Prenatal ultrasound use is skyrocketing despite limited evidence of improved outcomes. One factor driving this trend is the widely recognized psychological appeal of real-time fetal imaging. Meanwhile, considering imperfect safety evidence, U.S. professional guidelines dictate that prenatal ultrasound—a screening test—should be governed by expected clinical benefits—an opportunity for intervention. However, when women’s healthcare professionals themselves are pregnant, their access to ultrasound technology permits informal, personal use that may deviate from standard-of-care, e.g., for reassurance. Highlighting a poignant case wherein a pregnant (...) obstetrician’s personal ultrasound use had unforeseen negative consequences, we explore this issue within context of professional ethics and informal medical care. We discuss how women’s health professionals’ self-care may influence and inform prenatal care at large. We advocate curtailing informal prenatal ultrasound use, but also potentially broadening accepted indications for or relaxing proscriptions against ultrasounds for patients. Further research and updated, evidence-based, ethically-sound guidelines are needed. (shrink)

The pandemic of SARS-CoV-2 has led to unprecedented changes to society, causing unique problems that call for extraordinary solutions. We consider one such extraordinary proposal: ‘safer infection sites’ that would offer individuals the opportunity to be intentionally infected with SARS-CoV-2, isolate, and receive medical care until they are no longer infectious. Safer infection could have value for various groups of workers and students. Health professionals place themselves at risk of infection daily and extend this risk to their family members and (...) community. Similarly, other essential workers who face workplace exposure must continue their work, even if have high-risk household members and live in fear of infecting. When schools are kept closed because of the fear that they will be sites of significant transmission, children and their families are harmed in multiple ways and college students who are living on campus, whether or not they are attending classes in person, are contributing to high rates of transmission and experiencing high rates of exposure. We consider whether offering safer infection sites to these groups could be ethically defensible and identify the empirical unknowns that would need to resolve before reaching definitive conclusions. This article is not an endorsement of intentional infection with the coronavirus, but rather is meant to spark conversation on the ethics of out-of-the-box proposals. Perhaps most meaningfully, our paper explores the value of control and peace of mind for those among us most impacted by the pandemic: those essential workers risking the most to keep us safe. (shrink)

Little is known about health care professionals’ perceptions regarding what it means to treat patients and families with respect and dignity in the intensive care unit (ICU) setting. To address this gap, we conducted nine focus groups with different types of health care professionals (attending physicians, residents/fellows, nurses, social workers, pastoral care, etc.) working in either a medical or surgical ICU within the same academic health system. We identified three major thematic domains, namely, intrapersonal (attitudes and beliefs), interpersonal (behaviors), and (...) system (contextual) factors that influence treatment with respect and dignity. Participants suggested strategies for improving treatment of patients and families in the ICU with respect and dignity, as well as the related need for enhancing respect among the multidisciplinary team of clinicians. Implementing these strategies will require innovative educational interventions and leadership. Future research should focus on the design and evaluation of such interventions on the quality of care. (shrink)

Biomedical science is usually framed for the public in terms of its “promise.” When a breakthrough results from scientific inquiry, that promise is translated into a hope for a cure. The “promise” of such advances in biomedical research can have a paradoxical effect. In the case of pediatric neuromuscular disease, rather than reducing suffering, the expectation of cure can be a burden—both physically and emotionally—for affected children and their families. If a family expects a cure, it is likely to do (...) everything possible to help the child live as long as possible, in the hope that the child will eventually receive it. I am not arguing that the appropriate response to the paradox of promise is to impede scientific progress. What is needed, however, is a broader conception of hope—one that values hope for a good day, a good quality of life, good relationships, or even a good death—alongside the hope for a cure. (shrink)

This article analyzes Wittgenstein’s position on the grammatical incorrigibility of psychological self-ascriptions and shows how introspective statements can be of use to philosophers. In Wittgenstein On Rules and Private Language, Kripke notes Wittgenstein’s puzzling ambivalence toward introspection. On the one hand Wittgenstein repudiates introspection and on the other he uses it in his own philosophical investigations. To resolve the paradox, this paper distinguishes between introspective methodology in psychological and philosophical investigations. Wittgenstein’s arguments against introspection are specifically directed at introspective methodology (...) in psychology. He argues that the use of introspection to discover “inner causes” commits one to a conception of “direct inner awareness”. On that conception, psychological self-ascriptions are considered highly reliable due to the superiority of the subjective vantage point in ascertaining one’s own mental contents. As an alternative, Wittgenstein maintains that this reliability stems from the grammar of the ascription. The paper places Wittgenstein’s alternative conception of incorrigibility into the context of his argument against the use of introspection in psychology. (shrink)

Intellectual property can be an important asset for academic institutions. Good data management practices are important for capture, development and protection of intellectual property assets. Selected issues focused on the relationship between data management and intellectual property are reviewed and a thesis that academic institutions and scientists should honor their obligations to responsibly manage data.

This volume demonstrates how readers can become more effective parents, teachers, students, coaches, managers, or work supervisors, while also gaining practical skills to enhance their self-motivation, communication skills, and intervention acumen. The first eight chapters explain evidence-based principles from applied behavioral science that can be used to improve the human dynamics of any situation involving behavior. Fundamentals from humanism are integrated strategically to show how an ABS intervention can be more acceptable, influential, and sustainable. The following twelve chapters detail the (...) deployment of ABS interventions to optimize performance in a wide variety of fields, including occupational and transportation safety, quantity and quality of organizational work behavior, healthcare, athletic coaching, parenting, pre-school and college education, environmental sustainability, and the control of obesity and alcohol abuse. Applied Psychology provides a thorough review of the latest research in relation to these domains and explores issues for future investigation. (shrink)

Corpus of Middle Babylonian and Middle Assyrian Incantations. By Elyze Zomer. Leipziger Altorientalische Studien, vol. 9. Wiesbaden: HarrassowitZ Verlag, 2018. Pp. xxiv + 463, 3 pls. €84.

A recently published collection of articles focuses upon a relatively small group of texts dealing mainly with astronomical calculations and omens as well as physiognomic omens, attempting to use these as a basis for reconstructing ancient Jewish science in the Persian and Hellenistic periods. The present review raises questions regarding the aims and methods employed, offering an alternative suggestion for the transfer of technical knowledge from Babylonia to ancient Palestine.

Cancer susceptibility testing is likely to become routine in medical practice, despite many limitations and unanswered questions. These uncertainties greatly complicate the process of informed consent, creating an excellent opportunity to reconsider exactly how it should be conducted. Research with women's reactions to the availability of genetic susceptibility testing for breast cancer dramatically underscores that informed consent ought to be highly individualized, taking care to discern what patients believe about the disease and its causes and what role they want their (...) physician to play. (shrink)

The idea of Greek influences on Hellenistic Judaism appears to be so deeply engrained within modern scholarship that nothing could upset this apple cart, at least as reflected in two recent books on various aspects of magic, astronomy, and medicine in Jewish sources from the Hellenistic and Roman periods. The usual frame of reference relies upon paradigms clearly outlined by Saul Lieberman and Martin Hengel, that Greek culture and science had penetrated Jewish thinking to such an extent, that even Hebrew (...) and Aramaic texts from Qumran or the Mishnah were eventually integrated into an undefined Hellenistic-Greek Jewish episteme. The present review article advocates an alternative Near Eastern context for Jew- ish writings in the period, one that did not reflect Hellenism in any form. (shrink)

Taking its lead from analyses of gift exchange by Marcel Mauss and Marshall Sahlins as well as of contact by Charles Long and Jonathan Z Smith, this article elaborates a theory of the exchange, among dominant social subjects, of representations of their subjected proximate others in order to rectify the crisis precipitated by contact with otherness that threatens their claims to autonomy, authority, homogeneity, and universality. Specifically it situates the polemical exchange of representations of women among Friedrich Schlegel, G W (...) F Hegel, and Karl Gutzkow as exemplary German male bourgeois efforts to rectify the crises to subject formation generated, in part, by the emergence of gender-coded bifurcated bourgeois society and signaled by the Kantian and French Revolutions. The public dissemination of apotropaic representations screened the dependence upon proximate others by, and determined the positions among, exchange participants as well as maintained structures of domination. (shrink)

Superior recognition of positive emotional facial expressions compared to negative expressions is well established. However, it is unclear whether this superiority effect differs between non-parents and parents, for whom emotion perception (EP) is an indispensable skill. Although EP has been shown to be modulated by the neuropeptide oxytocin, a central factor in the development of parental care, very little research has addressed the relationship between EP skills, the transition to parenthood, and plasma oxytocin levels. In the present study, we assessed (...) EP abilities with a test battery and measured plasma oxytocin in 77 non-parent and 79 parent couples and applied structural equation modelling to the data. The results showed increased happiness perception abilities in both parents and individuals with elevated oxytocin levels. Furthermore, non-parents showed superior abilities to recognise anger expressions. No significant associations were found regarding the perception of other basic emotion categories or with a general EP factor. The findings are consistent with previous research indicating that elevated oxytocin levels are associated with enhanced EP abilities. They also extend the existing literature by demonstrating that mothers and fathers, regardless of their oxytocin levels, exhibit increased EP superiority. (shrink)

Confidentiality is a cornerstone of the physician-patient relationship. Breaches of confidentiality in the context of genetic testing are of particular concern for a number of reasons. First, genetic testing reveals information not only about a particular patient, but also about his or her family members. Second,genetic testing can label healthy people as “at risk,” subjecting them to possible stigmatization or discrimination by third parties. Third, as genetic testing becomes more widespread and is incorporated into primary care, breaches of confidentiality might (...) inadvertently occur more frequently because primary care providers may not be trained to understand the uniqueness of genetic information. Until now, genetic services have been provided primarily by medical geneticists and genetic counselors. However, with the proliferation of new genetic presymptomatic and carrier tests, primary care physicians are going to become increasingly involved in genetic testing. Currently, little is known about physicians’ attitudes toward disclosure of confidential genetic information to third parties. (shrink)

This paper presents Freud’s argument that the clinical process of psychoanalysis must continually combat the patient’s resistance to the analyst’s interpretations. It also presents systematically Wittgenstein’s counterargument. Wittgenstein contends that psychoanalytic interpretations are enormously attractive and that their “charm” predisposes the patient to accept them. He traces their charm to six sources, each of which is discussed.

Among those included in the lists of being sent out in 1922 as part of the “Philosophers’ Steamboat,” there was Sergei Nikolayevich (Father Sergius) Bulgakov (1871–1944). Prior to his deportation, Bulgakov, after many years of struggle, reunited his philosophical and theological journeys. This is reflected in his dialogues and essays, in particular, in At the Feast of the Gods and At the Walls of Chersonesus, and Tragedy of Philosophy. In exile, Bulgakov continued to reflect on the tragedy of a thinker (...) facing a spiritual catastrophe, the tragedy of Russia torn by wars and revolutions, and his personal tragedies. Having regained his firm foundation and a way to overcome his uprootedness, Bulgakov makes an outstanding contribution to preserving Russian culture. This paper focuses on Bulgakov as a person, and his philosophy of religion is considered from the vantage point of how it reflects his personal struggles and humanistic worldview. The Philosophers’ Steamboat, an act of ideological repressions that followed the turbulent years of the Bolshevik Revolution and the Civil War, bears a lesson for today when Russia is at war again, and many prominent cultural figures sever ties with their country. Sergei Bulgakov’s fate and work set an example of living and creating through tragedy. (shrink)

Background. As the development and use of genetic tests have increased, so have concerns regarding the uses of genetic information. Genetic discrimination, the differential treatment of individuals based on real or perceived differences in their genomes, is a recently described form of discrimination. The range and significance of experiences associated with this form of discrimination are not yet well known and are investigated in this study. Methods. Individuals at-risk to develop a genetic condition and parents of children with specific genetic (...) conditions were surveyed by questionnaire for reports of genetic discrimination. A total of 27,790 questionnaires were sent out by mail. Of 917 responses received, 206 were followed up with telephone interviews. The responses were analyzed regarding circumstances of the alleged discrimination, the institutions involved, issues relating to the redress of grievances, and strategies to avoid discrimination. (shrink)

We report the results of a randomized trial to assess the impact of an innovative ethics curriculum on the knowledge and confidence of 85 medical house officers in a university hospital programme, as well as their responses to a simulated clinical case. Twenty-five per cent of the house officers received a lecture series, 25 per cent received lectures and case conferences, with an ethicist in attendance, and 50 per cent served as controls. A post-intervention questionnaire was administered. Knowledge scores did (...) not differ among the groups. Confidence regarding ethical issues was significantly greater in the aggregate intervention group compared to the control group. Confidence regarding procedural issues related to ethics was significantly higher for the EI group than for the controls. Responses to a simulated case showed that significantly fewer house officers in the EI group would intubate a patient for whom such therapy would be futile. We conclude that ethics education can have an impact on house officers' confidence and their responses to a simulated case, and that the EI was more effective than the LI. Such results have implications regarding the implementation of ethics education during residency. (shrink)