Gatekeeping, or determining membership of your group, is crucial to science: the moniker ‘scientific’ is a stamp of epistemic quality or even authority. But gatekeeping in science is fraught with dangers. Gatekeepers must exclude bad science, science fraud and pseudoscience, while including the disagreeing viewpoints on which science thrives. This is a difficult tightrope, not least because gatekeeping is a human matter and can be influenced by biases such as groupthink. After spelling out these general tensions around (...) gatekeeping in science, we shed light on them with a case study from psychology. This concerns whether academic psychologists rightly or wrongly classify the applied-psychology framework of NLP (‘neuro-linguistic programming’) as unscientific and even pseudoscientific. This example of gatekeeping is particularly instructive because both the NLP community and the psychology community, we argue, make legitimate but also illegitimate moves. This case gives rise to several general insights about gatekeeping in science more generally. (shrink)

We examine the relationship between scientific knowledge and the legal system with a focus on the exclusion of expert testimony from trial as ruled by the Daubert standard in the US.We introduce a simple framework to understand and assess the role of judges as “gatekeepers”, monitoring the admission of science in the courtroom. We show how judges face a crucial choice, namely, whether to limit Daubert assessment to the abstract reliability of the methods used by the expert witness or also (...) to check whether the application of those methods was correct. Undesirable outcomes result from both choices, thereby giving rise to the “gatekeeper’s dilemma.” We illustrate the dilemma by analyzing in some detail two well-known cases of Daubert challenges to economic experts. Finally, we present reasons for the absence of straightforward solutions to the dilemma and for its likely endurance. (shrink)

Although informed consent models for prescribing hormone replacement therapy are becoming increasingly prevalent, many physicians continue to require an assessment and referral letter from a mental health professional prior to prescription. Drawing on personal and communal experience, the author argues that assessment and referral requirements are dehumanising and unethical, foregrounding the ways in which these requirements evidence a mistrust of trans people, suppress the diversity of their experiences and sustain an unjustified double standard in contrast to other forms of clinical (...) care. Physicians should abandon this unethical requirement in favour of an informed consent approach to transgender care. (shrink)

This paper proposes that we should think of epistemic agents as having, as one of their intellectual activities, a gatekeeping task: To decide in light of various criteria which ideas they should consider and which not to consider. When this task is performed with excellence, it is conducive to the acquisition of epistemic goods such as truth and knowledge, and the reduction of falsehoods. Accordingly, it is a worthy contender for being an intellectual virtue. Although gatekeeping may strike (...) one simply as the virtue of open- mindedness, I argue that it is not; gatekeeping does not favor a characteristic disposition to be willing to consider novel or opposing ideas. In fact, being told that an agent is excellent at gatekeeping reveals nothing about how frequently she considers or refuses to consider ideas. This paper will introduce and motivate the notion of gatekeeping, and offer some preliminary arguments in support of its candidacy as an intellectual virtue. (shrink)

The inevitable need for rationing of healthcare has apparently presented the medical profession with the dilemma of choosing the lesser of two evils. Physicians appear to be obliged to adopt either an implausible version of traditional professional ethics or an equally problematic ethics of bedside rationing. The former requires unrestricted advocacy of patients but prompts distrust, moral hazard and unfairness. The latter commits physicians to rationing at the bedside; but it is bound to introduce unfair inequalities among patients and lack (...) of political accountability towards citizens. In this paper I shall argue that this dilemma is false, since a third intermediate alternative exists. This alternative, which I term 'administrative gatekeeping', makes it possible for physicians to be involved in rationing while at the same time being genuine advocates of their patients. According to this ideal, physicians are required to follow fair rules of rationing adopted at higher organizational levels within healthcare systems. At the same time, however, they are prohibited from including considerations of cost in their clinical decisions. (shrink)

In _The Gatekeeper: Narrative Voice in Plato’s Dialogues_ Margalit Finkelberg offers the first narratological analysis of all of Plato’s transmitted dialogues. The book explores the dialogues as works of literary fiction, giving special emphasis to the issue of narrative perspective.

Regulation of gatekeepers of taxation has been so controversial and important that a review of ethical standards, professional responsibility and industry guidelines is examined. This paper explores whether gatekeepers of taxation need more ethics and enforcement to increase the compliance rate. In this paper we argue that an effective mixture of professional ethics and enforcement of gatekeepers can increase tax compliance. However, we question how much is optimal or reasonable? We theorize that ethics and enforcement should be proportionate to the (...) ecosystem because too much of it can lead to unintended consequences such as increase costs and higher noncompliance. A friendlier tax authority with less complex laws can enhance the compliance process. This strategy, in amalgamation with professional ethics, enforcement policies, and effective reporting systems, could increase the compliance rate. (shrink)

This paper examines the ethical issues that arise when healthcare providers act as gatekeepers to research involving vulnerable populations. Traumatised refugees serve as an example of this subset of research participants. Highlighting the particular vulnerabilities of this group, we argue that specific ethical considerations are required that go beyond the conventional research approaches. While gatekeeping responds to some of those vulnerabilities, it risks wronging through unwarranted paternalism. Instead, we will propose that a relational ethics of justice and care serves (...) as a more appropriate framework for responding to the challenges of research involving traumatised refugees. Specifically, such a framework allows us to reflect more deeply on the role of the gatekeeper. In conclusion, we recommend that clinicians and researchers collaborate with survivors’ advisory groups in the development of specific research ethical guidelines. (shrink)

The European Legacy, Volume 17, Issue 5, Page 706-707, August 2012.

Physicians have an ethical responsibility to their patients to offer the best available medical care. This responsibility conflicts with their role as gatekeepers of the limited health care resources available for all patients collectively. It is ethically untenable to expect doctors to face this trade-off during each patient encounter; the physician cannot be expected to compromise the wellbeing of the patient in the office in favour of anonymous patients elsewhere. Hence, as in other domains of public policy where individual and (...) collective interests conflict, some form of collective solution is required. Collective solutions may take the form of placing explicit resource constraints on resources available to physicians, or clinical practice guidelines that recognise cost-effective care as acceptable. Such solutions will be politically and ethically sustainable only if patients as citizens of the larger population accept the need for rationing of limited resources in health care. (shrink)

In his 2018 essay Down to Earth, the French philosopher Bruno Latour proposes a hypothesis that connects a number of contemporary issues, ranging from climate denialism to deregulation and growing inequality. While his hypothesis, namely that the elites act as if they live in another world and are leaving the rest of the world behind, might seem like a conspiracy theory, I will argue that there is a way to make sense of it. To do so, I will turn to (...) two other authors, Timothy Mitchell and Shoshana Zuboff, to highlight the kind of logic that Latour seems to have in mind. In the final section, I will propose to capture the commonalities of these authors through the concept of shifting reciprocities and will return to Latour’s political plea to define one’s territories, reinterpreted as reciprocities. (shrink)

The reward infrastructure in science centres on publication, in which journal editors play a key role. Reward distribution hinges on value assessments performed by editors, who draw from plural value systems to judge manuscripts. This conceptual paper examines the numerous biases and other factors that affect editorial decisions. Hybrid and often conflicting value systems contribute to an infrastructure in which editors manage reward through editorial review, commissioned commentaries and reviews and weighing of peer review judgments. Taken together, these systems and (...) processes push the editor into a role resembling censorship. Editors and authors both experience this phenomenon as an unintended side-effect of the reward infrastructure in science. To work towards a more constructive editor-author relationship, we propose a conversation, an exchange between editor and author in which value is collectively assessed as obligatory passage points in the publishing process are traversed. This paper contributes to the discourse on editorial practices by problematising editorial paradigms in a new way and suggesting solutions to entrenched problems. (shrink)

Physicians are increasingly confronted with the consequences of allocation policies. In several countries, physicians have been assigned a gatekeeper role for secondary health care. Many ethicists oppose this assignment for several reasons, concentrating on the harm the intrusion of societal arguments would inflict on doctor-patient relations. It is argued that these arguments rest on a distinction of spheres of values and of rationality, without taking into account the mixing of values and rationalities that takes place in everyday medical practice. If (...) medical practice, then, does not follow a single, pure rationality, can it also incorporate the societal rationality of the gatekeeper role?Using a case from general practice, I try to show how physicians may integrate societal arguments into their practice in a morally acceptable way. A version of the model of reflective equilibrium and especially Beauchamp and Childress's safeguards, may be helpful both to analyse and teach such balancing of values and rationalities. (shrink)

Florence Ashley has responded to our response to ‘Gatekeeping hormone replacement therapy for transgender patients is dehumanising.’ Ashley criticises some of our objections to their view that patients seeking hormone replacement therapy (HRT) for gender dysphoria should not have to undergo a prior psychological assessment. Here we clarify our objections, most importantly that concerning the parity between cosmetic surgery and the sort of intervention Ashley has in mind. Firstly, we show Ashley’s criticism of our comparison is insubstantial. We then (...) examine their comments regarding the analogy between abortion and HRT, and the language of informed consent. We also scrutinize the data upon which Ashley relies to defend the claim that informed consent without assessment always yields positive outcomes, finding this conclusion to be overstated. Finally, even if Ashley’s arguments were vindicated, the claim that the gatekeeping of HRT is motivated by hostility towards transgender people remains unsupported. (shrink)

Mandating psychiatric evaluation for patients who request physician‐assisted suicide may not offer the clearcut protection from possible coercion or other abuse that proponents assert. Competence itself is a complex concept and determinations of decisionmaking capacity are not straightforward, nor is the relationship between mental illness and decisionmaking capacity in dying patients clearly understood. And casting psychiatrists as gatekeepers in end‐of‐life decisions poses risks to the profession itself.

Improvements to the validity of psychological science depend upon more than the actions of individual researchers. Editors, journals, and publishers wield considerable power in shaping the incentives that have ushered in the generalizability crisis. These gatekeepers must raise their standards to ensure authors' claims are supported by evidence. Unless gatekeepers change, changes made by individual scientists will not be sustainable.

: Some argue that human groups have a stake in the outcome of population-genomics research and that the decision to participate in such research should therefore be subject to group permission. It is not possible, however, to obtain prior group permission, because the actual human groups under study, human demes, are unidentifiable before research begins. Moreover, they lack moral standing. If identifiable social groups with moral standing are used as proxies for demes, group approval could be sought, but at the (...) expense of unfairly exposing these surrogates to risks from which prior group approval is powerless to protect them. Unless population genomics can proceed without targeting socially defined groups, or can find other ways of protecting them, it may fall to individuals to protect the interests of the groups they care about, and to scientists to warn their subjects of the need to do so. (shrink)

We investigate how a broker firm’s initial public offering affects its analysts’ fiduciary duty of providing independent and objective recommendations. We find that the analysts of newly listed broker firms issue more positively biased recommendations in the first 2 to 3 years after their employers’ IPO than before the IPO. The increase in the recommendation bias is greater among analysts of affiliated brokers and brokers that raise additional capital after their IPO than among other analysts. Newly listed broker firms experience (...) significant increases in revenue and trading commission, and the increases are positively related to recommendation bias, after controlling for many other factors. More importantly, recommendation bias decreases as newly listed broker firms season and as the importance of trading commission declines. This suggests that public exposure through a broker firm’s IPO does not enhance the integrity and professional conduct of its financial analysts. Rather, economic incentives make financial analysts more accepting of unethical behavior. The overall results imply that the public trading of financial gatekeepers compromises the ethical relationship between financial service professionals and society in general. (shrink)

The publishing industry has a variety of gatekeepers that play a role in deciding which works become books. This article acknowledges the main gatekeepers as the agent and publishers, but also draws attention to the author, who is the first gatekeeper, and the reader, who is the last. The connections between gatekeepers highlight the role of power in these positions. Using Foucault’s theories of archaeology and genealogy, this article argues that positions within the industry provide space for the gatekeepers to (...) say what works deserve to be published. In doing so it highlights the dynamic flow of power, which rises from the bottom and provides a hierarchical structure within the industry. (shrink)

The purpose of the paper is to present the challenges and difficulties that may be encountered in the process of the evaluation of qualitative research on sex workers by ethics committees. Such research is usually subject to review by ethics committees because of the risk of harm to participants, who are considered “vulnerable”. At the same time, due to the social stigma arising from the provision of sex services, researchers, research participants, and ethics committee members may have their own ideas (...) and expectations about how ethical research in this area should be conducted. Referring to the experience of researchers from common law countries, this paper will discuss how these expectations and the requirements of ethics committees collide, confronting the researcher with the need to meet the divergent or even contradictory expectations of various social actors. I will also propose alternative procedures for Polish ethics committees to ensure that the process of obtaining their approval is more democratic and open to the diverse needs of both researchers and research participants. (shrink)

Although there is increasing public criticism of intensive livestock production, the market share of meat with an animal welfare standard exceeding legal requirements remains small. Food retailers, in their role as gatekeepers, can influence changes in production and consumption patterns. Their strategic role between farmers and consumers allows them to control commodity, information and value flow and therefore places them into a key position when it comes to the distribution of meat with a higher animal welfare standard. The aim of (...) this explorative study is to identify factors which motivate food retailers to take on the marketing of products of increased animal welfare standards, in this case, pasture-based beef. Nine in depth-interviews were conducted with representatives of the food retail industry. The interviews took place in June 2018, followed a structured guideline and were transcribed verbatim. The transcripts were categorized and evaluated using qualitative content analysis. Results showed that food retailers are driven by both extrinsic and intrinsic motives. The main extrinsic motive is the perceived customer demand. Consciousness for animal welfare and the regional production cycles, including close connection between farmers and retailers are inherently intrinsic motives. Interestingly, the interviewed retailers show a high personal interest and moral obligation with regard to sourcing and marketing pasture-based beef. As such, this research finds innovative retailers, who take on a new role in sustainable food systems which exceed classical distribution functions and may have a considerable effect in transforming the food system. (shrink)

Community and patient stakeholder partners serve in many roles. One particularly important role of community and patient organizations and representatives is to serve as gatekeepers; in this role, they monitor, and in some cases even determine, what research does and does not get conducted with their communities. Such gatekeeping can prevent “helicopter” research and community research fatigue. Gatekeeping can also aid in identifying and mitigating harms that might occur not only to individual participants but to third parties (who (...) do not provide consent for participation) or to the community as a whole. Although individual informed consent and independent review both aim to protect against research risks, in research with identifiable communities these protections may be insufficient to protect from other types of harms. Given the gaps in protection, the gatekeeping role of community research partners is an important supplement to informed consent and independent IRB review, but it also raises its own set of ethical challenges. Here, we discuss the limitations of informed consent and independent review in research with identifiable communities, the benefits of gatekeeping for protecting third parties and groups, types of gatekeepers, and issues in the selection of gatekeepers. (shrink)

Video assistant referee was officially introduced into soccer regulations in 2018, after many years in which referee errors were justified as being “part of the game.” The technology’s penetration into the soccer field was accompanied by concerns and much criticism that, to a large degree, continues to be voiced with frequency. This paper argues that, despite fierce objections and extensive criticism, VAR represents an important revision in modern professional soccer, and moreover, it completes a moral revolution in the evolution of (...) the sport as a whole. Theoretically speaking, this technology enables an improvement in the sport’s professional standards and its public image and prestige, and especially its moral standards – Fair play. Furthermore, the introduction of this technology makes it possible to discover additional weaknesses (Standardization for extra time, a clear definition of a handball offense and more) that professional soccer regulations will probably be forced to address in the future. (shrink)

This paper presents a study of gatekeeping in the U.S. political blog “Daily Kos.” Open online collectives like Daily Kos use relational mechanisms, such as gatekeeping, to manage organizational boundaries and filter the contributions of participants. However, neither prior theories of gatekeeping nor the existing analyses of open online collectives account for the character or implications of gatekeeping in the Daily Kos community. Using qualitative evidence as well as statistical analysis of a large sample of comment (...) threads on the site from 2008, I argue that gatekeeping on Daily Kos takes centralized and decentralized forms, and that both modes depend critically on relational boundary work among site participants. Centralized gatekeeping proceeds through actions by high-status members of the community. Decentralized gatekeeping, by contrast, consists of more numerous and small-scale interactions between community members, who filter and moderate each other’s participation. Both forms of gatekeeping enhance the ability of site leaders and incumbent community members to regulate access to privileges and agenda-setting responsibilities on the site. These findings imply that the egalitarian ethos of open online collectives exists in tension with the mechanisms through which participation and status inequalities emerge among participants. How collectives engaged in mobilization and discursive production resolve this tension will shape the long-term impact of online participation and blogs on the political and public spheres. (shrink)

Amyotrophic lateral sclerosis (ALS) is a progressive degenerative disorder of motor neurones. Although the genetic basis of familial forms of ALS has been well explored, the molecular basis of sporadic ALS is less well understood. Recent evidence has linked sporadic ALS with the failure to edit key residues in ionotropic glutamate receptors, resulting in excessive influx of calcium ions into motor neurones which in turn triggers cell death. Here we suggest that edited AMPA glutamate (GluR2) receptor subunits serve as gatekeepers (...) for motor neurone survival. BioEssays 30:1185–1192, 2008. © 2008 Wiley Periodicals, Inc. (shrink)

Philosophy has a language problem. A recent study by Schwitzgebel, Huang, Higgins and Gonzalez-Cabrera (2018) found that, in a sample of papers published in elite journals, 97% of citations were to work originally written in English. 73% of this same sample didn’t cite any paper that had been originally written in a language other than English. Finally, a staggering 96% of elite journal editorial boards are primarily affiliated with an Anglophone university. This is consistent with earlier data suggesting that journal (...) submissions from countries that are outside the Anglophone world and Europe have disturbingly low chances of being accepted. The route forward is not entirely clear. What is clear, however, is that this structural disadvantage deserves closer philosophical and empirical attention. We owe this to current and future members of our philosophical community who speak English non-natively. We also need this if we want to make sure philosophy is enriched by a diverse group of thinkers who have a grasp of different languages, and of the cultures strongly associated with them. (shrink)

The article by Wiggins and Wilbanks in this issue (2019) provides an important overview of the some of the forms and challenges of citizen involvement in health and biomedical research. Many such r...

ABSTRACTThe Theory of Event Coding predicts that exposure to affective cues can automatically trigger affectively congruent behaviour due to shared representational codes. An intriguing hypothesis from this theory is that exposure to aversive cues can automatically trigger actions that have previously been learned to result in aversive outcomes. Previous work has indeed found such a compatibility effect on reaction times in forced-choice tasks, but not for action selection in free-choice tasks. Failure to observe this compatibility effect for aversive cues in (...) free choice tasks suggests that control processes aimed at directing behaviour toward positive outcomes may overrule the automatic activation of affectively congruent responses in case of aversive cues. The present study tested whether minimising such control could cause selection of actions that have been learned to result in aversive outcomes. Results showed incidental exposure to aversive cues biased selection of behaviours with learned aver... (shrink)

Who are the gatekeepers in bioethics? Does editorial bias or institutional racism exist in leading bioethics journals? We analyzed the composition of the editorial boards of 14 leading bioethics journals by country. Categorizing these countries according to their Human Development Index (HDI), we discovered that approximately 95 percent of editorial board members are based in (very) high-HDI countries, less than 4 percent are from medium-HDI countries, and fewer than 1.5 percent are from low-HDI countries. Eight out of 14 leading bioethics (...) journals have no editorial board members from a medium- or low-HDI country. Eleven bioethics journals have no board members from low-HDI countries. This severe underrepresentation of bioethics scholars from developing countries on editorial boards suggests that bioethics may be affected by institutional racism, raising significant questions about the ethics of bioethics in a global context. (shrink)

This paper theorizes that care provision depends on the set of “contingencies,” or organizational and institutional structures, rules, narratives, and routines, surrounding professional work. Drawing on 95 interviews with U.S. pharmacists, I demonstrate how pharmacists prioritize specific contingencies and reveal how ethical decision-making depends on both organizational positioning and locus in inter-professional hierarchies.

Commercialization of medicine is a growing trend that threatens to undermine physicians’ commitments to patient care in favor of personal financial interests. Bemoaned by Arnold Relman as early as 1980, growing for-profit sectors of health care have been reshaping medicine from a profession into a business, forming the foundation of what he terms a “medical-industrial complex” that threatens to undermine professional identity and reshape health care funding. Commercialization poses new ethical challenges for health care providers who have a financial stake (...) in their health care decisions and may undermine their fiduciary duties to patients.Certainly, commercialization has brought about new trends in medicine — one need only to look as far as the rise in for-profit hospitals, diagnostic laboratories, and proprietary nursing homes to see how opportunities for financial gain reposition physicians’ orientations vis-à-vis patients. (shrink)

Medical necessity (claiming that a medical intervention or care is – at minimum – reasonable, appropriate and acceptable) depends on empirical evidence and on the interpretation of that evidence. Evidence and its interpretation define the standard of care. This commentary argues that both the evidence base and its interpretation are currently weak gatekeepers. Empirical meta-research suggests that very few medical interventions have high quality evidence in support of their effectiveness and very few of them also have relatively thorough assessments of (...) their potential harms. Therefore, evidence on the risk-benefit ratios carries almost always very large uncertainty. Arbitration about medical necessity is thus left to the interpretation process. Professional guidelines are notoriously unreliable and biased in this regard. Regulatory approval ends up being the key arbitrator, but over the years the regulatory process has been subverted. Regulatory approval currently does not mean that an intervention has a favourable risk-benefit ratio, but simply that it can be marketed, sold and made profit from. The process leads to a tragedy of commons where the final victim is society at large: medical necessity is invoked as an alibi for medicine to absorb societal resources. (shrink)

This essay responds to an article, ‘Variation in university research ethics review’, published in this issue. It argues that the authors of that paper do not fully distinguish the usual function of university research ethics committees from that of a gatekeeper. The latter term more accurately describes the task they happen to have asked them to fulfil in the course of conducting some empirical research. Whilst they are not alone in making it, the result of this conflation is that the (...) reflections they offer are misguided. In this short comment I briefly discuss the distinction between a REC and a gatekeeper, and indicate how it impacts on the proposals sketched by Vadeboncoeur et al. (shrink)