Although research has examined factors influencing understanding of informed consent in biomedical and forensic research, less is known about participants' attention to details in consent documents in psychological survey research. The present study used a randomized experimental design and found the majority of participants were unable to recall information from the consent form in both in-person and online formats. Participants were also relatively poor at recognizing important aspects of the consent form including risks to participants and confidentiality procedures. Memory effects (...) and individual difference characteristics also appeared to influence recall and recognition of consent form information. (shrink)

Research in which participants report potentially dangerous health-related behaviors raises ethical and professional questions about what to do with that information. Policies and laws regarding reportable behaviors vary across states and Institutional Review Boards (IRB). In alcohol research, IRBs often require researchers to respond to participants who report dangerous drinking practices. Researchers have little guidance regarding how best to respond in such cases. Personalized feedback or general nonpersonalized information may prove differentially effective as a function of gender and/or level of (...) self-determination. This study evaluated response strategies for reducing peak blood alcohol concentration (BAC) among participants reporting dangerous BACs (≥ .35%) in the context of a two-year longitudinal intervention trial with 818 heavy drinking college students. After each assessment, participants who reported drinking to estimated BACs at or greater than .35% were sent either a personalized letter expressing concern and indicating their reported BAC or a nonpersonalized pamphlet that included general information about alcohol and other substances, referral information, and a BAC handout. Hierarchical linear modeling results revealed that both strategies were associated with reduced peak BAC when controlling for previous BAC. The personalized letter was more effective for women and for students who tend to regulate their behavior based on others' expectations and contingencies in the environment. This research provides some guidance for researchers considering appropriate responses to participants who report dangerous health behavior in the context of a research trial. (shrink)

Thomas Chubb seems to have been an 18th century English artisan class version of Eric Hoffer. Only the subject for Chubb was Deism rather than democracy. This is not, of course, to deny the link between these two, a link which is accented to some extent in Chubb's own work. Bushell has given us a short biographical account of Chubb together with six chapters that dutifully comb Chubb's moral, political, and, especially, his theological writings for a synthetic view of (...) Chubb's opinion on such subjects as the historical Jesus, theodicy, providence, toleration, and natural law. Chubb seems to have attracted the curiosity of the intelligensia [[sic]] of his own and later times. But, on balance, he does not appear to be even a major minor figure.--E. A. R. (shrink)

Despite the lament of the decline and even the death of political theory, Germino contends that "the revival of political theory is one of the momentous intellectual and cultural developments of our time." The neglect of this revival is, in part, due to the myopia and false conception of political theory by modern political scientists and positivistically orientated philosophers. After criticizing the proponents of the "alleged decline" of political theory, Germino sketches a view of political theory as a tradition of (...) inquiry practiced by the great political theorists from Plato to Hegel. He both describes and criticizes the assault upon political theory by such thinkers as Tracy, Comte, and Marx. The revival of political theory in the grand manner is to be found in such representatives as Oakeshott, Arendt, Jouvenel, and Strauss. It is Eric Voegelin that is the true hero of this revival, and despite his neglect, Germino suggests that later generations may well acclaim Voegelin "as the greatest political theorist of our time." This is a book with a strong positive thesis, and Germino balances developing stages in his argument with expositions of the positions that he both attacks and defends. There is a growing sympathy among both philosophers and political scientists for the defense of the viability of political theory developed in this book, although many of those sympathetic with the thesis may feel that sharper and more penetrating criticism is needed to defend the thesis, and may not share Germino's enthusiasm for Voegelin.--R. J. B. (shrink)

If ethics consultation services influence medical decisions it is important to evaluate how ethical dilemmas are dealt with by clinical ethics committees (CECs). Such evaluation is rare. This study presents a feasible and practical method of evaluating case discussions in CECs and the results emerging from the use of this method. A written presentation of an end-of-life dilemma was sent to all Norwegian ethics committees. The committees were asked to deal with the case as they would do if it was (...) a real case, and to prepare a written report of the discussion. A majority of the committees approached the case systematically. All emphasized the importance of good communication with the next of kin. However, their conclusions varied, medical facts were interpreted differently, possible patient suffering was dealt with differently, and some committees revealed insufficient legal knowledge. Such findings are useful in the future education of committee members. (shrink)

A central task for clinical ethics consultants and committees (CEC) is providing analysis of, and advice on, prospective or retrospective clinical cases. However, several kinds of biases may threaten the integrity, relevance or quality of the CEC's deliberation. Bias should be identified and, if possible, reduced or counteracted. This paper provides a systematic classification of kinds of bias that may be present in a CEC's case deliberation. Six kinds of bias are discussed, with examples, as to their significance and risk (...) factors. Possible remedies are suggested. The potential for bias is greater when the case deliberation is performed by an individual ethics consultant than when an entire clinical ethics committee is involved. (shrink)

There is growing interest in clinical ethics. However, we still have sparse knowledge about what is actually going on in the everyday practice of clinical ethics consultations. This paper introduces a descriptive evaluation tool to present, discuss and compare how clinical ethics case consultations are actually carried out. The tool does not aim to define ‘best practice’. Rather, it facilitates concrete comparisons and evaluative discussions of the role, function, procedures and ideals inherent in clinical ethics case consultation practices. The tool (...) was developed during meetings of the European Clinical Ethics Network. Based on written reports and participation in the network meetings, the development and the content of the tool and the results of its application in presenting and discussing 10 case consultations are summarized. The tool facilitated understanding of the details of clinical ethics case consultations across individuals and institutions with various experiences and cultures, and comparison between various practices. (shrink)

Background: Clinical ethics consultation services have been established in many countries during recent decades. An important task is to discuss concrete clinical cases. However, empirical research observing what is happening during such deliberations is scarce. Objectives: To explore clinical ethics committees’ deliberations and to identify areas for improvement. Design: A pilot study including observations of committees deliberating a paper case, semistructured group interviews, and qualitative analysis of the data. Participants: Nine hospital ethics committees in Norway. Results and interpretations: Key elements (...) of the deliberations included identifying the ethical problems; exploring moral values and principles; clarifying key concepts and relevant legal regulation; exploring medical facts, the patient’s situation, the therapists’ perspective, analogous clinical situations, professional uncertainties, the patient’s and relatives’ perspective, and clinical communication; identifying the involved parties and how to involve them; identifying possible courses of action, and possible conclusion and follow-up. The various elements were closely interwoven. The content and conclusions varied and seemed to be contingent on the committee members’ interpretations, experience and knowledge. Important aspects of a clinical ethics deliberation were sometimes neglected. When the committees used a deliberation procedure and a blackboard, the deliberations tended to become more systematic and transparent. Many of the committees were insecure about how to include the involved parties and how to document the deliberations. Conclusion: Clinical ethics committees may provide an important arena for multidisciplinary discussions of complex clinical ethics challenges. However, this seems to require adequate composition, adoption of transparent deliberation procedures, and targeted training. (shrink)

Background: A fair distribution of healthcare services for older patients is an important challenge, but qualitative research exploring clinicians’ consideration in daily clinical prioritisation in healthcare services for the aged is scarce.Objectives: To explore what kind of criteria, values, and other relevant considerations are important in clinical prioritisations in healthcare services for older patients.Design: A semi-structured interview-guide was used to interview 45 clinicians working with older patients. The interviews were analysed qualitatively using hermeneutical content analysis and template organising style.Participants: 20 (...) physicians and 25 nurses working in public hospitals and nursing homes in different parts of Norway.Results and interpretations: Important dilemmas relate to under-provision of community care and comprehensive approaches, and over-utilisation of certain specialised services. Overt ageism is generally not reported, but the healthcare services for the aged seem to be inadequate due to more subtle processes, for example, dominating considerations and ideals and operating conditions that do not pay sufficient attention to older patients’ needs and considerations of justice. Clinical prioritisations are described as being dominated by adapting traditional biomedical approaches to the operating conditions. Many of the clinicians indicate that there is a potential for improving end of life decisions and for reducing exaggerated use of life-prolonging treatment and hospitalisations.Conclusion: The interviews in this study indicate that considerations of justice and patients’ perspectives should be given more attention to strike a balance between specialised medical approaches and more general and comprehensive approaches in healthcare services for older patients. (shrink)

The aim of this article is to give more insight into what ethical challenges clinicians in mental healthcare experience and discuss with a Clinical Ethics Committee in psychiatry in the Region of Southern Denmark. Ethical considerations are an important part of the daily decision-making processes and thereby for the quality of care in mental healthcare. However, such ethical challenges have been given little systematic attention – both in research and in practices. A qualitative content analysis of 55 written case-reports from (...) the Clinical Ethics Committee. The Committee offers clinicians in mental healthcare structured ethical analyses of ethical challenges and makes a thorough written case-report. The ethical challenges are grouped into three overarching topics: 1. Clinicians and their relation to patients and relatives. 2. Clinicians and institutional aspects of mental healthcare 3. Clinicians and mental healthcare in a wider social context. Through presentation of illustrative examples the complexity of daily clinical life in mental healthcare becomes evident, as well as typical interests, values and arguments. This qualitative study indicates that difficult ethical challenges are an inherent part of mental healthcare that requires time, space and competence to be dealt with adequately. (shrink)

Background: Although fair distribution of healthcare services for older patients is an important challenge, qualitative research exploring clinicians’ considerations in clinical prioritisation within this field is scarce. Objectives: To explore how clinicians understand their professional role in clinical prioritisations in healthcare services for old patients. Design: A semi-structured interview-guide was employed to interview 45 clinicians working with older patients. The interviews were analysed qualitatively using hermeneutical content analysis. Participants: 20 physicians and 25 nurses working in public hospitals and nursing homes (...) in different parts of Norway. Results and interpretations: The clinicians struggle with not being able to attend to the comprehensive needs of older patients, and being unfaithful to professional ideals and expectations. There is a tendency towards lowering the standards and narrowing the role of the clinician. This is done in order to secure the vital needs of the patient, but is at the expense of good practice and holistic role modelling. Increased specialisation, advances and increase in medical interventions, economical incentives, organisational structures, and biomedical paradigms, may all contribute to a narrowing of the clinicians’ role. Conclusion: Distributing healthcare services in a fair way is generally not described as integral to the clinicians’ role in clinical prioritisations. If considerations of justice are not included in clinicians’ role, it is likely that others will shape major parts of their roles and responsibilities in clinical prioritisations. Fair distribution of healthcare services for older patients is possible only if clinicians accept responsibility in these questions. (shrink)

Aim: This study explores priority dilemmas in dialysis treatment and care offered elderly patients within the Norwegian public healthcare system.Background: Inadequate healthcare due to advanced age is frequently reported in Norway. The Norwegian guidelines for healthcare priorities state that age alone is not a relevant criterion. However, chronological age, if it affects the risk or effect of medical treatment, can be a legitimate criterion.Method: A qualitative approach is used. Data were collected through semistructured interviews and analysed through hermeneutical content analysis. (...) The informants were five physicians and four nurses from dialysis wards.Findings: Pressing priority dilemmas centre around decision-making concerning withholding and withdrawal of dialysis treatment. Advanced age is rarely an absolute or sole priority criterion. It seems, however, that advanced age appears to be a more subtle criterion in relation with, for example, comorbidity, functional status and cognitive impairment. Nurses primarily prioritise specialised dialysis care and not comprehensive nursing care. The complex needs of elderly patients are therefore often not always met.Conclusions: Clinical priorities should be made more transparent in order to secure legitimate and fair resource allocation in dialysis treatment and care. Difficult decisions concerning withholding or withdrawal of dialysis ought to be openly discussed within the healthcare team as well as with patients and significant others. The biomedical focus and limitations on comprehensive care during dialysis should be debated. (shrink)

This introduction to the Common Knowledge symposium titled “Comparative Relativism” outlines a variety of intellectual contexts where placing the unlikely companion terms comparison and relativism in conjunction offers analytical purchase. If comparison, in the most general sense, involves the investigation of discrete contexts in order to elucidate their similarities and differences, then relativism, as a tendency, stance, or working method, usually involves the assumption that contexts exhibit, or may exhibit, radically different, incomparable, or incommensurable traits. Comparative studies are required to (...) treat their objects as alike, at least in some crucial respects; relativism indicates the limits of this practice. Jensen argues that this seeming paradox is productive, as he moves across contexts, from Lévi-Strauss's analysis of comparison as an anthropological method to Peter Galison's history of physics, and on to the anthropological, philosophical, and historical examples offered in symposium contributions by Barbara Herrnstein Smith, Eduardo Viveiros de Castro, Marilyn Strathern, and Isabelle Stengers. Comparative relativism is understood by some to imply that relativism comes in various kinds and that these have multiple uses, functions, and effects, varying widely in different personal, historical, and institutional contexts that can be compared and contrasted. Comparative relativism is taken by others to encourage a “comparison of comparisons,” in order to relativize what different peoples—say, Western academics and Amerindian shamans—compare things “for.” Jensen concludes that what is compared and relativized in this symposium are the methods of comparison and relativization themselves. He ventures that the contributors all hope that treating these terms in juxtaposition may allow for new configurations of inquiry. (shrink)

An ethics reflection group is one of a number of ethics support services developed to better handle ethical challenges in healthcare. The aim of this article is to evaluate the significance of ERGs in psychiatric and general hospital departments in Denmark. This is a qualitative action research study, including systematic text condensation of 28 individual interviews and 4 focus groups with clinicians, ethics facilitators and ward managers. Short written descriptions of the ethical challenges presented in the ERGs also informed the (...) analysis of significance. A recurring ethical challenge for clinicians, in a total of 63 cases described and assessed in 3 ethical reflection groups, is to strike a balance between respect for patient autonomy, paternalistic responsibility, professional responsibilities and institutional values. Both in psychiatric and general hospital departments, the study participants report a positive impact of ERG, which can be divided into three categories: 1) Significance for patients, 2) Significance for clinicians, and 3) Significance for ward managers. In wards characterized by short-time patient admissions, the cases assessed were retrospective and the beneficiaries of improved dialogue mainly future patients rather than the patients discussed in the specific ethical challenge presented. In wards with longer admissions, the patients concerned also benefitted from the dialogue in the ERG. This study indicates a positive significance and impact of ERGs; constituting an interdisciplinary learning resource for clinicians, creating significance for themselves, the ward managers and the organization. By introducing specific examples, this study indicates that ERGs have significance for the patients discussed in the specific ethical challenge, but mostly indirectly through learning among clinicians and development of clinical practice. More research is needed to further investigate the impact of ERGs seen from the perspectives of patients and relatives. (shrink)

Although we find Gangestad & Simpson's argument intriguing, we question some of its underlying assumptions, including: (1) that fluctuating asymmetry (FA) is consistently heritable; (2) that symmetry is driving the effects; (3) that use of parametric tests with FA is appropriate; and (4) that a short-term mating strategy produces more offspring than a long-term strategy.

The language of “participant-driven research,” “crowdsourcing” and “citizen science” is increasingly being used to encourage the public to become involved in research ventures as both subjects and scientists....

Identifying and characterizing geomechanical domains is important for understanding how a reservoir will respond to hydraulic fracturing, including interaction with natural fractures to create new permeable pathways. We have used a rock-mass characterization approach, which describes the mechanical reservoir package by combining parameters of the intact rock, such as brittleness, with inferred geometry and density of natural fractures. Insights from outcrop observations are important to complement the interpretation of fracture geometry and density derived from subsurface data, to give a more (...) complete understanding of natural fracture networks. This integrated approach is applied to a data set from the Duvernay play in Western Canada. A synthetic model of the subsurface reservoir is constructed using data from well logs, cores, and outcrop analogs. Numerical simulation of the response of the artificial rock mass to hydraulic fracturing is performed using a distinct element code. Independent validation of the model is obtained by achieving an agreement between the simulated microseismic response and the observed distribution of microseismicity during hydraulic fracturing. (shrink)

A quick question! Who’s the first name that comes to mind when the periodic table is mentioned? Dmitrii Ivanovich Mendeleev is the obvious and universal answer. And the second name? Most of you would probably agree with my answer: Eric R. Scerri, Lecturer in Chemistry and History and Philosophy of Science at the University of California, Los Angeles, and founding editor of this journal, devoted to the philosophy of chemistry, another of his specialties.Through the years I have followed Scerri’s (...) work on the periodic table, reading his numerous articles and reviewing his two previous books (Scerri 2007; Laing and Kauffman 2007; Scerri 2009; Kauffman 2011). In his latest book he comprehensively but succinctly examines this true cultural iconic symbol of science that is used by artists, advertisers, and of course, scientists in all fields. It is almost as familiar to the general public as the chemical formula for water, and an understanding and appreciation for it is essential to the physi. (shrink)

Introduction Jan Abbink and Hans Vermeulen This volume consists of essays and studies by authors inspired by the work of Eric Wolf, a central figure in ...