There is currently little empirical information about attitudes towards cognitive enhancement - the use of pharmaceutical drugs to enhance normal brain functioning. It is claimed this behaviour most commonly occurs in students to aid studying. We undertook a qualitative assessment of attitudes towards cognitive enhancement by conducting 19 semi-structured interviews with Australian university students. Most students considered cognitive enhancement to be unacceptable, in part because they believed it to be unethical but there was a lack of consensus on whether it (...) was similar or different to steroid use in sport. There was support for awareness campaigns and monitoring of cognitive enhancement use of pharmaceutical drugs. An understanding of student attitudes towards cognitive enhancement is important in formulating future policy. (shrink)

Addiction is increasingly described as a “chronic and relapsing brain disease”. The potential impact of the brain disease model on the treatment of addiction or addicted individuals’ treatment behaviour remains uncertain. We conducted a qualitative study to examine: (i) the extent to which leading Australian addiction neuroscientists and clinicians accept the brain disease view of addiction; and (ii) their views on the likely impacts of this view on addicted individuals’ beliefs and behaviour. Thirty-one Australian addiction neuroscientists and clinicians (10 females (...) and 21 males; 16 with clinical experience and 15 with no clinical experience) took part in 1 h semi-structured interviews. Most addiction neuroscientists and clinicians did not uncritically support the use of brain disease model of addiction. Most were cautious about the potential for adverse impacts on individuals’ recovery and motivation to enter treatment. While some recognised the possibility that the brain disease model of addiction may provide a rationale for addicted persons to seek treatment and motivate behaviour change, Australian addiction neuroscientist and clinicians do not assume that messages about “diseased brains” will always lead to increased treatment-seeking and reduced drug use. Research is needed on how neuroscience research could be used in ways that optimise positive outcomes for addicted persons. (shrink)

Developments in neuroscience have raised the possibility that pharmaceuticals may be used to enhance memory, mood, and attention in people who do not have an illness or disorder, a practice known as “cognitive enhancement.” We describe historical experiences with two medicinal drugs for which similar enhancement claims were made, cocaine in the late 19th and early 20th centuries, and amphetamines in the mid 20th century. These drugs were initially introduced as medicinal agents in Europe and North America before becoming more (...) widely used for a variety of purposes, including what would nowadays be considered cognitive enhancement. Their trajectory of use conformed to the typical use cycle of psychotropic drugs. There was an initial steep rise in prescribing for medical use, followed by expanded nonmedical use that was fueled by enthusiasm for the drugs’ effects. As the number of regular users increased, problems related to use (such as addiction) became apparent, societal concern increased, and laws were passed banning nonmedical use and eventually, medical use. This historical experience draws attention to the adverse side effects of enhancement use that only become apparent with regular, wide-scale use of a drug. We highlight the similarities between the enthusiasms for cocaine and amphetamines and the current enthusiasms for using prescription stimulants for cognitive enhancement. We argue bioethicists should not encourage the cognitive enhancement use of drugs such as methylphenidate in the absence of evidence on the efficacy and safety of their use for cognitive enhancement purposes. (shrink)

Impaired control over drug use is a defining characteristic of addiction in the major diagnostic systems. However there is significant debate about the extent of this impairment. This qualitative study examines the extent to which leading Australian addiction neuroscientists and clinicians believe that addicted individuals have control over their drug use and are responsible for their behaviour. One hour semi-structured interviews were conducted during 2009 and 2010 with 31 Australian addiction neuroscientists and clinicians (10 females and 21 males; 16 with (...) clinical experience and 15 with no clinical experience). Although many addiction neuroscientists and clinicians described uncontrolled or compulsive drug use as characteristic of addiction, most were ambivalent about whether or not addicted people could be said to have no control of their drug use. Most believed that addicted individuals have fluctuating levels of impaired control over their drug use but they nonetheless believed that addicted persons were responsible for their behaviour, including criminal behaviour engaged in to fund their drug use. Addiction was not seen as exculpating criminal behaviour but as a mitigating factor. (shrink)

How do we know that our own actions belong to us? How are we able to distinguish self-generated sensory events from those that arise externally? In this paper, I will briefly discuss experiments that were designed to investigate these questions. In particularly, I will review psychophysical and neuroimaging studies that have investigated how we recognise the consequences of our own actions, and why patients with delusions of control confuse self-produced and externally produced actions and sensations. Studies investigating the failure of (...) this 'self-monitoring' mechanism in patients with delusions of control will be discussed in the context of the hypothesis that overactivity in the parietal cortex and the cerebellum contribute to the misattribution of an action to an external source (). (shrink)

This study examines employee perceptions on the effective adoption of artificial intelligence principles in their organizations. 49 interviews were conducted with employees of 24 organizations across 11 countries. Participants worked directly with AI across a range of positions, from junior data scientist to Chief Analytics Officer. The study found that there are eleven components that could impact the effective adoption of AI principles in organizations: communication, management support, training, an ethics office, a reporting mechanism, enforcement, measurement, accompanying technical processes, a (...) sufficient technical infrastructure, organizational structure, and an interdisciplinary approach. The components are discussed in the context of business code adoption theory. The findings offer a first step in understanding potential methods for the effective adoption of AI principles in organizations. (shrink)

When a liberal-democratic state signs a treaty or wages a war, does its whole polity do those things? In this article, we approach this question via the recent social ontological literature on collective agency. We provide arguments that it does and that it does not. The arguments are presented via three considerations: the polity's control over what the state does; the polity's unity; and the influence of individual polity members. We suggest that the answer to our question differs for different (...) liberal-democratic states and depends on two underlying considerations: the amount of discretion held by the state's officeholders; the extent to which the democratic procedure is deliberative rather than aggregative. (shrink)

_Animal Experimentation: Working Towards a Paradigm Change_ critically appraises current animal use in science and discusses ways in which we can contribute to a paradigm change towards human-biology based approaches.

It is well established that beliefs provide powerful cues that influence reasoning. Over the last decade research has revealed that judgments based upon logical structure may also pre-empt deliberative reasoning. Evidence for ‘intuitive logic’ has been claimed using a range of measures (i.e. confidence ratings or latency of response on conflict problems). However, it is unclear how well such measures genuinely reflect logical intuition. In this paper we introduce a new method designed to test for evidence of intuitive logic. In (...) two experiments participants were asked to make random judgments about the logical validity of a series of simple and complex syllogistic arguments. For simple arguments there was an effect of logical validity on random responding, which was absent for complex arguments. These findings provide a novel demonstration that people are intuitively sensitive to logical structure. (shrink)

A standard objection to socioeconomic human rights is that they are not claimable as human rights: their correlative duties are not owed to each human, independently of specific institutional arrangements, in an enforceable manner. I consider recent responses to this ‘claimability objection,’ and argue that none succeeds. There are no human rights to socioeconomic goods. But all is not lost: there are, I suggest, human rights to ‘socioeconomic consideration’. I propose a detailed structure for these rights and their correlative duties, (...) while remaining neutral on substantive moral debates. I argue that socioeconomic-consideration human rights are satisfactorily claimable and sufficiently practical. (shrink)

It is well established that beliefs provide powerful cues that influence reasoning. Over the last decade research has revealed that judgments based upon logical structure may also pre-empt deliberative reasoning. Evidence for ‘intuitive logic’ has been claimed using a range of measures (i.e. confidence ratings or latency of response on conflict problems). However, it is unclear how well such measures genuinely reflect logical intuition. In this paper we introduce a new method designed to test for evidence of intuitive logic. In (...) two experiments participants were asked to make random judgments about the logical validity of a series of simple and complex syllogistic arguments. For simple arguments there was an effect of logical validity on random responding, which was absent for complex arguments. These findings provide a novel demonstration that people are intuitively sensitive to logical structure. (shrink)

The Default Interventionist account suggests that by default, we often generate belief-based responses when reasoning and find it difficult to draw the logical inference. Recent research, h...

There has long been interest in identifying and studying ‘‘successful psychopaths.” This study sampled psychologists with an interest in law, attorneys, and clinical psychology professors to obtain descriptions of individuals considered to be psychopaths who were also successful in their endeavors. The results showed a consistent description across professions and convergence with descriptions of traditional psychopathy, though the successful psychopathy profile had higher scores on conscientiousness, as measured within the five-factor model (FFM). These results are useful in documenting the existence (...) of successful psychopathy, demonstrating the potential benefit of informant methodology, and providing an FFM description that distinguishes successful psychopaths from unsuccessful psychopaths studied more routinely within prison settings. (shrink)

Ethical issues in biomedical research are traditionally examined as distinct from those of clinical care. However, this traditional framing may obscure questions of equity and fairness in both rese...

Background: Clinical genomic implementation studies pose challenges for informed consent. Consent forms often include complex language and concepts, which can be a barrier to diverse enrollment, and these studies often blur traditional research-clinical boundaries. There is a move toward self-directed, web-based research enrollment, but more evidence is needed about how these enrollment approaches work in practice. In this study, we developed and evaluated a literacy-focused, web-based consent approach to support enrollment of diverse participants in an ongoing clinical genomic implementation study. (...) Methods: As part of the Cancer Health Assessments Reaching Many (CHARM) study, we developed a web-based consent approach that featured plain language, multimedia, and separate descriptions of clinical care and research activities. CHARM offered clinical exome sequencing to individuals at high risk of hereditary cancer. We interviewed CHARM participants about their reactions to the consent approach. We audio recorded, transcribed, and coded interviews using a deductively and inductively derived codebook. We reviewed coded excerpts as a team to identify overarching themes. Results: We conducted 32 interviews, including 12 (38%) in Spanish. Most (69%) enrolled without assistance from study staff, usually on a mobile phone. Those who completed enrollment in one day spent an average of 12 minutes on the consent portion. Interviewees found the information simple to read but comprehensive, were neutral to positive about the multimedia support, and identified increased access to testing in the study as the key difference from clinical care. Conclusions: This study showed that interviewees found our literacy-focused, web-based consent approach acceptable; did not distinguish the consent materials from other online study processes; and valued getting access to testing in the study. Overall, conducting empirical bioethics research in an ongoing clinical trial was useful to demonstrate the acceptability of our novel consent approach but posed practical challenges. (shrink)

Surrogates’ decisions to withhold or withdraw life-sustaining treatments (LSTs) are pervasive. However, the factors influencing surrogates’ decisions to initiate LSTs are relatively unknown. We present evidence from two experiments indicating that some surrogates’ decisions about when to initiate LSTs can be predictably manipulated. Factors that influence surrogate decisions about LSTs include the patient’s cognitive state, the patient’s age, the percentage of doctors not recommending the initiation of LSTs, the percentage of patients in similar situations not wanting LSTs, and default treatment (...) settings. These results suggest that some people may use heuristics when making these important life-and-death decisions. These findings may have important moral implications for improving surrogate decisions about LSTs and reconsidering paternalism. (shrink)

Healthcare delivery is an interpersonal endeavor. In every clinical interaction, providers have an ethical obligation to show respect to their patients, and ideally over time these interactions lea...

ABSTRACTThe Assistance Principle is common currency to a wide range of moral theories. Roughly, this principle states: if you can fulfil important interests, at not too high a cost, then you have a moral duty to do so. I argue that, in determining whether the ‘not too high a cost’ clause of this principle is met, we must consider three distinct costs: ‘agent-relative costs’, ‘recipient-relative costs’ and ‘ideal-relative costs’.

Some contemporary states are morally culpable for historically distant wrongs. But which states for which wrongs? The answer is not obvious, due to secessions, unions, and the formation of new states in the time since the wrongs occurred. This paper develops a framework for answering the question. The argument begins by outlining a picture of states’ agency on which states’ culpability is distinct from the culpability of states’ members. It then outlines, and rejects, a plausible-seeming answer to our question: that (...) culpability transmits from a past state’s action to a present state just if the two states share a numerical identity, for example as determined by international law. I advocate a different answer: culpability transmits from a past action to a present state to the extent that the present state ‘descends from’ the aspects of the past state that underpinned the past action. One potential upshot is that some present-day settler-colonies (such as Australia) are culpable for the centuries-ago invasion of their lands by European powers—even though these states did not perform these invasions and indeed did not exist at the time. (shrink)

This is a response to the critial comments by Anne Schwenkenbecher, Olle Blomberg, Bill Wringe and Gunnar Björnsson.

Volume 19, Issue 5, May 2019, Page 41-42.

Background Standard interpretations of the ethical principle of respect for persons have not incorporated the views and values of patients, especially patients from groups underrepresented in research. This limits the ability of research ethics scholarship, guidance, and oversight to support inclusive, patient-centered research. This study aimed to identify the practical approaches that patients in community-based settings value most for conveying respect in genomics research. Methods We conducted a 3-round, web-based survey using the modified Delphi technique to identify areas of agreement (...) among English-speaking patients at primary care clinics in Washington State and Idaho who had a personal or family history of cancer. In Round 1, respondents rated the importance of 17 items, identified in prior qualitative work, for feeling respected. In Round 2, respondents re-rated each item after reviewing overall group ratings. In Round 3, respondents ranked a subset of the 8 most highly rated items. We calculated each item’s mean and median rankings in Round 3 to identify which approaches were most important for feeling respected in research. Results Forty-one patients consented to the survey, 21 (51%) completed Round 1, and 18 (86% of Round 1) completed each of Rounds 2 and 3. Two sets of rankings were excluded from analysis as speed of response suggested they had not completed the Round 3 ranking task. Respondents prioritized provision of study information to support decision-making (mean ranking 2.6 out of 8; median ranking 1.5) and interactions with research staff characterized by kindness, patience, and a lack of judgment (mean ranking 2.8; median ranking 2) as the most important approaches for conveying respect. Conclusions Informed consent and interpersonal interactions are key ways that research participants experience respect. These can be supported by other approaches to respecting participants, especially when consent and/or direct interactions are infeasible. Future work should continue to engage with patients in community-based settings to identify best practices for research without consent and examine unique perspectives across clinical and demographic groups in different types of research. (shrink)

The occurrence of the novel severe acute respiratory syndrome coronavirus-2 at the end of 2019 comes along with many challenges. Besides worry for one’s own health and the well-being of the family, all measures applied to limit the spread of the coronavirus affected daily life. School closures, economic shutdown and contact restrictions have led to high levels of stress. The impact on health and families has been widely discussed. However, population-based data are scarce. Here, we have assessed health, quality of (...) life and intrafamilial relations depending on the COVID-19 pandemic. Using a three-step random-route approach, a population-based sample of 2,515 persons was recruited during the second COVID-19 wave in Germany in winter 2020/21. While the majority of participants reported no change in their health status and the relationship with their partner and children, more than half of participants reported a decreased quality of life since the beginning of the pandemic. Female gender, age above 60 years, a low household income, not living with a partner and the experience of childhood adversity were associated with a higher risk for a worsening of health, quality of life and intrafamilial relations. These had already been well-established risk factors ahead of the pandemic. In order to avoid further increase of inequality in our society and more devastating impact of the pandemic on health and intrafamilial relations, low-level support and intervention programs are urgently needed. (shrink)

Millum and Bromwich provide a thorough and thoughtful analysis of what is required for sufficient informed consent, offering distinct conceptualizations of the ethical requirements of disclo...

Ethical issues in biomedical research are traditionally examined as distinct from those of clinical care. However, this traditional framing may obscure questions of equity and fairness in both rese...

Noninvasive, prenatal whole genome sequencing may be a technological reality in the near future, making available a vast array of genetic information early in pregnancy at no risk to the fetus or mother. Many worry that the timing, safety, and ease of the test will lead to informational overload and reproductive consumerism. The prevailing response among commentators has been to restrict conditions eligible for testing based on medical severity, which imposes disputed value judgments and devalues those living with eligible conditions. (...) To avoid these difficulties, we propose an unrestricted testing policy, under which prospective parents could obtain information on any variant of known significance after a careful informed consent process that uses an interactive decision aid to deliver a mandatory presentation on the purposes, techniques, and limitations of genomic testing, as well as optional resources for reflection and consultation. This process would encourage thoughtful, informed deliberation by prospective parents before deciding whether or how to use NIPW. (shrink)

In this pathbreaking book, which includes a powerful new translation of Hesiod's Works and Days by esteemed translator David Grene, Stephanie Nelson argues that a society's vision of farming contains deep indications about its view of the human place within nature, and our relationship to the divine. She contends that both Hesiod in the Works and Days and Vergil in the Georgics saw farming in this way, and so wrote their poems not only about farming itself, but also about (...) its deeper ethical and religious implications. Hesiod, Nelson argues, saw farming as revealing that man must live by the sweat of his brow, and that good, for human beings, must always be accompanied by hardship. Within this vision justice, competition, cooperation, and the need for labor take their place alongside the uncertainties of the seasons and even of particular lucky and unlucky days to form a meaningful whole within which human life is an integral part. Vergil, Nelson argues, deliberately modeled his poem upon the Works and Days, and did so in order to reveal that his is a very different vision. Hesiod saw the hardship in farming; Vergil sees its violence as well. Farming is for him both our life within nature, and also our battle against her. Against the background of Hesiods poem, which found a single meaning for human life, Vergil thus creates a split vision and suggests that human beings may be radically alienated from both nature and the divine. Nelson argues that both the Georgics and the Works and Days have been misread because scholars have not seen the importance of the connection between the two poems, and because they have not seen that farming is the true concern of both, farming in its deepest and most profoundly unsettling sense. (shrink)

In this pathbreaking book, which includes a powerful new translation of Hesiod's Works and Days by esteemed translator David Grene, Stephanie Nelson argues that a society's vision of farming contains deep indications about its view of the human place within nature, and our relationship to the divine. She contends that both Hesiod in the Works and Days and Vergil in the Georgics saw farming in this way, and so wrote their poems not only about farming itself, but also about (...) its deeper ethical and religious implications. Hesiod, Nelson argues, saw farming as revealing that man must live by the sweat of his brow, and that good, for human beings, must always be accompanied by hardship. Within this vision justice, competition, cooperation, and the need for labor take their place alongside the uncertainties of the seasons and even of particular lucky and unlucky days to form a meaningful whole within which human life is an integral part. Vergil, Nelson argues, deliberately modeled his poem upon the Works and Days, and did so in order to reveal that his is a very different vision. Hesiod saw the hardship in farming; Vergil sees its violence as well. Farming is for him both our life within nature, and also our battle against her. Against the background of Hesiods poem, which found a single meaning for human life, Vergil thus creates a split vision and suggests that human beings may be radically alienated from both nature and the divine. Nelson argues that both the Georgics and the Works and Days have been misread because scholars have not seen the importance of the connection between the two poems, and because they have not seen that farming is the true concern of both, farming in its deepest and most profoundly unsettling sense. (shrink)

Evidence Van de Vliert draws on is more consistent with the idea that settlement in the frontier encourages independent mentality and individualistic social institutions. This cultural system can sometimes flourish, generating both wealth and power, but clearly not always. In our view, wealth is, for the most part, a measure of success of any given cultural group, and climate is important to the extent that it plays a role in creating rugged lands of frontier.