The application of artificial intelligence and machine learning technologies in healthcare have immense potential to improve the care of patients. While there are some emerging practices surro...

This article shares reflections from members of the community of philosophers of education in the United States and Canada who were invited to express their insights in response to the theme ‘Snaps...

Case-based instruction is a stable feature of ethics education, however, little is known about the attributes of the cases that make them effective. Emotions are an inherent part of ethical decision-making and one source of information actively stored in case-based knowledge, making them an attribute of cases that likely facilitates case-based learning. Emotions also make cases more realistic, an essential component for effective case-based instruction. The purpose of this study was to investigate the influence of emotional case content, and complementary (...) socio-relational case content, on case-based knowledge acquisition and transfer on future ethical decision-making tasks. Study findings suggest that emotional case content stimulates retention of cases and facilitates transfer of ethical decision-making principles demonstrated in cases. (shrink)

ABSTRACTDepression is associated with increased emotional response to stress. This is especially the case during the developmental period of adolescence. Cognitive reappraisal is an effective emotion regulation strategy that has been shown to reduce the impact of emotional response on psychopathology. However, less is known about whether cognitive reappraisal impacts the relationship between depressive symptoms and emotional responses, and whether its effects are specific to emotional reactivity or emotional recovery. The current study examined whether cognitive reappraisal moderated the relationship between (...) depressive symptoms and trait or state measures of emotional reactivity and recovery. A community sample of 127 adolescents, at an age of risk for depression, completed self-report measures of trait emotional responding and depressive symptoms. In addition, they completed an in vivo social stress task and were assessed on state emotional reactivity and recove... (shrink)

Volume 20, Issue 7, July 2020, Page 77-80.

Russell articulates compelling reasons that bioethicists and health care professionals should take individual responsibility for deconstructing structural injustices in healthcare through in...

The coronavirus disease-2019 (COVID-19) has caused shortages of life-sustaining medical resources, and future waves of the virus may cause further scarcity. The Yale New Haven Health System developed a triage protocol to allocate scarce medical resources during the COVID-19 pandemic, with the primary goal of saving the most lives possible, and a secondary goal of making triage assessments and decisions consistent, transparent, and fair. We outline the process of developing the protocol, summarize the protocol, and discuss the major ethical challenges (...) encountered, along with our answers to the challenges. These challenges include (1) the role of age and chronic comorbidities; (2) evaluating children and pregnant patients; (3) racial, ethnic, and socioeconomic disparities in health; (4) prioritization of healthcare workers; and (5) balancing clinical judgment versus protocolized assessments.We conclude with a review of the limitations of our protocol and the lessons learned. We hope that a robust public discussion of such protocols and the ethical challenges they raise will result in the fairest possible processes, less need for triage, and more lives saved during future waves of the pandemic and similar public health emergencies. (shrink)

The Search for the Legacy of the USPHS Syphilis Study at Tuskegee is a collection of essays from experts in a variety of fields seeking to redefine the legacy of the infamous Tuskegee Syphilis Study. The essayists place the legacy of the study within the evolution of racial and ethnic relations in the United States. Contributors include two leading historians on the study, two former United States Surgeons General, and other prominent scholars from a wide range of fields.

Cognitive Science, Volume 46, Issue 6, June 2022.

Until now, adult crying has received relatively little interest from investigators, whereas in the popular media there are many strong claims about crying (e.g., crying brings relief) of which the scientific basis is not clear. In this review, we provide an overview of the current state of the scientific literature with respect to crying. We identify gaps in knowledge and propose questions for future research. The following topics receive special attention: Ontogenetic development, antecedents, individual and gender differences, and the intra- (...) and interindividual effects of crying. We conclude that the study of crying may help us obtain better insight into human nature, that is, not only our emotional, but also social, and moral functioning. (shrink)

Is helping those whose subsistence needs are not meet a matter of charity or an obligation? What role should ordinary citizens of developed nations play? In a globalized world, the causes, connections, and responsibilities become complicated. Agriculture subsidies that keep food prices low for many in relatively rich countries may, for example, negatively impact poor farmers in developing countries. Students in Ethics/Philosophy 352 report on their project examining whether, and to what extent, a true obligation to aid exists.

Background: Compassion fatigue is recognized as impacting the health and effectiveness of healthcare providers, and consequently, patient care. Compassion fatigue is distinct from “burnout.” Reliable measurement tools, such as the Professional Quality of Life scale, have been developed to measure the prevalence, and predict risk of compassion fatigue. This study reviews the prevalence of compassion fatigue among healthcare practitioners, and relationships to demographic variables. Methods: A systematic review was conducted using key words in MEDLINE, PubMed, and Ovid databases. Data were (...) extracted from a total of 71 articles meeting inclusion criteria, from studies measuring compassion fatigue in healthcare providers using a validated instrument. Quantitative and qualitative data were extracted and compiled by three independent reviewers into an evidence table that included basic study characteristics, study strength and quality determination, measurements of compassion fatigue, and general findings. Meta-analysis, where data allowed, was stratified by Professional Quality of Life version, heterogeneity was quantified, and pooled means were reported with 95% confidence interval. A table of major study characteristics and results was created. Ethical consideration: This paper contains no primary data obtained directly from research participants. Data obtained from previously published resources have been acknowledged within references. Psychological distress, particularly compassion fatigue, can be insidious, no health profession is immune, and may significantly impact the ability to provide care. Results: A total of 71 studies were included. Compassion fatigue was reported across all practitioner groups studied. Relationships to most demographic variables such as years of experience and specialty were either not statistically significant or unclear. Variability in reporting of Professional Quality of Life results was found. Interpretation: Compassion fatigue exists across diverse practitioner groups. Prevalence is highly variable, and its relationship with demographic, personal, and/or professional variables is inconsistent. Questions are raised about how to mitigate compassion fatigue. (shrink)

This volume includes the texts of Erasmus's 1524 diatribe against Luther,De Libero Arbitrio, and Luther's violent counterattack,De Servo Arbitrio.

Several lines of evidence suggest that children born via Cesarean section are at greater risk for adverse health outcomes including allergies, asthma and obesity. Vaginal seeding is a medical procedure in which infants born by C-section are swabbed immediately after birth with vaginal secretions from the mother. This procedure has been proposed as a way to transfer the mother's vaginal microbiome to the child, thereby restoring the natural exposure that occurs during vaginal birth that is interrupted in the case of (...) babies born via C-section. Preliminary evidence indicates partial restoration of microbes. However, there is insufficient evidence to determine the health benefits of the procedure. Several studies, including trial, are currently underway. At the same time, in the clinic setting, doctors are increasingly being asked to by expectant mothers to have their babies seeded. This article reports on the current research on this procedure and the issues it raises for regulators, researchers, physicians, and patients. (shrink)

While previous methodological studies have suggested that coding is a useful technique for analyzing qualitative data, there is a stark lack of discussion about the incongruities that inevitably arise as researchers accomplish the actual work of coding. This article explores the complexities of the coding process, and how incongruities get resolved as researchers accomplish the practical work of coding. Three primary themes emerged from this study: <creating agreement>, <maintaining the integrity of the codes>, and <completing the work>. These three activities (...) are grounded in the naturally evolving work of coding, and are rendered visible through an ethnomethodological investigation into this work. (shrink)

Background Institutional review board (IRB) expertise is necessarily limited by maintaining a manageable board size. IRBs are therefore permitted by regulation to rely on outside experts for review. However, little is known about whether, when, why, and how IRBs use outside experts.Methods We conducted a national survey of U.S. IRBs to characterize utilization of outside experts. Our study uses a descriptive, cross-sectional design to understand how IRBs engage with such experts and to identify areas where outside expertise is most frequently (...) requested.Results The survey response rate was 18.4%, with 55.4% of respondents reporting their institution’s IRB uses outside experts. Nearly all respondents who reported using outside experts indicated they do so less than once a month, but occasionally each year (95%). The most common method of identifying an outside expert was securing a previously known subject matter expert (83.3%). Most frequently, respondents sought consultation for scientific expertise not held by current members (69.6%). Almost all respondents whose IRBs had used outside experts reported an overall positive impact on the IRB review process (91.5%).Conclusions Just over half of the IRBs in our sample report use of outside experts; among them, outside experts were described as helpful, but their use was infrequent overall. Many IRBs report not relying on outside experts at all. This raises important questions about what type of engagement with outside experts should be viewed as optimal to promote the highest quality review. For example, few respondents sought assistance from a Community Advisory Board, which could address expertise gaps in community perspectives. Further exploration is needed to understand how to optimize IRB use of outside experts, including how to recognize when expertise is lacking, what barriers IRBs face in using outside experts, and perspectives on how outside expert review impacts IRB decision-making and review quality. (shrink)

The effectiveness of case-based learning in ethics education varies widely regarding how cases are presented. Case process instruction may impact case-based ethics education to promote sensemaking processes, ethical sensemaking strategy use, and ethical decision making (EDM) quality. This study examined two teaching techniques, notes and review, and participants completed note-taking and review activities examining a case-based scenario during an ethics education course. Results suggest that providing case notes in outline form improves sensemaking processes, strategy use, and EDM quality. In addition, (...) combining processes of provided notes and passive review results in incremental, additive performance via certain ethical sensemaking strategies and EDM quality. (shrink)

While solid organ transplantation for patients with substance use issues has attracted ethical discussion, a typology of the ethics themes has not been articulated in the literature. We conducted a scoping review of peer-reviewed literature on solid organ transplantation and substance use published between January 1997 and April 2016. We aimed to identify and develop a typology of the main ethical themes discussed in this literature and to identify gaps worthy of future research. Seventy articles met inclusion criteria and underwent (...) inductive content analysis. Four main ethical themes were identified: (1) personal responsibility; (2) utility; (3) moral character; and (4) fairness. Each theme had multiple sub-themes and there was substantial overlap between themes. This scoping review identified a disproportionate emphasis in the literature regarding personal responsibility, which was referenced by each of the other themes, and a narrow focus on alcohol and liver. We recommend future research further investigate these connections between ethical themes and focus on ethical issues associated with transplants from organ groups other than liver for patients who use substances other than alcohol. (shrink)

Recent research has shown a memory advantage for minimally counterintuitive concepts, over concepts that are either intuitive or maximally counterintuitive, although the general result is heavily affected by context. Items from one such study were given to subjects who were asked to create novel stories using at least three concepts from a list containing all three types. Results indicated a preference for using MCI items, and further disclosed two styles of usage, an accommodative style and an assimilative style. The results (...) extend recent memory research and suggest extensions to recent theories intended to explain the prevalence of counterintuitive religious concepts. (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.

BackgroundHigh levels of moral distress in nursing professionals, of which oncology nurses are particularly prone, can negatively impact patient care, job satisfaction, and retention.Aim“Positive Attitudes Striving to Rejuvenate You: PASTRY” was developed at a tertiary cancer center to reduce the burden of moral distress among oncology nurses.Research DesignA Quality Improvement (QI) initiative was conducted using a pre- and post-intervention design, to launch PASTRY and measure its impact on moral distress of the nursing unit, using Hamric’s Moral Distress Scale–Revised (MDS-R.) This (...) program consisted of monthly 60-minute sessions allowing nurses to address morally distressing events and themes, such as clinicians giving “false hope” to patients or families. The PASTRY program sessions were led by certified clinicians utilizing strategies of discussion and mind-body practices.ParticipantsClinical nurses working on an adult leukemia/lymphoma unit.Ethical considerationsThis was a QI initiative, participation was voluntary, MDS-R responses were collected anonymously, and the institution’s Ethics Committee oversaw PASTRY’s implementation.FindingsWhile improvement in moral distress findings were not statistically significant, the qualitative and quantitative findings demonstrated consistent themes. The PASTRY program received strong support from nurses and institutional leaders, lowered the nursing unit’s moral distress, led to enhanced camaraderie, and improved nurses’ coping skills.DiscussionMeasurement of moral distress is innately challenging due to its complexity. This study reinforces oncology nurses have measurable moral distress. Interventions should be implemented for a safe and healing environment to explore morally distressing clinical experiences. Poor communication among multidisciplinary team members is associated with moral distress among nurses. Programs like PASTRY may empower nurses to build support networks for change within themselves and institutions.ConclusionThis QI initiative shows further research on moral distress reduction should be conducted to verify findings for statistical significance and so that institutional programs, like PASTRY, can be created. (shrink)

Cognitive neuroscience has inspired a number of methodological advances to extract the highest signal-to-noise ratio from neuroimaging data. Popular techniques used to summarize behavioral data include sum-scores and item response theory. While these techniques can be useful when applied appropriately, item dimensionality and the quality of information are often left unexplored allowing poor performing items to be included in an itemset. The purpose of this study is to highlight how the application of two-stage approaches introduces parameter bias, differential item functioning (...) can manifest in cognitive neuroscience data and how techniques such as the multiple indicator multiple cause model can identify and remove items with DIF and model these data with greater sensitivity for brain–behavior relationships. This was performed using a simulation and an empirical study. The simulation explores parameter bias across two separate techniques used to summarize behavioral data: sum-scores and IRT and formative relationships with those estimated from a MIMIC model. In an empirical study participants performed an emotional identification task while concurrent electroencephalogram data were acquired across 384 trials. Participants were asked to identify the emotion presented by a static face of a child across four categories: happy, neutral, discomfort, and distress. The primary outcomes of interest were P200 event-related potential amplitude and latency within each emotion category. Instances of DIF related to correct emotion identification were explored with respect to an individual’s neurophysiology; specifically an item’s difficulty and discrimination were explored with respect to an individual’s average P200 amplitude and latency using a MIMIC model. The MIMIC model’s sensitivity was then compared to popular two-stage approaches for cognitive performance summary scores, including sum-scores and an IRT model framework and then regressing these onto the ERP characteristics. Here sensitivity refers to the magnitude and significance of coefficients relating the brain to these behavioral outcomes. The first set of analyses displayed instances of DIF within all four emotions which were then removed from all further models. The next set of analyses compared the two-stage approaches with the MIMIC model. Only the MIMIC model identified any significant brain–behavior relationships. Taken together, these results indicate that item performance can be gleaned from subject-specific biomarkers, and that techniques such as the MIMIC model may be useful tools to derive complex item-level brain–behavior relationships. (shrink)

BackgroundAssisted dying has wide support among the general population but there is evidence that those providing care for the dying may be less supportive. Senior doctors would be involved in implementing the proposed change in the law. We aimed to measure support for legalising physician assisted dying in a representative sample of senior doctors in England and Wales, and to assess any association between doctors' characteristics and level of support for a change in the law.MethodsWe conducted a postal survey of (...) 1000 consultants and general practitioners randomly selected from a commercially available database. The main outcome of interest was level of agreement with any change in the law to allow physician assisted suicide.ResultsThe corrected participation rate was 50%. We analysed 372 questionnaires. Respondents' views were divided: 39% were in favour of a change to the law to allow assisted suicide, 49% opposed a change and 12% neither agreed nor disagreed. Doctors who reported caring for the dying were less likely to support a change in the law. Religious belief was also associated with opposition. Gender, specialty and years in post had no significant effect.ConclusionMore senior doctors in England and Wales oppose any step towards the legalisation of assisted dying than support this. Doctors who care for the dying were more opposed. This has implications for the ease of implementation of recently proposed legislation. (shrink)

This article is an attempt to develop a measure of ethical sensitivity to racial and gender intolerance that occurs in schools. Acts of intolerance that indicate ethically insensitive behaviors in American schools were identified and tied to existing professional ethical codes developed by school-based professional organizations. The Racial Ethical Sensitivity Test consists of 5 scenarios that portray acts of racial intolerance and ethical insensitivity. Participants viewed 2 videotaped scenarios and then responded to a semistructured interview protocol adapted from Bebeau and (...) Rest. After a 2-week interval, this procedure was repeated. Stability of the REST across time was determined by using the overall test-retest coefficient. Internal as well as interrater consistency was also calculated for each scenario. Overall findings indicate promise for the REST as a reliable measure to assess racial and ethnic sensitivity. (shrink)

Emerging research has highlighted the utility of measuring individual differences in decision-making competence (DMC), showing that consistently following normatively rational principles is associated with positive psychosocial and health behaviors. From another level of analysis, functional theories of personality suggest that broad trait dimensions represent variation in underlying self-regulatory systems, providing a mechanistic account for robust associations between traits and similar life outcomes. Yet, the degree to which broad dispositional personality dimensions predict global tendencies to respond rationally is less understood. In (...) a large online community sample (N = 804), we tested the associations between HEXACO personality dimensions, a 6-factor structural trait model, and a subset of DMC indicators (Applying Decision Rules, Resistance to Framing, Recognizing Social Norms, and Consistency in Risk Perception). Additionally, we examined gender differences across the DMC, first considering the potential for measurement non-invariance across groups for the DMC. We observed partial measurement invariance between men and women; only the Applying Decision Rules scale showed evidence of differential functioning across groups. Controlling for these differences, analyses revealed that higher Conscientiousness, Honesty/Humility, and Openness were associated with higher DMC scores. In contrast, Emotionality and Extraversion demonstrated gender-specific associations. Speci... (shrink)

Cases have been employed across multiple disciplines, including ethics education, as effective pedagogical tools. However, the benefit of case-based learning in the ethics domain varies across cases, suggesting that not all cases are equal in terms of pedagogical value. Indeed, case content appears to influence the extent to which cases promote learning and transfer. Consistent with this argument, the current study explored the influences of contextual and personal factors embedded in case content on ethical decision-making. Cases were manipulated to include (...) a clear description of the social context and the goals of the characters involved. Results indicated that social context, specifically the description of an autonomy-supportive environment, facilitated execution of sensemaking processes and resulted in greater decision ethicality. Implications for designing optimal cases and case-based training programs are discussed. (shrink)

The coronavirus disease (COVID-19) crisis provoked an organizational ethics dilemma: how to develop ethical pandemic policy while upholding our organizational mission to deliver relationship- and patient-centered care. Tasked with producing a recommendation about whether healthcare workers and essential personnel should receive priority access to limited medical resources during the pandemic, the bioethics department and survey and interview methodologists at our institution implemented a deliberative approach that included the perspectives of healthcare professionals and patient stakeholders in the policy development process. Involving (...) the community more, not less, during a crisis required balancing the need to act quickly to garner stakeholder perspectives, uncertainty about the extent and duration of the pandemic, and disagreement among ethicists about the most ethically supportable way to allocate scarce resources. This article explains the process undertaken to garner stakeholder input as it relates to organizational ethics, recounts the stakeholder perspectives shared and how they informed the triage policy developed, and offers suggestions for how other organizations may integrate stakeholder involvement in ethical decision-making as well as directions for future research and public health work. (shrink)

Journal Name: Cognitive Linguistics Issue: Ahead of print.

Job burnout, organizational commitment, and work environment continue to be important areas of research to be studied in the realm of company employment and employee retention. Job burnout is the state of physical and emotional exhaustion and perceiving one’s profession as dull or overwhelming. Meanwhile, organizational commitment refers to the company’s attitude towards the organization and their employees, encompassing loyalty, moral responsibility, and their willingness to work. And lastly, work environment provides opportunities for employees to establish connections, develop skills, and (...) maximize their full potential in performing tasks. For the current study, researchers utilized descriptive-correlational research design to investigate the influence of Work Environment towards the job burnout and organizational commitment of BPO agents in selected companies in Bulacan, Philippines. Hence, Danish Psychosocial Work Environment Questionnaire (DPQ), Maslach Burnout Inventory - General Survey (MBI-GS), and the Three-Dimensional Model of Organizational Commitment Scale (ACS, NCS, CCS) were employed to properly assess the study's objectives. Multiple Linear Regression Analysis was performed to analyze the collected data. Based on the analysis, findings show that work environment has no significant influence on the job burnout and organizational commitment of BPO Agents. Furthermore, the results of this study were thoroughly evaluated, leading to an in-depth discussion. Based on the findings, recommendations were made to benefit the stakeholders of the study and contributeto the existing body of knowledge. (shrink)

Martin Luther, to the venerable D. Erasmus of Rotterdam, wishing Grace and Peace in Christ. hat I have been so long answering your Diatribe on Free-will, ...

Psychopathy is typically seen as a trait that is undesirable in any context, including the workplace. But several authors have suggested that people high in psychopathy might possess resources that preserve their ability to perform well in stressful contexts. We consider the possibility that primary psychopathy is adaptive—for the employee, if not for the organization—under conditions of abusive supervision. In particular, we draw from the multimotive model of interpersonal threat and the theory of purposeful work behavior to argue that high (...) primary psychopathy individuals possess characteristics that enable them to experience higher levels of well-being and lower levels of anger than their peers under abusive supervisors. Based on a scenario study and a time-lagged field study, we found support for a model in which abusive supervision moderates the relationships between primary psychopathy and positive work-related outcomes, such that these relationships are positive under conditions of abusive supervision and either diminished or negative under conditions of low abusive supervision. Abusive supervision also affected the relationship between primary psychopathy and anger in the field study such that high primary psychopathy individuals were less angry under more abusive supervisors. Thus, there appears to be some credence to the notion of a “psychopathic advantage” in that primary psychopaths do have access to greater psychological resources than their peers under abusive supervision. However, these findings also suggest that abusive supervisors may empower employees with characteristics that hold strong potential to damage the organization and its stakeholders. (shrink)

Our question “How many chickens does it take to make an egg?” was inspired by the successful replacement of egg-based mayonnaise with plant-based mayonnaise in general dining at the University of California, Santa Barbara, in order to increase animal welfare. Our indicator of improved animal welfare due to decreased egg consumption was the reduction in number of chickens in the stressful and unhealthy conditions of the US egg industry. To measure this we calculated the ratio of chickens to eggs and (...) found it takes 6.3 chickens to make 1000 eggs. This equals 158 eggs per chicken, less than half the amount of eggs per laying hen because of mortality from hatching to entering the laying flock, including the disposal of male chicks. In addition, greenhouse gas emissions, irrigation water, reactive nitrogen, and land use would be reduced 43–98% from that of eggs. While the impact of plant-based mayonnaise was relatively small, we also estimated the substitution of eggs with tofu, which had a much greater impact: substituting 50% of eggs with tofu in first-year student breakfasts on all UC campuses would reduce the number of chickens in the egg industry by 9245. If this substitution was made by the US population, the welfare and environmental benefits would be 29 thousand times greater. Reducing egg consumption would greatly improve chicken welfare even if welfare certified eggs are replaced, since the requirements of the most commonly used chicken welfare certification programs do relatively little to reduce chicken suffering. (shrink)

Complex clinical ethics cases require a blend of compassion, sensitivity, and tenacity in order to navigate the hard work required of stakeholders. Each person comes to the table with rich historie...