Accession Number: ATLA0001712129; Hosting Book Page Citation: p 207-225.; Language(s): English; General Note: Bibliography: p 222-225.; Issued by ATLA: 20130825; Publication Type: Essay.

ABSTRACTAlthough attention bias toward threat has been associated with Social Anxiety Disorder, concerns regarding the ability of current measures to detect change in AB following treatm...

The law applicable to genomics in the United States is currently in transition and under debate. The rapid evolution of the science, burgeoning clinical research, and growing clinical application pose serious challenges for federal and state law. Although there has been some empirical work in this area, this is the first paper to survey and interview key scientific and legal stakeholders in the field of genomics to help ground identification of the most important legal problems that must be solved to (...) successfully integrate genomics into clinical care. The respondents in this study identified a wide range of interconnected issues, focusing specifically on the need for clear guidelines about how to use these data, fear of liability for those who use these data, and the need to protect patients from use of this information particularly by insurers, while endorsing data sharing. Developing legal strategies to support appropriate use of genomics now and in the future clearly will require making trade-offs, taking into account the full complexity of this legal ecosystem. (shrink)

An increasing recognition over the past five decades of the importance of patients’ autonomy and the right to be able to choose to limit medical treatment at the end of life has led to the development of a number of documents related to advance care planning, including the advance directive, medical power of attorney, and portable orders for life-sustaining treatment (POLST). While these documents are important aspects of advance care planning, without having goals-ofcare conversations, a specific plan, and necessary supports (...) to achieve these goals, the documents alone offer a false promise. Healthcare professionals must be trained on how to have indepth goals-of-care conversations with patients and their families, and effectively document the decisions. Advance care planning needs to be viewed as a process that must continue as the patient’s health status, social support system, and living environment change. Designating a healthcare representative who participates in goals-of-care conversations and can work with the healthcare team to make “just in time” decisions about care reduces the burden and stress on friends and family. In this article we discuss the strengths and limitations of advance directives, medical power of attorney forms, and POLST forms; propose concrete changes to optimize the effectiveness of each; and present a comprehensive approach to advance care planning that we hope will improve care for those nearing the end of life, and ensure that their wishes and goals to have or to limit treatment are more consistently honored. (shrink)

No consensus yet exists on how to handle incidental fnd-ings in human subjects research. Yet empirical studies document IFs in a wide range of research studies, where IFs are fndings beyond the aims of the study that are of potential health or reproductive importance to the individual research participant. This paper reports recommendations of a two-year project group funded by NIH to study how to manage IFs in genetic and genomic research, as well as imaging research. We conclude that researchers (...) have an obligation to address the possibility of discovering IFs in their protocol and communications with the IRB, and in their consent forms and communications with research participants. Researchers should establish a pathway for handling IFs and communicate that to the IRB and research participants. We recommend a pathway and categorize IFs into those that must be disclosed to research participants, those that may be disclosed, and those that should not be disclosed. (shrink)

Edited by Thomas A. Shannon, this series provides anthologies of critical essays and reflections by leading ethicists in four pivotal areas: reproductive technologies, genetic technologies, death and dying, and health care policy. The goal of this series is twofold: first, to provide a set of readers on thematic topics for introductory or survey courses in bioethics or for courses with a particular theme or time limitation. Second, each of the readers in this series is designed to help students focus more (...) thoroughly and effectively on specific topics that flesh out the ethical issues at the core of bioethics. The series is also highly accessible to general readers interested in bioethics. (shrink)

Qualitative and quantitative research on the impact of medical and health humanities teaching in baccalaureate education is sparse. This paper reviews recent studies of the impact of medical and health humanities coursework in pre-health professions education and describes a pilot study of baccalaureate students who completed semester-long medical humanities courses in the Division of Medical Humanities & Bioethics at the University of Rochester. The study format was an email survey. All participants were current or former baccalaureate students who had taken (...) one or more courses in literature and narrative in medicine, bioethics, history of medicine, and/or visual arts and healthcare during the past four years. The survey gathered numerical data in several areas: demographic information, career plans, self-reported influence of coursework on educational and career plans, and self-reported influence of coursework on intellectual skills and abilities. It also gathered narrative commentary that elaborated on students’ responses to the numerically-based questions. Notable findings from preliminary analysis of the data include higher scores of self-reported impact of the coursework on specific habits of mind and on preparedness for intended career rather than on gaining admission to future educational programs. Discussion of the results focuses on several potential future directions this type of study might take, including multi-center, longitudinal, and sequential approaches. (shrink)

ABSTRACTPrior research on attention bias in anxious youth, often utilising a visual dot probe task, has yielded inconsistent findings, which may be due to how bias is assessed and/or variability in the phenomenon. The present study utilises eye gaze tracking to assess attention bias in socially anxious adolescents, and explores several methodological and within-subject factors that may contribute to variability in attention bias. Attention bias to threat was measured in forty-two treatment-seeking adolescents diagnosed with Social Anxiety Disorder. Bias scores toward (...) emotional stimuli and bias scores away from emotional stimuli were explored. Bias scores changed between vigilance and avoidance within individuals and over the course of stimulus presentation. These differences were not associated with participant characteristics nor with self-reported social anxiety symptoms. However, clinician rated severity of social anxiety, explained a signific... (shrink)

American Academy of Pediatrics (AAP) and American College of Medical Genetics (ACMG) recently provided two recommendations about predictive genetic testing of children. The Clinical Sequencing Exploratory Research Consortium's Pediatrics Working Group compared these recommendations, focusing on operational and ethical issues specific to decision making for children. Content analysis of the statements addresses two issues: (1) how these recommendations characterize and analyze locus of decision making, as well as the risks and benefits of testing, and (2) whether the guidelines conflict or (...) come to different but compatible conclusions because they consider different testing scenarios. These statements differ in ethically significant ways. AAP/ACMG analyzes risks and benefits using best interests of the child and recommends that, absent ameliorative interventions available during childhood, clinicians should generally decline to order testing. Parents authorize focused tests. ACMG analyzes risks and benefits using the interests of the child and other family members and recommends that sequencing results be examined for additional variants that can lead to ameliorative interventions, regardless of age, which laboratories should report to clinicians who should contextualize the results. Parents must accept additional analysis. The ethical arguments in these statements appear to be in tension with each other. (shrink)

Despite attempts to encourage whistleblowing, lingering reluctance to report questionable acts remains frustratingly apparent. Our objective is to examine the regret a professional anticipates when evaluating the action of reporting or not reporting, and whether the framing of the action influences regret. Responses from 263 professionals indicate that regret depends on the moral intensity of the situation and how the action is framed. Regret for whistleblowing is not comparable to regret for not remaining silent, despite the fact that these two (...) descriptions result in the same action. This important implication may inform the way we educate and encourage whistleblowing. (shrink)

Emotions are keys to understanding the response to environmental problems. We discuss three important roles. First, emotions like worry, anxiety, pride and hope can motivate pro-environmental behaviour. Second, emotions are also consequences; the emotional impacts of environmental degradation, such as climate anxiety, can affect mental health, and recognising these impacts is necessary to encourage individual and societal resilience. Finally, emotion also has a communicative function and is part of shared experience. The ability to describe and elicit shared emotions in response (...) to environmental problems allows those problems to become part of social discourse, which is necessary for addressing them. Research in all these areas can help guide an adaptive response to environmental challenges. (shrink)

Clayton Crockett and Jeffrey Robbins describe a number of the intellectual developments and movements that preceded and influenced radical theology. They pay special attention to the hermeneutics of suspicion of Feuerbach, Marx, Freud, and Nietzsche; the phenomenology of Husserl, Heidegger, and Merleau-Ponty; and the linguistic structuralism of Saussure. Crockett and Robbins pay close attention to the role of Derrida’s lecture, “Structure, Sign, and Play in the Discourse of the Human Sciences,” in 1966 before moving on to the Death of (...) God movement. They emphasize the way Tillich’s thought was radicalized by G. Vahanian, Altizer, Daly, and others in combination with Tillich’s theology of culture and existential theology and Bonhoeffer’s influence on the early Death of God thinkers. Finally, Crockett and Robbins discuss radical theology’s hybridization with deconstruction in the work of Raschke, Mark C. Taylor, and Winquist and hybridizing RT with deconstruction. (shrink)

What is the future of Continental philosophy of religion? These forward-looking essays address the new thinkers and movements that have gained prominence since the generation of Derrida, Deleuze, Foucault, and Levinas and how they will reshape Continental philosophy of religion in the years to come. They look at the ways concepts such as liberation, sovereignty, and post-colonialism have engaged this new generation with political theology and the new pathways of thought that have opened in the wake of speculative realism and (...) recent findings in neuroscience and evolutionary psychology. Readers will discover new directions in this challenging and important area of philosophical inquiry. (shrink)

James Allen, qui fut pendant 21 ans le mari d’Abigail, mourut à la suite d’un accident du travail. C’est à cette époque que les médecins découvrirent qu’Allen était une femme. De nombreux journaux britanniques en parlèrent. Cet article situe le cas d’Allen dans le contexte plus large des female husbands (telles que Mary Hamilton et Catherine Vizzani) et analyse trois aspects récurrents dans la presse de 1829, ainsi que dans les autres récits : d’abord le travestissement et la dissimulation, ensuite (...) la sexualité féminine, y compris le lesbianisme, et enfin la terminologie utilisée, ce qui ouvre un débat sur la multiplicité générique, confrontée à l’organisation dichotomique de la société. (shrink)

James Allen, qui fut pendant 21 ans le mari d’Abigail, mourut à la suite d’un accident du travail. C’est à cette époque que les médecins découvrirent qu’Allen était une femme. De nombreux journaux britanniques en parlèrent. Cet article situe le cas d’Allen dans le contexte plus large des female husbands (telles que Mary Hamilton et Catherine Vizzani) et analyse trois aspects récurrents dans la presse de 1829, ainsi que dans les autres récits : d’abord le travestissement et la dissimulation, ensuite (...) la sexualité féminine, y compris le lesbianisme, et enfin la terminologie utilisée, ce qui ouvre un débat sur la multiplicité générique, confrontée à l’organisation dichotomique de la société. (shrink)

Much of the research on the delivery of advice by professionals such as physicians, health workers and counsellors, both on the telephone and in face-to-face interaction more generally, has focused on the theme of client resistance and the consequent need for professionals to adopt particular formats to assist in the uptake of the advice. In this article we consider one setting, Kid’s Helpline, the national Australian counselling service for children and young people, where there is an institutional mandate not to (...) give explicit advice in accordance with the values of self-direction and empowerment. The article examines one practice, the use of script proposals by counsellors, which appears to offer a way of providing support which is consistent with these values. Script proposals entail the counsellors packaging their advice as something that the caller might say — at some future time — to a third party such as a friend, teacher, parent or partner, and involve the counsellor adopting the speaking position of the caller in what appears as a rehearsal of a forthcoming strip of interaction. Although the core feature of a script proposal is the counsellor’s use of direct reported speech, they appear to be delivered not so much as exact words to be followed, but as the type of conversation that the client needs to have with the third party. Script proposals, in short, provide models of what to say as well as alluding to how these could be emulated by the client. In their design, script proposals invariably incorporate one or more of the most common rhetorical formats for maximizing the persuasive force of an utterance such as a three-part list or a contrastive pair. Script proposals, moreover, stand in a complex relation to the prior talk and one of their functions appears to be to summarize, respecify or expand upon the client’s own ideas or suggestions for problem solving that have emerged in these preceding sequences. (shrink)

This volume argues that the commitment to justice is a fundamental motive and that, although it is typically portrayed as serving self-interest, it sometimes takes priority over self-interest. To make this case, the authors discuss the way justice emerges as a personal contract in children's development; review a wide range of research studying the influences of the justice motive on evaluative, emotional and behavioral responses; and detail common experiences that illustrate the impact of the justice motive. Through an extensive critique (...) of the research on which some alternative models of justice are based, the authors present a model that describes the ways in which motives of justice and self-interest are integrated in people's lives. They close with a discussion of some positive and negative consequences of the commitment to justice. (shrink)

In 2004, the United States Sentencing Commission amended the Federal Sentencing Guidelines to allow firms that create “effective compliance and ethics programs” to receive better treatment if prosecuted for fraud. Effective compliance and ethics, however, appear to be limited to activities focused on complying with the firms’ internal legal and ethical standards. We explored a potential connection between the firms’ external corporate social responsibility (CSR) behaviors and internal compliance: Is there an organizationally valid relationship between these two firm activities? That (...) is, when organizations demonstrate CSR with behaviors external to the firm, such as employee volunteerism, are their employees more likely to demonstrate uncompromised legal and ethical compliance behavior internally? We collected data from 164 working professionals enrolled in a top-tier MBA program in the southeastern United States regarding their employer-sponsored volunteer activities and their intentions to comply in various organizational compliance vignettes. We found that employer-sponsored volunteerism is associated with uncompromised compliance choices in one of the three vignettes. This finding indicates preliminary support for further inquiry into the relationship within the firm between external CSR behaviors and policies regarding organizational compliance. Post hoc analyses suggest that employer-sponsored volunteerism is strongly associated with a positive organizational identity, but organizational identity is not associated with the significant compliance vignette. This evidence suggests that the underlying mechanism that connects external CSR behaviors and internal compliance intentions is complex and requires future study. (shrink)

In this article, the author focuses on the allocation of decision-making authority between parents and physicians. She argues that parents should have substantial room to decide whether genetic testing is good for their child and that they may appropriately consider interests in addition to those of their child in making such choices. A physician, however, may refuse to act pursuant to parental views about testing, when in the physician's view, the parents' choices would pose a risk of significant harm to (...) the child. The balance of control between parents and physicians is illustrated by discussion of a series of case vignettes. Refusal to perform requested testing is most often warranted for testing for carrier status and for genetic predisposition to late onset disease. The author concludes her analysis by discussing why it is appropriate to give increasing deference to the views of the child as the child grows older. (shrink)

The virulence of a virus is determined by its ability to adversely affect the host cell, host organism or population of host organisms. Influenza A viruses have been responsible for four pandemics of severe human respiratory disease this century. Avian species harbour a large reservoir of influenza virus strains, which can contribute genes to potential new pandemic human strains. The fundamental importance of understanding the role of each of these genes in determining virulence in birds and humans was dramatically emphasised (...) by the recent direct transmission of avian influenza A viruses to humans, causing fatal infection but not community spread. An understanding of the factors involved in transmission between avian and mammalian species should assist in the development of better surveillance strategies for early recognition of influenza A virus strains having human pandemic potential, and possibly in the design of anti‐viral strategies. BioEssays 25:657–671, 2003. © 2003 Wiley Periodicals, Inc. (shrink)

Aesop's Fables With the possible exception of the New Testament, no works written in Greek are more widespread and better known than Aesop’s Fables. For at least 2500 years they have been teaching people of all ages and every social status lessons how to choose correct actions and the likely consequences of choosing incorrect actions. … Continue reading Aesop's Fables →.

Exploring the Illusion of Free Will and Moral Responsibility is an edited collection of new essays by an internationally recognized line-up of contributors. It is aimed at readers who wish to explore the philosophical and scientific arguments for free will skepticism and their implications.

The 2008 financial crisis has raised serious ethical questions about behaviors associated with the free market system and the effectiveness of undergraduate business ethics education. We offer opposing interpretations of the crisis, a “Markets Work” and a “Critical” perspective, in order to provide students with an opportunity to examine their ethical assumptions. We frame our discussion around legitimacy; therefore, we utilize an institutional theory lens to frame the processes by which financial organizations are rewarded with social legitimacy for using “proper” (...) structures and following “appropriate” procedures and punished when they do not. By presenting these two opposing narratives of the crisis, we provide a richer framework for discussing the crisis and relating it to the larger issue of corporate malfeasance. We draw upon a wealth of readily available, easily accessible material. We identify films, readings, and provide notes that may use to set the direction and tenor of classroom discussion. (shrink)