While every health care system stakeholder would seem to be concerned with obtaining the greatest value from a given technology, there is often a disconnect in the perception of value between a technology’s promoters and those responsible for the ultimate decision as to whether or not to pay for it. Adopting an empirical ethics approach, this paper examines how five Canadian medical device manufacturers, via their websites, frame the corporate “value proposition” of their innovation and seek to respond to what (...) they consider the key expectations of their customers. Our analysis shows that the manufacturers’ framing strategies combine claims that relate to valuable socio-technical goals and features such as prevention, efficiency, sense of security, real-time feedback, ease of use and flexibility, all elements that likely resonate with a large spectrum of health care system stakeholders. The websites do not describe, however, how the innovations may impact health care delivery and tend to obfuscate the decisional trade-offs these innovations represent from a health care system perspective. Such framing strategies, we argue, tend to bolster physicians’ and patients’ expectations and provide a large set of stakeholders with powerful rhetorical tools that may influence the health policy arena. Because these strategies are difficult to counter given the paucity of evidence and its limited use in policymaking, establishing sound collective health care priorities will require solid critiques of how certain kinds of medical devices may provide a better (i.e., more valuable) response to health care needs when compared to others. (shrink)

ABSTRACT To date, the American Psychological Association Ethical Standards and Code of Conduct does not include direct guidance about how psychologists should navigate social media. Given the variety of roles psychologists can choose to engage on social media, it is imperative that guidelines are established. These guidelines should consider the multidimensionality that exists as psychologists may choose to present on social media through a personal presence, a business presence, and/or even an influencer/content creator presence. Specific ethical considerations and recommendations are (...) provided. (shrink)

The Royal Society possesses three long-focus simple lenses of diameters 195, 210 and 230 mm, all inscribed with the signature ‘C. Huygens’ and various dates in the year 1686. These prove to have been made by Constantine Huygens, the elder brother of the famous Christiaan Huygens. All three lenses have been examined by a variety of physical and chemical methods, both to define their optical characteristics and to establish the composition of dated samples of late-seventeenth-century Continental glass. The focal lengths (...) of 37·9, 50·1 and 65·2 metres found by combination agree with Huygens' own values of 122, 170 and 210 feet respectively, and are so great that practical employment of the lenses in aerial telescopes has rarely been achieved. All are made from the same very poor glass—a heterogeneous and discoloured potash-rich ‘forest glass’—with a refractive index of 1·516, a costringence of 60, and a density of 2·5 g cm−3. The three lenses were ground with just two concave laps, of radii of curvature 27·11 and 71·15 metres, one lens being plano-convex to a high degree of accuracy. A claim by previous investigators that one lens was a ‘light flint’ glass has been disproved. (shrink)

The legal requirements and justifications for collecting patient-identifiable data without patient consent were examined. The impetus for this arose from legal and ethical issues raised during the development of a population-based disease register. Numerous commentaries and case studies have been discussing the impact of the Data Protection Act 1998 and Caldicott principles of good practice on the uses of personal data. But uncertainty still remains about the legal requirements for processing patient-identifiable data without patient consent for research purposes. This is (...) largely owing to ignorance, or misunderstandings of the implications of the common law duty of confidentiality and section 60 of the Health and Social Care Act 2001. The common law duty of confidentiality states that patient-identifiable data should not be provided to third parties, regardless of compliance with the DPA1998. It is an obligation derived from case law, and is open to interpretation. Compliance with section 60 ensures that collection of patient-identifiable data without patient consent is lawful despite the duty of confidentiality. Fears regarding the duty of confidentiality have resulted in a common misconception that section 60 must be complied with. Although this is not the case, section 60 support does provide the most secure basis in law for collecting such data. Using our own experience in developing a disease register as a backdrop, this article will clarify the procedures, risks and potential costs of applying for section 60 support. (shrink)

The perception of behavior as a moral or conventional concern can be influenced by contextual variables, including status and power differences. We propose that social processes and in particular social role enactment through the exercise of power will psychologically motivate moralization. Punishing or rewarding others creates a moral dilemma that can be resolved by externalizing causation to incontrovertible moral rules. Legitimate power related to structure and position can carry moral weight but may not influence the power holder’s perceptions of rules (...) and general norms of behavior. Social identity theory suggests moralization could be promoted by a concern for shared, defining values. However, the tendency to moralize another’s behavior can be injurious to shared identity. We explored white-collar employees’ perceptions of several categories of noxious or deviant workplace behaviors and regressed these perceptions on the tendency to use legitimate, referent, or reward and punish power; social identity; and the interaction of social identity and power, in particular legitimate power. Only the tendency to influence others through punishment or reward predicted moralization. Alternative causal explanations for the findings were addressed through the absence of any relationships between punishment and reward power and perceptions of deviant behaviors as wrong, upsetting, or requiring punishment. We discuss these results in the context of self and social processes, the social construction of morals and power, and the impact of managers’ behavior on group or organizational ethics. (shrink)

Despite optimistic reports about the results of amputation for advanced vascular disease, the patient’s assessment of advantages and disadvantages is seldom acknowledged. A detailed social study of 67 amputees has revealed considerable disparity between the patient’s views and those of the medical staff. About a third of the patients are forced to retire from active work by the amputation; about three-quarters report a serious decline in their social activities; only about half are really independent with prostheses in the long term; (...) a quarter report severe and intractable symptoms related to their amputation stumps; only about a quarter feel that the amputation was definitely beneficial; and only about one in five feel that the medical staff have provided adequate support during their hospital stay. Amputees face physical and financial disability, isolation, and discomfort. Every effort must be made to explain the implications of amputation honestly and realistically and to ensure continuing patient assessment and support. (shrink)

Presents a plethora of approaches to developing human potential in areas not conventionally addressed. Organized in two parts, this international collection of essays provides viable educational alternatives to those currently holding sway in an era of high-stakes accountability.

This paper explores the psychological foundations of the 'Willingness to Pay/Willingness to Accept' discrepancy. Using a qualitative approach we find that the two response modes appear to invoke different strategies for completion. An examination of the heuristics used by respondents to answer questions concerning the buying and selling of the chance to play a straightforward lottery shows that only some could be taken as supporting current theories which aim to explain the discrepancy.

Scientific models represent aspects of the empirical world. I explore to what extent this representational relationship, given the specific properties of models, can be analysed in terms of propositions to which truth or falsity can be attributed. For example, models frequently entail false propositions despite the fact that they are intended to say something "truthful" about phenomena. I argue that the representational relationship is constituted by model users "agreeing" on the function of a model, on the fit with data and (...) on the aspects of a phenomenon that are modelled. Model users weigh the propositions entailed by a model and from this decide which of these propositions are crucial to the acceptance and continued use of the model. Thus, models represent phenomena when certain propositions they entail are true, but this alone does not exhaust the representational relationship. Therefore, the constraints that produce the choice of the relevant propositions in a model must also be examined and their analysis contributes to understanding the relationship between models and phenomena. (shrink)

Scientists have used models for hundreds of years as a means of describing phenomena and as a basis for further analogy. In Scientific Models in Philosophy of Science, Daniela Bailer-Jones assembles an original and comprehensive philosophical analysis of how models have been used and interpreted in both historical and contemporary contexts. Bailer-Jones delineates the many forms models can take (ranging from equations to animals; from physical objects to theoretical constructs), and how they are put to use. She examines (...) early mechanical models employed by nineteenth-century physicists such as Kelvin and Maxwell, describes their roots in the mathematical principles of Newton and others, and compares them to contemporary mechanistic approaches. Bailer-Jones then views the use of analogy in the late nineteenth century as a means of understanding models and to link different branches of science. She reveals how analogies can also be models themselves, or can help to create them. The first half of the twentieth century saw little mention of models in the literature of logical empiricism. Focusing primarily on theory, logical empiricists believed that models were of temporary importance, flawed, and awaiting correction. The later contesting of logical empiricism, particularly the hypothetico-deductive account of theories, by philosophers such as Mary Hesse, sparked a renewed interest in the importance of models during the 1950s that continues to this day. Bailer-Jones analyzes subsequent propositions of: models as metaphors; Kuhn's concept of a paradigm; the Semantic View of theories; and the case study approaches of Cartwright and Morrison, among others. She then engages current debates on topics such as phenomena versus data, the distinctions between models and theories, the concepts of representation and realism, and the discerning of falsities in models. (shrink)

Thepresentwork is arevisedand enlarged English versionofa book originally writtenin Spanish and published in late 1996, La rejlexion de DavidHume en lorno a /a religion. SinceDavidHume is arguablynot only the most important philosopherwhohaseverwrittenintheEnglishlanguage,butthemoststudiedand influential,itisonlynaturalthatsoonerthanlaterIwouldfeelthe urgencyto bring totheattentionofamuchwiderpublicaworkwhoseoutlook is, I think, signifi cantlydifferentfrom that ofother books which deal with the Scottish thinker's worksonreligionandnaturaltheology.Thisdesirewassostrongastoallowmeto overcome the all-too-natural fear that my wavering and uncertain command of English wouldmakethe few valuableinsights theworkmight containappearun clear,andmyphilosophicalerrors,evenmoreastonishing. This book is addressednot only to scholarswhomay beinterested in modem philosophy in (...) generalorHume'sphilosophyofreligion in particular,but also to themoreextensivecompassofreaderseitherintriguedortroubledby religion and themyriadofissuesandproblemsitposes,whichare, as it were, the primematter forphilosophicalanalysisandtheorizing.Inspiteofitsphilosophicaland linguistic limitations,forwhichIamentirelyresponsible,Iferventlyhopethatthisworkmay befoundtocontainsomethingofthatelusivetruthafterwhichHumestrove, andto whichheremainedconstantto theend, particularlyatatime whenthe priceto be paidforthepublicationofcontroversialphilosophicalandreligious views wascon siderablyhigherthanthatofbecominganeasytargetforuniversalridicule. Thecompletionofthisworkhasbeenmadepossible principally by asabbatical leavethattheUniversityofPuertoRico grantedme fortheyear 1999. This leave gavemethenecessarytimeto readandstudy thepertinentliterature,aswell asto writemostoftheEnglish manuscript.Italsoallowedmeto visit Edinburgh and spendmostofJuly andAugust 1999 attheNationalLibraryofScotlandand the EdinburghUniversityLibrary.Although Ihaveincorporatedinto thepresentwork onlyasmallpartofmyresearchatthose libraries,ifthis bookshows agreaterap preciation of the immediate social and religious context of Hume's thought than its Spanish predecessor, it is in no small measure due to the books, articles, and xi xii Preface manuscritsIwasabletoconsultatthe time. Inthis respect, Iwouldliketo thank Professor Peter Jones, Director of the Institute for Advanced Studies in the HumanitiesattheUniversityofEdinburgh, who was very instrumental in making myvisittoEdinburghareality,andgenerouslyputthefacilitiesoftheInstitute at mydisposal. Manythoughts andlinesofargumentcontained in this bookdatebackto my doctoraldissertation,andsomeearlierversionsofanumberofchaptersorsections ofchaptershavebeenpublished in differentphilosophyjournalsor anthologies. I oftheminthebibliographyundermy name. But sincemy previousworks listall onthe subjecthavebeenrevisedandmodifiedsomanytimes in the lightofnew fmdingsortomeetactualorpossiblecriticism,Ican saythatthey havebeeneffec tivelysupersededbythepresentwriting. (shrink)

: This paper contains the analysis of nine interviews with UK scientists on the topic of scientific models. Scientific models are an important, very controversially discussed topic in philosophy of science. A reasonable expectation is that philosophical conceptions of models ought to be in agreement with scientific practice. Questioning practicing scientists on their use of and views on models provides material against which philosophical positions can be measured.

A multidisciplinary faculty committee designed a curriculum to shape biomedical graduate students into researchers with a high commitment to professionalism and social responsibility and to provide students with tools to navigate complex, rapidly evolving academic and societal environments with a strong ethical commitment. The curriculum used problem-based learning (PBL), because it is active and learner-centred and focuses on skill and process development. Two courses were developed: Scientific Professionalism: Scientific Integrity addressed discipline-specific and broad professional norms and obligations for the ethical (...) practice of science and responsible conduct of research (RCR). Scientific Professionalism: Bioethics and Social Responsibility focused on current ethical and bioethical issues within the scientific profession, and implications of research for society. Each small-group session examined case scenarios that included: (1) learning objectives for professional norms and obligations; (2) key ethical issues and philosophies within each topic area; (3) one or more of the RCR instructional areas; and (4) at least one type of moral reflection. Cases emphasised professional standards, obligations and underlying philosophies for the ethical practice of science, competing interests of stakeholders and oversight of science (internal and external). To our knowledge, this is the first use of a longitudinal, multi-semester PBL course to teach scientific integrity and professionalism. Both faculty and students endorsed the active learning approach for these topics, in contrast to a compliance-based approach that emphasises learning rules and regulations. (shrink)

Nanomedicine is yielding new and improved treatments and diagnostics for a range of diseases and disorders. Nanomedicine applications incorporate materials and components with nanoscale dimensions where novel physiochemical properties emerge as a result of size-dependent phenomena and high surface-to-mass ratio. Nanotherapeutics and in vivo nanodiagnostics are a subset of nanomedicine products that enter the human body. These include drugs, biological products, implantable medical devices, and combination products that are designed to function in the body in ways unachievable at larger scales. (...) Nanotherapeutics andin vivonanodiagnostics incorporate materials that are engineered at the nanoscale to express novel properties that are medicinally useful. These nanomedicine applications can also contain nanomaterials that are biologically active, producing interactions that depend on biological triggers. Examples include nanoscale formulations of insoluble drugs to improve bioavailability and pharmacokinetics, drugs encapsulated in hollow nanoparticles with the ability to target and cross cellular and tissue membranes and to release their payload at a specific time or location, imaging agents that demonstrate novel optical properties to aid in locating micrometastases, and antimicrobial and drug-eluting components or coatings of implantable medical devices such as stents. (shrink)

This paper examines the process of modelling a complex empirical phenomenon in modern astrophysics: extended extragalactic radio sources. I show that modelling is done piecemeal, addressing selected striking or puzzling features of that phenomenon separately and individually. The result is various independent and separate sub-models concerned only with limited aspects of the same phenomenon. Because the sub-models represent features of the same physical phenomenon, they need to be reasonably consistent with each other - a criterion not always fully adhered to (...) - and there needs to be a way to conceptually `re-unite' the sub-models to form an overall-model. Visualisation, that is, supplying a concrete interpretation of abstract, theoretical sub-models, aids this modelling process. My case study further endorses the view that modelling is `work in progress', i.e. a form of developing knowledge whereby models represent, not replicate, a phenomenon. (shrink)

In the first half of the 20th century, scientific models were hardly mentioned in philosophy of science. Models were not thought to be central elements of science, in contrast to theories. This attitude can be better understood when considering philosophical trends - Operationalism and Logical Empiricism - and scientific developments - the advent of quantum theory and relativity theory. This paper traces the philosophical currents and positions that prevented models from being recognized as playing an important role in science. It (...) goes on to examine why the hostile attitude towards models slowly tempered in the 1950s. The contributions of Mary Hesse and Ernest Hutten are shown to foreshadow recent debates that have arisen in the context of the philosophical study of scientific models. /// Segundo a autora, na primeira metade do século XX, os modelos científicos praticamente não eram mencionados em Filosofia da Ciência. Os modelos não eram considerados como elementos centrais da Ciência, ao contrário das teorias. Para a autora, uma tal atitude pode ser melhor compreendida se se atender ao influxo de importantes movimentos filosóficos, como sejam o Operacionalismo e o Empirismo Lógico, bem como ao impacto de alguns desenvolvimentos científicos, como sejam o aparecimento da teoria quântica e da teoria da relatividade. Nesse sentido, o presente artigo visa estabelecer as correntes filosóficas e as posições científicas que contribuíram para que os modelos não fossem reconhecidos no importante papel que desempenham no desenvolvimento da Ciência. De um modo especial, a autora examina com particular cuidado o lento processo de redução da hostilidade em relação aos modelos durante a década de 50 do século xx. Assim, o artigo mostra de um modo especial até que ponto os contributos de Mary Hesse e de Ernest Hutten foram antecipadores de alguns dos debates mais recentes que se sucederam no contexto do estudo filosófico dos modelos científicos. (shrink)

Objective We conducted a process evaluation to (a) assess the effectiveness of a new problem-based learning curriculum designed to teach professionalism and scientific integrity to biomedical graduate students and (b) modify the course to enhance its relevance and effectiveness. The content presented realistic cases and issues in the practice of science, to promote skill development and to acculturate students to professional norms of science. Method We used 5-step Likert-scaled questions, open-ended questions, and interviews of students and facilitators to assess curricular (...) effectiveness. Results Both facilitators and students perceived course objectives were achieved. For example, respondents preferred active learning over lectures; both faculty and students perceived that the curriculum increased their understanding of norms, role obligations and responsibilities of professional scientists. They also reported an increased ability to identify ethical situations and felt that they had developed skills in moral reasoning and effective group work. Conclusions These data helped to improve course implementation and instructional material. For example, to correct a negative perception that this was an ‘ethics’ course, we redesigned case debriefing activities to reinforce learning objectives and important skills. We refined cases to be more engaging and relevant for students, and gave facilitators more specific training and resources for each case. The problem-based learning small group strategy can stimulate an environment whereby participants are more aware of ethical implications of science, and increase their socialisation and open communication about professional behaviour. (shrink)

Half of the 33.2 million people living with HIV today are women. Yet, responses to the epidemic are not adequately meeting the needs of women. This article critically evaluates how prevention of mother-to-child transmission (PMTCT) programs, the principal framework under which women's health is currently addressed in the global response to AIDS, have tended to focus on the prevention of HIV transmission from HIV-positive women to their infants. This paper concludes that more than ten years after their inception, PMTCT programs (...) still do not successfully ensure the adequate treatment, care and support of HIV-infected women. Of particular concern is the continued widespread use of single-dose nevirapine despite World Health Organization recommendations to employ more effective combination therapies that do not potentially jeopardize women's future treatment outcomes. In response, the article calls for a more comprehensive approach that places women's health needs at the centre of AIDS responses. This is critical in settings where the pandemic is generalized and there is a push to greatly expand PMTCT programs, as a more effective and equitable way of meeting the needs of women in the context of HIV. Without such a comprehensive approach, women will continue to be impacted disproportionately by the pandemic, and current strategies for prevention, including PMTCT, and treatment will not be as effective and responsive as they need to be. (shrink)

Feminist scholarship has demonstrated the importance of sustained critical engagement with ultrasound visualizations of pregnant women’s bodies. In response to portrayals of these images as “objective” forms of knowledge about the fetus, it has drawn attention to the social practices through which the meanings of ultrasound are produced. This article makes a novel contribution to this project by addressing an empirical context that has been neglected in the existing feminist literature concerning ultrasound, namely, its use during pregnancies that women decide (...) to terminate. Drawing on semi-structured interviews with women concerning their experiences of abortion in England, I explore how the meanings of having an ultrasound prior to terminating a pregnancy are discursively constructed. I argue that women’s accounts complicate dominant representations of ultrasound and that in so doing, they multiply the subject positions available to pregnant women. (shrink)