that govern birthing spaces. Relevance to clinical practice. New trauma-informed assessment strategies recon- struct the relationality within historically disempowering perinatal relationships through potentiating difference which avoids retraumatising women with re- experiencing the process of coming out as queer in opposition to the expectation of heterosexuality. (shrink)

The following Acknowledgments were omitted in the original publication.

In the first of a trilogy of articles published in the New England Journal of Medicine in May 2015, physician–journalist Lisa Rosenbaum observes that the crucial question regarding conflicts of interest between physicians and commercial industry is the extent to which interactions between the two are “beneficial or harmful to patients?”. She goes on to note that the answer to this question “depends on how you define harm,”1 and argues that many of the claims of harm flowing from COI (...) are incomplete, insufficient, or are based on “suggestive extrapolations from data”. If there are benefits to be gained from physician–industry relationships, and if the evidence... (shrink)

Presentism is held by most to be the intuitive theory of time, due in large part to the view's supposed preservation of time's passage. In this paper, I strike a blow against presentism's intuitive pull by showing how the presentist, contrary to overwhelming popular belief, is unable to establish temporal change upon which the passage of time is based. I begin by arguing that the presentist's two central ontological commitments, the Present Thesis and the Change Thesis, are incompatible. The main (...) problem is that satisfying the Change Thesis to establish passage requires the existence of more than one moment. This conflicts with the Present Thesis that only the present moment exists. The presentist's response is to appeal to surrogates to stand proxy for the past, so as to account for the difference between what does exist and what did exist. I argue that, for this surrogate strategy to be successful, the proposed surrogates must track what actually happened. I demonstrate that there is no guarantee that t.. (shrink)

Delusions are a common symptom of schizophrenia and dementia. Though most English dictionaries define a delusion as a false opinion or belief, there is currently a lively debate about whether delusions are really beliefs and indeed, whether they are even irrational. The book is an interdisciplinary exploration of the nature of delusions. It brings together the psychological literature on the aetiology and the behavioural manifestations of delusions, and the philosophical literature on belief ascription and rationality. The thesis of the book (...) is that delusions are continuous with ordinary beliefs, a thesis that could have important theoretical and practical implications for psychiatric classification and the clinical treatment of subjects with delusions. By bringing together recent work in philosophy of mind, cognitive psychology and psychiatry, the book offers a comprehensive review of the philosophical issues raised by the psychology of normal and abnormal cognition, defends the doxastic conception of delusions, and develops a theory about the role of judgements of rationality and of attributions of self-knowledge in belief ascription. Presenting a highly original analysis of the debate on the nature of delusions, this book will interest philosophers of mind, epistemologists, philosophers of science, cognitive scientists, psychiatrists, and mental health professionals. (shrink)

We are currently seeing dramatic changes in the ways we imagine and experience time. Permanent debt, unending violent conflict, climate change, economic instability, and widening social inequalities have led to suggestions that we are now living in the time of the 'end times'. In the shadow of a foreshortened future, the present is increasingly experienced as a form of 'non-stop inertia', resulting in experiences of time as both frenetic but also stuck - revving up, as Ivor Southwood puts it, to (...) go nowhere. So, where do we go and how when all options seem to have run their course and time is no longer moving forward? Enduring Time proposes some alternative relations of time which provide hopeful alternatives to the dominating models of oppression, limitation and exploitation. A strikingly original philosophy of time which also provides students and scholars with a rigorous and detailed survey of contemporary theories of time, Enduring Time is an indispensable read for those attempting to live meaningfully in the current age. (shrink)

Some claim that moral factors affect the epistemic status of our beliefs. Call this _the moral encroachment thesis_. It’s been argued that the moral encroachment thesis can explain at least part of the wrongness of racial profiling. The thesis predicts that the high moral stakes in cases of racial profiling make it more difficult for these racist beliefs to be justified or to constitute knowledge. This paper considers a class of racial generalizations that seem to do just the opposite of (...) this. The high moral stakes of the beliefs we infer from these generalizations make it _easier_ rather than _harder_ for these beliefs to be justified or to constitute knowledge. I argue that the existence of this class of cases—cases of “positive profiling”—give us reason to expand our account of moral encroachment in a way that brings it closer to the ideal of pragmatic encroachment that motivates it in the first place. (shrink)

A survey was administered during fall 2013 to 163 self-identified adult ethical vegans and/or ethical vegetarians in the United States to determine whether the respondents+ beliefs meet the definition of religion according to U.S. federal law. The data demonstrate that a majority of the surveyed group possesses beliefs concordant with the definition of "religion" according to federal statutes, federal judicial tests, and regulatory law. Since religion is a protected characteristic in U.S. law, and ethical veganism meets various definitions for religion, (...) then ethical veganism should be recognized as a religion and a protected characteristic under U.S. law. (shrink)

Locke’s metaphysical commitments are a matter of some controversy. Further controversy attends the issue of whether and how Locke adapts his views in order to accommodate the success of Newton’s Principia. The chapter lays out an interpretation of Locke’s commitments according to which Locke’s response to Newton on gravity does not require the positing of brute powers and is consistent with his core essentialism. The chapter raises the question of how the hypothesis concerning the creation of matter, alluded to at (...) 4.10.18, fits with these commitments. The chapter concludes that the De grav hypothesis would represent a significant revision to the background metaphysical picture of the Essay, but that nevertheless its attractions to Locke are intelligible and illuminating. (shrink)

Current approaches to formal representation in biomedicine are characterized by their focus on either the static or the dynamic aspects of biological reality. We here outline a theory that combines both perspectives and at the same time tackles the by no means trivial issue of their coherent integration. Our position is that a good ontology must be capable of accounting for reality both synchronically (as it exists at a time) and diachronically (as it unfolds through time), but that these are (...) two quite different tasks, whose simultaneous realization is by no means trivial. The paper is structured as follows. We begin by laying out the methodological and philosophical background of our approach. We then summarize the structure and elements of the Basic Formal Ontology on which it rests, in particular the SNAP ontology of objects and the SPAN ontology of processes. Finally, we apply the general framework to the specific domain of biomedicine. (shrink)

Stanford Encyclopedia Entry on Delusions.

This paper considers three modes of captivity with an eye to examining the effects of captivity on free agency and whether these modes depend on or constitute coercion. These modes are: physical captivity, psychological captivity, and social/legal captivity. All these modes of captivity may severely impact capacities a person relies on for free agency in different ways. They may also undermine or destroy a person’s identity-constituting cares and values. On a Nozick-style view of coercion, coercion amounts to conditional threats and (...) so many of the processes creating captivity are not coercive. However, this view overlooks the role that barriers to action play in making threats effective. Thus, an enforcement view of coercion is better to understand the coercion that takes place in captivity but the effects of the use of power on a captive’s psychology remains an important area of investigation. (shrink)

In this paper we address Bernard Williams' argument for the undesirability of immortality. Williams argues that unavoidable and pervasive boredom would characterise the immortal life of an individual with unchanging categorical desires. We resist this conclusion on the basis of the distinction between habitual and situational boredom and a psychologically realistic account of significant factors in the formation of boredom. We conclude that Williams has offered no persuasive argument for the necessity of boredom in the immortal life. 1.

There is no satisfactory account for the general phenomenon of confabulation, for the following reasons: (1) confabulation occurs in a number of pathological and non-pathological conditions; (2) impairments giving rise to confabulation are likely to have different neural bases; and (3) there is no unique theory explaining the aetiology of confabulations. An epistemic approach to defining confabulation could solve all of these issues, by focusing on the surface features of the phenomenon. However, existing epistemic accounts are unable to offer sufficient (...) conditions for confabulation and tend to emphasise only its epistemic disadvantages. In this paper, we argue that a satisfactory epistemic account of confabulation should also acknowledge those features which are (potentially) epistemically advantageous. For example, confabulation may allow subjects to exercise some control over their own cognitive life which is instrumental to the construction or preservation of their sense of self. (shrink)

Humans routinely transmit and interpret subtle information about their mental states through the language they use, even when only the language text is available. This suggests humans can utilize the linguistic signature of a mental state, comprised of features in the text. Once the relevant features are identified, mindprints can be used to automatically identify mental states communicated via language. We focus on the mindprints of eight mental states resulting from intentions, attitudes, and emotions, and present a mindprint-based machine learning (...) technique to automatically identify these mental states in realistic language data. By using linguistic features that leverage available semantic, syntactic, and valence information, our approach achieves near-human performance on average and even exceeds human performance on occasion. Given this, we believe mindprints could be very valuable for intelligent systems interacting linguistically with humans. Keywords: mental state; linguistic features; mindprint; natural language processing; information extraction. (shrink)

Lange (2000) famously argues that although Jeffrey Conditionalization is non-commutative over evidence, it’s not defective in virtue of this feature. Since reversing the order of the evidence in a sequence of updates that don’t commute does not reverse the order of the experiences that underwrite these revisions, the conditions required to generate commutativity failure at the level of experience will fail to hold in cases where we get commutativity failure at the level of evidence. If our interest in commutativity is, (...) fundamentally, an interest in the order-invariance of information, an updating sequence that does not violate such a principle at the more fundamental level of experiential information should not be deemed defective. This paper claims that Lange’s argument fails as a general defense of the Jeffrey framework. Lange’s argument entails that the inputs to the Jeffrey framework differ from those of classical Bayesian Conditionalization in a way that makes them defective. Therefore, either the Jeffrey framework is defective in virtue of not commuting its inputs, or else it is defective in virtue of commuting the wrong kinds of ones. (shrink)

For many years there has been a debate about the role of the parietal lobe in the generation of behavior. Does it generate movement plans (intention) or choose objects in the environment for further processing? To answer this, we focus on the lateral intraparietal area (LIP), an area that has been shown to play independent roles in target selection for saccades and the generation of visual attention. Based on results from a variety of tasks, we propose that LIP acts as (...) a priority map in which objects are represented by activity proportional to their behavioral priority. We present evidence to show that the priority map combines bottom-up inputs like a rapid visual response with an array of top-down signals like a saccade plan. The spatial location representing the peak of the map is used by the oculomotor system to target saccades and by the visual system to guide visual attention. (shrink)

The contributors to this special issue of _Tikkun_ seek to redefine the boundaries of political and ethical responsibility by crediting a worldview in which we are held to account for the well-being of everyone who has “passed through our city,” if only momentarily. Their conclusions challenge the ethos of materialism that _Tikkun_ believes is at the root of globalized capitalism and, alternatively, articulate a social justice ethos derived from the Jewish tradition of “accompaniment,” the call to take care of those (...) who enter our common space. Contributors from Christian, Muslim, and Jewish traditions bring an interfaith perspective to the foundations of social responsibility, laying the groundwork for a new global notion of justice. Drawing on a model from Rabbinic Judaism, one contributor discusses homelessness in Los Angeles, calling us to adopt a new, radical sense of obligation in relation to our neighbors. Another offers challenging insights from the point of view of one who grew up homeless. An essay from the Christian tradition expands this model by comparing our mutual relationships to body parts that all belong to the same whole. Another essay extracts from medieval Islamic texts a vision of the state as a caregiver and then compares this vision to life in Vancouver, where citizens’ taxes underwrite robust social services for those in need. Contributors:_ _Rumee Ahmed, Aryeh Cohen, Estelle Frankel, Jill Goldberg, Lisa “Tiny” Gray-Garcia, Peter Laarman, Ana Levy-Lyons, Alexia Salvatierra Michael Lerner is editor of _Tikkun_ and rabbi of Beyt Tikkun; his writings have appeared in many national publications. Alana Yu-lan Price is managing editor of _Tikkun_. Aryeh Cohen is a contributing editor to _Tikkun_. (shrink)

We aim to show how collective emotions can be incorporated into the study of episodes of political contention. In a critical vein, we systematically explore the weaknesses in extant models of collective action, showing what has been lost through a neglect or faulty conceptualization of collective emotional configurations. We structure this discussion in terms of a review of several “pernicious postulates” in the literature, assumptions that have been held, we argue, by classical social-movement theorists and by social-structural and cultural critics (...) alike. In a reconstructive vein, however, we also lay out the foundations of a more satisfactory theoretical framework. We take each succeeding critique of a pernicious postulate as the occasion for more positive theory-building. Drawing upon the work of the classical American pragmatists–especially Peirce, Dewey, and Mead–as well as aspects of Bourdieu's sociology, we construct, step by step, the foundations of a more adequate theorization of social movements and collective action. Accordingly, the negative and positive threads of our discussion are woven closely together: the dismantling of pernicious postulates and the development of a more useful analytical strategy. (shrink)

One of the deepest tensions in Locke’s Essay, a work full of profound and productive conflicts, is one between Locke’s metaphysical tendencies—his inclination to presuppose or even to argue for substantive metaphysical positions—and his devout epistemic modesty, which seems to urge agnosticism about major metaphysical issues. Both tendencies are deeply rooted in the Essay. Locke is a theorist of substance, essence, quality. Yet, his favorite conclusions are epistemically pessimistic, even skeptical; when it comes to questions about how the world is (...) constituted, our understandings cannot penetrate very far. Locke seems torn between metaphysics and modesty, between dogmatism and skepticism. This chapter will consider two specific examples of this sort of tension. The first involves the ontology of body, and the second, the ontology of mind. The conflict concerning bodily natures looks like this: As is well-known, Locke typically describes bodies in the terms of the corpuscularian science of his day, as exemplified especially by the natural philosopher Robert Boyle. Locke’s characterizations of the real essences of bodies are mechanist. He envisions them as corpuscularian textures-- spatial arrangements of particles possessing size. (shrink)

Contemporary philosophers and bioethicists argue that life extension is bad for the individual. According to the agency objection to life extension, being constrained as an agent adds to the meaningfulness of human life. Life extension removes constraints, and thus it deprives life of meaning. In the paper, I concede that constrained agency contributes to the meaningfulness of human life, but reject the agency objection to life extension in its current form. Even in an extended life, decision-making remains constrained, and many (...) obstacles to the fulfilment of an agent’s goals are preserved. Agents with longer lives are also presented with new challenges: for instance, it might be harder for them to avoid chronic boredom, and sustain their motivation to act in the pursuit of their goals. Although objections from agency and boredom are often used in combination to support the view that a much longer life is likely to bring misery or become meaningless, I argue that the acceptance of the boredom objection undermines the persuasiveness of the agency objection. (shrink)

This chapter contains section titled: I. Life and Works II. Theoretical Natural Philosophy: Boyle's Corpuscularianism III. Experimental Natural Philosophy and Methodology IV. Theology, Metaphysics, and Natural Philosophy V. Boyle's Influence.

Such an absence seems ultimately fatal. Yet as this volume amply demonstrates, the richness of his social theory can be opened up by contemporary feminism.

I. Introduction Siris, Berkeley's last major work, is undeniably a rather odd book. It could hardly be otherwise, given Berkeley's aims in writing it, which are three-fold: 'to communicate to the public the salutary virtues of tar-water,'1 to provide scientific background supporting the efficacy of tar-water as a medicine, and to lead the mind of the reader, via gradual steps, toward contemplation of God.2 The latter two aims shape Berkeley's extensive use of contemporary natural science in Siris. In particular, Berkeley's (...) focus on what he calls fire (or aether or light) as a quasiuniversal 'cause' of natural change3 serves these purposes, for the 'activity' of the aether, in his view, can both explain the miraculous virtues of a certain medicine, i.e. tar-water, and reveal God's action and his divine order.4 Berkeley's corpuscular speculations, including his use of fire-theory, are not especially idiosyncratic as natural philosophy. In his theorizing, as Jessop and other have noted, he is heavily indebted to the work of Hermann Boerhaave, the Dutch chemist, botanist, and physician whose teachings were highly influential in mid-eighteenth century Britain.5 Boerhaave, along with other Dutch natural philosophers cited by Berkeley, assigned a central role in accounting for physio-chemical activity to fire, a subtle, insensible particulate substance, sometimes identified with light. (shrink)

Feminists, critical race scholars, and other social‐justice theorists sometimes object to “abstraction” in liberal normative theory. Arguing that oppression affects individual agents in powerful yet subtle ways, they contend that allegedly abstract theories often reinforce oppressive power structures. Here I critically examine and ultimately reject Onora O'Neill's “abstraction without idealization” as a solution to this problem. Because O'Neill defines abstraction as simply the “bracketing of certain predicates,” her methodology fails to guide decisions about what to bracket and what to include (...) in the theory. Moreover, it may not be possible to abstract without also relying on some particular ideals. While abstraction is unavoidable, I conclude that it must be employed with greater attention to sociopolitical hierarchies and by using ideals that do not collude with structures of oppression. I discuss the work of Susan Babbitt and Elizabeth Anderson as examples of how nonoppressive ideals might be incorporated into normative theory. (shrink)

Descartes and Boyle were the most influential proponents of strict mechanist accounts of the physical world, accounts which carried with them a distinction between primary and secondary (or sensible) qualities. For both, the distinction is a piece of natural philosophy. Nevertheless the distinction is quite differently articulated, and, especially, differently grounded in the two thinkers. For Descartes, reasoned reflection reveals to us that bodies must consist in mere extension and its modifications, and that sensible qualities as we conceive of them (...) based on sense perception can pertain only to the mind. Just how we are supposed to arrive at this realization is, this essay will argue, a deep puzzle that brings us to the basic assumptions of Descartes' metaphysics. For Boyle, by contrast, while reflection can reveal the unique explanatory status of mechanism, and, thus, the primary/secondary quality distinction, only experience can confirm its truth. Our central focus will be on Descartes, and on the question: How does he intend to remove the sensible qualities from the physical world, how does he strip them from bodies? I will try to show that Descartes has an argument that he takes to show a priori that sensible qualities cannot be attributed to the material world (as foundational qualities, or, as we conceive of them based on sense experience). The argument fails, however, leaving him with at best a partly empirical case for removing the sensible qualities, based on the purported explanatory success of his physics. (shrink)

In _Law’s Rule_, Gerald Postema provides a robust theoretical framework of the rule of law that technology scholars can use to analyze power in the digital world. He articulates how the rule of law can be concerned with private power, and not just public power. His emphasis on the ethos of fidelity allows us to see how the rule of law of law may be degraded in the digital era through the erosion of the informal institutions and practices needed to (...) sustain the rule of law. In addition to outlining these contributions, this paper argues that Postema’s account of digital power needs to focus more on digital power structures rather than digital power wielding, that digital power structures erode many informal constraints on power, and that addressing sociotechnical systems might require rethinking law’s distinctive instrumentalities in order to embrace the use of digital technologies to increase transparency and compliance. (shrink)

Film Ethics considers a range of films and texts of film criticism alongside disparate philosophical discourses of ethics by Levinas, Derrida, Foucault, ...

Current controversy over whether the Office of Management and Budget system of racial and ethnic classification should be used in pharmacogenetics research as suggested by the U.S. Federal Drug Administration has been couched in terms of realist-social constructionist debates on race. The assumptions both parties to these debates share instead need to be relinquished—specifically, dichotomies between the social and scientific and what is descriptive and evaluative/normative. This paper defends a pragmatic approach to the question of the appropriateness of the OMB (...) group categories in pharmacogenetics research, an approach that is local and context-specific rather than global, incorporates practical and ethical as well as theoretical dimensions, and recognizes intersections of the social and the biological in the constitution of group categories. (shrink)

In this article, we explore how a posthumanist stance has enabled us to work a different consideration of the way in which voice is constituted and constituting in educational inquiry; that is, we position voice in a posthuman ontology that is understood as attributable to a complex network of human and nonhuman agents that exceed the traditional understanding of an individual. Drawing on the work of Deleuze and Guattari, Barad, and Bennett, we present a research artifact that illustrates how this (...) posthuman voice is productively bound to an agentic assemblage. The reconfiguration of a posthuman voice with/in an educational research artifact further enables us to explore various analytic questions: What happens when voice exceeds language and is more than vocalized words emanating from a speaking subject? If the materiality of voice is not limited to sound, how do we account for it? That is, how might the materiality of voice be located in the space of intra-action among human and non-human objects? We conclude with implications for thinking qualitative methodology in education differently. (shrink)

Philosophy and Happiness addresses the need to situate any meaningful discourse about happiness in a wider context of human interests, capacities and circumstances. How is happiness manifested and expressed? Can there be any happiness if no worthy life projects are pursued? How is happiness affected by relationships, illness, or cultural variants? Can it be reduced to preference satisfaction? Is it a temporary feeling or a persistent way of being? Is reflection conducive to happiness? Is mortality necessary for it? These are (...) the questions people ask themselves when they stop and think about how they feel, how their lives are going, and how they would be going if different choices had been made or different values had been prioritized. These are the questions that contributors to this volume begin to answer, adopting different methodologies, among which the analysis of widespread intuitions about imaginary and real-life scenarios, and reflection on the interpretation of the relevant empirical evidence emerging from psychology and economics. (shrink)

Nearly 90 % of allegations of biomedical research misconduct in the United States are dismissed by responsible institutions without any faculty assessment or auditable record. Recently, members of the U.S. Congress have complained that the penalties for those against whom findings of research misconduct are made are too light and that too few grant funds associated with research misconduct have been recovered for use by other researchers and taxpayers. Here we discuss the laws that empower federal agencies that can oversee (...) investigations of biomedical research misconduct: the Office of Research Integrity and the Office of the Inspector General, both located within the Department of Health and Human Services. Research misconduct investigations pertaining to U.S. physical sciences funded through the National Science Foundation are overseen by the NSF’s OIG. While OIGs may provide some improvement over the ORI in the handling of research misconduct, we have found that a much more serious flaw exists which undermines an ability to conduct performance audits of the effectiveness by which allegations of research misconduct are handled in the United States. Specifically, sufficient data do not need to be retained by U.S. research institutions funded by HHS or NSF to allow effective audit of why allegations of research misconduct are dismissed before being seen by faculty inquiry or investigative committees. U.S. federal Generally Accepted Government Auditing Standards, if applied to the research misconduct oversight process, would allow a determination of whether the handling of allegations of biomedical research misconduct actually functions adequately, and if not, how it might be improved. In particular, we propose that independent, external peer review under GAGAS audit standards should be instituted without delay in assessing the performance of ORI, or any other similarly tasked federal agency, in handling allegations of research misconduct. (shrink)