Ethics courses are most commonly evaluated using reaction measures. However, little is known about the specific types of reaction data being collected and how these reaction data relate to improvements in trainee performance. Using a sample of 381 ethics training sessions, major reaction data categories were identified. Content and course satisfaction were the most frequently collected types of reaction criteria. Furthermore, content relevance and course satisfaction showed strong, positive relationships with performance criteria, whereas content satisfaction demonstrated a moderate, negative relationship. (...) These results and future directions for ethics training evaluation are discussed. (shrink)

ABSTRACT Research examining ethical decision-making has focused on how people engage in EDM, leading many researchers to focus on sensemaking models of EDM. Although the merits of a sensemaking approach with respect to EDM are evident in the literature, less is known about the specific cognitive processes by which sensemaking impacts EDM. This study examines the impact of three late-cycle cognitive processes – idea generation, evaluation, and revision – as well as the timing of these processes on EDM. Results indicate (...) that information gathering early on is critical to EDM; a finding which supports an active sensemaking model over an intuitive one. (shrink)

Despite the growing body of literature on training in the responsible conduct of research, few studies have examined the effectiveness of delivery formats used in ethics courses. The present effort sought to address this gap in the literature through a meta-analytic review of 66 empirical studies, representing 106 ethics courses and 10,069 participants. The frequency and effectiveness of 67 instructional and process-based content areas were also assessed for each delivery format. Process-based contents were best delivered face-to-face, whereas contents delivered online (...) were most effective when restricted to compliance-based instructional contents. Overall, hybrid courses were found to be most effective, suggesting that ethics courses are best delivered using a blend of formats and content areas. Implications and recommendations for future development of ethics education courses in the sciences are discussed. (shrink)

These essays critically reassess the widely accepted view that statistical methods of analysis can, and do, yield causal understanding of social phenomena. They emphasize the historical, philosophical and conceptual perspectives that underlie and inform current methodological controversies.

BackgroundThe proper and ethical inclusion of PWLHIV and their young children in research is paramount to ensure valid evidence is generated to optimize treatment and care. Little empirical data exists to inform ethical considerations deemed most critical to these populations. Our study aimed to systematically review the empiric literature regarding ethical considerations for research participation of PWLHIV and their young children.MethodsWe conducted this systematic review in partnership with a medical librarian. A search strategy was designed and performed within the following (...) electronic databases: Ovid MEDLINE, Embase and CINAHL. We screened titles and abstracts using the following inclusion criteria: (1) a study population of PWLHIV or children under 5 years of age; and (2) collection of qualitative or quantitative data regarding ethics of research participation. Excluded were reviews, commentaries, policy statements, clinical care-related ethics concerns, abstracts, case studies, or studies unrelated to HIV research. Studies were appraised for quality, data were extracted, and studies were qualitatively analyzed using a principle-based ethical framework within the Belmont Report.ResultsOf the 7470 titles identified, 538 full-text articles were reviewed for eligibility and only three articles met full criteria for inclusion within this review. While we allowed for inclusion of studies involving young children born to mothers with HIV, only articles focused on PWLHIV were identified. Within the results of these studies, four themes emerged: (1) adequacy of informed consent; (2) consideration of paternal involvement; (3) balancing risks; and (4) access to research and treatment. A strength of this review is that it included perspectives of international research investigators, community leaders, and male partners. However, only two studies collected empiric data from PWLHIV regarding their experiences participating in researchConclusionResearchers and funding agencies should be aware of these considerations and appreciate the value of and critical need for formative research to ensure clinical trials involving PWLHIV promote ethical, well-informed research participation and, ultimately, improve care outcomes. More research is needed to create a comprehensive ethical framework for researchers when conducting studies with PWLHIV. (shrink)

Traditional whistleblowing theories have purported that whistleblowers engage in a rational process in determining whether or not to blow the whistle on misconduct. However, stressors inherent to whistleblowing often impede rational thinking and act as a barrier to effective whistleblowing. The negative impact of these stressors on whistleblowing may be made worse depending on who engages in the misconduct: a peer or advisor. In the present study, participants are presented with an ethical scenario where either a peer or advisor engages (...) in misconduct, and positive and the negative consequences of whistleblowing are either directed to the wrongdoer, department, or university. Participant responses to case questions were evaluated for whistleblowing intentions, moral intensity, metacognitive reasoning strategies, and positive and negative, active and passive emotions. Findings indicate that participants were less likely to report the observed misconduct of an advisor compared to a peer. Furthermore, the findings also suggest that when an advisor is the source of misconduct, greater negative affect results. Post-hoc analyses were also conducted examining the differences between those who did and did not intend to blow the whistle under the circumstances of either having to report an advisor or peer. The implications of these findings for understanding the complexities involved in whistleblowing are discussed. (shrink)

Incapacitated adults with a legally appointed guardian or conservator may be recruited for or involved with medical, behavioral, or social science research. Much of the research in which such persons participate is aimed at evaluating medical interventions for them, or contributing to general knowledge about disorders from which they may suffer. In this paper we will consider how the appointment of guardians for patients with disorders of consciousness —severe brain injuries that affect a patient’s level of arousal and ability to (...) interact —impacts such patients’ access to research.Such persons may be under guardianship because they have lost decisional capacity (i.e., those in a coma or... (shrink)

This research examined the role of thought suppression in the formation of mental blocks. In Experiment 1, participants were asked to generate a series of creative associates for two target words after initially suppressing a word that was semantically related to one of the two target words. Participants produced fewer responses, and experienced a greater sensation of being mentally blocked, when attempting to produce associates for the target word that was semantically related to the suppressed word. In Experiment 2, participants (...) either thought about or suppressed a series of words prior to completing a word fragment completion task. Each word either corresponded exactly to one of the word fragment solutions or resembled one of the solutions but was slightly different in its orthographic properties. Participants performed most poorly on the items for which they had initially suppressed negative primes. (shrink)

This research examined the role of thought suppression in the formation of mental blocks. In Experiment 1, participants were asked to generate a series of creative associates for two target words after initially suppressing a word that was semantically related to one of the two target words. Participants produced fewer responses, and experienced a greater sensation of being mentally blocked, when attempting to produce associates for the target word that was semantically related to the suppressed word. In Experiment 2, participants (...) either thought about or suppressed a series of words prior to completing a word fragment completion task. Each word either corresponded exactly to one of the word fragment solutions or resembled one of the solutions but was slightly different in its orthographic properties . Participants performed most poorly on the items for which they had initially suppressed negative primes. (shrink)

As clinical trials end, little is understood about how participants exiting from clinical trials approach decisions related to the removal or post-trial use of investigational brain implants, such as deep brain stimulation (DBS) devices. This empirical bioethics study examines how research participants experience the process of exit from research at the end of clinical trials of implanted neural devices. Using a modified grounded theory study design, we conducted semi-structured, in-depth interviews with 16 former research participants from clinical trials of DBS (...) and responsive neurostimulation (RNS). Open-ended questions elicited motivations for joining the trial, understanding of study procedures at the time of initial informed consent, the process of exiting from research, and decisions about device removal or post-trial device use. Thematic analysis identified categories related to: limited preparedness for the end of research participation, straightforwardness of decisions to explant or keep the device, reconciling with the end of research participation, reconciling post-trial expectations, and achieving a sense of closure after exit from research. A preliminary theoretical model describes contextual factors influencing the process and experience of exit from research. Experiences of clinical trial participants should guide research practices to enhance the ethical design and conduct of clinical trials in DBS and other brain devices. (shrink)

Traditional whistleblowing theories have purported that whistleblowers engage in a rational process in determining whether or not to blow the whistle on misconduct. However, stressors inherent to whistleblowing often impede rational thinking and act as a barrier to effective whistleblowing. The negative impact of these stressors on whistleblowing may be made worse depending on who engages in the misconduct: a peer or advisor. In the present study, participants are presented with an ethical scenario where either a peer or advisor engages (...) in misconduct, and positive and the negative consequences of whistleblowing are either directed to the wrongdoer, department, or university. Participant responses to case questions were evaluated for whistleblowing intentions, moral intensity, metacognitive reasoning strategies, and positive and negative, active and passive emotions. Findings indicate that participants were less likely to report the observed misconduct of an advisor compared to a peer. Furthermore, the findings also suggest that when an advisor is the source of misconduct, greater negative affect results. Post-hoc analyses were also conducted examining the differences between those who did and did not intend to blow the whistle under the circumstances of either having to report an advisor or peer. The implications of these findings for understanding the complexities involved in whistleblowing are discussed. (shrink)

The announcement of the birth of Dolly the cloned sheep evoked widespread response from the Christian Churches. These responses are identified, organized thematically, and discussed critically. The churches have viewed reproductive human cloning either with unqualified opposition or with grave suspicion. Some statements have discussed animal cloning, generally granting limited approval, and nonreproductive human cloning, either in opposition or expressing an openness to entertain specific proposals as the technology develops.

As improvements in neuroscience have enabled a better understanding of disorders of consciousness as well as methods to treat them, a hurdle that has become all too prevalent is the denial of coverage for treatment and rehabilitation services. In 2011, a settlement emerged from a Vermont District Court case, Jimmo v. Sebelius, which was brought to stop the use of an “improvement standard” that required tangible progress over an identifiable period of time for Medicare coverage of services. While the use (...) of this standard can have deleterious effects on those with many chronic conditions, it is especially burdensome for those in the minimally conscious state, where improvements are unpredictable and often not manifested through repeatable overt behaviors. Though the focus of this paper is on the challenges of brain injury and the minimally conscious state, which an estimated 100,000 to 200,000 individuals suffer from in the United States, the post-Jimmo arguments presented can and should have a broad impact as envisioned by the plaintiffs who brought the case on behalf of multiple advocacy groups representing patients with a range of chronic care conditions. (shrink)

In A Dentist and a Gentleman the sociologist Tracey Adams retells a familiar professionalization story, this time about elite dental practitioners in nineteenth‐century Ontario who launched a status‐enhancement project to reshape their self‐ and public image into “professional gentlemen” and establish monopoly control over dental practice. Dentists secured legislation in 1868 giving them authority to set entrance requirements, test and license practitioners, and establish a college. In subsequent decades they campaigned against those they called “quacks” who practiced without a license, (...) advertised, charged low fees, maintained dirty offices, misled patients about pain, or brought the gentlemanly status of dentistry into disrepute.Despite early resistance, the project had mostly succeeded by 1918, as dentists skillfully linked their expertise to emerging public health concerns and a professional image subtly reoriented toward an ideal of public service. By 1900 dental rhetoric was warning Canadians of an impending crisis of tooth decay and dental disease that would bring physical deterioration and mass feeblemindedness in its wake. Racial degeneracy, dentists warned, began in the mouth; the advance of civilization produced too much soft food and sugar, too little chewing, and too many high‐strung and overindulgent mothers. Only dentists, as “sentinels at the portal of the alimentary tract” , could stand against this threat to Anglo‐Saxon civilization. Rhetoric like this, combined with doses of guilt heaped on mothers, teachers, school boards, and public health agencies, resulted by 1915 in regular dental inspections of schoolchildren, free dental clinics, and the creation of the army dental corps.Dentistry brought unique twists to this familiar professionalization story. Prior to 1860 dentistry was an especially low‐status craft, associated with uneducated, itinerant tooth‐drawers or craftsmen like blacksmiths and gunsmiths . Professionalizing dentists therefore felt a special imperative to recast themselves as “gentlemen”; this image also reassured the upper‐middle‐class women who were dentists' main clientele. Unexpectedly, as Adams shows in an intriguing analysis, dentists benefited from an invaluable social alliance with physicians, who offered no opposition of the sort they raised against other rival groups of healers to dentists' professional aspirations.The study deals extensively with how gender shapes professions. Dentistry's professionalization, Adams insists, involved the adoption of a new ideal of personal masculinity, as seen in admonitions to dentists to establish firm, courteous, expert authority over their clients and in dentists' efforts to shape the imagined persona of the ideal dental assistant as uniquely female and wifelike. This masculine crafting of the profession notwithstanding, Ontario dentists evinced less overt opposition to women aspirants than did doctors or lawyers. Nevertheless, the proportion of female practitioners was much lower in dentistry than in medicine or law and remains substantially lower today. Adams brings considerable insight to her discussion of these facts and their causes, and she presents useful comparisons among the professions.This study has a few limitations. Perhaps because the author's sources are mainly professional journals, her account mostly mirrors the outlook of the professionalizing elite and her prose occasionally adopts their moralizing and improving tone. Regrettably, the book deals scarcely at all with what dentists actually did. One learns little about how changing scientific and medical ideas affected dentists' work, how dentists utilized anaesthesia and coped with the problem of pain, and what controversies over diagnostics and treatment animated the profession or about dentists' training and income. This is a history of dentistry's professionalization, not of dental medicine per se. But Isis readers impressed by this solid and modest study will hope that a history of dental practice will be Tracey Adams's next project. (shrink)

The use of cost-benefit analysis (CBA) in environmental decision-making and the contingent valuation (CV) technique as input into traditional CBA to elicit environmental values in monetary terms has stimulated an extensive debate. Critics have questioned the appropriateness of both the method and the technique. Some alternative suggestions for the elicitation of environmental values are based on a social process of deliberation. However, just like traditional economic theory, these alternative approaches may be questioned on their implicit value judgements regarding the legitimacy (...) of the social-political organisation of the process of value elicitation. Instead of making assumptions a priori, research efforts should be focused on the processes by which actual public attitudes and preferences towards the environment can best be elicited and fed into environmental or other public policy decision-making. In the study presented in this paper, support was found for both the individual WTP based approach and a participatory social deliberation approach to inform the environmental decision-making process, suggesting that a combination of both approaches is most appropriate. (shrink)

Individualism: The Cultural Logic of Modernity is an edited collection of sixteen essays on the idea of the modern sovereign individual in the western cultural tradition. Reconsidering the eighteenth-century realist novel, twentieth-century modernism, and underappreciated topics on individualism and literature, this volume provocatively revises and enriches our understanding of individualism as the generative premise of modernity itself.

Within the past ten years, the discussion of the nature of folk psychology and its role in explaining behavior and thought has become central to the philosophy of mind. However, no comprehensive account of the contemporary debate or collection of the works that make up this debate has yet been available. Intending to fill this gap, this volume begins with the crucial background for the contemporary debate and proceeds with a broad range of responses to and developments of these works (...) -- from those who argue that "folk theory" is a misnomer to those who regard folk theory as legitimately explanatory and necessary for any adequate account of human behavior. Intended for courses in the philosophy of mind, psychology, and science, as well as anthropology and social psychology, this anthology is also of great value in courses focusing on folk models, eliminative materialism, explanation, psychological theory, and -- in particular -- intentional psychology. It is accessible to both graduate students and upper-division undergraduate students of philosophy and psychology as well as researchers. As an aid to students, a thorough discussion of the field and the articles in the anthology is provided in the introduction; as an aid to researchers, a complete bibliography is also provided. (shrink)

Deaths of Despair (DoD), or mortality resulting from suicide, drug overdose, and alcohol-related liver disease, have been rising steadily in the United States over the last several decades. In 2020, a record 186,763 annual despair-related deaths were documented, contributing to the longest sustained decline in US life expectancy since 1915–1918. This forum feature considers how health humanities disciplines might fruitfully engage with this era-defining public health catastrophe and help society better understand and respond to the crisis.

We are grateful to Friesen and colleagues for drawing attention to the tension between the protection of populations that may experience vulnerability with their inclusion in research (Friesen et a...

The scope of Philosophy in Multiple Voices provides the reader with eight philosophical streams of thought-African-American, Afro-Caribbean, Asian-American, Feminist, Latin-American, Lesbian, Native-American and Queer-that introduce readers to alternative, complex philosophical questions concerning gendered, sexed, racial and ethnic identities, canon formation, and meta-philosophy. The overriding theme of the text is that philosophy is pluralistic in voice, rich in diversity, and ought to valorize democratic intellectual spaces of philosophical engagement.