Members of the Clinical Ethics Consultation Affairs Standing Committee of the American Society for Bioethics and Humanities present a collection of insights and recommendations developed from their collective experience, intended for those engaged in the work of healthcare ethics consultation.

Representatives from eight European countries compared the legal, ethical and professional settings within which decision making for neonates takes place. When it comes to limiting treatment there is general agreement across all countries that overly aggressive treatment is to be discouraged. Nevertheless, strong emphasis has been placed on the need for compassionate care even where cure is not possible. Where a child will die irrespective of medical intervention, there is widespread acceptance of the practice of limiting aggressive treatment or alleviating (...) suffering even if death may be hastened as a result. Where the infant could be saved but the future outlook is bleak there is more debate, but only two countries have tested the courts with such cases. When it comes to the active intentional ending of life, the legal position is standard across Europe; it is prohibited. However, recognising those intractable situations where death may be lingering and unpleasant, Dutch paediatricians have reported that they do sometimes assist babies to die with parental consent. Two cases have been tried through the courts and recent official recommendations have set out standards by which such actions may be assessed. (shrink)

To gain insight into the reasons that the public may have for endorsing or eschewing pharmacological moral enhancement for themselves or for others, we used empirical tools to explore public attitudes towards these issues. Participants from the United States were recruited via Amazon’s Mechanical Turk and were randomly assigned to read one of several contrastive vignettes in which a 13-year-old child is described as bullying another student in school and then is offered an empathy-enhancing program. The empathy-enhancing program is described (...) as either involving taking a pill or playing a video game on a daily basis for four weeks. In addition, participants were asked to imagine either their own child bullying another student at school, or their own child being bullied by another student. This resulted in a 2 × 2 between-subjects design. In an escalating series of morally challenging questions, we asked participants to rate their overall support for the program; whether they would support requiring participation; whether they would support requiring participation of children who are at higher risk to become bullies in the future; whether they would support requiring participation of all children or even the entire population; and whether they would be willing to participate in the program themselves. We found that people were significantly more troubled by pharmacological as opposed to non-pharmacological moral enhancement interventions. The results indicate that members of the public for the greater part oppose pharmacological moral bioenhancement, yet are open to non-biomedical means to attain moral enhancement. [248 words]. (shrink)

Anecdotal evidence has long lamented the status of social studies in elementary classrooms as observed by preservice teachers. As standardized testing has risen for mathematics and language arts, social studies has been pushed aside. In the aftermath of accountability legislation such as No Child Left Behind, research indicates that social studies is less visible in elementary classrooms due to an instructional focus on tested content areas (e.g. math, language arts, reading). In this study, approximately 90 elementary preservice teachers enrolled in (...) a social studies methods course responded to a survey and indicated the frequency and quality of lessons they observed over the course of a single semester. Findings report that preservice elementary teachers witnessed few, if any, lessons in social studies in the elementary classroom. Implications for teacher education are discussed. (shrink)

Background To describe the preferences for disclosure of individual biomarker results among mothers participating in a longitudinal birth cohort. Methods We surveyed 343 mothers that participated in the Health Outcomes and Measures of the Environment Study about their biomarker disclosure preferences. Participants were told that the study was measuring pesticide metabolites in their biological specimens, and that the health effects of these low levels of exposure are unknown. Participants were asked whether they wanted to receive their results and their child's (...) results. In addition, they were asked about their preferred method (letter vs in person) and format (more complex vs less complex) for disclosure of results. Results Almost all of the study participants wanted to receive their individual results (340/343) as well as their child's results (342/343). However, preferences for receiving results differed by education level. Mothers with less than a college degree preferred in-person disclosure of results more often than mothers with some college education or a college degree (34.3% vs 17.4% vs 7.9%, p<0.001). Similarly, mothers with less than a college education preferred a less complex disclosure format than mothers with some college education or a college degree (59.7% vs 79.1% vs 86.3%, p<0.0001). Conclusion While almost all study participants preferred to receive results of their individual biomarker tests, level of education was a key factor in predicting preferences for disclosure of biomarker results. To ensure effective communication of this information, disclosure of biomarker results should be tailored to the education level of the study participants. (shrink)

According to some testimonies, the Aristotelian ethics have been torn between a hedonist reading, as much as an anti‑hedonist one, throughout Antiquity. From Critolaos to Verginius Rufus and Sosicrates, pleasure is considered both as “an evil [that] gives birth to many other evils” and as the first appropriate thing and the supreme good. This noteworthy disagreement stems from a famous difficulty within the Aristotelian corpus, raised by Aspasius, i.e. the alleged coexistence of two ‘definitions’ of pleasure in Aristotle’s Nicomachean Ethics (...) VII and X. In this paper, I offer a reconstruction of Alexander’s treatment of this difficulty, based on some passages from Alexander’s Ethical Problems and the Mantissa. I try to show that Alexander does not dismiss the so‑called “definition A” of pleasure as being spurious, although he obviously values more the definition B. Even if he never openly brands the definition A as “dialectic”, Alexander takes it as a reputable endoxon, which however needs to be emended in that it blurs the distinction between pleasure and activity. Pleasure only supervenes on the activity to which it is appropriate, and this supervenience is precisely what accounts for the inaccuracy of the definition A. As much as the child conflates the apparent good and the good, so the hedonist takes pleasure to be identical with the activity and the telos of human life. On the contrary, for Alexander, pleasure is actually only a sign of happiness and the shadow of the activity. (shrink)

In list-method directed forgetting, reexposure to forgotten List 1 items has been shown to reduce directed forgetting. proposed that reexposure to a few List 1 items only during a direct test of memory reinstates the entire List 1 episode. In the present experiments, part-list reexposure in the context of indirect as well as direct memory tests reduced directed forgetting. Directed forgetting was reduced when 50% or more of the items were reexposed, and was intact when only 25% were reexposed. Furthermore, (...) part-list reexposure appeared to reinstate only reexposed items-not the entire List 1 episode. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:A Plea for PityRobert H. KimballIntroductionDoes the ability to feel pity toward the unfortunate represent one of humanity's better instincts, on par with the capacity for love, compassion, and forgiveness? Or is pity actually one of our morally baser emotions, like jealousy, envy, or hatred, because pity can include contempt for its object and an attitude of morally reprehensible superiority on the part of the pitier? Surprisingly, there is (...) little philosophical consensus on this issue, with informed opinion nearly equally divided. That the same emotion can elicit such contrary evaluations shows how elusive a clear understanding of pity can be.Furthermore, is there something wrong—either logically or morally—with attempting to arouse the emotion of pity in others when they do not already feel it themselves (or do not feel it as intensely as we want them to)? Should appeals to pity be rejected because any emotion is inimical to clear thinking or simply irrelevant to the justification of action? Or is there something particularly morally reprehensible about trying to manipulate another's emotions and actions specifically on the basis of pity? Alternatively, at least in some cases could an exhortation to pity be an acceptable, even desirable, aspect of moral education or an often-necessary reminder to care about the misfortunes of others and not just to pursue our own self-interests? Surprisingly, opinion (at least in the informal fallacy tradition) is remarkably unanimous about the undesirability of appealing to pity. But I think their reasons can be improved upon.Traditional analyses of appeal to pity do not seriously analyze the emotion being appealed to, and most treatments of pity as an emotion do not address its use in rhetorical manipulation. I claim that what is wrong with appeal to pity can be satisfactorily understood only if pity itself is adequately understood. I propose to proceed by combining these two questions: what is wrong with pity? and what is wrong with appeal to pity? [End Page 301]In answering the second question, the textbook tradition of informal fallacy analysis holds that when a speaker attempts to arouse pity in an audience in order to induce an action, this situation should be interpreted not under the rubric of nonlogical causal influence, manipulation, or rhetorical persuasion but rather as belonging to the domain of (informal) logic, and in particular as a failed attempt at argument in which a descriptive premise that A pities B does not entail the normative conclusion that B deserves A's help (or that A should help B). Thus in the informal fallacy tradition, experiencing the emotion of pity is never a valid justification for action.2 I believe this rigid reason/emotion distinction has little basis in our actual belief-forming and decision-making practices. Nor do I believe that emotion should be excluded from reasoning, since our emotions are often informative and are sometimes more reliable guides to action than argument.In Appeal to Pity, Douglas Walton (1997) presents a nuanced and considerably more subtle alternative to the textbook tradition, in which he evaluates epistemically the effect of the emotional state of pity on practical reasoning. Analyzing such cases as charitable appeals (e.g., for starving people and disaster victims, arguments for hardship exemptions from general rules, and alleged atrocities), he emphasizes especially the particularizing nature of pity and the way it overrides universal principles, especially of justice. Under Walton's epistemic evaluation of pity, it emerges as a reason-clouding emotion under certain conditions. Furthermore, he shows how the occurrence of pity is susceptible to manipulation; he emphasizes especially cases in which pity is not actually deserved or justified but is manipulatively made to seem so.But Walton looks at a very small slice of the landscape of pity and what might be problematic about it. So in order to evaluate pity fully—not just epistemically but also as a moral emotion and its role in a fully flourishing life—we need to expand our concept of pity. In fact, pity is a very difficult and complex emotion to analyze (Solomon 1993).Definition of "pity"In pitying someone, such as a homeless person, a starving child, or a mutilated... (shrink)