We argue that a turn toward virtue ethics as a way of understanding medical professionalism represents both a valuable corrective and a missed opportunity. We look at three ways in which a closer appeal to virtue ethics could help address current problems or issues in professionalism education—first, balancing professionalism training with demands for professional virtues as a prerequisite; second, preventing demands for the demonstrable achievement of competencies from working against ideal professionalism education as lifelong learning; and third, avoiding temptations to (...) dismiss moral distress as a mere “hidden curriculum” problem. As a further demonstration of how best to approach a lifelong practice of medical virtue, we will examine altruism as a mean between the extremes of self-sacrifice and selfishness. (shrink)

An individual's health, genetic, or environmental-exposure data, placed in an online repository, creates a valuable shared resource that can accelerate biomedical research and even open opportunities for crowd-sourcing discoveries by members of the public. But these data become “immortalized” in ways that may create lasting risk as well as benefit. Once shared on the Internet, the data are difficult or impossible to redact, and identities may be revealed by a process called data linkage, in which online data sets are matched (...) to each other. Reidentification, the process of associating an individual's name with data that were considered deidentified, poses risks such as insurance or employment discrimination, social stigma, and breach of the promises often made in informed-consent documents. At the same time, re-ID poses risks to researchers and indeed to the future of science, should re-ID end up undermining the trust and participation of potential research participants. The ethical challenges of online data sharing are heightened as so-called big data becomes an increasingly important research tool and driver of new research structures. Big data is shifting research to include large numbers of researchers and institutions as well as large numbers of participants providing diverse types of data, so the participants’ consent relationship is no longer with a person or even a research institution. In addition, consent is further transformed because big data analysis often begins with descriptive inquiry and generation of a hypothesis, and the research questions cannot be clearly defined at the outset and may be unforeseeable over the long term. In this article, we consider how expanded data sharing poses new challenges, illustrated by genomics and the transition to new models of consent. We draw on the experiences of participants in an open data platform—the Personal Genome Project—to allow study participants to contribute their voices to inform ethical consent practices and protocol reviews for big-data research. (shrink)

This essay is composed of five stories written by practicing physicians about their patients. Each clinical story describes a challenging ethical condition–potential abuse of medical power, gravely ill and probably over-treated newborns, iatrogenic narcotic addiction, deceived dying people. Rather than singling out one ethical conflict to resolve or adjudicate, the authors attempt, through literary methods, to grasp the singular experiences of their patients and to act according to the deep structures of their patients' lives. Examining these five stories with simple (...) literary tools–attention to narrative frames, time, plot, and desire–reveals the mechanisms through which acts of writing and reading contribute to clinical clarity and ethical actions. (shrink)

An informed consent and voluntary assent in biomedical research with adolescents is contingent on a variety of factors, including adolescent and parent perceptions of research risk, benefit, and decision-making autonomy. Thirty-seven adolescents with asthma and their parents evaluated a high or low aversion form of a pediatric asthma research vignette and provided an enrollment decision; their perceptions of family influence over the participation decision; and evaluations of risk, aversion, benefit, and burden of study procedures. Adolescents and their parents agreed on (...) research participation decisions 74% of the time, yet both claimed ultimate responsibility for the participation decision. Both rated most study procedures as significantly more aversive than risky. Parents were more likely to rate aspects of the hypothetical study as beneficial and to provide higher risk ratings for procedures. Disagreements concerning research participation decisions and decision-making autonomy have implications for the exercise of voluntary assent in biomedical research. (shrink)

A letter to the editor from Howard Brody, David Buchanan, and Franklin G. Miller in response to the recent article by Erik Malmqvist Understanding Exploitation," March-April 2011).

Originally published in 1948, this book contains an edited version of The Tree of Commonwealth, which was written by Edmund Dudley while imprisoned in the Tower of London in 1509 prior to his execution for treason the following year. Brodie notes any variations between manuscripts and provides a brief biography of Dudley and the impact of his famous text on later monarchs. This book will be of value to anyone with an interest in Tudor history or the history of (...) English statesmanship. (shrink)

Psychological literacy, the ability to apply psychological knowledge to personal, family, occupational, community and societal challenges, is promoted as the primary outcome of an undergraduate education in psychology. As the concept of psychological literacy becomes increasingly adopted as the core business of undergraduate psychology training courses world-wide, there is urgent need for the construct to be accurately measured so that student and institutional level progress can be assessed and monitored. Key to the measurement of psychological literacy is determining the underlying (...) factor-structure of psychological literacy. In this paper we provide a first approximation of the measurement of psychological literacy by identifying and evaluating self-report measures for psychological literacy. Multi-item and single-item self-report measures of each of the proposed nine dimensions of psychological literacy were completed by two samples (N = 218 and N = 381) of undergraduate psychology students at an Australian university. Single and multi-item measures of each dimension were weakly to moderately correlated. Exploratory and confirmatory factor analyses of multi-item measures indicated a higher order three factor solution best represented the construct of psychological literacy. The three factors were reflective processes, generic graduate attributes, and psychology as a helping profession. For the measurement of psychological literacy to progress there is a need to further... (shrink)

The Patient Self Determination Act of 1991 brought much needed attention to the importance of advance care planning and surrogate decision-making. The purpose of this law is to ensure that a patient’s preferences for medical care are recognized and promoted, even if the patient loses decision-making capacity. In general, patients are presumed to have DMC. A patient’s DMC may come under question when distortions in thinking and understanding due to illness, delirium, depression or other psychiatric symptoms are identified or suspected. (...) Physicians and other healthcare professionals working in hospital settings where medical illness is frequently comorbid with depression, adjustment disorders, demoralization and suicidal ideation, can expect to encounter ethical tension when medically sick patients who are also depressed or suicidal request do not resuscitate orders. (shrink)

For many years the damages available to an employee in a wrongful dismissal action have been somewhat limited. A conservative approach to the question of measure of damages has prevailed and the recoverable heads of damage have been restricted. In particular, damages for injury to feelings and reputation have not been available. The House of Lords decision in Malik v BCCI [1998] AC 20, where the plaintiffs were held to be entitled to compensation for the damage the dismissals caused to (...) future employment prospects, has resulted in a significant change in the law. The decision in Malik comes at a time when the law of the employment contract is undergoing significant change. Perhaps the most notable instance of this has been the emergence of the implied obligation of mutual trust and confidence; that obligation being central to the plaintiffs case in Malik. Against that background this article considers whether further reform of the damages available in a wrongful dismissal action might usefully take place. It is argued that, for reasons of public policy, the law should aim to compensate fully an employee who has been wrongfully dismissed. This would involve a radical re-thinking on the approach to measure of damages. It would also require a change in the position on compensation for injury to feelings. (shrink)

Background If trials of therapeutic interventions are to serve society's interests, they must be of high methodological quality and must satisfy moral commitments to human subjects. The authors set out to develop a clinical - trials compendium in which standards for the ethical treatment of human subjects are integrated with standards for research methods. Methods The authors rank-ordered the world's nations and chose the 31 with >700 active trials as of 24 July 2008. Governmental and other authoritative entities of the (...) 31 countries were searched, and 1004 English-language documents containing ethical and/or methodological standards for clinical trials were identified. The authors extracted standards from 144 of those: 50 designated as ‘core’, 39 addressing trials of invasive procedures and a 5% sample of the remainder. As the integrating framework for the standards we developed a coherent taxonomy encompassing all elements of a trial's stages. Findings Review of the 144 documents yielded nearly 15 000 discrete standards. After duplicates were removed, 5903 substantive standards remained, distributed in the taxonomy as follows: initiation, 1401 standards, 8 divisions; design, 1869 standards, 16 divisions; conduct, 1473 standards, 8 divisions; analysing and reporting results, 997 standards, four divisions; and post-trial standards, 168 standards, 5 divisions. Conclusions The overwhelming number of source documents and standards uncovered in this study was not anticipated beforehand and confirms the extraordinary complexity of the clinical trials enterprise. This taxonomy of multinational ethical and methodological standards may help trialists and overseers improve the quality of clinical trials, particularly given the globalisation of clinical research. (shrink)

Human clinical research has become a huge economic enterprise (Morin et al. 2002; Noah 2002). Because the human subject at the center can be so easily marginalized, many commentators recommend spec...

Morality based upon categorical imperatives. On a supposed right to tell lies from benevolent motives, by I. Kant.--Utilitarian morality, by H. Sidgwick.--What makes right acts right? by Sir D. Ross.--Utilitarianism, universalisation, and our duty to be just, by J. Harrison.--Extreme and restricted utilitarianism, by J. J. C. Smart.--What if everyone did that? by C. Strang.--Toward a credible form of utilitarianism, by R. B. Brandt.

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)

Family medicine has grown as a specialty from its early days of general practice. It was established as a Board Certified specialty in 1969. This growth and maturation can be traced in the philosophy of family medicine as articulated by Edmund D. Pellegrino, M.D. Long before it was popular to do so, Pellegrino supported the development of family medicine. In this essay I examine the development of Pellegrino's philosophical thought about family practice, and contrast it to other thinkers like Ian (...) McWhinney, Kerr White, Walter Spitzer, Donald Ransom, and Hebert Vandervoort. The arguments focus on whether the goals of family medicine and family practice (possibly two distinct entities) can be articulated, especially considering the definitional problems of family and community. I conclude by echoing Pellegrino's hope that family medicine can contribute a fresh alternative to isolated, individualistic and technological thinking in medicine. (shrink)

Chauncey D. Leake (1896–1978) occupies a unique place in the history of American bioethics. A pharmacologist, he was largely an autodidact in both history and philosophy, and believed that ethics should ideally be taught to medical students by those with philosophical training. After pioneering work on medical ethics during the 1920s, he helped to lay the groundwork for important centers for bioethics and medical humanities at two institutions where he worked, the University of California-San Francisco and the University of Texas (...) Medical Branch-Galveston. Understanding Leake’s role in American bioethics requires navigating a number of paradoxes—why he was described respectfully in his time but largely forgotten today; how in the 1920s he could write forward-looking pieces that anticipated many of the themes taken up by bioethics a half-century later, yet played largely a reactionary role when the new bioethics actually arrived; and why he advocated turning to philosophy and philosophers for a proper understanding of ethics, yet appeared often to misunderstand philosophical ethics. (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...

Edmund D. Pellegrino has played a central role in shaping the fields of bioethics and the philosophy of medicine. His writings encompass original explorations of the healing relationship, the need to place humanism in the medical curriculum, the nature of the patient’s good, and the importance of a virtue-based normative ethics for health care. In this anthology, H. Tristram Engelhardt, Jr., and Fabrice Jotterand have created a rich presentation of Pellegrino’s thought and its development. Pellegrino’s work has been dedicated to (...) showing that bioethics must be understood in the context of medical humanities, and that medical humanities, in turn, must be understood in the context of the philosophy of medicine. Arguing that bioethics should not be restricted to topics such as abortion, third-party-assisted reproduction, physician-assisted suicide, or cloning, Pellegrino has instead stressed that such issues are shaped by foundational views regarding the nature of the physician-patient relationship and the goals of medicine, which are the proper focus of the philosophy of medicine. This volume includes a preface by Dr. Pellegrino and a comprehensive Introduction by the editors. Of interest to medical ethicists as well as students, scholars, and physicians, _The Philosophy of Medicine Reborn_ offers fascinating insights into the emergence of a field and the work of one of its pioneers. “After a long period of dormancy, philosophy of medicine has blossomed with new life. The single most important physician-philosopher in that rebirth has been Edmund Pellegrino. His contributions to virtue theory, the concept of beneficence, the dispute over the internal and external sources of a morality for medicine, and the role of the Hippocratic tradition are all critical. The essays collected in this volume have changed the history of the philosophy of medicine. He shows that philosophy of medicine can be done with both passion and compassion.” —_Robert M. Veatch, Kennedy Institute of Ethics, Georgetown University_ “Edmund Pellegrino's words have helped medical students, faculty, scholars and patients address the challenges they encounter in medicine and medical practice. His personal support has also been critical for many of us in developing programs in medical ethics and philosophy of medicine in our universities. Dr. Pellegrino combines the wisdom of a great physician with those of a great philosopher to produce a body of writing that will continue to inspire us all. This volume contains some of his best and most influential work.” —_Loretta Kopelman, The Brody School of Medicine, East Carolina University_ _ _ “Edmund Pellegrino has been a leading light in the philosophy of medicine for a generation. He was instrumental in the birth of bioethics, founded one of the leading journals, and provided able leadership in organizing early activities of the profession. He has served as department chairman, dean, and university president. Most recently, he chairs the President’s Council on Bioethics. In all this, first and foremost, he has been a physician. Those who are ill and suffering make a claim upon him. To respond to this claim, Pellegrino creatively brings together the worlds of science and of the humanities. For him, that is what medicine is about, making it the most scientific of the humanities and the most humane of the sciences. Fortunately for us, Pellegrino brings these worlds together in thought, as well as in practice. In this selection from his writings, Engelhardt and Jotterand have captured the heart of Pellegrino’s project, both in depth and breadth, so we can also hear that claim of the ill and so we can see what worlds must come together if we are to respond in the appropriate way.” —_George Khushf, University of South Carolina_ “Pellegrino’s work is both a treasure and important for understanding bioethics. His work in philosophy of medicine addresses the crucial questions that are so important to understanding the practice of medicine and the ethics of health care.” —_Kevin Wildes, President, Loyola University_ _ _. (shrink)

Available from UMI in association with The British Library. Requires signed TDF. ;The main part of the thesis concerns how things, in the sense of individuals, might have been. The topic is what limits there are on the counterfactual possibilities for individuals: in other words, what essential properties, if any, they have. ;In Chapters 3-6 three answers to this question that have been given in recent philosophical literature are examined. They are: that each thing has a unique individual essence ; (...) that there are features of the origin of an individual without which it could not possibly have existed ; and, finally, that there are sortal concepts that represent essential properties of the things that fall under them . ;All of these answers, and many of the arguments that have been given for them, are criticised. Sometimes the criticism takes the form of pointing to unpalatable consequences that result from the acceptance of the doctrine in question. Sometimes the criticism consists in pointing to difficulties or inadequacies in the arguments that have been presented in its favour. ;A preliminary chapter prepares the ground by setting out the conceptual framework, and the chief formal characteristics, of the essentialism discussed in the later chapters. Chapter 2 discusses the nature of necessary a posteriori truth, touching on questions in the philosophy of language and mind concerning the notion of de re thought. ;It is argued that essentialism about natural kinds raises problems of its own: some of these are discussed in Chapters 7 and 8. Here the main topic is the connection between semantic theory and natural kind essentialism. Concluding that the essentialism should be regarded as in an important sense independent of semantic theory, the chapters add to, and also criticise, the work of other writers who have reached the same verdict. Scepticism is also expressed about the independent plausibility of natural kind essentialism. ;Recent interest in essentialism owes its genesis chiefly to the work of Saul Kripke and Hilary Putnam: these figures stand in the background throughout the discussion. Among the other writers whose work is discussed are Baruch Brody, Gareth Evans, Graeme Forbes, Colin McGinn, J. L. Mackie, D. H. Mellor, Nathan Salmon, and David Wiggins. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Active Euthanasia and Assisted SuicidePat Milmoe McCarrick (bio)Although the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research in its 1983 report, Deciding to Forego Life-Sustaining Treatment, described the words and terms "euthanasia," "right to die," and "death with dignity" as slogans or code words—"empty rhetoric," (I, p. 24), the literature reviewed for this Scope Note continues to use these terms. Therefore, to (...) discuss the termination of a patient's life by a physician at the patient's request, the phrase active euthanasia is used, and the supplying of a means by a physician whereby a patient can end his or her life is referred to as assisted suicide.Euthanasia, either as the "good death" from classical Greek or "mercy killing" to end unbearable suffering in the dying, has long been a topic of interest in western civilization (III, Brody 1989). In recent years, public awareness of this discussion about control over the time of one's death has been informed by a series of well-publicized events. They include the November 1991 rejection by a vote of 54 percent to 46 percent of the Washington state Initiative 119, which would have allowed the option of requesting one's physician to "aid-in-dying" for adult patients in a "medically terminal condition" (V, Gross 1991); two medical journal articles describing physician's actions in helping bring death to two patients (V, Anonymous 1988; V, Quill 1991); Dr. Jack Kevorkian's assistance in the suicide of three women (V, Belkin 1990; V, Wilkerson 1991); and the best seller status of a how-to book on committing suicide with opiates obtained from a physician (III, Humphry 1991).For the most part, material included in the annotated bibliography in Scope Note 18 has been chosen from works published in the four years since "It's Over, Debbie" (V, Anonymous 1988) appeared in early January 1988 in the Journal of the American Medical Association.Dr. Edmund D. Pellegrino (V, 1991, pp. 3118-19) presented opposing views about active voluntary euthanasia as follows:Those who favor voluntary euthanasia argue that it is a beneficent and compassionate act; it respects autonomy by preserving the patient's control of the manner, method, [End Page 79] and timing of death; it takes the matter outside the reach of "medical power" (accessed in this Scope Note's bibliography at V, Fletcher 1973; V, Nowell-Smith 1989) and scrupulosity; and it prevents the injustice that allows some patients to choose death by refusal of life-support measures, while denying others the right to do so by active euthanasia....The opponents of active euthanasia argue that it undermines the value of, and respect for, all human life (V, Kass 1989; V, Coyle 1990; V, Singer 1990). They fear that guidelines cannot avoid sliding down the "slippery slope" to involuntary euthanasia and selective devaluation of the lives of the most vulnerable among us.... If euthanasia is legal, it is predicted that patients will feel subtle pressure to conform so as to relieve the economic and emotional burdens they impose on family and friends.Euthanasia, its opponents further argue, is socially destructive: it undermines trust in physicians, desensitizes society to killing, and imperils the ground already gained in legitimating passive euthanasia(IV, Wolf 1989).Physicians were not particularly involved with a patient's death until after World War II when participation grew in proportion to the growth of technology. Since the complex, life-sustaining equipment that could forestall death was located in a hospital, death itself became almost completely medicalized (V, Dagi 1991). For terminally ill persons who would like to die a painless death, either by their own hand or with assistance, physicians have almost a monopoly on obtaining strong drugs for distribution to patients (V, Abrams 1990).Active euthanasia for human beings is not legalized anywhere in the world (V, VonDrehle 1991). It is classified as homicide or murder in all fifty states and in Great Britain, Canada, Australia, and the Phillippines (V, Nerland 1989). Twentysix states in the United States prohibit assisted suicide by statute (V, Rosenblum 1990).In 1969 in the Netherlands, a physician named Jan Hendrik van... (shrink)

There seems to be something self-evident—irresistibly so, to judge from its gleeful propagation—about the use of the phrase, “Jane Austen and the Masturbating Girl,” as the Q.E.D. of phobic narratives about the degeneracy of academic discourse in the humanities. But what? The narrative link between masturbation itself and degeneracy, though a staple of pre-1920s medical and racial science, no longer has any respectable currency. To the contrary: modern views of masturbation tend to place it firmly in the framework of optimistic, (...) hygienic narratives of all-too-normative individual development. When Jane E. Brody, in a recent “Personal Health” column in the NewYork Times, reassures her readers that, according to experts, it is actually entirely possible for people to be healthy without masturbating; “that the practice is not essential to normal development and that no one who thinks it is wrong or sinful should feel he or she must try it”; and that even “’those who have not masturbated … can have perfectly normal sex lives as adults,’” the all but perfectly normal Victorianist may be forgiven for feeling just a little—out of breath.3 In this altered context, the self-evidence of a polemical link between autoeroticism and narratives of wholesale degeneracy 4 draws on a very widely discredited body of psychiatric and eugenic expertise whose only direct historical continuity with late twentieth-century thought has been routed straight through the rhetoric and practice of fascism. But it now draws on this body of expertise under the more acceptable gloss of the modern, trivializing, hygienic-developmental discourse, according to which autoeroticism not only is funny—any sexuality of any power is likely to hover near the threshold of hilarity—but also must be relegated to the inarticulable space of infantility. 3. Jane E. Brody, “Personal Health,” New York Times, 4 Nov. 1987.4. Rosenblatt, “The Universities,” p. 3. Eve Kosofsky Sedgwick is professor of English at Duke University and the author of Between Men: English Literature and Male Homosocial Desire and Epistemology of the Closet. (shrink)

D. H. Mellor; VI*—Conscious Belief, Proceedings of the Aristotelian Society, Volume 78, Issue 1, 1 June 1978, Pages 87–102, https://doi.org/10.1093/aristotelian.

Everything we do relies on causation. We eat and drink because this causes us to stay alive. Courts tell us who causes crimes, criminology tell us what causes people to commit them. D.H. Mellor shows us that to understand the world and our lives we must understand causation. _The Facts of Causation_, now available in paperback, is essential reading for students and for anyone interested in reading one of the ground-breaking theories in metaphysics. We cannot understand the world and our (...) place in it without understanding causation. Yet a complete account of the nature and implications of causation does not exist. D.H Mellor's new book is that account. (shrink)

D. H. Mellor; VI*—Conscious Belief, Proceedings of the Aristotelian Society, Volume 78, Issue 1, 1 June 1978, Pages 87–102, https://doi.org/10.1093/aristotelian.

Everything we do relies on causation. We eat and drink because this causes us to stay alive. Courts tell us who causes crimes, criminology tell us what causes people to commit them. D.H. Mellor shows us that to understand the world and our lives we must understand causation. _The Facts of Causation_, now available in paperback, is essential reading for students and for anyone interested in reading one of the ground-breaking theories in metaphysics. We cannot understand the world and our (...) place in it without understanding causation. Yet a complete account of the nature and implications of causation does not exist. D.H Mellor's new book is that account. (shrink)

'Why did the window break when it was hit by the stone? Because the window is brittle and the stone is hard; hardness and brittleness are powers, dispositional properties or dispositions.' Dispositions are essential to our understanding of the world. This book is a record of the debate on the nature of dispositions between three distinguished philosophers - D. M. Armstrong, C. B. Martin and U. T. Place - who have been thinking about dispositions all their working lives. Their distinctive (...) accounts cover many of the issues surrounding dispositions such as the nature of mind, matter, universals, existence, laws of nature and causation. Dispositions illuminates this central topic in analytic philosophy and at the same time highlights deeper concerns of metaphysics. (shrink)

This paper argues that the concept and role of ‘institutional racism’ in contemporary discussions of race should be reconsidered. It starts by distinguishing between ‘intrinsic institutional racism’, which holds that institutions are racist in virtue of their constitutive features, and ‘extrinsic institutional racism’, which holds that institutions are racist in virtue of their negative effects. It accepts intrinsic institutional racism, but argues that a ‘disparate impact’ conception of extrinsic conception faces a number of objections, the most serious being that it (...) has no plausible account of what it is that makes extrinsically racist institutions racist. It also argues that claims about the explanatory indispensability of institutional racism are overstated (individual racism is at least as important), critiques structural approaches to racial inequality, and suggests that there is reason to doubt whether institutional reform can provide us with all that morality may require in the racial domain. (shrink)

In The Quantum Self, Danah Zohar argues that the insights of modem physics can illuminate our understanding of everyday life -- our relationships to ourselves, to others, and to the world at large. Guiding us through the strange and fascinating workings of the subatomic realm to create a new model of human consciousness, the author addresses enduring philosophical questions. Does the new physics provide a basis by which our consciousness might continue beyond death? How does the material world (for instance, (...) ugly inner cities) impinge upon our sense of self? Is there a subatomic wellspring from which our creativity, our empathy with others, and our feelings of unity with the inanimate world originate?Most important, Zohar shows how the vitality of the new physics combats the alienation and fragmentation of twentieth-century life, and replaces it with a model of reality in which the universe itself may possess a type of consciousness, of which human consciousness is one expression. (shrink)

As humans, we frequently engage in mental time travel, reliving past experiences and imagining possible future events. This study examined whether similar factors affect the subjective experience associated with remembering the past and imagining the future. Participants mentally “re-experienced” or “pre-experienced” positive and negative events that differed in their temporal distance from the present , and then rated the phenomenal characteristics associated with their representations. For both past and future, representations of positive events were associated with a greater feeling of (...) re-experiencing than representations of negative events. In addition, representations of temporally close events contained more sensorial and contextual details, and generated a stronger feeling of re-experiencing than representations of temporally distant events. It is suggested that the way we both remember our past and imagine our future is constrained by our current goals. (shrink)

Objective—To determine the prevalence of, and attitudes towards, observed and personal research misconduct among newly appointed medical consultants. Design—Questionnaire study.Setting—Mersey region, United Kingdom.Participants—Medical consultants appointed between Jan 1995 and Jan 2000 in seven different hospital trusts (from lists provided by each hospital's personnel department). Main outcome measures—Reported observed misconduct, reported past personal misconduct and reported possible future misconduct.Results—One hundred and ninety-four replies were received (a response rate of 63.6%); 55.7% of respondents had observed some form of research misconduct; 5.7% of (...) respondents admitted to past personal misconduct; 18% of respondents were either willing to commit or unsure about possible future research misconduct. Only 17% of the respondents reported having received any training in research ethics. Anaesthetists reported a lower incidence of observed research misconduct (33.3%) than the rest of the respondents (61.5%) (p<0.05). Conclusion—There is a higher prevalence of observed and possible future misconduct among newly appointed consultants in the UK than in the comparable study of biomedical trainees in California. Although there is a need for more extensive studies, this survey suggests that there is a real and potential problem of research misconduct in the UK. (shrink)