We examine the role of need satisfaction in non-comparative justice ratings about endowments with goods. As normative approaches, we discuss utilitarianism, prioritarianism, and sufficientarianism. Using a vignette experiment, we show that a need context increases the prevalence of prioritarianistic and sufficientarianistic justice ratings, which leads to an ethically problematic sigmoid shape of the justice evaluation function.

Imagine that only the state can meet the need for housing but decides not to do so. Unsurprisingly, participants in a vignette experiment deem this scenario unjust. Hence, justice ratings increase when the living situation improves. To a lesser extent, this also holds beyond the need threshold, understood as the minimum amount necessary for a decent life. Surprisingly, however, the justice evaluation function is highly convex below this point. The resulting S-shaped curve is akin to the value function in prospect (...) theory, with the need threshold providing the point of reference and inflection. A control treatment without needs-information supports this interpretation. Needs-information furthermore compresses the perceived injustice of arbitrary inequality. As in prospect theory, such reference dependency suggests biases in judgment and decision making. A consequence may be that the lot of the poorest in society does not receive the attention it would otherwise get. (shrink)

Need considerations play an important role in empirically informed theories of distributive justice. We propose a concept of need-based justice that is related to social participation and provide an ethical measurement of need-based justice. The β-ε-index satisfies the need-principle, monotonicity, sensitivity, transfer and several »technical« axioms. A numerical example is given.

This book is derived from the author's Concise guide to ethics in mental health care, published in 2004. It has been revised, updated, and rewritten with new chapters, topics and data.

This new edition of Professionalism and Ethics: Q & A Self-Study Guide for Mental Health Professionals thoroughly updates the highly regarded and groundbreaking first edition, offering the contemporary reader clinical wisdom and ethical guidance for challenging times. As with its predecessor, the second edition features commentaries by leaders in psychiatric ethics, plus two foundational chapters on ethics and professionalism in the field of mental health. These commentaries and introductory chapters provide an overview of essential ethical principles and concepts, the professional (...) obligations of the mental health clinician, common ethical tensions found in practice, ethical aspects of caring for special populations, and ethical issues in professional training and research. The introductory chapters are followed by case-oriented questions and answers on core concepts and topics in clinical care, medical research, and interactions with colleagues and trainees. Topics explored in-depth include authorship, disclosure, and ethical peer review for scientific publications; assisted suicide and euthanasia; professional voyeurism versus patient privacy online and on social media; the appropriate process for reporting an impaired colleague; and problems of burnout, work-life balance, and professional well-being. Professionalism and Ethics: Q & A Self-Study Guide for Mental Health Professionals poses and plumbs critically important ethical dilemmas in a compelling, down-to-earth way for today's practitioners and learners. (shrink)

Professionalism and Ethics in Medicine: A Study Guide for Physicians and Physicians-in-Training is a unique self-study guide for practitioners and trainees covering the core competency areas of professionalism, ethics, and cultural sensitivity. This novel title presents real-world dilemmas encountered across the specialties of medicine, offering guidance and relevant information to assist physicians, residents, and medical students in their decision-making. The text is divided into two parts: Foundations and Questions with Answers. The first part provides a substantive foundation of knowledge in (...) the principles, scholarship, policy guidelines, and decision-making strategies of the modern health professions. The second part assists practitioners and trainees in preparing for the complex issues that arise each day in the settings where health professionals work and train – clinics, research centers, educational contexts, and communities. Developed by renowned leaders in a broad range of clinical fields, Professionalism and Ethics in Medicine: A Study Guide for Physicians and Physicians-in-Training is a major, invaluable contribution to the literature and an indispensable reference for clinicians at all levels. (shrink)

Many consumers implicitly associate sustainability with lower product strength. This so-called ethical = less strong intuition (ELSI) poses a major threat for the success of sustainable products. This article explores this pervasive lay theory and examines whether it is a key barrier for sustainable consumption patterns. Even more importantly, little is known about the underlying mechanisms that might operate differently at the implicit and explicit levels of the consumer’s decision-making. To fill this gap, three studies examine how the implicit judgments (...) that consumers activate automatically shape their consumption behaviors, in concert with their more controlled explicit beliefs about sustainable products. The Main Study investigates the ELSI’s imprint on actual shopping patterns and disentangles the implicit and explicit mechanisms of the lay theory. This paper also asks how this negative influence can be attenuated by examining whether the consumer’s interest in sustainable consumption reduces reliance on the ELSI. Two follow-up studies confirm the robustness from different methodological and practical perspectives. Implications for companies and policy makers are derived. (shrink)

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

Pancreatitis is a complex, progressively destructive inflammatory disorder. Alcohol was long thought to be the primary causative agent, but genetic contributions have been of interest since the discovery that rare PRSS1, CFTR and SPINK1 variants were associated with pancreatitis risk. We now report two associations at genome-wide significance identified and replicated at PRSS1-PRSS2 and X-linked CLDN2 through a two-stage genome-wide study. The PRSS1 variant likely affects disease susceptibility by altering expression of the primary trypsinogen gene. The CLDN2 risk allele is (...) associated with atypical localization of claudin-2 in pancreatic acinar cells. The homozygous CLDN2 genotype confers the greatest risk, and its alleles interact with alcohol consumption to amplify risk. These results could partially explain the high frequency of alcohol-related pancreatitis in men. © 2012 Nature America, Inc. All rights reserved. (shrink)

This paper seeks to draw policy makers into a discussion of the need to guide technological change and of the steps required to accomplish this.

With this issue we initiate the policy of expanding the scope of Tulane Studies in Philosophy to include, in addition to the work of members of the department, contributions from philosophers who have earned advanced degrees from Tulane and who are now teaching in other colleges and universities. The Editor THE LOGIC OF OUR LANGUAGE ROBERT L. ARRINGTON Wittgenstein wrote in the Tractatus that "logic is not a body of doctrine, but a mirror-image of the world. " 1 In (...) line with his suggestion that a proposition is a 'picture', Wittgenstein argued that propositions 'show' the logical structure of the real. He was insistent, however, that "the apparent logical form of a proposition need not be its real one. " 2 As a result of this we can misunderstand the structure of fact. Philosophical problems arise just when "the logic of our language is mis understood. " 3 It is common knowledge that much of this view of logic was rejected by Wittgenstein himself in the Philosophical Investi gations. There we are told that language has no ideal or sublime 4 logic which mirrors the structure of the extra-linguistic world. Consequently, inferences from the structure of language to the structure of that extra-linguistic world are invalid. Reality can be 'cut up' in any of a number of ways by language. Wittgenstein adopted a view of philosophy which would render that discipline a non-explanatory, non-critical study of the multiple ways in which language can be used. (shrink)

We propose a cognitive-dissonance model of norm compliance to identify conditions for selfishly biased information acquisition. The model distinguishes between: (i) objective norm compliers, for whom the right action is a function of the state of the world; (ii) subjective norm compliers, for whom it is a function of their belief. The former seek as much information as possible; the latter acquire only information that lowers, in expected terms, normative demands. The source of ‘moral wiggle room’ is not belief manipulation, (...) but the coarseness of normative prescriptions under conditions of uncertainty. In a novel experimental setup, we find evidence for such strategic information uptake. Our results suggest that attempts to change behavior by subjecting individuals to norms can lead to biased information acquisition instead of compliance. (shrink)

The definitive book on ethics for chemical dependency treatment professionals.

Community-based participatory research (CBPR) focuses on specific community needs, and produces results that directly address those needs. Although conducting ethical CBPR is critical to its success, few academic programs include this training in their curricula. This article describes the development and evaluation of an online training course designed to increase the use of CBPR in mental health disciplines. Developed using a participatory approach involving a community of experts, this course challenges traditional research by introducing a collaborative process meant to encourage (...) increased participation by special populations and narrow the parity gap in effective mental health treatment and services delivery. (shrink)

Human research is accepted in our society because it is seen as generating valuable new knowledge that may alleviate suffering and bring benefit to ill persons now and in the future (Brody 1998; Fa...

Little is known about how researchers view ethically salient aspects of human studies. As part of a National Institutes of Mental Health-funded study, the authors performed a confidential written survey to assess the attitudes, views, and experiences of researchers with institutional review board approved protocols at the University of New Mexico. A total of 363 researchers (57% response rate) participated. Investigators overall held favorable views of general ethical aspects of research and ethics-based safeguards, and they identified a positive role of (...) ethics training. Investigators with more experience encountering ethical problems (p < .001), more ethics training (p = .001), and a PhD or MD/PhD (p = .003) held more favorable general ethical perspectives. Women investigators (p < .03), nonphysician investigators (p < .001), those whose training had been helpful in resolving ethical dilemmas (p = .006), and those for whom spirituality is important (p = .008) more strongly endorsed ethical safeguards. Investigators perceive the scientific and ethical aspects of their work as valuable and linked, and they affirm the role of safeguards in human studies. Formal ethics preparation and training initiatives were also viewed positively by investigators. (shrink)

Recent studies show that psychiatry residents express a relatively greater need for ethics curricula than their colleagues in other specialties. Such studies have been limited in their generalizability because they were conducted at one site. This study of 151 psychiatry residents at seven U.S. psychiatry programs aims to address that limitation. Residents were surveyed on issues pertaining to ethics and professionalism education. Participants were found to support such curricula during training and to value its relevance to the practice of psychiatry. (...) Gender differences and the influence of the “hidden curriculum” on such results merit further study. (shrink)

The effects of research ethics training on medical students' attitudes about clinical research are examined. A preliminary randomized controlled trial evaluated 2 didactic approaches to ethics training compared to a no-intervention control. The participant-oriented intervention emphasized subjective experiences of research participants (empathy focused). The criteria-oriented intervention emphasized specific ethical criteria for analyzing protocols (analytic focused). Compared to controls, those in the participant-oriented intervention group exhibited greater attunement to research participants' attitudes related to altruism, trust, quality of relationships with researchers, desire (...) for information, hopes about participation and possible therapeutic misconception, importance of consent forms, and deciding quickly about participation. The participant-oriented group also agreed more strongly that seriously ill people are capable of making their own research participation decisions. The criteria-oriented intervention did not affect learners' attitudes about clinical research, ethical duties of investigators, or research participants' decision making. An empathy-focused approach affected medical students' attunement to research volunteer perspectives, preferences, and attributes, but an analytically oriented approach had no influence. These findings underscore the need to further examine the differential effects of empathy-versus analytic-focused approaches to the teaching of ethics. (shrink)

The effects of research ethics training on medical students' attitudes about clinical research are examined. A preliminary randomized controlled trial evaluated 2 didactic approaches to ethics training compared to a no-intervention control. The participant-oriented intervention emphasized subjective experiences of research participants. The criteria-oriented intervention emphasized specific ethical criteria for analyzing protocols. Compared to controls, those in the participant-oriented intervention group exhibited greater attunement to research participants' attitudes related to altruism, trust, quality of relationships with researchers, desire for information, hopes about (...) participation and possible therapeutic misconception, importance of consent forms, and deciding quickly about participation. The participant-oriented group also agreed more strongly that seriously ill people are capable of making their own research participation decisions. The criteria-oriented intervention did not affect learners' attitudes about clinical research, ethical duties of investigators, or research participants' decision making. An empathy-focused approach affected medical students' attunement to research volunteer perspectives, preferences, and attributes, but an analytically oriented approach had no influence. These findings underscore the need to further examine the differential effects of empathy-versus analytic-focused approaches to the teaching of ethics. (shrink)

Schizophrenia affects more than 1% of the world's population, causing great personal suffering and socioeconomic burden. These costs associated with schizophrenia necessitate inquiry into the causes and treatment of the illness but generate ethical challenges related to the specific nature and deficits of the illness itself. In this article, we present a systematic analysis of narrative data from 63 people living with the illness of schizophrenia collected through semistructured interviews about their attitudes, beliefs, and experiences related to psychiatric research. In (...) the comments of these individuals, half of whom had had prior personal experience in research protocols, we identified factors influencing openness toward research involvement as well as deterrents that appear to lessen interest in participation. Clear response pattern differences emerged between those with prior research experience and those without such experience. In the discussion, we explore these key findings and outline the implications for safeguards in mental illness research. (shrink)

Background: Empirical ethics inquiry works from the notion that stakeholder perspectives are necessary for gauging the ethical acceptability of human studies and assuring that research aligns with societal expectations. Although common, studies involving different populations often entail comparisons of trends that problematize the interpretation of results. Using graphical model selection—a technique aimed at transcending limitations of conventional methods—this report presents data on the ethics of clinical research with two objectives: (1) to display the patterns of views held by ill and (...) healthy individuals in clinical research as a test of the study's original hypothesis and (2) to introduce graphical model selection as a key analytic tool for ethics research. Methods: In this institutional review board (IRB)-approved, National Institutes of Health-funded project, data were collected from 60 mentally ill and 43 physically ill clinical research protocol volunteers, 47 healthy protocol-consented participants, and 29 healthy individuals without research protocol experience. Respondents were queried on the ethical acceptability of research involving people with mental and physical illness (i.e., cancer, HIV, depression, schizophrenia, and posttraumatic stress disorder) and non-illness-related sources of vulnerability (e.g., age, class, gender, ethnicity). Using a statistical algorithm, we selected graphical models to display interrelationships among responses to questions. Results: Both mentally and physically ill protocol volunteers revealed a high degree of connectivity among ethically salient perspectives. Healthy participants, irrespective of research protocol experience, revealed patterns of views that were not highly connected. Conclusions: Between ill and healthy protocol participants, the pattern of views was vastly different. Experience with illness was tied to dense connectivity, whereas healthy individuals expressed views with sparse connections. In offering a nuanced perspective on the interrelation of ethically relevant responses, graphical model selection has the potential to bring new insights to the field of ethics. (shrink)

This volume addresses the issues of the Third Age--that time after retirement when financial stability and reduced obligations to others, together, allow for freedom--and good health makes it possible to enjoy that freedom. How, in this special time of life, is meaning and purpose to be found? And what alternatives are available? These difficult questions are responded to by scholars in the field of aging, some themselves in the Third Age.

Like _Beyond All Appearances_,_ _which it supplements, Paul Weiss’s new book is a fundamental work which faces all the hard issues which are not only at the heart of philosophy but at the core of our entire culture. Readers of Mr. Weiss’s phenomenology of religion will need no introduction to this new work which expands and clari­fies many of the issues raised in _Beyond All Appearances. _However, no knowl­edge of Paul Weiss’s previous books is required to understand (...) and appreciate this brilliant new exposition. Weiss’s plain style makes his ideas accessible to all intelligent readers, whether or not they have been trained as professional philosophers. Here in _First Considerations _Mr. Weiss addresses himself to such topics as actuality, internalization, evidence, names, substance, being, natures and possibilities, existence, unity and the cosmos—issues which have engrossed him as a moral philosopher and meta­physician throughout his distinguished career. In his progress through the ideas and issues expounded in this new book Mr. Weiss is concerned with the human condition distinctive of this species of ours. Rigorously applied, his moral philosophy is as complete and thorough as that of any of the major thinkers, and provides as complete a guide as, for example, that of Buddhism. A highly original work, no doubt well in advance of current trends in philosophy, _First Considerations _will provoke further thought and discussion and will be regarded as a seminal work in modern philosophical approaches. (shrink)