Person-centered care offers a promising way to manage clinicians’ conscientious objection to providing services they consider morally wrong. Health care centered on persons, rather than patients, recognizes clinicians and patients on the same stratum. The moral interests of clinicians, as persons, thus warrant as much consideration as those of other persons, including patients. Interconnected moral interests of clinicians, patients, and society construct the clinician as a socially embedded and integrated self, transcending the simplistic duality of private conscience versus public role (...) expectations. In this milieu of blurred boundaries, person-centered care offers a constructive way to accommodate conscientious objection by clinicians. The constitutionally social nature of clinicians commits and enables them, through care mechanisms such as self-care, to optimize the quality of health care and protect the welfare of patients. To advance these conditions, it is recommended that the medical profession develop a person-centered culture of care, along with clinician virtues and skills for person-centered communication. (shrink)
This paper proposes a refocusing of consent for clinical genetic testing, moving away from an emphasis on autonomy and information provision, towards an emphasis on the virtues of healthcare professionals seeking consent, and the relationships they construct with their patients. We draw on focus groups with UK healthcare professionals working in the field of clinical genetics, as well as in-depth interviews with patients who have sought genetic testing in the UK’s National Health Service. We explore two aspects of consent: first, (...) how healthcare professionals consider the act of ‘consenting’ patients; and second how these professional accounts, along with the accounts of patients, deepen our understanding of the consent process. Our findings suggest that while healthcare professionals working in genetic medicine put much effort into ensuring patients’ understanding about their impending genetic test, they acknowledge, and we show, that patients can still leave genetic consultations relatively uninformed. Moreover, we show how placing emphasis on the informational aspect of genetic testing is not always reflective of, or valuable to, patients’ decision-making. Rather, decision-making is socially contextualised – also based on factors outside of information provision. A more collaborative on-going consent process, grounded in virtue ethics and values of honesty, openness and trustworthiness, is proposed. (shrink)
Practically every contemporary mainstream scientist presumes that all aspects of mind are generated by brain activity. We demonstrate the inadequacy of this picture by assembling evidence for a variety of empirical phenomena which it cannot explain. We further show that an alternative picture developed by F. W. H. Myers and William James successfully accommodates these phenomena, ratifies the common sense view of ourselves as causally effective conscious agents, and is fully compatible with contemporary physics and neuroscience.
Background: Individuals with psychopathic traits demonstrate an attenuated emotional response to aversive stimuli. However, recent evidence suggests heterogeneity in emotional reactivity among individuals with psychopathic or callous-unemotional (CU) traits, the emotional detachment dimension of psychopathy. We hypothesize that primary variants of psychopathy will respond with blunted affect to negatively valenced stimuli, whereas individuals marked with histories of childhood trauma/maltreatment exposure, known as secondary variants, will display heightened emotional reactivity. To test this hypothesis, the present study examined fear-potentiated startle between psychopathy (...) variants while viewing aversive, pleasant, and neutral scenes. Method: 238 incarcerated adolescent (M age = 16.8, SD = 1.11 years) boys completed a picture-startle paradigm and self-report questionnaires assessing CU traits, antisocial-aggressive behavior, and maltreatment. Results: Latent profile analyses identified four classes; primary variants (high CU traits, high aggression, low maltreatment; n = 46), secondary variants (high CU traits, high aggression, high maltreatment; n = 42), and two nonpsychopathic groups differentiated on maltreatment experience (n = 148). Findings from an ANOVA comparing identified groups on startle amplitude difference scores (i.e., aversive-neutral) suggested a main effect for group, F(3,196)=8.91, p<.001, η2 = .12. Primary variants of juvenile psychopathy displayed reduced startle potentiation to aversive images (threat and victim scenes), whereas secondary variants distinguished by high levels of childhood maltreatment did not. Conclusions: Findings add to a rapidly growing body of literature supporting the possibility of multiple developmental pathways to psychopathy (i.e., equifinality), and extend it by finding support for divergent potential biomarkers between primary and secondary psychopathy variants. (shrink)
Callous unemotional (CU) traits (i.e., a lack of empathy/remorse and poverty of emotion) that co-occur with childhood antisocial behaviour are believed to be the developmental precursor to psychopathy in adulthood. An increasing volume of evidence supports two distinct variants of CU traits/psychopathy, known as primary and secondary. Primary variants are thought to show core deficits in emotional reactivity (e.g., attenuated autonomic activity), whereas secondary variants present with high levels of anxiety and this may be reflected in increased emotional sensitivity to (...) negative stimuli. -/- Aims: The current study is the first of its kind to examine the role of anxiety in modulating emotional processing as indexed by heart rate (HR) in incarcerated boys with CU traits. -/- Methods: HR was recorded continuously while 205 adolescents (aged 14 to 18 years) completed an emotional pictures dot-probe task. The task consisted of four blocks of 18 trials, beginning with a 500 ms central fixation cross, a 250 ms picture pair presentation (i.e., neutral, positive, negative valence), followed by a probe appearing in either the top or bottom picture location until response, and lastly a 2000 ms inter-trial interval recovery period. Four groups were formed on the basis of median-split scores on the Revised Children's Manifest Anxiety Scale and the Inventory of Callous Unemotional Traits, reflecting a primary variant (high CU/low anxiety), secondary variant (high CU/high anxiety), and two nonpsychopathic groups (low CU/high anxiety and low CU/low anxiety). -/- Results: The HR data indicated relative HR deceleration during the picture-probe period, regardless of group. Additionally, compared to all other groups, HR deceleration was greatest for the high CU/high anxiety secondary group and smallest for the high CU/low anxiety primary group during negative stimuli. Conclusions: This result is thought to reflect differences between CU/psychopathy variants in attentional orienting to distressing stimuli, consistent with theory. (shrink)
There is a long-standing debate in philosophy about whether it is morally permissible to harm one person in order to prevent a greater harm to others and, if not, what is the moral principle underlying the prohibition. Hypothetical moral dilemmas are used in order to probe moral intuitions. Philosophers use them to achieve a reflective equilibrium between intuitions and principles, psychologists to investigate moral decision-making processes. In the dilemmas, the harms that are traded off are almost always deaths. However, the (...) moral principles and psychological processes are supposed to be broader than this, encompassing harms other than death. Further, if the standard pattern of intuitions is preserved in the domain of economic harm, then that would open up the possibility of studying behaviour in trolley problems using the tools of experimental economics. We report the results of two studies designed to test whether the standard patterns of intuitions are preserved when the domain and severity of harm are varied. Our findings show that the difference in moral intuitions between bystander and footbridge scenarios is replicated across different domains and levels of physical and non-physical harm, including economic harms. (shrink)
There are more forms of intersubjectivity or more ways of how we experience the overlaps of our subjectivity to the other, to the alter in his different forms. The paper focuses on some selected aspects of this problem, which are related to the phenomenological reduction and situated at the intersection point of two theses: Subjectivity is intersubjectivity; Intersubjectivity is subjectivity. The discussion is based on selected texts of Edmund Husserl and Natalie Depraz.
Upshot: Thanks to the commentaries we have been able to further clarify the situation of generative first-person analysis in the general framework of neurophenomenology and more specifically of cardio-phenomenology as its extension and reformulation. We have also provided more detailed information about the way phenomenology as transcendental philosophy is genuinely operating as a practice in cardio-phenomenology and has a central function regarding the creation of categories and their suspensive questioning thanks to the epoché method. We have also drawn great benefits (...) from the questions about how micro-phenomenology allows a refinement of descriptive categories and the way new categories are generated, and we have been able to provide some answers about different scales of newness in the generative process. (shrink)