ABSTRACT Various mechanisms to ensure the protection of subjects in human research have been suggested, including the presence of witnesses during the informed consent process. For our commentary on the use of witnesses and their potential role and responsibility during the consent process, we start by addressing current guidelines for human subjects research in four Latin American countries. By using examples from public health research, we highlight some of the practical difficulties of using witnessed consent, from becoming a meaningless ritual (...) at one end of the spectrum to the research subject feeling intimidated or coerced to participate at the other. Apart from these practical difficulties, it is unclear what responsibility the witness could and should have. We argue that there are important ethical questions about the role of witnesses that have not been adequately addressed in national and international regulations. This work addresses these gaps and argues that more debate is required to define the role and responsibilities of witnesses in the consent process, their training requirements and whether a universal legal requirement for witnessed consent, regardless of the type of research, is desirable. (shrink)

Background Paternalism/overprotection limits communication between healthcare professionals and patients and does not promote shared therapeutic decision-making. In the global north, communication patterns have been regulated to promote autonomy, whereas in the global south, they reflect the physician’s personal choices. The goal of this study was to contribute to knowledge on the communication patterns used in clinical practice in Mexico and to identify the determinants that favour a doctor–patient relationship characterized by low paternalism/autonomy. Methods A self-report study on communication patterns in (...) a sample of 761 mental healthcare professionals in Central and Western Mexico was conducted. Multiple ordinal logistic regression models were used to analyse paternalism and associated factors. Results A high prevalence of paternalism was observed among mental health professionals in Mexico. The main determinants of low paternalism/autonomy were medical specialty and gender, with female physicians being more likely to explicitly share diagnoses and therapeutic strategies with patients and their families. A pattern of highly explicit communication was strongly associated with low paternalism/autonomy. Finally, a modifying effect of age strata on the association between communication pattern or specialty and low paternalism/autonomy was observed. Conclusions Among mental health professionals in Mexico, high paternalism prevailed. Gender, specialty, and a pattern of open communication were closely associated with low paternalism/autonomy. Strengthening health professionals’ competencies and promoting explicit communication could contribute to the transition towards more autonomist communication in clinical practice in Mexico. The ethical implications will need to be resolved in the near future. (shrink)

In this paper we want to briefly illustrate the ways in which technical, ethical and political judgements of various kinds are interwoven in the processes of healthcare decision-making in the UK. Drawing upon the research for the “Choices in Health Care” project we will borrow the notion of the hidden curriculum from education to illuminate the nature of resource allocation decision processes. In particular we will indicate some of the fundamental but largely hidden political factors in play in these processes (...) and the importance of the inchoate and implicit notion of “NHS values” in shaping UK resource allocation policies. We suggest that these more diffuse, holistic and system level value judgements are both central to understanding priority setting and at the same time difficult to reduce or abstract out into lists of single values/principles. (shrink)

Research Ethics Committees (RECs) are frequently a focus of complaints from researchers, but evidence about the operation and decisions of RECs tends to be anecdotal. We conducted a systematic study to identify and compare the ethical issues raised in 54 letters to researchers about the same 18 applications submitted to three RECs over one year. The most common type of ethical trouble identified in REC letters related to informed consent, followed by scientific design and conduct, care and protection of research (...) participants, confidentiality, recruitment and documentation. Community considerations were least frequently raised. There was evidence of variability in the ethical troubles identified and the remedies recommended. This analysis suggests that some principles may be more institutionalized than others, and offers some evidence of inconsistency between RECs. Inconsistency is often treated as evidence of incompetence and caprice, but a more sophisticated understanding of the role of RECs and their functioning is required. (shrink)

BackgroundLow-stakes crimes related to alcohol and/or drugs are common around the world, but research is lacking on police–suspect interactions of such crimes. A large proportion of these suspects are intoxicated during interrogations, and many may have substance use disorder, making them potentially vulnerable to interrogative pressure.MethodsTo address this lack of knowledge, the taxonomy of interrogation methods framework and a common classification of question types were applied in the coding of written police interrogations. Two archival studies, one pilot and one main (...) study analyzed police interrogations with suspects of alcohol- and drug-related crimes in Sweden.ResultsFor both Study 1 and 2, suspects showed signs of alcohol and/or drug intoxication, hangover or withdrawal in more than 50% of all interrogations. In Study 2, additional coding indicated that suspects displayed signs of substance use disorder in 57% of the interrogations. The main results from both studies revealed a large number of direct questions asked by the police across all interrogations, and relatively little use of the strategic interrogation techniques from the taxonomy of interrogation methods framework. In fact, when it came to interrogation techniques, law enforcement used more confrontational techniques in their interactions with intoxicated suspects compared to sober suspects. Furthermore, suspects displaying signs of substance use disorder were significantly more cooperative and prone to confess than suspects without indicators of substance use disorder.ConclusionAs the first novel study on low-stakes crime interrogations related to alcohol and/or drugs, the present study provides useful information about current Swedish interrogation practices and areas for improvement. The study results indicate that suspects displaying signs of intoxication or substance use disorder may be more vulnerable during police interrogations. This may in turn have the potential to inform the development of new interrogation policies. Due to the novelty of this research, more studies are needed, both on a national and international level, to examine interrogations in low-stakes crimes further. (shrink)

In this paper a formalized logic of propositions, PA1, is presented. It is proven consistent and its relationships to traditional logic, to PM ([15]), to subjunctive (including contrary-to-fact) implication and to the “paradoxes” of material and strict implication are developed. Apart from any intrinsic merit it possesses, its chief significance lies in demonstrating the feasibility of a general logic containing theprinciple of subjunctive contrariety, i.e., the principle that ‘Ifpwere true thenqwould be true’ and ‘Ifpwere true thenqwould be false’ are incompatible.

Anyone, today, with even a slight interest in the methodology of science will be aware of the heated debate which has raged in regard to the thesis of the logical symmetry between explanation and prediction, which is entailed by the hypotheticodeductive account of scientific theory. The symmetry thesis, which received its classical exposition in a well-known article by Hempel and Oppenheim [2], has been subject to a steadily growing criticism by several eminent thinkers. My intention, in this article, is to (...) argue that the current reaction to the Hempel-Oppenheim position, as exemplified by Professors Hanson, Scriven, et al., represents a retrograde movement in the philosophy of science, which, as the number of its converts grows, could undermine the progress, which has been accomplished in the broad tradition that extends from Mach and Poincaré through the Vienna Circle to the present day. Specifically, it is my contention that the aforementioned reaction is symptomatic of a contemporary trend in the direction of irrationalism which, of all branches of philosophy, the philosophy of science should seek to dispel rather than to foster. For the sake of brevity, I propose to focus my remarks wholly on the original widely read article of Hanson on this subject [1]. That I single out this particular source should not be taken to belie the admiration I hold for the masterful scholarship of its author. (shrink)

Philosophers have long debated whether, if determinism is true, we should hold people morally responsible for their actions since in a deterministic universe, people are arguably not the ultimate source of their actions nor could they have done otherwise if initial conditions and the laws of nature are held fixed. To reveal how non-philosophers ordinarily reason about the conditions for free will, we conducted a cross-cultural and cross-linguistic survey (N = 5,268) spanning twenty countries and sixteen languages. Overall, participants tended (...) to ascribe moral responsibility whether the perpetrator lacked sourcehood or alternate possibilities. However, for American, European, and Middle Eastern participants, being the ultimate source of one’s actions promoted perceptions of free will and control as well as ascriptions of blame and punishment. By contrast, being the source of one’s actions was not particularly salient to Asian participants. Finally, across cultures, participants exhibiting greater cognitive reflection were more likely to view free will as incompatible with causal determinism. We discuss these findings in light of documented cultural differences in the tendency toward dispositional versus situational attributions. (shrink)

Burnout syndrome and obesity are two growing conditions that affect employees’ health and company productivity. Recently, several studies have pointed to a possible relationship between both phenomena. However, such a relationship has not been clearly defined. This research analyzes the relationship between BS dimensions and body mass index, the latter being treated as a moderator variable among obese senior and middle managers in the Mexican maquiladora industry through a structural equation model. A total of 361 senior and middle managers completed (...) both the Maslach Burnout Inventory-General Survey [with emotional exhaustion, cynicism, and professional efficacy as subscale dimensions] and a sociodemographic questionnaire. The results showed a statistically significant relationship between EE and PE, with BMI acting as a moderator variable. The results showed that when BMI increases as a moderator variable, the strength of the relationship between EE and PE also changes. For example, although PE had a negative value of 0.14 before the moderator effect, the value increased up to 0.32 when the BMI was factored into the relationship. Therefore, maquiladora industries are being advised to increase their investments on the identification and prevention of employees’ EE and obesity. Such interventions would promote a better quality of life and could prevent economic losses resulting from poor employee performance. (shrink)

Purpose This study aims to understand the allure and danger of fake news in social media environments and propose a theoretical model of the phenomenon. Design/methodology/approach This qualitative research study used the uses and gratifications theory approach to analyze how and why people used social media during the 2016 US presidential election. Findings The thematic analysis revealed people were gratified after using social media to connect with friends and family and to gather and share information and after using it as (...) a vehicle of expression. Participants found a significant number of fake news stories on social media during the 2016 US presidential election. Participants tried to differentiate between fake news and real news using fact-checking websites and news sources and interacted with the social media users who posted fake news and became part of the echo chamber. Behaviors like these emerged in the analysis that could not be completely explained by UGT and required further exploration which resulted in a model that became the core of this study. Research limitations/implications This is a small-scale exploratory study with eight diverse participants, findings should not be generalized to larger populations. Time-specific self-reporting of information from social media and fake news during the 2016 US presidential election. Upgrading public policies related to social media is recommended in the study, contributing to burgeoning policy discussions and provides recommendations for both purveyors of social media and public policymakers. Practical implications Upgrade in public policies related to social media is recommended in the study and contributes to burgeoning policy discussions and provides recommendations for both purveyors of social media and public policymakers. Social implications Social media users are spending increased time on their preferred platforms. This study increases the understanding of the nature, function and transformation of virtual social media environments and their effects on real individuals, cultures and societies.What is original/of value about the paper?This exploratory study establishes the foundation on which to expand research in the area of social media use and fake news. Originality/value This exploratory study establishes the foundation to expand research in the area of social media use and fake news. (shrink)