Growing literature has linked attention bias variability to the experience and treatment of posttraumatic stress disorder. Unlike assessments of attention bias in only one direction, A...

Recent research has provided compelling evidence that children experience the negative counterfactual emotion of regret, by manipulating the presence of a counterfactual action that would have led to participants receiving a better outcome. However, it remains unclear if children similarly experience regret’s positive counterpart, relief. The current study examined children’s negative and positive counterfactual emotions in a novel gain-or-loss context. Four- to 9-year-old children (N = 136) were presented with two opaque boxes concealing information that would lead to a gain (...) or loss of stickers, respectively. Half of the children chose between two keys that matched each box, whereas the other half were compelled to select one box because only one of the two keys matched. After seeing inside the alternative, non-chosen box, children were significantly more likely to report a change in emotion when they could have opened that box than when they could not have. The effects were similar for children who lost stickers and won stickers, and neither effect varied with age. These findings suggest that children may become capable of experiencing regret and relief around the same time, although their expression of these counterfactual emotions may vary with actual and counterfactual gains and losses. (shrink)

It is clear that the concept of scientific misconduct continues to evolve. As always it is the goal of Science and Engineering Ethics to move the discussion forward, to encourage and facilitate discussion of the ethical issues and problems that practicing scientists and engineers encounter in the course of pursuing their professions. This collection of articles and commentaries provides a variety of perspectives that we expect will facilitate communication among and within the groups who must participate in this evolution.

The cultivation of an organization’s moral resources has become a priority for many executives who understand that such resources are key to competitive advantage. Yet, traditional strategic management courses at both the undergraduate and MBA levels generally overlook these resources when discussing the resource-based view of the firm. We propose that moral resources be discussed in strategic management classrooms to provide additional insight for students about the critical nature of such resources. We also provide a simple tool for faculty to (...) use in the classroom to stimulate discussion and enhance student learning in this important area. (shrink)

The ethical culture of any organization is not simply a reflection of its mission statement or even its code of conduct. Rather, the real ethics of institutions are often embedded in their reward systems. We suggest how ethics professors can lead students to develop a greater understanding of rewards by providing a review of various forms of organizational rewards. We also offer insights into how professors can compare reward systems in their classes. We conclude by addressing a number of pedagogical (...) approaches that are useful in equipping ethics students with awareness and understanding of reward systems’ power and influence on employee attitudes and behaviors surrounding ethical decision making. (shrink)

Despite an increase in international business ethics research in recent years, the number of studies focused on Latin America and China has been deficient. As trade among Pacific Rim nations increases, an understanding of the ethical beliefs of the people in this region of the world will become increasingly important. In the current study 208 respondents from Peru and China are queried about their ethical ideologies, firm practices, and commitment to organizational performance. The empirical results reveal that Chinese workers are (...) more relativistic and less idealistic than their Peruvian counterparts. One explanation for the disparity between these two groups is likely the variation in collectivism that can be traced to different levels of importance across ingroups and outgroups. In addition to a summary of the results, future research directions and managerial implications are discussed. (shrink)

The ethical culture of any organization is not simply a reflection of its mission statement or even its code of conduct. Rather, the real ethics of institutions are often embedded in their reward systems. We suggest how ethics professors can lead students to develop a greater understanding of rewards by providing a review of various forms of organizational rewards. We also offer insights into how professors can compare reward systems in their classes. We conclude by addressing a number of pedagogical (...) approaches that are useful in equipping ethics students with awareness and understanding of reward systems’ power and influence on employee attitudes and behaviors surrounding ethical decision making. (shrink)

Based on a framework that integrates job demands-resources theory, social cognitive theory Handbook of personality, Guilford Press, New York, pp 154–196, 1999) and regulatory focus theory, the purpose of this research is to investigate the relationship between perceptions of organizational politics and subsequent moral disengagement and unethical behavior. We conducted a laboratory study and also collected data in two separate surveys 6 weeks apart from 206 individuals working full time to investigate the relationships presented in our model. In both studies, (...) we examined the direct relationship of politics perceptions on unethical behavior in organizations as well as the indirect relationship through the influence of moral disengagement. We investigated the moderating effect of regulatory focus on the relationship between moral disengagement and unethical behavior using the survey data. Results indicated that perceptions of politics were significantly related to our mediator, moral disengagement, which was significantly related to our dependent variable, unethical behavior. However, only prevention-focus moderated the relationships examined. Implications for future research and managerial practice are discussed. (shrink)

Using medical advances to enhance human athletic, aesthetic, and cognitive performance, rather than to treat disease, has been controversial. Little is known about physicians? experiences, views, and attitudes in this regard. We surveyed a national sample of physicians to determine how often they prescribe enhancements, their views on using medicine for enhancement, and whether they would be willing to prescribe a series of potential interventions that might be considered enhancements. We find that many physicians occasionally prescribe enhancements, but doctors hold (...) nuanced and ambiguous views of these issues. Most express concerns about the potential effects of enhancements on social equity, yet many also believe specific enhancements that are safe and effective should be available but not covered by insurance. These apparently contradictory views might reflect inherent tensions between the values of equity and liberty, which could make crafting coherent social policies on medical enhancements challenging. [Supplementary materials are available for this article. Go to the publisher's online edition of American Journal of Bioethics for the following free supplemental resource(s): An additional table (Table 5) referred to on p. 5]. (shrink)

Patients and physicians often perceive the current health care system to be unfair, in part because of the ways in which coverage decisions appear to be made. To address this problem the Ethical Force Program, a collaborative effort to create quality improvement tools for ethics in health care, has developed five content areas specifying ethical criteria for fair health care benefits design and administration. Each content area includes concrete recommendations and measurable expectations for performance improvement, which can be used by (...) those organizations involved in the design and administration of health benefits packages, such as purchasers, health plans, benefits consultants, and practitioner groups. (shrink)

With this issue, we begin a regular feature on bioethics and public health. We welcome Matthew K. Wynia, M.D., M.P.H., Director of the Institute for Ethics of the American Medical Association as our new Contributing Editor. If you have comments or suggestions regarding this feature, please email us at manuscript@ bioethics.net.

Responses to public health emergencies can entail difficult decisions about restricting individual liberties to prevent the spread of disease. The quintessential example is quarantine. While isolating sick patients tends not to provoke much concern, quarantine of healthy people who only might be infected often is controversial. In fact, as the experience with severe acute respiratory syndrome (SARS) shows, the vast majority of those placed under quarantine typically don't become ill. Efforts to enforce involuntary quarantine through military or police powers also (...) can backfire, stoking both panic and disease spread. Yet quarantine is part of a limited arsenal of options when effective treatment or prophylaxis is not available, and some evidence suggests it can be effective, especially when it is voluntary, home-based and accompanied by extensive outreach, communication and education efforts. Even assuming that quarantine is medically effective, however, it still must be ethically justified because it creates harms for many of those affected. Moreover, ethical principles of reciprocity, transparency, non-discrimination and accountability should guide any implementation of quarantine. (shrink)

There are three broad ethical issues related to handling public health emergencies. They are the three R's - rationing, restrictions and responsibilities. Recently, a severe shortage of annual influenza vaccine in the US, combined with the threat of pandemic flu, has provided an opportunity for policy makers to think about rationing in very concrete terms. Some lessons from annual flu vaccination likely will apply to pandemic vaccine distribution, but many preparatory decisions must be based on very rough estimates. What ethical (...) principles should guide rationing decisions, what data should inform these decisions, how to revise decisions as new data emerge, and how to implement rationing decisions on the ground are all important considerations. In addition, ethicists might be able to help policy makers think through the importance of international cooperation in surmounting global rationing dilemmas and to accept the inevitable responsibilities of government in making and implementing rationing decisions. (shrink)

Volume 20, Issue 7, July 2020, Page 75-77.

This paper describes how to ethically conduct research with Black populations at the intersection of COVID-19 and the Black Lives Matter movement. We highlight the issues of historical mistrust in the USA and how this may impact Black populations’ participation in COVID-19 vaccination trials. We provide recommendations for researchers to ethically engage Black populations in research considering the current context. Our recommendations include understanding the impact of ongoing trauma, acknowledging historical context, ensuring diverse research teams and engaging in open and (...) honest conversations with Black populations to better address their needs. The core of our recommendation is recognising the impact of trauma in our research and health care practices. (shrink)

*The views in this article are the author's alone and should not be construed as policy statements of the American Medical Association.

* Disclaimer: The views expressed are the author's own. This article should not be construed as representing policies of the American Medical Association.

The three primary ethical challenges in preparing for public health emergencies - addressing questions of rationing, restrictions and responsibilities - all entail confronting uncertainty. But the third, considering whether people and institutions will live up to their responsibilities in a crisis, is perhaps the hardest to predict and therefore plan for. The quintessential example of a responsibility during a public health emergency is that of health care professionals' obligation to continue caring for patients during epidemics. Historically, this 'duty to treat' (...) has sometimes gone unrecognized or ignored, but it has also famously been adhered to, including during the recent SARS epidemic. And non-crisis examples of health professionals working in the face of personal risk are very common. The duty to treat should be circumscribed by several considerations, including the levels or risk and benefit at issue, the degree of public reliance on health professional action, and the nature of the individual health professional's acceptance of greater than usual risk. Examining the professional duty to treat and the legitimate questions it raises can provide insight into other actors' responsibilities. Public health ethics as well as professional ethics can help frame answers to some key questions: How strong are ethical responsibilities during crises? To whom do they apply? Should they be more explicit - and hence more circumscribed - or less explicit and hence largely aspirational? And how can public health policies encourage responsible actions? (shrink)

Recent arguments over whether certain public health interventions should be mandatory raise questions about what counts as a "mandate." A mandate is not the same as a mere recommendation or the standard of practice. At minimum, a mandate should require an active opt-out and there should be some penalty for refusing to abide by it. Over-loose use of the term "mandate" and the easing of opt-out provisions could eventually pose a risk to the gains that truly mandatory public health interventions, (...) such as childhood vaccines, have provided over the last 50 years. Already, confusion about what counts as a mandate, and about what criteria should be used to determine when a public health intervention should be implemented as a mandate, has led to some inappropriate public policy decisions. For instance, by any reasonable criteria, the yearly influenza vaccine should be mandatory for health care workers. To enforce this mandate, those who refuse vaccination should be required to sign a waiver, and patients - especially those at high risk from flu - should be informed when they receive care from unvaccinated practitioners. (shrink)

*The views expressed are the author's own. This article should not be construed as representing policies of the American Medical Association.

Science communication via testimony requires a certain level of trust. But in the context of ideologically-entangled scientific issues, trust is in short supply—particularly when the issues are politically ‘entangled’. In such cases, cultural values are better predictors than scientific literacy for whether agents trust the publicly-directed claims of the scientific community. In this paper, we argue that a common way of thinking about scientific literacy—as knowledge of particular scientific facts or concepts—ought to give way to a second-order understanding of science (...) as a process as a more important notion for the public’s trust of science. (shrink)

*The views represented are the author's alone and should not be construed as representing policies of the American Medical Association.

Confidentiality is a core value in medicine and public health yet, like other core values, it is not absolute. Medical ethics has typically allowed for breaches of confidentiality when there is a credible threat of significant harm to an identifiable third party. Medical ethics has been less explicit in spelling out criteria for allowing breaches of confidentiality to protect populations, instead tending to defer these decisions to the law. But recently, issues in military detention settings have raised the profile of (...) decisions to breach medical confidentiality in efforts to protect the broader population. National and international ethics documents say little about the confidentiality of detainee medical records. But initial decisions to use detainee medical records to help craft coercive interrogations led to widespread condemnation, and might have contributed to detainee health problems, such as a large number of suicide attempts several of which have been successful. More recent military guidance seems to reflect lessons learned from these problems and does more to protect detainee records. For the public health system, this experience is a reminder of the importance of confidentiality in creating trustworthy, and effective, means to protect the public's health. (shrink)

Each year, infection with Human Papillomavirus (HPV) leads to millions of abnormal Pap smears and thousands of cases of cervical cancer in the US. Throughout the developing world, where Pap smears are less common, HPV is a leading cause of cancer death among women. So when the international pharmaceutical giant Merck developed a vaccine that could prevent infection with several key strains of HPV, the public health community was anxious to celebrate a major advance. But then marketing and lobbying got (...) in the way. Merck chose to pursue an aggressive lobbying campaign, trying to make its new vaccine mandatory for young girls. The campaign stoked public mistrust about how vaccines come to be mandated, and now it's not just Merck's public image that has taken a hit. The public health community has also been affected. What is the lesson to be learned from this story? Public health communication relies on public trust. (shrink)

The Centers for Disease Control and Prevention (CDC) recently recommended that HIV screening should become routine for all adults in the United States. Implicit in the CDC proposal is the notion that pre-test counseling would be more limited than at present, and that written informed consent to screening would no longer be required. If widely implemented, routine testing would mark a tremendous shift in the US HIV screening strategy. There are a number of considerations used to determine what screening tests (...) should be routine, and HIV fits the bill in almost every regard. Yet the stigma associated with HIV infection remains, making the CDC's recommendation highly controversial. Will minimizing requirements for pre-test counseling and special written informed consent lead to unexpected or unwanted HIV testing, or do these stringent counseling and consent requirements needlessly scare people away? Will widespread and routine testing be associated with declining stigmatization, or will it drive some patients away from seeking desperately needed health care? These are high stakes questions, and we're about to find out the answers. (shrink)

*Disclaimer: The views expressed are the author's and should not be ascribed to the American Medical Association.

The American Journal of Bioethics, Volume 11, Issue 7, Page 1-2, July 2011.

In lieu of an abstract, here is a brief excerpt of the content:Conflicts—and Consensus—about Conflicts of Interest in MedicineMatthew K. Wynia and Bette–Jane Crigger*This fascinating collection of essays about individual experiences of conflict of interest leaves little doubt that physicians remain divided about the importance, impact and meaning of conflicts of interest in their work. These essays offer differing views about what conflicts of interest look and feel like “on the ground” and about whether specific conflicts of interest are bad, (...) just a fact of life, or maybe even good.Conflict, Conflict EverywhereThese essays situate conflict of interest in a variety of contexts: the treatment recommendations a physician makes for an individual patient; the relationship between teaching physician and medical student or practicing physician and health care organization; the interaction between academic researchers and industry collaborators or professional bodies and industry supporters. In this, the narratives taken together reflect the scope of concern about conflict of interest in medicine familiar in the literature. In his classic 1993 essay, Dennis Thompson noted that concerns about conflict of interest encompass issues of physician self–referral, risk sharing between physicians and health care institutions, gifts from industry, hospital purchasing practices, as well as sponsored research and research with patients (Thompson 1993). To that list have subsequently been added relationships with industry in medical education at all levels, physicians’ service as consultants to industry or members of industry speakers bureau, and development of clinical practice guidelines (Lo & Fields 2009).That almost none of these essays draw attention to some widely publicized situations of conflict of interest—for example, gifts to physicians or the provision of drug samples—should, we think, be seen more as an artifact of the authors’ varied individual experiences than as a failure by the authors to engage key concerns in the ongoing professional and public debate. It could also be that the authors, asked to submit personal stories, assumed that yet another essay about the ‘traditional’ issues in the conflicts of interest literature would be seen as redundant, routine or even boring. Or, there is the tantalizing possibility that the absence of some of the more familiar conflicts from these narratives is the early fruit of efforts to address these traditional issues through policies governing interactions between physicians and industry promulgated by academic medical centers and health systems, medical specialty societies, and industry.One significant area of concern that has emerged in recent years is conflict of interest in the development of clinical practice guidelines. E.g., Choudry et al. 2002; Sniderrman & Furberg 2009; Guyatt et al. 2010. Although none of the essays in this [End Page 101] collection address it head on, Perlmutter touches on several key issues. His depiction of how an FDA committee process limited the input he was able to provide as an expert, undermined his potential to contribute to the professional dialogue, and raised concerns about the objectivity of the drug approval process echoes concerns about objectivity, the role of expert opinion, and the presence on guideline development panels of individuals with financial interests in the recommendations to be developed that have been explored at some length in the literature, most recently by the Institute of Medicine in reports on evidentiary standards (Eden et al 2011) and principles for guideline development (Graham et al. 2011).Conflict of Interest or Dual Agency?Several essays set out physicians’ experience in navigating situations of diverging expectations. Bierut, for example, reflects on the disjunction between the goals and products of academic researchers and commercial sponsors. She saw herself advancing basic knowledge and was forced to grapple with the reality of sponsors’ goals to advance commercial ends as well. Nagldinne and Mikulec each recall struggles to reconcile their obligation to exercise professional judgment on behalf of patients with the demands of health care organizations focussed also on the bottom line. Cruz–Flores attests to the challenge of making recommendations for care when one is both a practicing clinician and a clinical investigator engaged in research that might offer benefit to a patient for whom there are limited options.Thompson defined conflicts of interest as “a set of conditions in which professional judgment concerning a primary interest (such as a patient’s welfare or the validity of... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Patricia Kelly, Ressourcement Theology:A Review EssayMatthew K. MinerdIntroductionAlthough now over seventy years in the past, the theological and ecclesiastical events of the 1940s, most often styled under some banner akin to "the crisis over the nouvelle théologie," leading up to the promulgation of the encyclical Humani Generis, retain a currency and interest to this very day. No doubt, the later influence of many of the so-called nouveaux théologiens leading (...) up to, during, and following the Second Vatican Council has contributed to the continued currency of their thought and the debates connected to it. Numerous monographs continue to be written concerning themes of "ressourcement," theological reform, and engagement with the world, all of which were dear to many of those who were embroiled in the philosophical and theological controversies of the 1930s and 1940s. Moreover, increased interest in certain long-buried conservative Thomist thinkers from this same era has led to renewed consideration regarding the concerns that they expressed at the time. In fact, it would seem that today, in 2022, the evaluation expressed in Nineteenth Century Scholasticism: The Search for a Unitary Method by Fr. Gerald McCool (from a perspective rather different from my own) remains true, as the Church continues to live in the midst of an ongoing crisis of modernity that places us in tight continuity with so much of the past several centuries of European Christian intellectual history:In contemporary Catholic theology, the relationship between apologetics, or fundamental theology, and speculative theology is as much [End Page 353] an issue as it was in the nineteenth century.... And in contemporary Catholic theology, the relation between positive theology and speculative theology still remains a problem whose solution demands the use of a coherent system of epistemology and metaphysics.... The contemporary debate over theological method is simply another phase in the dialectical movement of Catholic theology's response to post-Enlightenment thought from the beginning of the nineteenth century through Vatican I, Aeterni Patris, the modernist crisis, between-the-wars Thomism, the New Theology controversy, and Vatican II up to the present.1The great crisis of the 1940s—whether we name it nouvelle théologie, after the reform-advocates of the era, or dialogue theologique, in honor of the Toulouse Dominicans' attempt to present a Scholastic position between, on the one hand, Fr. Chenu's and Congar's view of what the Saulchoir should be, and, on the other hand, the more-conservative Thomism of Frs. Garrigou-Lagrange, Gagnebet, and Gillon in Rome2—was and remains, in the words of Etienne Fouilloux, "the only theological debate of real [quelque] importance, at least in France, from the condemnation of Modernism to the time of the Second Vatican Council."3 And like any truly great event or crisis in intellectual-spiritual culture, it remains with us today in its fruits, both resolved and unresolved.Thus, when a new work is published dedicated to these events and the figures involved therein, the Catholic intellectual world should take heed, for our own self-understanding—whatever sui iuris Church in which we are ascribed—is at stake. Hence, the arrival of the collection of translations by Dr. Patricia Kelly of the University of St. Andrews is an event to be welcomed, even if elements of its publication also give rise to concern. This volume, Ressourcement Theology: A Sourcebook,4 gathering together essays by various parties involved on both sides of the specifically Francophone debates over theological method and truth that came to a head in the 1940s, provides the reading public with a dual "service": it presents in English a [End Page 354] number of texts not heretofore available, while also, unfortunately, bearing witness to the academic prejudices lingering against the authors writing from Rome and Toulouse concerning certain veins of thought in theological methodology during the inter-war and immediate post-war era. Although my review will be somewhat negative on certain points—both for technical textual reasons and because of the slanted narrative presented by Dr. Kelly—I wish only the best to her and her work, hoping that the concerns that I voice can serve as a springboard to dialogue, not retrenchment... (shrink)

Dispersal of biota by humans is a hallmark of civilization, but the results are often unforeseen and sometimes costly. Like kudzu vine in the American South, some examples become the stuff of regional folklore. In recent decades, "invasion biology," conservation-motivated scientists and their allies have focused largely on the most negative outcomes and often promoted the perception that introduced species are monsters. However, cases of monstering by scientists preceded the rise of popular environmentalism. The story of tamarisk (Tamarix spp.), flowering (...) trees and shrubs imported to New England sometime before 1818, provides an example of scientific "monstering" and shows how slaying the monster, rather than allaying its impacts, became a goal in itself. Tamarisks' drought and salt tolerance suggested usefulness for both coastal and inland erosion control, and politicians as well as academic and agency scientists promoted planting them in the southern Great Plains and Southwest. But when erosion control efforts in Arizona, New Mexico and Texas became entangled with water shortages, economic development during the Depression and copper mining for national defense during World War Two, federal hydrologists moved quickly to recast tamarisks as water-wasting foreign monsters. Demonstrating significant water salvage was difficult and became subsidiary to focusing on ways to eradicate the plants, and a federal interagency effort devoted specifically to the latter purpose was organized and continued until it, in turn, conflicted with regional environmental concerns in the late 1960s. (shrink)

*The views expressed are the author's own. This article should not be construed as representing policies of the American Medical Association.

The scientific community, we hold, often provides society with knowledge—that the HIV virus causes AIDS, that anthropogenic climate change is underway, that the MMR vaccine is safe. Some deny that we have this knowledge, however, and work to undermine it in others. It has been common to refer to such agents as “denialists”. At first glance, then, denialism appears to be a form of skepticism. But while we know that various denialist strategies for suppressing belief are generally effective, little is (...) known about which strategies are most effective. We see this as an important first step toward their remediation. This paper leverages the approximate comparison to various forms of philosophical skepticism to design an experimental test of the efficacy of four broad strategies of denial at suppressing belief in specific scientific claims. Our results suggest that assertive strategies are more effective at suppressing belief than questioning strategies. (shrink)