The marketing of health care services raises the prospect that an ethic of strangers will govern relations between providers and patients. A fiduciary model that emphasizes honesty and public accountability, as well as the patient's good and avoiding unnecessary services, can keep marketing consistent with the ethical tradition of medicine.

BackgroundStructured, systematic methods to formulate consensus recommendations, such as the Delphi process or nominal group technique, among others, provide the opportunity to harness the knowledge of experts to support clinical decision making in areas of uncertainty. They are widely used in biomedical research, in particular where disease characteristics or resource limitations mean that high-quality evidence generation is difficult. However, poor reporting of methods used to reach a consensus – for example, not clearly explaining the definition of consensus, or not stating (...) how consensus group panellists were selected – can potentially undermine confidence in this type of research and hinder reproducibility. Our objective is therefore to systematically develop a reporting guideline to help the biomedical research and clinical practice community describe the methods or techniques used to reach consensus in a complete, transparent, and consistent manner.MethodsThe ACCORD project will take place in five stages and follow the EQUATOR Network guidance for the development of reporting guidelines. In Stage 1, a multidisciplinary Steering Committee has been established to lead and coordinate the guideline development process. In Stage 2, a systematic literature review will identify evidence on the quality of the reporting of consensus methodology, to obtain potential items for a reporting checklist. In Stage 3, Delphi methodology will be used to reach consensus regarding the checklist items, first among the Steering Committee, and then among a broader Delphi panel comprising participants with a range of expertise, including patient representatives. In Stage 4, the reporting guideline will be finalised in a consensus meeting, along with the production of an Explanation and Elaboration document. In Stage 5, we plan to publish the reporting guideline and E&E document in open-access journals, supported by presentations at appropriate events. Dissemination of the reporting guideline, including a website linked to social media channels, is crucial for the document to be implemented in practice.DiscussionThe ACCORD reporting guideline will provide a set of minimum items that should be reported about methods used to achieve consensus, including approaches ranging from simple unstructured opinion gatherings to highly structured processes. (shrink)

Philosophy is an exciting and accessible subject, and this engaging text acquaints students with the core problems of philosophy and the many ways in which they are and have been answered. Introducing Philosophy: A Text with Integrated Readings, Eighth Edition, insists both that philosophy is very much alive today and that it is deeply rooted in the past. Accordingly, it combines substantial original sources from significant works in the history of philosophy and current philosophy with detailed commentary and explanation that (...) help to clarify the readings. The selections range from the oldest known fragments to cutting-edge essays in feminism, multiculturalism, and cognitive science. At the end of each chapter is a summary, a list of review questions, a glossary, and a bibliography with suggestions for further reading. Important philosophical terms are carefully introduced in the text and also summarized at the end of each chapter, and brief biographies of the philosophers are provided at the end of the book. New to the Eighth Edition: Addressing the needs of a new generation of students, Robert C. Solomon has included for the first time more than 300 study and review questions. Appearing throughout the text and at the end of each chapter, these questions require immediate feedback from students. They encourage students to articulate the central ideas of what they have just read, instead of just "passing through" on the way to the next reading . New selections expand and update the chapters on religion, knowledge, mind and body, freedom, ethics, justice, and beauty. The selections include work by Charles Hartshorne, Cory Juhl, Friedrich Nietzsche, Jean-Paul Sartre, Sextus Empiricus, Edmund L. Gettier, David Braddon-Mitchell and Frank Jackson, Colin McGinn, Daniel Dennett, Harry Frankfurt, Gilbert Harman, Emma Goldman, and Arthur C. Danto. A companion website at www.oup.com/us/solomon8e features 300 study and review questions (100 multiple-choice, 100 true-or-false, and 100 fill-in-the-blank), discussion questions, chapter overviews and summaries, topical links, suggestions for further reading, and PowerPoint lecture aids. (shrink)

The new National Institutes of Health (NIH) Policy on the Use of a Single Institutional Review Board (sIRB) for Multi-Site Research was adopted primarily to simplify and speed the review of complex multisite clinical trials. However, speeding review requires overcoming a number of obstacles. Perhaps the most substantial obstacle is the time and effort needed to develop reliance agreements among the participating sites. We conducted 102 semistructured interviews with sIRB personnel, including directors, chairs, reviewers, and staff, from 20 IRBs that (...) acted as sIRBs for multisite research, including 6 commercial/independent sIRBs, and 10 university-based academic and 4 federal sIRBs. Almost without exception, the interviewees agreed that reliance agreements were complex, difficult to develop, and time-consuming. A major problem for relying sites was that different agreements specified different responsibilities for the relying sites. Attitudes differed about whether these problems will be resolved as IRB staff and managers become more experienced with sIRBs. However it is clear that the process of developing reliance agreements must be simplified. Federal assistance in standardizing at least some sections of reliance agreements might reduce the difficulties involved. (shrink)

Part 1 of this exploratory study demonstrated that for terminal, instrumental, and work values, supervisors could only accurately assess the extent to which their terminal values are congruent with their employees, whereas, employees could only accurately describe degrees of alignment with their supervisors' work values. Thus, supervisors appear to possess conscious awareness of the terminal values held by their employees and employees similarly possess conscious awareness of their supervisors' work values. Part 2 of the study examined what each of these (...) two parties might do with their conscious knowledge concerning value congruence with the other member. Supervisor ratings and employee self-ratings concerning employee job performance, citizenship, climate fit, working relationship (LMX), and other issues, were correlated with supervisor terminal value congruence estimates and employee work value congruence estimates respectively. For supervisors, only one significant finding was noted, indicating a positive relationship between the supervisors' awareness of terminal value congruence with the employee and the supervisors' estimate of the employee's potential for future promotion. For employees, seven hypotheses received support demonstrating relationships between the employees' awareness of supervisor/employee work value congruence and self-ratings of work behaviours, citizenship behaviours, volunteerism behaviours, work climate behaviours, work climate attitudes, work climate organizational-wide attitudes, and the supervisor/employee working relationship. Implications for management and future research are discussed. (shrink)

This exploratory study examines awareness of the other party's instrumental, terminal, and work values by members of supervisor and employee dyads. Subjective estimates of value congruence, provided by either member of the dyad, correlated with actual value congruence scores determine conscious awareness levels in all cases. Results demonstrate supervisory awareness of employee terminal values, but not work values or instrumental values, even though these latter value types probably possess the greatest relevance to achieving organizational goals. Further, employees possess awareness of (...) supervisor work values but not instrumental or terminal values. These findings challenge traditional assumptions underlying the functionalism position on organizational culture that appears in the literature most frequently read by practicing managers. (shrink)

The following description is based upon an actual case in which a patient initiated legal action after suffering a complication subsequent to an invasive diagnostic procedure performed by a senior fellow. Named as codefendants were the senior fellow, attending physician, and the hospital. Because any hospital with house staff is potentially vulnerable to similar litigation, Ethics Committees at Work is addressing the questions raised by this dilemma.

A standard objection to act utilitarian theories is that they are not helpful in deciding what it is morally permissible for us to do when we actually have to make a choice between alternatives. That is, such theories are worthless as decision procedures. A standard reply to this objection is that act utilitarian theories can be evaluated solely as theories about right-making characteristics and, when so evaluated, their inadequacy as decision procedures is irrelevant. Even if somewhat unappealing, this is an (...) effective reply to the standard objection. (shrink)

We consider a situation in which individuals search for accurate decisions without direct feedback on their accuracy, but with information about the decisions made by peers in their group. The “wisdom of crowds” hypothesis states that the average judgment of many individuals can give a good estimate of, for example, the outcomes of sporting events and the answers to trivia questions. Two conditions for the application of wisdom of crowds are that estimates should be independent and unbiased. Here, we study (...) how individuals integrate social information when answering trivia questions with answers that range between 0% and 100%. We find that, consistent with the wisdom of crowds hypothesis, average performance improves with group size. However, individuals show a consistent bias to produce estimates that are insufficiently extreme. We find that social information provides significant, albeit small, improvement to group performance. Outliers with answers far from the correct answer move toward the position of the group mean. Given that these outliers also tend to be nearer to 50% than do the answers of other group members, this move creates group polarization away from 50%. By looking at individual performance over different questions we find that some people are more likely to be affected by social influence than others. There is also evidence that people differ in their competence in answering questions, but lack of competence is not significantly correlated with willingness to change guesses. We develop a mathematical model based on these results that postulates a cognitive process in which people first decide whether to take into account peer guesses, and if so, to move in the direction of these guesses. The size of the move is proportional to the distance between their own guess and the average guess of the group. This model closely approximates the distribution of guess movements and shows how outlying incorrect opinions can be systematically removed from a group resulting, in some situations, in improved group performance. However, improvement is only predicted for cases in which the initial guesses of individuals in the group are biased. (shrink)

Reply to a commentary by Felicitas Holzer and Ignacio Mastroleoon “Models of Consent to Return of Incidental Findings in Genomic Research.”.

How did the human brain evolve so that consciousness of art could develop? In The Psychology of Art and the Evolution of the Conscious Brain, Robert Solso describes how a consciousness that evolved for other purposes perceives and creates art.Drawing on his earlier book Cognition and the Visual Arts and ten years of new findings in cognitive research, Solso shows that consciousness developed gradually, with distinct components that evolved over time. One of these components is an adaptive consciousness that (...) includes the ability to imagine objects that are not present--an ability that allows us to create visual art.Solso describes the neurological, perceptual, and cognitive sequence that occurs when we view art, and the often inexpressible effect that a work of art has on us. He shows that there are two aspects to viewing art: nativistic perception--the synchronicity of eye and brain that transforms electromagnetic energy into neuro-chemical codes--which is "hard-wired" into the sensory-cognitive system; and directed perception, which incorporates personal history and knowledge--the entire set of our expectations and past experiences. Both forms of perception are part of the appreciation of art, and both are products of the evolution of the conscious brain over hundreds of thousands of years.Solso also investigates the related issues of neurological and artistic perception of the human face, the effects of visual illusions, and the use of perspective. The many works of art used as examples are drawn from a wide range of artistic traditions, from ancient Egypt to Africa and India and the European Renaissance. (shrink)

The nature of measurement is a topic of central concern in the philosophy of science and, indeed, measurement is the essential link between science and mathematics. Professor Ellis's book, originally published in 1966, is the first general exposition of the philosophical and logical principles involved in measurement since N. R. Campbell's Principles of Measurement and Calculation, and P. W. Bridgman's Dimensional Analysis. Professor Ellis writes from an empiricist standpoint. His object is to distinguish and define the basic concepts in measurement, (...) for example: scale, quantity, unit. dimension, number and probability. He discusses the problem of classifying scales of measurement and the special logical problems associated with each kind of scale. A translation of mach's Critique on the Concept of Temperature, which gives his views on the nature of measurement more fully than in any of his other works, is given as an appendix. (shrink)

Written with the general reader in mind, this collection will prove useful by both scholar and student, and will lead the general reader to encounter one of the ...

Addressing both collegiate and professional sports, the updated edition of Fair Play explores the ethical presuppositions of competitive athletics and their ...

The interactivist approach to development generates a framework of types of constraints on what can be constructed. The four constraint types are based on: (1) what the constructed systems are about; (2) the representational relationship itself; (3) the nature of the systems being constructed; and (4) the process of construction itself. We give illustrations of each constraint type. Any developmental theory needs to acknowledge all four types of constraint; however, some current theories conflate different types of constraint, or rely on (...) a single constraint type to explicate development. Such theories will be inherently unable to explain important aspects of development. (shrink)

Addressing both collegiate and professional sports, the updated edition of Fair Play: The Ethics of Sport explores the ethical presuppositions of competitive athletics and their connection both to ethical theory and to concrete moral dilemmas that arise in actual athletic competition. This fourth edition has been updated with new examples, including a discussion of Spygate by the New England Patriots and recent discoveries on the use of performance enhancing drugs by top athletes. Two additional authors, Cesar R. Torres and Peter (...) F. Hager, bring to this edition a discussion of the moral issues involved in youth sports and the ethics of being a fan, as well as a fresh perspective on the theories of broad internalism and the quest for excellence. Furthermore, major criticisms of broad internalism by philosophers William J. Morgan and Scott Kretchmar add a new dimension to the discussion on the moral foundations of winning. (shrink)

How did the human brain evolve so that consciousness of art could develop? In The Psychology of Art and the Evolution of the Conscious Brain, Robert Solso describes how a consciousness that evolved for other purposes perceives and creates art.Drawing on his earlier book Cognition and the Visual Arts and ten years of new findings in cognitive research, Solso shows that consciousness developed gradually, with distinct components that evolved over time. One of these components is an adaptive consciousness that (...) includes the ability to imagine objects that are not present--an ability that allows us to create visual art.Solso describes the neurological, perceptual, and cognitive sequence that occurs when we view art, and the often inexpressible effect that a work of art has on us. He shows that there are two aspects to viewing art: nativistic perception--the synchronicity of eye and brain that transforms electromagnetic energy into neuro-chemical codes--which is "hard-wired" into the sensory-cognitive system; and directed perception, which incorporates personal history and knowledge--the entire set of our expectations and past experiences. Both forms of perception are part of the appreciation of art, and both are products of the evolution of the conscious brain over hundreds of thousands of years.Solso also investigates the related issues of neurological and artistic perception of the human face, the effects of visual illusions, and the use of perspective. The many works of art used as examples are drawn from a wide range of artistic traditions, from ancient Egypt to Africa and India and the European Renaissance. (shrink)

Contemporary scientific theories assume a primarily micro-deterministic view of nature. This paper explores the question of whether micro-determinism is incompatible with the alleged emergence of properties and laws that some biologists and philosophers assert occurs in various biological systems. I argue that a preferable unified treatment of these emergence claims takes properties, rather than laws, to be the units of emergence. Four distinct conceptions of emergence are explored and three shown to be compatible with micro-determinism. The remaining concept of emergence, (...) direct macro-determination, does not, I argue, meet the general requirement that an adequate scientific explanation provide a coherent mechanism or effective means of determination. (shrink)

It is not possible to date when environmental studies became ‘Environmental Studies’. Nevertheless it has had a turbulent history marked by inconsistency, conflict and change. It is not surprising that at present it lacks disciplinary coherence and is subject to various definitions, often contradictory. There is ongoing speculation as to the cause of this identity crisis: ‘curricular universalism’ (absence of a unifying concept), academic territorialism and pedagogical clashes. I argue that a philosophical inquiry into the role of values in Environmental (...) Studies provides the missing coherence and unity. Further, I argue that environmental problems directly related to deliberate human action are the province of applied philosophy and offer a formal argument to support this claim, and briefly address and dismiss the controversy over the teaching of values. I conclude that Environmental Studies is inherently part of the philosophical enterprise; as such it belongs with the humanities. The discussion takes as its starting point the context of college and university education in the US, but the issues raised have more general relevance. (shrink)

The threat to the survival of humankind posed by nuclear weapons has been a frightening and essential focus of public debate for the last four decades and must continue to be so if we are to avoid destroying ourselves and the natural world around us. One unfortunate result of preoccupation with the nuclear threat, however, has been a new kind of "respectability" accorded to conventional war. In this radical and cogent argument for pacifism, Robert Holmes asserts that all war--not (...) just nuclear war--has become morally impermissible in the modern world. Addressing a wide audience of informed and concerned readers, he raises dramatic questions about the concepts of "political realism" and nuclear deterrence, makes a number of persuasive suggestions for nonviolent alternatives to war, and presents a rich panorama of thinking about war from St. Augustine to Reinhold Niebuhr and Herman Kahn. Holmes's positions are compellingly presented and will provoke discussion both among convinced pacifists and among those whom he calls "militarists." "Militarists," we realize after reading this book, include the majority of us who live a friendly and peaceful personal life while supporting a system which, if Holmes is correct, guarantees war and risks eventual human extinction. Originally published in 1989. The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist of Princeton University Press. These editions preserve the original texts of these important books while presenting them in durable paperback and hardcover editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905. (shrink)

This article offers a critique of research practices typical of experimental philosophy. To that end, it presents a review of methodological issues that have proved crucial to the quality of research in the biobehavioral sciences. It discusses various shortcomings in the experimental philosophy literature related to (1) the credibility of self-report questionnaires, (2) the validity and reliability of measurement, (3) the adherence to appropriate procedures for sampling, random assignment, and handling of participants, and (4) the meticulousness of study reporting. It (...) argues that the future standing of experimental philosophy will hinge upon improvements in research methods. (shrink)

Advertisers often have been accused of using techniques which manipulate and control the behavior of consumers and hence violate their autonomy. Some of these techniques are puffery, subliminal advertising, and indirect information transfer. After examining both criticisms and defenses of such practices, this paper presents an analysis of four of the concepts involved in the debate — the concepts of autonomous desire, rational desire, free choice, and control. Applying the results to the case of advertising, it is shown that advertising (...) cannot be found guilty of intrinsically or frequently violating the consumer's autonomy in any of the relevant senses of this notion. (shrink)

This volume provides a wide-ranging and lucid introduction to the major ethical theories found in the history of Western philosophy.