A decade after the ‘‘Sokal Hoax,’’ Alan Sokal and Paul Boghossian still claim that postmodern arguments are incoherent attacks on reason and truth. However, both also continue to mischaracterize ‘‘constructivist’’ epistemology, to engage in highly problematic logical gymnastics to defend their own views, and to ignore changes in philosophy of science and science studies since 1996. I offer a brief description of my own, rather different understanding of postmodern science criticism in order to contextualize my dissatisfaction with Sokal and Boghossian’s (...) arguments, and to highlight the value of cross-subfield anthropological collaboration based on the constructivist perspective articulated by Barbara Herrnstein Smith. Downloaded by [New York University] at 03:33 19 July 2011.. (shrink)

At the time I wrote my original review (Schultz 2010) of the books by Sokal (2008), Boghossian (2006), and Smith (2006), I did not know that I would have the opportunity to reply to their responses to my review. Nevertheless, I value the occasion this offers to correct errors and respond to their commentary. Let me say, first of all, that Alan Sokal is quite correct in pointing out that the citation from Donna Haraway which I attribute to him (...) is incorrect. I realize now that I copied that version of the citation from an earlier working notes file for the review. I should have verified that the copied version was identical to the citation in the Beyond the Hoax text (Sokal 2008) before I sent off the review. That I did not do so is an error that I deeply regret, and for which I apologize. In line with this, I also apologize for, and retract, my observations in the review about the omitted passages in the citation, for which Sokal obviously was not responsible. So, does consideration of the full quotation by Donna Haraway in any way affect the rest of my critique? Not at all, as it happens, because the focus of the rest of my remarks is on the way Sokal treats this passage by Haraway. That is, he presents the excerpt to readers in isolation, and makes no effort to.. (shrink)

Coregulation refers to the process by which relationship partners form a dyadic emotional system involving an oscillating pattern of affective arousal and dampening that dynamically maintains an optimal emotional state. Coregulation may represent an important form of interpersonal emotion regulation, but confusion exists in the literature due to a lack of precision in the usage of the term. We propose an operational definition for coregulation as a bidirectional linkage of oscillating emotional channels between partners, which contributes to emotional stability for (...) both partners. We propose several distinctions and raise unanswered questions that will need to be addressed in order to understand the relevance of coregulation for well-being in adulthood. (shrink)

Everything is constantly changing. Our emotions are one of the primary ways we track, evaluate, organize, and motivate responsive action to those changes. Furthermore, emotions are inherently interpersonal. We learn what to feel from others, especially when we are children. We “catch” other people’s emotions just by being around them. We get caught in escalating response–counterresponse emotional sequences. This all takes place in time, generating complex patterns of interpersonal emotional dynamics. This review summarizes theory, empirical findings, and key challenges for (...) future research regarding three processes that contribute to interpersonal affective dynamics: Convergence of social partners’ emotional responses to the external world, emotional reactivity of social partners to each other, and interpersonal emotion regulation. (shrink)

Topics related to ethical issues in agricultural production, particularly farm animal welfare, are increasingly featured in mainstream news media. Media representations of farm animal welfare issues are important because the media is a significant source of information, but also because the way that the issues are represented, or framed, defines these issues in particular ways, suggests causes or solutions, and provides moral evaluations. As such, analysis of media frames can reveal how issues are being made public and identify the cues (...) that audiences are given to help them make sense of complex ethical issues. Previous research on media frames and animal welfare has tended to focus on single issues or events; however we sought to identify whether media frames extended across different farm animal welfare-related issues to investigate whether there is any commonality between issues. We analysed articles published in the mainstream press in Australia between 2014 and 2016 related to farm animal welfare, and identified two dominant frames: that governments and the farm animal production industries cannot be trusted to ensure good farm animal welfare; and that consumers can act to improve animal welfare through ethical consumption. These frames have implications for how the Australian public interpret and understand the roles and responsibilities of different actors in the food production system. This research also contributes to discussion about the role of the media in shaping public opinion about ethical issues in agriculture and how, in turn, the media landscape itself is being shaped by consumer attitudes. (shrink)

In Living for Pleasure, philosopher Emily Austin offers a lively, jargon-free tour of Epicurean strategies for diminishing anxiety, achieving satisfaction, and relishing joys.

Rimé makes the important observation that the literature on adult emotion and emotion regulation has largely focused on the individual level of analysis. He argues, we believe correctly, that emotion research would benefit by addressing the fact that emotional events provoke not only individual responses, but systematic social responses as well. We present examples of our own research that are in accord with Rimé's central claims, and that demonstrate the benefits of considering the goals that are provoked and satisfied by (...) emotions, as well as the social context of emotional responding. We conclude by advocating a dynamic systems approach that would allow an integration of individual and social levels of analysis in the study of adult emotion and emotion regulation. (shrink)

Medical ethics assumes a clear boundary between clinical research and clinical medicine: one produces knowledge for the benefit of future patients, while the other provides optimal care to individuals right now. It also assumes that the two cannot be integrated without sacrificing the needs of the current patient to those of future patients. But integration could allow us to provide better care to everyone, now and in the future.

Journal Name: Apeiron Issue: Ahead of print.

People in an emotional exchange form a temporal interpersonal emotion system (TIES), in which their emotions are interconnected over time (Butler, 2011). These systems can be in various states, defined by the pattern of emotional interconnections. We have defined coregulation as one such state involving coupled dampened oscillations between partners’ emotions that converge on a stable level. Coregulation could be distinguished from other states, such as stress buffering, by comparing statistical models that represent the theoretical distinctions between states. Optimal data (...) for such modeling includes assessments of both partners’ emotions over time and a contrast between securely attached partners, strangers, and being alone. Research of this sort is needed to uncover the mechanisms by which emotional interdependence promotes well-being. (shrink)

This article examines five different Medical-Legal Partnerships associated with Yale Law School in New Haven, Connecticut to illustrate how MLP addresses the social determinants of poor health. These MLPs address varied and distinct health and legal needs of unique patient populations, including: 1) children; 2) immigrants; 3) formerly incarcerated individuals; 4) patients with cancer in palliative care; and 5) veterans. The article charts a research agenda to create the evidence base for quality and evaluation metrics, capacity building, sustainability, and best (...) practices; it also focuses specifically on a research agenda that identifies the value of the lawyers in MLP. Such a focus on the “L” has been lacking and is overdue. (shrink)

Some individuals facing dementia contemplate hastening their own death: weighing the possibility of living longer with dementia against the alternative of dying sooner but avoiding the later stages of cognitive and functional impairment. This weighing resonates with an ethical and legal consensus in the United States that individuals can voluntarily choose to forgo life‐sustaining interventions and also that medical professionals can support these choices even when they will result in an earlier death. For these reasons, whether and how a terminally (...) ill individual can choose to control the timing of their death is a topic that cannot be avoided when considering the dementia trajectory. With a focus on the U.S. context, this landscape review considers the status of provisions that would legally permit people facing dementia to hasten death with appropriate support from medical professionals. This review can be used to plan and guide clinical and legal practitioner discussion and policy development concerning evolving questions not fully covered by existing medical decision‐making provisions. (shrink)

Coordinated group behaviour can result in conflict or social cohesion. Thus having a better understanding of coordination in social groups could help us tackle some of our most challenging social problems. Historically, the most common way to study group behaviour is to break it down into sub-processes, such as cognition and emotion, then ideally manipulate them in a social context in order to predict some behaviour such as liking versus distrusting a target person. This approach has gotten us partway to (...) understanding many important collective behaviours, but I argue that making major changes in the world will require a more integrated approach. In this review, I introduce dynamic systems theory, with a focus on interpersonal systems, where all the processes we typically study in individuals, such as cognition and emotion, become intertwined between social partners over time. I focus on the concept of coordination, defined as a temporal correlation between interacting components of a system (or systems) arising due to coupling between them. Finally, I show how this perspective could be used to guide investigations of social problems such as polarisation. (shrink)

The rule of rescue describes the moral impulse to save identifiable lives in immediate danger at any expense. Think of the extremes taken to rescue a small child who has fallen down a well, a woman pinned beneath the rubble of an earthquake, or a submarine crew trapped on the ocean floor. No effort is deemed too great. Yet should this same moral instinct to rescue, regardless of cost, be applied in the emergency room, the hospital, or the community clinic? (...) -/- In health care, the desire to save lives at any cost must be reconciled with the reality of resource scarcity. As one example, the estimated cost for prophylactic Factor VIII to treat one patient with hemophilia for one year is $300,000. Costs of this magnitude have been accepted by public and private insurers in the developed world, even though, in principle, these sums could provide greater overall health benefit if allocated to pay for the unmet health care needs of many other patients. Looking forward, however, broad application of the rule of rescue will be increasingly untenable. But the moral instinct will remain: the desire to help those weakest among us, especially when their small numbers allow us to see them as unique individuals. What, then, is the ethical framework that can guide coverage and reimbursement decisions for orphan drugs into the future? (shrink)

Name der Zeitschrift: Archiv für Geschichte der Philosophie Jahrgang: 98 Heft: 8 Seiten: 1-20.

We argued last year in this journal that extensive integration of research and care is a worthy goal of health system design, and we second the call from Ruth Faden and colleagues to move toward learning health care systems. As they recognize, learning health care systems demand the coordination of research and medical ethics—two sets of normative commitments that have long been considered distinct. In offering a novel ethics framework for such systems, Faden et al. advance the scholarly debate about (...) how best to do this and challenge us to think more deeply about its practical implications. However, we believe that at least three issues they raise require additional attention. First, the research‐care distinction has more normative bite than they are willing to concede. Second, the role for independent oversight requires clarification. Finally, they neglect the concept of stewardship as a guiding obligation of learning health care systems. (shrink)

We argued last year in this journal that extensive integration of research and care is a worthy goal of health system design, and we second the call from Ruth Faden and colleagues to move toward learning health care systems. As they recognize, learning health care systems demand the coordination of research and medical ethics—two sets of normative commitments that have long been considered distinct. In offering a novel ethics framework for such systems, Faden et al. advance the scholarly debate about (...) how best to do this and challenge us to think more deeply about its practical implications. However, we believe that at least three issues they raise require additional attention. First, the research‐care distinction has more normative bite than they are willing to concede. Second, the role for independent oversight requires clarification. Finally, they neglect the concept of stewardship as a guiding obligation of learning health care systems. (shrink)

To ensure that the information resulting from research is relevant to patients, the Patient‐Centered Outcomes Research Institute eschews the “traditional health research” paradigm, in which investigators drive all aspects of research, in favor of one in which patients assume the role of research partner. If we accept the premise that patient engagement can offer fresh perspectives that shape research in valuable ways, then at least two important sets of questions present themselves. First, how are patients being engaged—and how should they (...) be engaged? Second, which patients are being engaged—and which patients should be? This set has received relatively less attention, and the neglect is surprising, given that the “who” question is conceptually prior to the question of “how.”This article focuses attention on the “who” of patient engagement in research. First, we provide background on the rationale for patient engagement, underscoring the importance of ensuring the representativeness of engaged patients. Second, we present what little is known about patients engaged in PCORI‐funded research. Third, we identify and discuss the ethical implications of ways in which current practices of patient identification and recruitment may lead to a lack of representativeness. These practices include reliance on the well‐connected and well‐informed, reliance on patients who are not well trained or well‐informed, and reliance on patient advocacy organizations. Finally, we consider several strategies for addressing these pitfalls in order to maximize the positive goals of patient engagement. Patient engagement is intended to address the inability of researchers, funders, and others to fully represent patient views and priorities, but without sufficient attention, the patients selected for this role may still leave important gaps. (shrink)

During spring of 2020, environmental ethics students at a medium sized metropolitan university in the Southeastern United States were asked to read and comment on classic essays from Robert Heilbroner and Garrett Hardin, essays regarding our responsibilities towards future generations. In general, students seemed to hold more with Heilbroner’s stance, which left room for compassion, while condemning Hardin’s harshness. Students were then asked to provide written responses stating whether they would personally sacrifice their eventual retirement in order to stop COVID-19 (...) and the reasons for their views. Responses were analyzed and categorized to detect inconsistencies between students’ described views and their willingness to personally sacrifice for the sake of others. Almost 72% of respondents asserted that they would be willing to intervene to stop the novel coronavirus by sacrificing their retirement. A fair number of respondents that stated they would sacrifice said that they would do so because they would benefit personally from the avoidance of guilt and/or from the opportunity to feel good about themselves, suggesting that even seemingly selfless behaviors are sometimes driven by egoistic motivations. Forty percent of all respondents held inconsistent views. Most notably, a number of students condemned Hardin for his lack of compassion, yet were not willing to act compassionately themselves. (shrink)

Interest in the use of medical data for health research is increasing. Yet, as Elizabeth Ford and colleagues rightly note, there are open questions about the suitability of existing ethical and regulatory oversight frameworks for these research approaches. In their feature article, ‘Should free text data in electronic medical records be shared for research? A citizen’s jury study in the United Kingdom’, Ford et al report the results of a deliberative engagement study in which 18 members of the public were (...) asked whether and under what conditions free text data from medical records should be shared for research purposes. The authors’ explicit aim was to inform national policy on sharing medical text. Public attitudes—stated otherwise, the attitudes of patients whose medical information will ultimately be used under any data sharing policy—are a necessary input into ethical and regulatory decision-making about use of medical data for health research. Though public attitudes will rarely be determinative, they must be weighed in order to uphold the ethical principle of respect for persons.1 Ford et al ’s article is, therefore, an important contribution to …. (shrink)

Competition among scientists for funding, positions and prestige, among other things, is often seen as a salutary driving force in U.S. science. Its effects on scientists, their work and their relationships are seldom considered. Focus-group discussions with 51 mid- and early-career scientists, on which this study is based, reveal a dark side of competition in science. According to these scientists, competition contributes to strategic game-playing in science, a decline in free and open sharing of information and methods, sabotage of others’ (...) ability to use one’s work, interference with peer-review processes, deformation of relationships, and careless or questionable research conduct. When competition is pervasive, such effects may jeopardize the progress, efficiency and integrity of science. (shrink)

Over the course of human life, health care decision‐making is often interdependent. In this article, we use “interdependence” to refer to patients’ engagement of nonclinicians—for example, family members or trusted friends—to reach health care decisions. Interdependence, we suggest, is common for patients in all stages of life, from early childhood to late adulthood. This view contrasts with the common bioethical assumption that medical decisions are either wholly independent or dependent and that independence or dependence is tightly coupled with a person's (...) decision‐making capacity. In this article, we array various approaches to decision‐making along a continuum of interdependence. An appreciation of this continuum can empower patients and elucidate ethical challenges that arise when people transition between different kinds of interdependence across the life span. (shrink)

In this issue of the Hastings Center Report, James Sabin and his colleagues ask what responsibility investigators in a learning health organization have to patients when research—particularly research of which patients might be unaware—illuminates problematic aspects of the patients' care. Sabin and his colleagues were confronted by this question in the midst of designing a randomized controlled trial that sought to determine if an educational intervention targeted at patients with atrial fibrillation and their clinicians reduces underuse of oral anticoagulants. Worried (...) about harm that might befall patients in the control group and fearing that they would be negligent bystanders if they knew these patients were at risk and did nothing, the investigators adopted a “workaround.” But the “workaround,” I suggest, was not a solution to the negligent bystander problem. Nor was it a solution to the problem as I would alternatively frame it—how to address instances of suboptimal patient care identified through research within learning health organizations. (shrink)

Public health agencies undertake a broad range of health promotion and injury and disease prevention activities in collaboration with an array of actors, such as the community, businesses, and non-profit organizations. These activities are “multisectoral” in nature and centered on public health agencies that oversee and engage with the other actors. Public health agencies can influence the hazardous activities in the private sector in a variety of ways, “ranging from prohibition and regulation to volunteerism, and from cooperation to cooption.” Hence, (...) a public health agency that possesses the necessary administrative resources and authority is vital to the effective implementation of health policies and regulations.In the developing world, however, many state health agencies lack these basic capacities in dealing with critical health threats, including their ability to avert epidemics of communicable diseases arising from poor sanitary conditions. A serious constraint is the shortage of public health funding for health agencies in the developing world for typical agency functions. This is often aggravated by the transaction-intensive demands entailed in enforcing regulations among an array of private and public sector actors including individuals, businesses, and local bodies responsible for providing civic services. (shrink)

Developing country efforts to enforce basic public health standards are often hindered by limited agency resources and poorly designed enforcement mechanisms, including excessive reliance on slow and erratic judicial systems. Traditional public health regulation can therefore be difficult to implement. This article examines innovative approaches to the implementation of public health regulations that have emerged in recent years within the OECD countries. These approaches aim to improve compliance with health standards among the different actors while reducing dependence on the legal (...) system and the administrative resources of public health agencies in developing countries. Developing countries may find some useful lessons from these approaches that can be adapted for use in their own institutional settings. (shrink)

Growing interest in embedded research approaches—where research is incorporated into clinical care—has spurred numerous studies to generate knowledge relevant to the real-world needs of patients and other stakeholders. However, it also has presented ethical challenges. An emerging challenge is how to understand the nature and extent of investigators’ obligations to patient-subjects. Prior scholarship on investigator duties has generally been grounded upon the premise that research and clinical care are distinct activities, bearing distinct duties. Yet this premise—and its corresponding implications—are challenged (...) when research and clinical care are deliberately integrated. After presenting three case studies from recent pragmatic clinical trials, we identify six differences between explanatory trials and embedded research that limit the application of existing scholarship for ascertaining investigator duties. We suggest that these limitations indicate a need to account for the implications of usual care and to move beyond a narrow focus on the investigator-subject dyad, one that better reflects the team- and institution-based nature of contemporary health systems. (shrink)

This groundbreaking interactive book contains the tools that you will need in order to clean your emotional house from top to bottom. It includes a journal as well as access to audio meditations for you to listen along to as you read. The meditations will help you dig deep into past trauma and discover when and how trauma took root, learn to get in touch with various parts of the physical and energy body, and how to use them to let (...) go of stored traumas. From this, you will learn to live from a new mindful and powerful space. (shrink)

For the complex or boundary objects in which I am interested . . . dimensions implode . . . they collapse into each other . . . story telling . . . is a fraught practice . . . In no way is story telling opposed to materiality, [sic] But materiality itself is tropic; it makes us swerve, it trips us; it is a knot of the textual, technical, mythic/oneric [sic], organic, political and economic.

Background Diversity in Institutional Review Board (IRB) membership is important for both intrinsic and instrumental reasons, including fairness, promoting trust, improving decision quality, and responding to systemic racism. Yet U.S. IRBs remain racially and ethnically homogeneous, even as gender diversity has improved. Little is known about IRB chairpersons’ perspectives on membership diversity and barriers to increasing it, as well as current institutional efforts to promote diversity, equity, and inclusion (DEI) within IRB membership.Methods We surveyed IRB chairpersons leading U.S. boards registered (...) with the Office for Human Research Protections. Here, we focus exclusively on responses from a subset of 388 chairpersons of IRBs at universities and academic medical centers (AMCs).Results Board chairs were predominantly white and evenly split between men and women. Only about half reported that their boards had at least one member who is Black or African American (51%), Asian (56%), or Hispanic (48%), with 85% of university/AMC boards comprised entirely (15%) or mostly (70%) of white members. Most IRB chairpersons (64%) reported satisfaction with the current diversity of their membership. Participants largely agreed that considering diversity in the selection of IRB members is important (91%), including to improve the quality of IRB deliberation (80%), with an emphasis on racial/ethnic (85%) and gender diversity (74%). Most participants (80%) reported some type of active DEI effort regarding board membership at their university/AMC and just over half (57%) expressed satisfaction with these efforts.Conclusions Our national survey found that although university/AMC IRB chairpersons report valuing diversity in board membership, it may be lacking in key areas. Going forward, it will be important to specify clear reasons for diversity in the IRB context, as well to establish targets for acceptable levels of board diversity and to match DEI efforts to those targets. (shrink)