Academic medical ethics must be a bulwark against a disturbing trend toward post-truth cultures. Activism of course has its place in massive cultural debates like abortion. The fact that so many people care so deeply about these debates is part of what makes them so important. But especially when coming from clinicians, academics, and others to whom we entrust the care of our public discourse, interventions into the debates must be disciplined by a thoroughgoing commitment to engage with the available (...) data to back up the central claims even when those claims seem like common sense—perhaps especially when they seem like common sense. (shrink)

The disruptions to everyday life wrought by the COVID-19 pandemic include distortions in the experience of time, as reported widely by ordinary citizens and observed by journalists and social scientists. But how does this temporal disruption play out in different time scales—in the individual day as opposed to the medium- and long-term futures? And how might place influence how individuals experience and understand the pandemic's temporal transformations? This essay examines a range of temporal disruptions reported in day diaries and surveys (...) submitted to the Everyday Life in Middletown project, an online archive that has been documenting ordinary life in Muncie, Indiana, USA since 2016. Viewing these materials as instances of life writing, the essay probes the interactions between temporal disruptions and the local setting as they inflect the autobiographical selves our writers construct in their pandemic writings. It shows how living in Muncie—a postindustrial city with its particular combination of historical, demographic, economic, social, and political dynamics—structures the autobiographical stories available to our writers, and how the disruption of time produces new variations and problems for life writing. In the midst of a global crisis, we glimpse the pandemic's reshaping of a local structure of feeling in which a pervasive, local narrative of civic decline frames individual self-fashioning. (shrink)

As COVID-19 drags on and new vaccines promise widespread immunity, the world's attention has turned to predicting how the present pandemic will end. How do societies know when an epidemic is over and normal life can resume? What criteria and markers indicate such an end? Who has the insight, authority, and credibility to decipher these signs? Detailed research on past epidemics has demonstrated that they do not end suddenly; indeed, only rarely do the diseases in question actually end. This article (...) examines the ways in which scholars have identified and described the end stages of previous epidemics, pointing out that significantly less attention has been paid to these periods than to origins and climaxes. Analysis of the ends of epidemics illustrates that epidemics are as much social, political, and economic events as they are biological; the “end,” therefore, is as much a process of social and political negotiation as it is biomedical. Equally important, epidemics end at different times for different groups, both within one society and across regions. Multidisciplinary research into how epidemics end reveals how the end of an epidemic shifts according to perspective, whether temporal, geographic, or methodological. A multidisciplinary analysis of how epidemics end suggests that epidemics should therefore be framed not as linear narratives—from outbreak to intervention to termination—but within cycles of disease and with a multiplicity of endings. (shrink)

ChatGPT has taken the academic community by storm (Cotton, Cotton, and Shipway 2023; Cox and Tzoc 2023; Sullivan, Kelly, and McLaughlan 2023). Since its release in November 2022, chatGPT has predic...

Following recent arguments that cultural practices in wild animal populations have important conservation implications, we argue that recognizing captive animals as cultural has important welfare implications. Having a culture is of deep importance for cultural animals, wherever they live. Without understanding the cultural capacities of captive animals, we will be left with a deeply impoverished view of what they need to flourish. Best practices for welfare should therefore require concern for animals’ cultural needs, but the relationship between culture and welfare (...) is also extremely complex, requiring us to rethink standard assumptions about what constitutes and contributes to welfare. (shrink)

Who is right? In Risk and Rationality, Kristin Shrader-Frechette argues that neither charges of irresponsible endangerment nor countercharges of scientific illiteracy frame the issues properly.

The societal and ethical implications of artificial intelligence (AI) have sparked discussions among academics, policymakers and the public around the world. What has gone unnoticed so far are the likewise vibrant discussions in China. We analyzed a large sample of discussions about AI ethics on two Chinese social media platforms. Findings suggest that participants were diverse, and included scholars, IT industry actors, journalists, and members of the general public. They addressed a broad range of concerns associated with the application of (...) AI in various fields. Some even gave recommendations on how to tackle these issues. We argue that these discussions are a valuable source for understanding the future trajectory of AI development in China as well as implications for global dialogue on AI governance. (shrink)

Social norms are commonly understood as rules that dictate which behaviors are appropriate, permissible, or obligatory in different situations for members of a given community. Many researchers have sought to explain the ubiquity of social norms in human life in terms of the psychological mechanisms underlying their acquisition, conformity, and enforcement. Existing theories of the psychology of social norms appeal to a variety of constructs, from prediction-error minimization, to reinforcement learning, to shared intentionality, to domain-specific adaptations for norm acquisition. In (...) this paper, we propose a novel methodological and conceptual framework for the cognitive science of social norms that we call normative pluralism. We begin with an analysis of the explanatory aims of the cognitive science of social norms. From this analysis, we derive a recommendation for a reformed conception of its explanandum: a minimally psychological construct that we call normative regularities. Our central empirical proposal is that the psychological underpinnings of social norms are most likely realized by a heterogeneous set of cognitive, motivational, and ecological mechanisms that vary between norms and between individuals, rather than by a single type of process or distinctive norm system. This pluralistic approach, we suggest, offers a methodologically sound point of departure for a fruitful and rigorous science of social norms. (shrink)

When applied in the health sector, AI-based applications raise not only ethical but legal and safety concerns, where algorithms trained on data from majority populations can generate less accurate or reliable results for minorities and other disadvantaged groups.

A system is autonomous if it uses its own information to modify itself and its environment to enhance its survival, responding to both environmental and internal stimuli to modify its basic functions to increase its viability. Autonomy is the foundation of functionality, intentionality and meaning. Autonomous systems accommodate the unexpected through self-organizing processes, together with some constraints that maintain autonomy. Early versions of autonomy, such as autopoiesis and closure to efficient cause, made autonomous systems dynamically closed to information. This contrasts (...) with recent work on open systems and information dynamics. On our account, autonomy is a matter of degree depending on the relative organization of the system and system environment interactions. A choice between third person openness and first person closure is not required. (shrink)

Anticipation allows a system to adapt to conditions that have not yet come to be, either externally to the system or internally. Autonomous systems actively control their own conditions so as to increase their functionality (they self-regulate). Living systems self-regulate in order to increase their own viability. These increasingly stronger conditions, anticipation, autonomy and viability, can give an insight into progressively stronger classes of models of autonomy. I will argue that stronger forms are the relevant ones for Artificial Life. This (...) has consequences for the design of and accurate simulation of living systems. Keywords: autonomy, modelling, function, simulation, anticipation, emergence DUBOIS’ CONJECTURE Autonomy basically means self-regulation. Self-regulation implies internal control of system states to achieve greater functionality, either internally or interactively with the environment. Functionality, as a teleological notion, implies that the system must be directed by likely future states; that is, it must anticipate and (possibly) adapt to likely future states. Functionality does not require autonomy (assuming functional goals are externally set), but merely that current states of the system can select suitable future states on the basis of suitable input. In this.. (shrink)

Ongoing changes in many Western countries have resulted in more healthcare services being transferred to municipalities and taking place in patients’ homes. This greatly impacts nurses’ work in home care, making their work increasingly diverse and demanding. In this study, we explore home‐care nursing through a critical discourse analysis of focus group interviews with home‐care nurses. Drawing on insights from positioning theory, we discuss the content and delineation of their work and the interweaving of contextual changes. Nurses hold a crucial (...) position in home healthcare, particularly in ensuring care for sicker patients with complex needs. Assessing health needs, performing advanced care, and at the same time, providing customized solutions in various homes were identified as distinctive for home‐care nurses’ work. Changes have made nurses’ work become driven by comprehensive tasks and acute medical needs that require much of their competence and time. Urgent care seems to take precedence in nurses’ work, leaving less time and attention for other tasks such as conversations and support for coping with everyday life. This underlines the need to investigate and discuss the content and scope of nurses’ work to help shape the further development of home‐care nursing. (shrink)

Despite claims of ‘evidence based policy’, the place of empirical evidence in family law reform is ambiguous. There is ongoing socio-legal analysis of the differential value and uses of quantitative data and anecdote in detailing women’s experiences and advocating for change. In this paper, we engage with these issues through a focus on how data were constructed in a key government report, Every Picture Tells a Story, which was used to officially define the problem and outline recommendations in the controversial (...) 2006-08 reform of the Australian Child Support Scheme. Our discussion focuses on two questions: what legitimacy is accorded to different kinds of evidence in family law reform processes?; and, how is this legitimacy gendered? We applied feminist critical discourse analysis to the type, source and claims of the data included in the child support chapter of the report. Our findings indicate that both quantitative data and anecdote were used to privilege fathers’ financial interests and autonomy; in contrast, women’s voices and interests were marginalised. Thus, we argue the legitimacy of data is ascribed through its relationship to the gendered definition of the ‘problems’ of child support, rather than the type of data per se. (shrink)

The ideal of trust pervades nursing. This article uses empirical material from acute psychiatry that reveals that it is distrust rather than trust that is prevalent in this field. Our data analyses show how distrust is expressed in the therapeutic environment and in the relationship between nurse and patient. We point out how trust can nonetheless be created in an environment that is characterized by distrust. Both trust and distrust are exposed as `fragile' phenomena that can easily `tip over' towards (...) their opposites. Trust is not something that nurses possess or are given; it is rather something that they earn and have to work hard to achieve. Regarding themselves as potential causes of distrust and active wielders of power can contribute to nurses developing a more realistic view of their practice. Assuming a realistic middle-way perspective can help to manoeuvre between the extremities of excellence and resignation, which in turn can lead to processes that create trust between psychotic patients and nurses. (shrink)

The use of child support is a politically and personally contested issue and a policy challenge across developed countries. This offers an opportunity to identify family practices and relationships through which hegemonic masculinity and socially valued femininities are reproduced and challenged. We present data from interviews with 28 fathers and 30 mothers to argue that when people discuss how child support is or should be spent, they are managing gendered parenting identities. Most fathers defined child support as “special money.” This (...) position buttresses the hegemonic masculine characteristics of authority and breadwinning, discursively de-genders the care of children, and challenges mothers’ conformity to feminine and good mothering ideals. A minority of fathers presented an alternative definition of child support and fathering that underplayed the relevance of money and values mothers’ and fathers’ care and financial contributions. Mothers’ accounts of using child support emphasized their financial authority and child-centered consumption in ways that both challenge and reproduce socially valued femininity. We conclude that definitions of how child support should be used reproduce relationships of dominance and subordination that constitute the gender order. (shrink)

Informed consent represents a cornerstone of the endeavours to make health care research ethically acceptable. Based on experience of qualitative research on power dynamics in nursing care in acute psychiatry, we show that the requirement for informed consent may be practised in formalistic ways that legitimize the researcher's activities without taking the patient's changing perception of the situation sufficiently into account. The presentation of three patient case studies illustrates a diversity of issues that the researcher must consider in each situation. (...) We argue for the necessity of researchers to base their judgement on a complex set of competencies. Consciousness of research ethics must be combined with knowledge of the challenges involved in research methodology in qualitative research and familiarity with the therapeutic arena in which the research is being conducted. The article shows that the alternative solution is not simple but must emphasize the researcher's ability to doubt and be based on an awareness of the researcher's fallibility. (shrink)

Indigenous Sustainable Wisdom: First Nation Know-How for Global Flourishing’s contributors describe ways of being that reflect a worldview that has guided humanity for 99% of human history; they describe the practical traditional wisdom stemming from Nature-based relational cultures that were or are guided by this worldview. Such cultures did not cause the kinds of anti-Nature and de-humanizing or inequitable policies and practices that now pervade our world. Far from romanticizing Indigenous histories, Indigenous Sustainable Wisdom offers facts about how human beings, (...) with our potential for good and evil behaviors, can live in relative harmony again. Contributions cover views from anthropology, psychology, sociology, leadership, native science, native history, native art. (shrink)

Companies increasingly seek to use gay protagonists in audio-visual commercials to attract a new affluent target group. There is also growing demand for the diversity present in society to be reflected in media formats such as advertising. Studies have shown, however, that heterosexual consumers, who may be part of the company's loyal consumer base, tend to react negatively to gay-themed advertising campaigns. Searching for an instrument to mitigate this unwanted effect, the present study investigated whether carefully selected background music can (...) shape the perceived gender of gay male advertising protagonists. In a 2 × 2 between-subjects online experiment, 218 heterosexual participants watched a commercial promoting engagement rings that featured gay male protagonists, scored with feminine- or masculine-connoted background music. As expected, women generally reacted more positively than men to the advertising. Men exposed to the masculine-connoted background music rated the promoted brand more positively, and masculine music also enhanced these men's acceptance of gay men in general more than was the case for feminine background music. Carefully selected background music affecting the perceived gender of gay male advertising protagonists may prevent negative reactions from heterosexual audiences and, therefore, motivate companies to use gay protagonists in television commercials on a more regular basis. (shrink)

Tomasello et al. propose that shared intentionality is a uniquely human ability. In light of this, we discuss several cultural behaviors that seem to result from a motivation to share experiences with others, suggest evidence for coordination and collaboration among chimpanzees, and cite recent findings that counter the argument that the predominance of emulation in chimpanzees reflects a deficit in intention reading.

HIV prevention is a critical health issue in Nigeria; a country that has one of the worst HIV epidemic profiles in the world. With 270,000 new infections in 2012, Nigeria is a prime site for HIV prevention research. One effect of the HIV epidemic has been to revolutionalise ethical norms for the conduct of research: it is now considered unethical to design and implement HIV related studies without community engagement. Unfortunately, there is very little commensurate effort in building the capacity (...) of local persons to engage actively with researchers, and there is no existing platform to facilitate dialogue between researchers and communities engaged in research in Nigeria. In an effort to address this gap, we undertook a series of three community dialogues and two community-researcher interface meetings in Nigeria. This paper aims to give an empirical account of the dialogue from these community engagement processes and provide a resulting critique of the implementation of research ethics practices in Nigeria. It is anticipated that the outputs will: support researchers in designing community-based research protocols; inform ethics committees of key considerations during research protocol reviews from a community perspective; and inform policy makers and research sponsors about issues of primary concern to communities with respect to HIV research. (shrink)

Rapid advancements in artificial intelligence and machine learning (AI/ML) in healthcare raise pressing questions about how much users should trust AI/ML systems, particularly for high stakes clinical decision-making. Ensuring that user trust is properly calibrated to a tool’s computational capacities and limitations has both practical and ethical implications, given that overtrust or undertrust can influence over-reliance or under-reliance on algorithmic tools, with significant implications for patient safety and health outcomes. It is, thus, important to better understand how variability in trust (...) criteria across stakeholders, settings, tools and use cases may influence approaches to using AI/ML tools in real settings. As part of a 5-year, multi-institutional Agency for Health Care Research and Quality-funded study, we identify trust criteria for a survival prediction algorithm intended to support clinical decision-making for left ventricular assist device therapy, using semistructured interviews (n=40) with patients and physicians, analysed via thematic analysis. Findings suggest that physicians and patients share similar empirical considerations for trust, which were primarilyepistemicin nature, focused on accuracy and validity of AI/ML estimates. Trust evaluations considered the nature, integrity and relevance of training data rather than the computational nature of algorithms themselves, suggesting a need to distinguish ‘source’ from ‘functional’ explainability. To a lesser extent, trust criteria were also relational (endorsement from others) and sometimes based on personal beliefs and experience. We discuss implications for promoting appropriate and responsible trust calibration for clinical decision-making use AI/ML. (shrink)

The language of ‘experience’ in nursing research This paper is an analysis of how the signifier ‘experience’ is used in nursing research. We identify a set of issues we believe accompany the use of experience but are rarely addressed. These issues are embedded in a spectrum that includes ontological commitments, visions of the person/self and its relation to ‘society’, understandings of research methodology and the politics of nursing. We argue that a poststructuralist understanding of the language of experience in research (...) opens up additional ways to analyze the relationship between the conduct of nursing research and cultural/political commitments. (shrink)

We thank the open peer commentators for their thoughtful responses to our article, "The Social Determinants of Health: Why Should We Care?" (Preda and Voigt 2015). Since space constraints prevent us from responding in detail to all the comments raised, we focus on two areas of concern that emerged from the commentaries. The first is our claim that avoidability is neither necessary nor sufficient for defining unjust or unfair health inequalities. The second area relates to the reasons we might give (...) for treating health inequalities as morally problematic. (shrink)

Interest in children’s agency within the research process has led to a renewed consideration of the relationships between researchers and children. Child protection concerns are sometimes not recognised by researchers, and sometimes ignored. Yet much research on children’s lives, especially in health, has the potential to uncover child abuse. University research guidance should be in place to safeguard both researchers and the populations under scrutiny. The aim of this study was to examine university guidance on protecting children in research contexts.

The nonmetaphysical interpretation of Hegel's philosophy asserts that the metaphysical reading is not credible and so his philosophy must be rationally reconstructed so as to elide its metaphysical aspects. This article shows that the thesis of the extended mind approaches the metaphysical reading, thereby undermining denials of its credibility and providing the resources to articulate and defend the metaphysical reading of Hegel's philosophy. This fully rehabilitates the metaphysical Hegel. The article does not argue for the truth of the metaphysical Hegel's (...) claims. Rather, it defends the correctness of reading his philosophy as metaphysical. (shrink)

Volume 19, Issue 7, July 2019, Page 34-36.

Medical therapy, research and technology enable us to make our bodies, or parts of them, available to others in an increasing number of ways. This is the case in organ, tissue, egg and sperm donation as well as in surrogate motherhood and clinical research. Bringing together leading scholars working on the ethical, social and cultural aspects of such bodily exchanges, this cutting-edge book develops new ways of understanding them. Bodily Exchanges, Bioethics and Border Crossing both probes the established giving and (...) selling frameworks for conceptualising bodily exchanges in medicine, and seeks to develop and examine another, less familiar framework: that of sharing. A framework of sharing can capture practices that involve giving up and giving away part of one's body, such as organ and tissue donation, and practices that do not, such as surrogacy and research participation. Sharing also recognizes the multiple relationalities that these exchanges can involve and invites inquiry into the context in which they occur. In addition, the book explores the multiple forms of border crossing that bodily exchanges in medicine involve, from the physical boundaries of the body to relational borders - as can happen in surrogacy - to national borders and the range of ethical issues that these various border-crossings can give rise to. Engaging with anthropology, sociology, philosophy, and feminist and postcolonical perspectives, this is an original and timely contribution to contemporary bioethics in a time of increasing globalization. It will be of use to students and researchers from a range of humanities and social science backgrounds as well as medical and other healthcare professionals with an interest in bioethics. (shrink)

We seek to constitute the extended mind’s fourth wave, socially distributed group cognition, and we do so by thinking with Hegel. The extended mind theory’s first wave invokes the parity principle, which maintains that processes that occur external to the organism’s skin should be considered mental if they are regarded as mental when they occur inside the organism. The second wave appeals to the complementarity principle, which claims that what is crucial is that these processes together constitute a cognitive system. (...) The first two waves assume that cognitive systems have well-defined territories or boundaries, and that internal and external processes do not switch location. The third wave rejects these assumptions, holding instead that internal processes are not privileged, and internal and external processes can switch, and that processes can be distributed among individuals. The fourth wave would advocate socially distributed group cognition. Groups are deterritorialized collective agents; they are ineliminatively and irreducibly real, they have mental states. Individuals constitute groups, but groups also constitute individuals. What counts as an individual and a group is a function of the level of analysis. And they are conflicted. (shrink)

It is commonly thought that Hume endorses the claim that causal cognition can be fully explained in terms of nothing but custom and habit. Associative learning does, of course, play a major role in the cognitive psychology of the Treatise. But Hume recognizes that associations cannot provide a complete account of causal thought. If human beings lacked the capacity to reflect on rules for judging causes and effects, then we could not (as we do) distinguish between accidental and genuine regularities, (...) and Hume could not (as he does) carry out his science of human nature. One might reply that what appears to be rule-governed behavior might emerge from associative systems that do not literally employ rules. But this response fails: there is a growing consensus in cognitive science that any adequate account of causal learning must invoke active, controlled cognitive processes. (shrink)

The referral is the key source of information that enables radiologists and radiographers to provide quality services. However, the frequency of suboptimal referrals is widely reported. This research reviews the literature to illuminate the challenges suboptimal referrals present to the delivery of care in radiology departments. The concept of suboptimal referral includes information, that is; missing, insufficient, inconsistent, misleading, hard to interpret or wrong. The research uses the four ethical principles ofnon-maleficence, beneficence, AutonomyandJusticeas an analytic framework.Suboptimal referrals can causeharmby hindering (...) safe contrast-media administration, proper radiation protection by justification of procedures, and compassionate patient care. Suboptimal referrals also hinder promoting patientbenefitsfrom the correct choice of imaging modality and protocol, an optimal performed examination, and an accurate radiology report. Additionally, patientautonomyis compromised from the lack of information needed to facilitate benefit–risk communication. Finally, suboptimal referrals challengejusticebased on lack of reasonable patient prioritising and the unfairness caused by unnecessary examinations.These findings illuminate how suboptimal referrals can inhibit good health and well-being for patients in relation to safety, missed opportunities, patient anxiety and dissatisfaction. The ethical challenges identified calls for solutions. Referral-decision support tools and artificial intelligence may improve referral quality, when implemented. Strategies addressing efforts of radiology professionals are inevitable, including gatekeeping, shared decision-making and inter-professional communication; thereby raising awareness of the importance of good referral quality and promoting commitment to ethical professional conduct. (shrink)

Despite efforts to foster gender equality in academia, women are vastly under-represented in tenured professorships, specifically in STEM disciplines. While previous research investigated structural and organizational barriers for women in academia, we explored professors’ subjective view on attributes required before and after reaching tenure. The perspective of professors is needed as they are gatekeepers when it comes to the career advancement of junior researchers. Hence, we interviewed 25 tenured STEM professors in Germany about which attributes they personally consider to be (...) required pre- versus post-tenure and analyzed whether these attributes are associated with gender stereotypes. We found that different attributes are mentioned in the pre- versus the post-tenure career stage and that the required attributes can be associated with gender stereotypes: While agentic–stereotypically male–attributes were mentioned more frequently than communal attributes in the pre-tenure career stage, communal–stereotypically female–attributes were reported slightly more often than agentic attributes after reaching tenure. Based on these novel findings, we discuss important implications for gender research and practice to contribute to more diversity and transparency in academic career advancement. (shrink)

The aim of this study was to explore which group-based emotion regulation goals and strategies are offered in the group culture of Jehovah's Witnesses (JWS). Based on interviews with 29 group-active JWS in Norway, a thematic analysis was conducted in which an overall pattern of cognition taking precedence over emotions was found. Due to endtime expectations and a long-term goal of eternal life in Paradise, future emotions were prioritized. The emotion regulation strategies identified among JWS were social sharing and the (...) interconnected cognitive reappraisal. A new concept, emotional forecasting, was introduced, describing a reappraisal tactic of regulation using prospects of future emotions to regulate the here and now. It was concluded that the prospection of the future is a strong regulator of emotions of the here and now and should be included in psychological models of emotion regulation. (shrink)

_ Source: _Page Count 32 The aim of this study was to explore which group-based emotion regulation goals and strategies are offered in the group culture of Jehovah’s Witnesses. Based on interviews with 29 group-active JW s in Norway, a thematic analysis was conducted in which an overall pattern of cognition taking precedence over emotions was found. Due to end-time expectations and a long-term goal of eternal life in Paradise, future emotions were prioritized. The emotion regulation strategies identified among JW (...) s were _social sharing_ and the interconnected _cognitive reappraisal_. A new concept, _emotional forecasting_, was introduced, describing a reappraisal tactic of regulation using prospects of future emotions to regulate the here and now. It was concluded that the prospection of the future is a strong regulator of emotions of the _here and now_ and should be included in psychological models of emotion regulation. (shrink)