A traditional approach to teaching medical ethics aims to provide knowledge about ethics. This is in line with an epistemological view on ethics in which moral expertise is assumed to be located in theoretical knowledge and not in the moral experience of healthcare professionals. The aim of this paper is to present an alternative, contextual approach to teaching ethics, which is grounded in a pragmatic-hermeneutical and dialogical ethics. This approach is called moral case deliberation. Within moral case deliberation, healthcare professionals (...) bring in their actual moral questions during a structured dialogue. The ethicist facilitates the learning process by using various conversation methods in order to find answers to the case and to develop moral competencies. The case deliberations are not unique events, but are a structural part of the professional training on the work floor within healthcare institutions. This article presents the underlying theory on ethics and illustrates this approach with an example of a moral case deliberation project in a Dutch psychiatric hospital. The project was evaluated using the method of responsive evaluation. This method provided us with rich information about the implementation process and effects the research process itself also lent support to the process of implementation. (shrink)

The authors present a case study involving truth telling responsibilities in the setting of nonepileptic seizures. Specifically, over the course of several suspected nonepileptic seizures, a patient’s seizures stopped after he received a saline flush meant to precede the administration of anti-seizure medication. The patient and his surrogate believed he had received the medication each time, and the team wondered whether they should disclose the truth. Some worried that disclosure would reinforce the suspected psychogenic behavior, exacerbating the patient’s condition. In (...) this way, the case study presents a twist on the traditional truth telling archetype. While most truth telling cases center on navigating cultural differences or worries about emotional harm, this case presented concerns about medical harm in the form of exacerbating the patient’s condition. The authors describe the complex patient-family-team dynamic that preceded this ethical dilemma, describe the case, analyze the ethical issue, and describe the outcome. (shrink)

To properly understand behavior, we must obtain both ultimate and proximate explanations. Put briefly, ultimate explanations are concerned with why a behavior exists, and proximate explanations are concerned with how it works. These two types of explanation are complementary and the distinction is critical to evolutionary explanation. We are concerned that they have become conflated in some areas of the evolutionary literature on human behavior. This article brings attention to these issues. We focus on three specific areas: the evolution of (...) cooperation, transmitted culture, and epigenetics. We do this to avoid confusion and wasted effort—dangers that are particularly acute in interdisciplinary research. Throughout this article, we suggest ways in which misunderstanding may be avoided in the future. (shrink)

Background Ethically, informed consent regarding randomised controlled trials (RCTs) should be understandable to patients. The patients can then give free consent or decline to participate in a RCT. Little is known about what patients really understand in consultations about RCTs. Methods Cancer patients who were asked to participate in a randomised trial were surveyed using a semi-standardised interview developed by the authors. The interview addresses understanding, satisfaction and needs of the patients. The sample included eight patients who participated in a (...) trial and two who declined. The data were analysed on the basis of Mayring's qualitative analysis. Results Patients' understanding of informed consent was less developed than anticipated, especially concerning key elements such as randomisation, content and procedure of RCTs. Analysing the result about satisfaction of the patients, most of the patients described their consultations as hectic and without advance notice. Health limitations due to cancer played a decisive role. However, most of the patients perceived their physician to be sympathetic. Analysing the needs of patients, they ask for a clear informed consent consultation with enough time and adequate advance notice. Conclusion This study fills an important empirical research gap of what is ethically demanded in an RCT consultation and what is really understood by patients. The qualitative approach enabled us to obtain new results about cancer patients' understanding of informed consent, to clarify patients' needs and to develop new ideas to optimise the informed consent. (shrink)

Syntactic and structural models specify relationships between their constituents but cannot show what outcomes their interaction would produce over time in the world. Simulation consists in iterating the states of a model, so as to produce behaviour over a period of simulated time. Iteration enables us to trace the implications and outcomes of inference rules and other assumptions implemented in the models that make up a theory. We apply this method to experiments which we treat as models of the particular (...) aspects of reality they are designed to investigate. Scientific experiments are constantly designed and re-designed in the context of implementation and use. They mediate between theoretical understanding and the practicalities of engaging with the empirical and social world. In order to model experiments we need to identify and represent features that all experiments have in common. We treat these features as parameters of a general model of experiment so that by varying these parameters different types of experiment can be modelled. (shrink)

The new field of experimental philosophy has emerged as the methods of psychological science have been brought to bear on traditional philosophical issues. Oxford Studies in Experimental Philosophy will be the place to go to see outstanding new work in the field. It will feature papers by philosophers, papers by psychologists, and papers co-authored by people in both disciplines. The series heralds the emergence of a truly interdisciplinary field in which people from different disciplines are working together to address a (...) shared set of questions. The inaugural volume is roughly structured into four sections. The first three papers focus on recent developments in moral psychology, a topic that has seen lively debate and a great deal of progress over the last decade. The second section highlights three contributions that bring new methods to moral psychology: formal modeling and special populations. The third section brings together four papers that adopt an experimental philosophy approach to novel topics, including intuitive dualism, generics, joint action, and happiness. And the last two papers provide critical and historical context to the development of experimental philosophy. (shrink)

Accumulating evidence for the unique social, behavioral, and physical health benefits of positive emotion and related well-being constructs has led to the development and testing of positive psychological interventions to increase emotional well-being and enhance health promotion and disease prevention. PPIs are specifically aimed at improving emotional well-being and consist of practices such as gratitude, savoring, and acts of kindness. The purpose of this narrative review was to examine the literature on PPIs with a particular focus on positive emotion outcomes. (...) We evaluated the evidence on the effects of PPIs on positive emotion specifically, and discussed the range of evidence regarding the relative responsiveness of emotion measures to PPIs in order to gain a better understanding of the specific emotional pathways through which PPIs influence psychological and physical well-being. We conclude with recommendations for best evaluating effects of PPIs on positive emotion outcomes. (shrink)

Originally published in 1938, this book examines the meaning of the word 'intuition'. Wild considers many different applications of the word in a variety of poetic and philosophical sources, and questions whether or not such a faculty truly can be said to exist. This book will be of value to anyone with an interest in intuition and the implications of such a word's usage.