Could an accreditation, certification, or rating mechanism help the pharmaceutical industry improve both its bioethical performance and its public reputation? Other industries have used such systems to assess, improve, distinguish, and demonstrate the quality of their services, processes, and products. These systems have also helped increase transparency, accountability, stakeholder confidence, and awareness of industry best practices. This article explains how market forces can be harnessed to recognize and promote better bioethical performance by pharmaceutical companies when there are good systems to (...) accredit, certify, or rate. It concludes with a review of relevant failures of credit-rating agencies — such as conflicts of interests and revolving-door practices — to illuminate some of the pitfalls of developing a bioethics accreditation, certification, or rating system for pharmaceutical companies. (shrink)
This article explores whether the bioethical performance and trustworthiness of pharmaceutical companies can be improved by harnessing market forces through the use of accreditation, certification, or rating. Other industries have used such systems to define best practices, set standards, and assess and signal the quality of services, processes, and products. These systems have also informed decisions in other industries about where to invest, what to buy, where to work, and when to regulate. Similarly, accreditation, certification, and rating programs can help (...) drug companies address stakeholder concerns in four areas: clinical trial design and management, dissemination of clinical trial results, marketing practices, and the accessibility of medicines. To illuminate processes — such as conflicts of interests and revolving-door policies — that can jeopardize the integrity of accreditation, certification, and ratings systems, the article concludes with a consideration of recent failures of credit-rating agencies and a review of the regulatory capture literature. (shrink)
Children and pregnant women are often excluded from clinical research. This has resulted in a paucity of evidence on how medicines work for fetuses, neonates, infants, and adolescents. It also raises bioethics, scientific, and public health concerns. For over half a century, doctors have prescribed medicines to children largely on the basis of how they work in adults, despite children’s varied physiologies and differences in how their bodies absorb and metabolize drugs. Regulations and legislation have led to an increase in (...) the number of pediatric studies and to better drug labeling. However, children at all stages of their lives often remain “therapeutic orphans” owing to insufficient evidence about how medicines work for them. (shrink)
Despite the burgeoning literature on professionalism in other health professions, psychology lags behind in the level of attention given to this core competency. In this article, we review definitions from other health professions and how they address professionalism. Next, we review how this competency evolved within health service psychology, and we propose a definition. We offer an approach for assessing professionalism within HSP. Consideration is given to strategies and methods for providing effective education and training in this multifaceted competency. Finally, (...) recommendations are made for creating a culture of professionalism within HSP and honoring psychology’s social contract with multiple publics. (shrink)
I reply to the excellent commentaries by Nancy Snow and Jennifer Cole Wright on my book, The Character Gap: How Good Are We? Topics discussed include the criteria of virtue, kinds of virtuous motives, vicious motivation and behavior, continence and incontinence, the possibility of widespread vice, and a recent meta-analysis of helping behavior.
We study the implications of model completeness of a theory for the effectiveness of presentations of models of that theory. It is immediate that for a computable model \ of a computably enumerable, model complete theory, the entire elementary diagram \\) must be decidable. We prove that indeed a c.e. theory T is model complete if and only if there is a uniform procedure that succeeds in deciding \\) from the atomic diagram \\) for all countable models \ of T. (...) Moreover, if every presentation of a single isomorphism type \ has this property of relative decidability, then there must be a procedure with succeeds uniformly for all presentations of an expansion \\) by finitely many new constants. (shrink)
This article explores the influence of East Asia's economic growth on the evolution of American neoconservative thought in the 1970s and 1980s. It traces how prominent neoconservative thinkers—Nathan Glazer, Peter L. Berger, Herman Kahn, Michael Novak, and Lawrence E. Harrison—developed the claim that the region's prosperity stemmed from its alleged Confucian tradition. Drawing in part from East Asian leaders and scholars, they argued that the region's growth demonstrated that tradition had facilitated, rather than hampered, the development of a distinct East (...) Asian capitalist modernity. The article argues that this Confucian thesis helped American neoconservatives articulate their conviction that “natural” social hierarchies, religious commitment, and traditional families were necessary for healthy and free capitalist societies. It then charts how neoconservatives mobilized this interpretation of Confucian East Asia against postcolonial critiques of capitalism, especially dependency theory. East Asia, they claimed, demonstrated that poverty and wealth were determined not by patterns of welfare, structural exploitation, or foreign assistance, but values and culture. The concept of Confucian capitalism, the article shows, was central to neoconservatives’ broad ideological agenda of protecting political, economic, and racial inequality under the guise of values, culture, and tradition. (shrink)
Increasingly, professionalism has been recognized as a core competency for health service professionals and is the domain in which vexing competence problems are observed in trainees. We begin by describing manifestations of problems of professionalism in accord with the values that fall within the rubric of this multifaceted construct. We provide an approach for evaluating problems of professionalism and discuss intervention for trainees with mild, moderate, or severe problems in this domain. We propose implications for training focused on enhancing the (...) culture of programs; bolstering the education, guidance, and mentoring provided related to professionalism; and encouraging best practices for addressing trainees with problems of professionalism. We conclude by sharing ideas about defining professionalism, identifying problems of professionalism, strengthening our approach to assessing professionalism and intervening when problems are evident, developing strategies for preventing professionalism problems, and ensuring that psychologists take seriously their responsibility to address professionalism concerns with colleagues. (shrink)
Mill's discussion of ‘the internal sanction’ in chapter III of Utilitarianism does not do justice to his understanding of internal sanctions; it omits some important points and obscures others. I offer an account of this portion of his moral psychology of motivation which brings out its subtleties and complexities. I show that he recognizes the importance of internal sanctions as sources of motives to develop and perfect our characters, as well as of motives to do our duty, and I examine (...) in some detail the various ways in which these sanctions give rise to motivating desires and aversions. (shrink)
The rationality of concern for oneself has been taken for granted by the authors of western moral and political thought in a way in which the rationality of concern for others has not. While various authors have differed about the morality of self-concern, and about the extent to which such concern is rationally required, few have doubted that we have at least some special reasons to care for our selves, reasons that differ either in degree or in kind from those (...) we have to care for others. The rationality of prudence as traditionally conceived was thus taken to be threatened by Lockean accounts of personal identity. For taking a person’s identity through time to consist in psychological continuity is often thought to result in the numerical distinctness of his present and future selves, thus leaving his present self in the unsavoury position of having to ask, “Why care specially about my future self, if he won’t really be me?”. (shrink)
Internet-based health research is increasing, and often offers financial incentives but fraudulent behavior by participants can result. Specifically, eligible or ineligible individuals may enter the study multiple times and receive undeserved financial compensation. We review past experiences and approaches to this problem and propose several new strategies. Researchers can detect and prevent Internet research fraud in four broad ways: through the questionnaire/instrument ; through participants' non-questionnaire data and seeking external validation through computer information,, and 4) through study design. These approaches (...) each have pros and cons, and raise ethical, legal, and logistical questions, given that ethical tensions can emerge between preserving the integrity of research vs. protecting the privacy and confidentiality of study respondents. While past discussions concerning the ethics of online research have tended to focus on the participants' ability to trust the researchers, needs now arise to examine researchers' abilities to trust the participants. This analysis has several critical implications for future practice, policy, and research. (shrink)
Everyone knows a picture is worth a thousand words. But sometimes, especially in journalism, a picture can be worth much, much more. This added value isn't always positive. Pictures can inflict lasting pain on victims of grief and tragedy. This paper by an undergraduate journalism student explores the ethical dilemmas photographers face when capturing such traumatic incidents on film and explores the lack of professional guidelines available to guide them.
American society tends to medicalize or criminalize social problems. Criminal justice reformers have made arguments for a positive role in the relief of poverty that are similar to those aired in healthcare today. The consequences of criminalizing poverty caution against its continued medicalization.
Martha A. Hall’s artists’ books documenting her experience of living with breast cancer offer future health professionals a unique opportunity to sit in the patient’s position of vulnerability and fear. Hall’s books have become a cornerstone of our medical humanities pedagogy at the Maine Women Writers Collection because of their emotional directness and their impact on readers. This essay examines the ways that Hall’s call for conversation with healthcare providers is enacted at the University of New England and provides a (...) model for how such works might be used at other educational institutions to encourage empathy between practitioners and patients by engaging in conversations about anger, fear, and other common reactions to life-threatening illness. We explore the unruly nature of Martha A. Hall’s narratives of illness and care, as well as how the form of the books themselves engages the reader in a deep relationship with Hall’s personal pain and her humanity itself. We explore, too, the cumulative effect of these powerful books on readers who handle them regularly, as we do in our roles as professor and archivist. (shrink)
ABSTRACTIn two experiments, we explored whether anecdotal stories influenced how individuals reasoned when evaluating scientific news articles. We additionally considered the role of education level and thinking dispositions on reasoning. Participants evaluated eight scientific news articles that drew questionable interpretations from the evidence. Overall, anecdotal stories decreased the ability to reason scientifically even when controlling for education level and thinking dispositions. Additionally, we found that article length was related to participants' ratings of the news articles. Our study demonstrates that anecdotes (...) can discourage scientific reasoning while also pointing to the potential influence of article length on judgements of quality. (shrink)
When animals choose between completing a cognitive task and “escaping,” proper interpretation of their behavior depends crucially on methodological details, including how forced and freely chosen tests are mixed and whether appropriate transfer tests are administered. But no matter how rigorous the test, it is impossible to go beyond functional similarity between human and nonhuman behaviors to certainty about human-like consciousness.
It is well established that language production and comprehension are influenced by information status, for example, whether information is given, new, topical, or predictable, and many scholars suggest that an important component of information status is keeping track of what information is in common ground, and what is not. Information status affects both speakers' choices and how listeners interpret the speaker's meaning. Although there is a wealth of scholarly work on information status, there is no consensus on the mechanisms by (...) which it is used, and in fact relatively little discussion of the underlying representations and psycholinguistic mechanisms. Moreover, a major challenge to understanding information status is that its effects are notoriously variable. This study considers existing proposals about information status, focusing on two questions: how is it represented; and by what mechanisms is it used? I propose that it is important to consider whether representations and mechanisms can be classified as either explicit or emergent. Based on a review of existing evidence, I argue that information status representations are most likely emergent, but the mechanisms by which they are used are both explicit and emergent. This review provides one of the first considerations of information status processing across multiple domains. (shrink)
If Christian ethics is to have an authentic connection to Jesus Christ, it is crucial to establish pedagogical objectives and best practices that are transformative. In this article, I examine how integrating Christian sexual ethics with Ignatian spirituality has fostered many students’ holistic growth and commitment to justice.