Using payment to recruit research subjects is a common practice, but it raises ethical concerns that coercion or undue inducement could potentially compromise participants’ informed consent. This is the first national study to explore the attitudes of IRB members and other human subjects protection professionals concerning whether payment of research participants constitutes coercion or undue influence, and if so, why. The majority of respondents expressed concern that payment of any amount might influence a participant’s decisions or behaviors regarding research participation. (...) Respondents expressed greater acceptance of payment as reimbursement or compensation than as an incentive to participate in research, and most agreed that subjects are coerced if the offer of payment makes them participate when they otherwise would not or when the offer of payment causes them to feel that they have no reasonable alternative but to participate . Views about undue influence were similar. We conclude that human subjects protection professionals hold expansive and inconsistent views about coercion and undue influence that may interfere with the recruitment of research participants and impede valuable research. (shrink)
Given that natural selection is so powerful at optimizing complex adaptations, why does it seem unable to eliminate genes (susceptibility alleles) that predispose to common, harmful, heritable mental disorders, such as schizophrenia or bipolar disorder? We assess three leading explanations for this apparent paradox from evolutionary genetic theory: (1) ancestral neutrality (susceptibility alleles were not harmful among ancestors), (2) balancing selection (susceptibility alleles sometimes increased fitness), and (3) polygenic mutation-selection balance (mental disorders reflect the inevitable mutational load on the thousands (...) of genes underlying human behavior). The first two explanations are commonly assumed in psychiatric genetics and Darwinian psychiatry, while mutation-selection has often been discounted. All three models can explain persistent genetic variance in some traits under some conditions, but the first two have serious problems in explaining human mental disorders. Ancestral neutrality fails to explain low mental disorder frequencies and requires implausibly small selection coefficients against mental disorders given the data on the reproductive costs and impairment of mental disorders. Balancing selection (including spatio-temporal variation in selection, heterozygote advantage, antagonistic pleiotropy, and frequency-dependent selection) tends to favor environmentally contingent adaptations (which would show no heritability) or high-frequency alleles (which psychiatric genetics would have already found). Only polygenic mutation-selection balance seems consistent with the data on mental disorder prevalence rates, fitness costs, the likely rarity of susceptibility alleles, and the increased risks of mental disorders with brain trauma, inbreeding, and paternal age. This evolutionary genetic framework for mental disorders has wide-ranging implications for psychology, psychiatry, behavior genetics, molecular genetics, and evolutionary approaches to studying human behavior. (Published Online November 9 2006) Key Words: adaptation; behavior genetics; Darwinian psychiatry; evolution; evolutionary genetics; evolutionary psychology; mental disorders; mutation-selection balance; psychiatric genetics; quantitative trait loci (QTL). (shrink)
Deception is a useful methodological device for studying attitudes and behavior, but deceptive studies fail to fulfill the informed consent requirements in the U.S. federal regulations. This means that before they can be approved by Institutional Review Boards, they must satisfy the four regulatory conditions for a waiver or alteration of these requirements. To illustrate our interpretation, we apply the conditions to a recent study that used deception to show that subjects judged the same wine as more enjoyable when they (...) believed it had a higher price. (shrink)
In The Healer's Power, Howard Brody placed the concept of power at the heart of medicine's moral discourse. Struck by the absence of “power” in the prevailing vocabulary of medical ethics, yet aware of peripheral allusions to power in the writings of some medical ethicists, he intuited the importance of power from the silence surrounding it. He formulated the problem of the healer's power and its responsible use as “the central ethical problem in medicine.” Through the prism of power he (...) refracted a wide range of ethical problems, from informed consent to truth-telling, from confidentiality to futility, from the physician's fantasies to the physician's virtues. At times this prism shed new light on old problems, enabling us to see from an unexpected angle the elements of which the problem was composed. At other times it exposed issues of ethical significance that had been neglected in the bioethics literature. (shrink)
Mood disorders, including major depressive disorder and bipolar disorder, are highly prevalent, frequently disabling, and sometimes deadly. Additional research and more effective medications are desperately needed, but clinical trials research in mood disorders is fraught with ethical issues. Although many authors have discussed these issues, most do so from a theoretical viewpoint. This manuscript uses available empirical data to inform a discussion of the primary ethical issues raised in mood disorders research. These include issues of consent and decision-making capacity, including (...) patients’ motivations for participating in research. We also address drug withdrawals, placebo controls, and the overall safety of research. Finally, we examine the extant literature for studies discussing potential indirect benefits of clinical trials research to participants. Taken together, the evidence suggests that clinical trials research incorporating drug withdrawals and placebo controls can be conducted safely and ethically, even in patients with severe or treatment-resistant mood disorders. In fact, given the dearth of effective treatment options for this population, it is our opinion that a moral imperative exists to extend the offer of research participation to severely ill or treatment-resistant groups. (shrink)
lecting statistics about missing bindings and macros, and other errors. This guides debugging and development eﬀorts, leading to iterative improvements in both the tools and the quality of the converted corpus. The build system thus serves as both a production conversion engine and software test harness. We have now processed the complete arχiv collection through 2006 consisting of more than 400,000 documents (a complete run is a processor-yearsize undertaking), continuously improving our success rate. We are now able to convert more (...) than 90% of these documents to XHTML+MathML. We consider over 60% to be successes, converted with no or minor warnings. While the remaining 30% can also be converted, their quality is doubtful, due to unsupported macros or conversion errors. (shrink)
In her paper, “True Faith: Against Doxastic Partiality about Faith (in God and Religious Communities) and in Defense of Evidentialism,” Katherine Dormandy argues against the view that there is a partiality norm on faith. Dormandy establishes this by showing that partiality views can’t give the right responses to encounters with stubborn counter evidence. Either they (anti-epistemic-partiality views) recommend flouting the evidence altogether in order hold on to positive beliefs about the object of faith or they (epistemic-partiality views) lower the epistemic (...) standards in objectionable ways to alleviate the epistemic pressure imposed by the counterevidence. However, one cannot have praiseworthy faith when one refuses to really grapple with the evidence against the goodness of the faith’s object. So, partiality norms, far from constituting what makes for great faith, importantly stand in its way. Thus, we should reject any partiality norms on faith. We argue that cases of praiseworthy faith involve dispositions to confront the object of faith when presented with stubborn counter evidence against their goodness. Recognizing this enables us to endorse a partiality norm while avoiding Dormandy’s worries. We argue that dispositions to confront the object of faith presuppose positive beliefs about it, thus vindicating partiality. We further argue that the confrontation makes an epistemic demand of the object of faith: produce high confidence in whether it is still worth having faith in, thus carving out a central role for evidentialist norms. (shrink)
In this review, we discuss how two evolutionarily conserved pathways at the interface of DNA replication and repair, template switching and break-induced replication, lead to the deleterious large-scale expansion of trinucleotide DNA repeats that cause numerous hereditary diseases. We highlight that these pathways, which originated in prokaryotes, may be subsequently hijacked to maintain long DNA microsatellites in eukaryotes. We suggest that the negative mutagenic outcomes of these pathways, exemplified by repeat expansion diseases, are likely outweighed by their positive role in (...) maintaining functional repetitive regions of the genome such as telomeres and centromeres. Break-induced replication and template switching are conserved mechanisms of replication fork restart. They do not cause microsatellite instability in prokaryotes, but promote repeat expansion in eukaryotes. We suggest that TS and BIR persisted in eukaryotes despite their mutagenic potential because they help maintain long repetitive telomeres and centromeres. (shrink)
This response (a) integrates non-equilibrium evolutionary genetic models, such as coevolutionary arms-races and recent selective sweeps, into a framework for understanding common, harmful, heritable mental disorders; (b) discusses the forms of ancestral neutrality or balancing selection that may explain some portion of mental disorder risk; and (c) emphasizes that normally functioning psychological adaptations work against a backdrop of mutational and environmental noise. (Published Online November 9 2006).
After more than a dozen years of activity, some 161 indictments, 64 arrests, and 47 surrenders, the International Criminal Tribunal for the former Yugoslavia (ICTY) has accomplished a good deal in terms of its primary task of prosecution. Nonetheless, there is still much debate over the state of transitional justice in the Balkans and what has been accomplished. We cannot forget that the ICTY was created with broad political and social purposes in mind, specifically to contribute to the restoration and (...) maintenance of peace. Using a comparative framework, we develop benchmarks of transitional justice outcomes to examine these vague but important and ambitious goals. Although conventional wisdom says that the ICTY is used instrumentally by Balkan leaders who are fundamentally opposed to the court’s existence, we demonstrate that there is also evidence of broader political and social change throughout the region. Thus, we contend that Balkan countries have indeed moved beyond mere prosecution. (shrink)
Cosmetic surgery is a fast-growing medical practice. In 1997 surgeons in the United States performed the four most common cosmetic procedures443,728 times, an increase of 150% over the comparable total for 1992. Estimated total expenditures for cosmetic surgery range from $1 to $2 billion. As managed care cuts into physicians' income and autonomy, cosmetic surgery, which is not covered by health insurance, offers a financially attractive medical specialty.
A. C. Graham's Later Mohist Logic, Ethics, and Sciences is the only Western-language translation of the obscure and textually corrupt chapters of the Mozi that purportedly constitute the foundations of ancient Chinese logic. Graham's presentation and interpretation of this difficult material has been largely accepted by scholars. This article questions the soundness of Graham's reconstruction of these chapters . Upon close examination, problems are revealed in both the structure and the content of the framework Graham uses to interpret the Canons. (...) Without a more reliable framework for interpreting the text, it seems best to remain skeptical about claims that the Canons represent evidence for the study of logic in early China. (shrink)