Uncivil behavior by leaders may be viewed as an effective way to motivate employees. However, supervisor incivility, as a form of unethical supervision, may be undercutting employees’ ability to do their jobs. We investigate linkages between workplace incivility and perceived work ability, a variable that captures employees’ appraisals of their ability to continue working in their jobs. We draw upon the appraisal theory of stress and social identity theory to examine incivility from supervisors as an antecedent to PWA, and to (...) investigate job involvement and grit as joint moderators of this association. Results from data collected in two samples of working adults provided evidence for three-way interactions in relation to PWA. Among employees with high levels of grit, there was no significant relation between supervisor incivility and PWA, regardless of employee job involvement. However, we found some evidence that for those low in grit, having high job involvement was associated with a stronger relationship between supervisor incivility and PWA. Findings attest to the importance of unethical supervisor behavior, showing the potential for supervisor incivility to erode PWA, as well as the importance of grit as a potential buffer. (shrink)

The Idea of Disability in the Eighteenth Century is a wide-ranging collection of essays that explores philosophy, biography, and texts about and by disabled people living in the eighteenth century. The book, which introduces and affirms the notion that disability studies predates most United States and United Kingdom findings by more than a hundred years, will be of interest to philosophers, historians, sociologists, and literary scholars.

In this paper, I examine the transition from zymotic views of disease to germ views in Britain in the mid-1800s. I argue that neither realist nor anti-realist accounts of theory-change can account for this case, because both rely on a well-defined notion of theory, which, as the paper will show, is inapplicable in this instance. After outlining the zymotic theory of disease, I show that, even though it hardly had anything in common with the germ theory, it was highly successful. (...) However, despite this success, it is not possible to identify stable elements that were carried over to the germ theory; thus, realists cannot account for the shift from one to the other. Anti-realists, however, don’t do much better: their focus tends to be on (radical) discontinuities across theories, yet the zymotic case does not exemplify this, either. Instead, there is a slow and complex evolution from zymotic to germ views, during which various zymotic elements are assimilated into the germ theory, until, eventually, none of the zymotic theory’s original elements are left. (shrink)

The author recounts some of the early history of what is now known as MBSR, and its relationship to mainstream medicine and the science of the mind/body connection and health. He stresses the importance that MBSR and other mindfulness-based interventions be grounded in a universal dharma understanding that is congruent with Buddhadharma but not constrained by its historical, cultural and religious manifestations associated with its counties of origin and their unique traditions. He locates these developments within an historic confluence of (...) two very different epistemologies encountering each other for the first time, that of science and that of the meditative traditions. The author addresses the ethical ground of MBSR, as well as questions of lineage and of skillful ?languaging? and other means for maximizing the possibility that the value of cultivating mindfulness in the largest sense can be heard and embraced and cultivated in commonsensical and universal ways in secular settings. He directly addresses mindfulness-based instructors on the subject of embodying and drawing forth the essence of the dharma without depending on the vocabulary, texts, and teaching forms of traditional Buddhist environments, even though they are important to know to one degree or another as part of one's own development. The author's perspective is grounded in what the Zen tradition refers to as the one thousand year view. Although it is not stated explicitly in this text, he sees the current interest in mindfulness and its applications as signaling a multi-dimensional emergence of great transformative and liberative promise, one which, if cared for and tended, may give rise to a flourishing on this planet akin to a second, and this time global, Renaissance, for the benefit of all sentient beings and our world. (shrink)

Background Regarding controversial medical services, many have argued that if physicians cannot in good conscience provide a legal medical intervention for which a patient is a candidate, they should refer the requesting patient to an accommodating provider. This study examines what US physicians think a doctor is obligated to do when the doctor thinks it would be immoral to provide a referral. Method The authors conducted a cross-sectional survey of a random sample of 2000 US physicians from all specialties. The (...) primary criterion variable was agreement that physicians have a professional obligation to refer patients for all legal medical services for which the patients are candidates, even if the physician believes that such a referral is immoral. Results Of 1895 eligible physicians, 1032 (55%) responded. 57% of physicians agreed that doctors must refer patients regardless of whether or not the doctor believes the referral itself is immoral. Holding this opinion was independently associated with being more theologically pluralistic, describing oneself as sociopolitically liberal, and indicating that respect for patient autonomy is the most important bioethical principle in one's practice (multivariable ORs, 1.6–2.4). Conclusions Physicians are divided about a professional obligation to refer when the physician believes that referral itself is immoral. These data suggest there is no uncontroversial way to resolve conflicts posed when patients request interventions that their physicians cannot in good conscience provide. (shrink)

Macroeconomic dynamics and the at-risk-of-poverty population in Slovakia This paper deals with analysis and presentation of the core findings under the EU SILC 2009 project. Particularly we are oriented on study of the socially vulnerable groups of population identified according their income situation. As a sorting criterion for this purpose we use the standard methodology set by OECD and Eurostat. It means the 60% of the national median equivalized disposable income is applied for this criterion as the poverty threshold. The (...) national income variable is firstly calculated as a total income for each surveyed household and dived by the equivalized size of household. By this procedure the households of various structures are transformed onto generally accepted scale. The special attention of our study is oriented on the cluster of population living on income below the poverty threshold. For this population we calculate so called social deficit. Through this value we show the volume of financial means needed to upgrade the living standard of the population living bellow poverty threshold at least to the poverty threshold level.Special section of the paper is devoted to study of relation among the core macroeconomic indicators and level and size of the at-risk-of-poverty population during the period of last economic development, including both economic growth and economic recession. According our tentative findings we did not find the significant impact of economic growth on the status of socially vulnerable population. This finding however should be studied in broader context, with longer time series of relevant data and with broader set of explanatory variables. (shrink)

Although the field of surgical ethics focuses primarily on informed consent, surgical decision‐making, and research ethics, some surgeons have started to consider ethical questions regarding justice and solidarity with poor and minoritized populations. To date, those calling for social justice in surgical care have emphasized increased diversity within the ranks of the surgical profession. This article, in contrast, foregrounds the agency of those most affected by injustice by bringing to bear an ethic of accompaniment. The ethic of accompaniment is born (...) from a theological tradition that has motivated work to improve health outcomes in those at the margins through its emphasis on listening, solidarity against systemic drivers of disease, and proximity to individuals and communities. Through a review of surgical ethics and exploration of a central patient case, we argue for applying an ethic of accompaniment to the care of surgical patients and their communities. (shrink)

Background Although medical ethicists and educators emphasise patient-centred decision-making, previous studies suggest that patients often prefer their doctors to make the clinical decisions. Objective To examine the associations between a preference for physician-directed decision-making and patient health status and sociodemographic characteristics. Methods Sociodemographic and clinical information from all consenting general internal medicine patients at the University of Chicago Medical Center were examined. The primary objectives were to (1) assess the extent to which patients prefer an active role in clinical decision-making, (...) and (2) determine whether religious service attendance, the importance of religion, self-rated spirituality, Charlson Comorbidity Index, self-reported health, Vulnerable Elder Score and several demographic characteristics were associated with these preferences. Results Data were collected from 8308 of 11 620 possible participants. Ninety-seven per cent of respondents wanted doctors to offer them choices and to consider their opinions. However, two out of three (67%) preferred to leave medical decisions to the doctor. In multiple regression analyses, preferring to leave decisions to the doctor was associated with older age (per year, OR=1.019, 95% CI 1.003 to 1.036) and frequently attending religious services (OR=1.5, 95% CI 1.1 to 2.1, compared with never), and it was inversely associated with female sex (OR=0.6, 95% CI 0.5 to 0.8), university education (OR=0.6, 95% CI 0.4 to 0.9, compared with no high school diploma) and poor health (OR=0.6, 95% CI 0.3 to 0.9). Conclusions Almost all patients want doctors to offer them choices and to consider their opinions, but most prefer to leave medical decisions to the doctor. Patients who are male, less educated, more religious and healthier are more likely to want to leave decisions to their doctors, but effects are small. (shrink)

(2011). Mindfulness: diverse perspectives on its meaning, origins, and multiple applications at the intersection of science and dharma. Contemporary Buddhism: Vol. 12, Mindfulness: diverse perspectives on its meaning, origins, and multiple applications at the intersection of science and dharma, pp. 1-18. doi: 10.1080/14639947.2011.564811.

We take up the challenge of developing an international network with capacity to survey the world's scientists on an ongoing basis, providing rich datasets regarding the opinions of scientists and scientific sub-communities, both at a time and also over time. The novel methodology employed sees local coordinators, at each institution in the network, sending survey invitation emails internally to scientists at their home institution. The emails link to a ‘10 second survey’, where the participant is presented with a single statement (...) to consider, and a standard five point Likert scale. In June 2023, a group of 30 philosophers and social scientists invited 20,085 scientists across 30 institutions in 12 countries to participate, gathering 6,807 responses to the statement 'Science has put it beyond reasonable doubt that COVID-19 is caused by a virus'. The study demonstrates that it is possible to establish a global network to quickly ascertain scientific opinion on a large international scale, with high response rate, low opt-out rate, and in a way that allows for significant (perhaps indefinite) repeatability. Measuring scientific opinion in this new way would be a valuable complement to currently available approaches, potentially informing policy decisions and public understanding across diverse fields. (shrink)

What would it be for a process to happen backwards in time? Would such a process involve different causal relations? It is common to understand the time-reversal invariance of a physical theory in causal terms, such that whatever can happen forwards in time can also happen backwards in time. This has led many to hold that time-reversal symmetry is incompatible with the asymmetry of cause and effect. This article critiques the causal reading of time reversal. First, I argue that the (...) causal reading requires time-reversal-related models to be understood as representing distinct possible worlds and, on such a reading, causal relations are compatible with time-reversal symmetry. Second, I argue that the former approach does, however, raise serious sceptical problems regarding the causal relations of paradigm causal processes and as a consequence there are overwhelming reasons to prefer a non-causal reading of time reversal, whereby time reversal leaves causal relations invariant. On the non-causal reading, time-reversal symmetry poses no significant conceptual nor epistemological problems for causation. _1_ Introduction _1.1_ The directionality argument _1.2_ Time reversal _2_ What Does Time Reversal Reverse? _2.1_ The B- and C-theory of time _2.2_ Time reversal on the C-theory _2.3_ Answers _3_ Does Time Reversal Reverse Causal Relations? _3.1_ Causation, billiards, and snooker _3.2_ The epistemology of causal direction _3.3_ Answers _4_ Is Time-Reversal Symmetry Compatible with Causation? _4.1_ Incompatibilism _4.2_ Compatibilism _4.3_ Answers _5_ Outlook. (shrink)

Experiences of motion and change are widely taken to have a ‘flow-like’ quality. Call this ‘temporal qualia’. Temporal qualia are commonly thought to be central to the question of whether time objectively passes: (1) passage realists take temporal passage to be necessary in order for us to have the temporal qualia we do; (2) passage antirealists typically concede that time appears to pass, as though our temporal qualia falsely represent time as passing. I reject both claims and make the case (...) that passage-talk plays no useful explanatory role with respect to temporal qualia, but rather obfuscates what the philosophical problem of temporal qualia is. I offer a ‘reductionist’ account of temporal qualia that makes no reference to the concept of passage and argue that it is well motivated by empirical studies in motion perception. (shrink)

“The universe is expanding, not contracting.” Many statements of this form appear unambiguously true; after all, the discovery of the universe’s expansion is one of the great triumphs of empirical science. However, the statement is time-directed: the universe expands towards what we call the future; it contracts towards the past. If we deny that time has a direction, should we also deny that the universe is really expanding? This article draws together and discusses what I call ‘C-theories’ of time — (...) in short, philosophical positions that hold time lacks a direction — from different areas of the literature. I set out the various motivations, aims, and problems for C-theories, and outline different versions of antirealism about the direction of time. (shrink)

Much attention has been focused in recent years on the ethical acceptability of physicians receiving gifts from drug companies. Professional guidelines recognize industry gifts as a conflict of interest and establish thresholds prohibiting the exchange of large gifts while expressly allowing for the exchange of small gifts such as pens, note pads, and coffee. Considerable evidence from the social sciences suggests that gifts of negligible value can influence the behavior of the recipient in ways the recipient does not always realize. (...) Policies and guidelines that rely on arbitrary value limits for gift-giving or receipt should be reevaluated. (shrink)

Modern physics has provided a range of motivations for holding time to be fundamentally undirected. But how does a temporally adirectional metaphysics, or ‘C-theory’ of time, fit with the time of experience? In this chapter, I look at what kind of problem human time poses for C-theories. First, I ask whether there is a ‘hard problem’ of human time: whether it is in principle impossible to have the kinds of experience we do in a temporally adirectional world. Second I consider (...) the ‘easy problem’: how specific directed aspects of our temporal experience are to be explained by C-theorists. This leads to a greater issue: is there such a thing as an experience of time direction at all to even be explained? I show how the kinds of experience we have that we typically associate with the idea of time being directed can be accommodated within a directionless picture of time. (shrink)

Bertrand Russell famously argued that causation is not part of the fundamental physical description of the world, describing the notion of cause as “a relic of a bygone age”. This paper assesses one of Russell’s arguments for this conclusion: the ‘Directionality Argument’, which holds that the time symmetry of fundamental physics is inconsistent with the time asymmetry of causation. We claim that the coherence and success of the Directionality Argument crucially depends on the proper interpretation of the ‘ time symmetry’ (...) of fundamental physics as it appears in the argument, and offer two alternative interpretations. We argue that: if ‘ time symmetry’ is understood as the time -reversal invariance of physical theories, then the crucial premise of the Directionality Argument should be rejected; and if ‘ time symmetry’ is understood as the temporally bidirectional nomic dependence relations of physical laws, then the crucial premise of the Directionality Argument is far more plausible. We defend the second reading as continuous with Russell’s writings, and consider the consequences of the bidirectionality of nomic dependence relations in physics for the metaphysics of causation. (shrink)

Today's medicine is spiritually deflated and morally adrift; this book explains why and offers an ethical framework to renew and guide practitioners in fulfilling their profession to heal. What is medicine and what is it for? What does it mean to be a good doctor? Answers to these questions are essential both to the practice of medicine and to understanding the moral norms that shape that practice. The Way of Medicine articulates and defends an account of medicine and medical ethics (...) meant to challenge the reigning provider of services model, in which clinicians eschew any claim to know what is good for a patient and instead offer an array of "health care services" for the sake of the patient's subjective well-being. Against this trend, Farr Curlin and Christopher Tollefsen call for practitioners to recover what they call the Way of Medicine, which offers physicians both a path out of the provider of services model and also the moral resources necessary to resist the various political, institutional, and cultural forces that constantly push practitioners and patients into thinking of their relationship in terms of economic exchange. Curlin and Tollefsen offer an accessible account of the ancient ethical tradition from which contemporary medicine and bioethics has departed. Their investigation, drawing on the scholarship of Leon Kass, Alasdair MacIntyre, and John Finnis, leads them to explore the nature of medicine as a practice, health as the end of medicine, the doctor-patient relationship, the rule of double effect in medical practice, and a number of clinical ethical issues from the beginning of life to its end. In the final chapter, the authors take up debates about conscience in medicine, arguing that rather than pretending to not know what is good for patients, physicians should contend conscientiously for the patient's health and, in so doing, contend conscientiously for good medicine. The Way of Medicine is an intellectually serious yet accessible exploration of medical practice written for medical students, health care professionals, and students and scholars of bioethics and medical ethics. (shrink)

Cognitive Science, Volume 46, Issue 6, June 2022.

This paper assesses branching spacetime theories in light of metaphysical considerations concerning time. I present the A, B, and C series in terms of the temporal structure they impose on sets of events, and raise problems for two elements of extant branching spacetime theories—McCall’s ‘branch attrition’, and the ‘no backward branching’ feature of Belnap’s ‘branching space-time’—in terms of their respective A- and B-theoretic nature. I argue that McCall’s presentation of branch attrition can only be coherently formulated on a model with (...) at least two temporal dimensions, and that this results in severing the link between branch attrition and the flow of time. I argue that ‘no backward branching’ prohibits Belnap’s theory from capturing the modal content of indeterministic physical theories, and results in it ascribing to the world a time-asymmetric modal structure that lacks physical justification. (shrink)

It is often said that the world is explained by laws of nature together with initial conditions. But does that mean initial conditions don’t require further explanation? And does the explanatory role played by initial conditions entail or require that time has a preferred direction? This chapter looks at the use of the ‘initialness defence’ in physics, the idea that initial conditions are intrinsically special in that they don’t require further explanation, unlike the state of the world at other times. (...) Such defences commonly assume a primitive directionality of time to distinguish between initial and final conditions. Using the case study of the time-asymmetry of thermodynamics and the so-called ‘past hypothesis’ — the hypothesis that the early universe was in a state of very low entropy —, I outline and support a deflationary account of the initialness defence that does not pre- suppose a basic directionality of time, and argue that there is a relevant explanatory asymmetry between initial conditions and the state of systems at other times only if certain causal conditions are satisfied. Hence, the initialness defence is available to those who reject a fundamental direction of time. (shrink)

In what sense is the direction of time a matter of convention? In 'The Direction of Time', Hans Reichenbach makes brief reference to parallels between his views about the status of time’s direction and his conventionalism about geometry. In this article, I: (1) provide a conventionalist account of time direction motivated by a number of Reichenbach’s claims in the book; (2) show how forwards and backwards time can give equivalent descriptions of the world despite the former being the ‘natural’ direction (...) of time; and (3) argue that this offers an important middle-ground position between existing realist and antirealist accounts of the direction of time. (shrink)

The increasing use of opioid treatment agreements has prompted debate within the medical community about ethical challenges with respect to their implementation. The focus of debate is usually on the efficacy of OTAs at reducing opioid misuse, how OTAs may undermine trust between physicians and patients and the potential coercive nature of requiring patients to sign such agreements as a condition for receiving pain care. An important consideration missing from these conversations is the potential for racial bias in the current (...) way that OTAs are incorporated into clinical practice and in the amount of physician discretion that current opioid guidelines support. While the use of OTAs has become mandatory in some states for certain classes of patients, physicians are still afforded great leeway in how these OTAs are implemented in clinical practice and how their terms should be enforced. This paper uses the guidelines provided for OTA implementation by the states of Indiana and Pennsylvania as case studies in order to argue that giving physicians certain kinds of discretion may exacerbate racial health disparities. This problem cannot simply be addressed by minimising physician discretion in general, but rather by providing mechanisms to hold physicians accountable for how they treat patients on long-term opioid therapy to ensure that such treatment is equitable. There are no data in this work. (shrink)

In this paper we theorize that cognitive ethical orientations play an influential role in the beliefs of consumers when faced with different ranges of moral dilemmas. We examine this proposition in transitional Eastern Europe and results from a sample of 210 Romanian consumers suggest that Romanians are faced with a moral situation where low levels of Machiavellianism and high levels of idealism appear to relate to a higher ethical concern about passively benefiting at the expense of others.

It is common wisdom that today’s medicine focuses too much on treating those who are sick and too little on preventing the sickness in the first place. This essay proposes that Jesus’ teaching in the Sermon on the Mount challenges that assumption and the preventive medicine to which it has given rise. In light of Jesus’ teaching, the essay identifies four apparent problems with much of preventive medicine. It then offers four heuristics that might form a basic Christian logic for (...) medicalizing risk—for discerning when and why it would be fitting, wise, and faithful for Christians to make use of medicine to avoid future illness and death. (shrink)

Research addressing the challenges emerging from the development and diffusion of digital technologies has grown rapidly in recent years. However, much of this literature tends to overlook the immersion of these technologies into our everyday lives. This everyday digitalization cannot be reduced to specific technological innovations and is obviously a crucial aspect of the social changes introduced by digital technologies. This themed issue sets out to explore the everyday dimension of digitalization, in the specific context of agri-food systems. We propose (...) a collection of papers that contribute to opening new approaches to digitalization in food and agriculture, by concentrating the attention on the mundane and ordinary aspects of digitalization and exploring their potential contributions to profound transformations in agri-food systems. The various forms of everyday digitalization that are presented in this symposium offer two particular ways of critically engaging with the digitalization of agriculture and food. Firstly, our everyday digitalization looks beyond examining the impacts of digitalization and positioning digital technologies in opposition to farmers, consumers, government, or other actors. Secondly, we shed light on the politics of uncertainty, which enables us to make anticipatory actions and see things beyond success and failure. What we observe is how these imaginaries participate in the co-production of digital realities through their encounter with the complexity of everyday life. Therefore, it remains essential to engage critically with both the imaginary and the everyday dimensions of digitalization in their multiplicity. (shrink)

This essay systematically reformulates an earlier argument about Locke and new world slavery, adding attention to Indians, natural law, and Locke's reception. Locke followed Grotian natural law in constructing a just-war theory of slavery. Unlike Grotius, though, he severely restricted the theory, making it inapplicable to America. It only fit resistance to "absolute power" in Stuart England. Locke was nonetheless an agent of British colonialism who issued instructions governing slavery. Yet they do not inform his theory--or vice versa. This creates (...) hermeneutical problems and raises charges of racism. If Locke deserves the epithet "racist," it is not for his having a racial doctrine justifying slavery. None of this makes for a flattering portrait. Locke's reputation as the champion of liberty would not survive the contradictions in which new world slavery ensnared him. Evidence for this may be found in Locke's reception, including by Southern apologists for slavery. (shrink)

We take up the challenge of developing an international network with capacity to survey the world’s scientists on an ongoing basis, providing rich datasets regarding the opinions of scientists and scientific sub-communities, both at a time and also over time. The novel methodology employed sees local coordinators, at each institution in the network, sending survey invitation emails internally to scientists at their home institution. The emails link to a ‘10 second survey’, where the participant is presented with a single statement (...) to consider, and a standard five-point Likert scale. In June 2023, a group of 30 philosophers and social scientists invited 20,085 scientists across 30 institutions in 12 countries to participate, gathering 6,807 responses to the statement Science has put it beyond reasonable doubt that COVID-19 is caused by a virus. The study demonstrates that it is possible to establish a global network to quickly ascertain scientific opinion on a large international scale, with high response rate, low opt-out rate, and in a way that allows for significant (perhaps indefinite) repeatability. Measuring scientific opinion in this new way would be a valuable complement to currently available approaches, potentially informing policy decisions and public understanding across diverse fields. (shrink)

There is a vast literature that seeks to uncover features underlying moral judgment by eliciting reactions to hypothetical scenarios such as trolley problems. These thought experiments assume that participants accept the outcomes stipulated in the scenarios. Across seven studies, we demonstrate that intuition overrides stipulated outcomes even when participants are explicitly told that an action will result in a particular outcome. Participants instead substitute their own estimates of the probability of outcomes for stipulated outcomes, and these probability estimates in turn (...) influence moral judgments. Our findings demonstrate that intuitive likelihoods are one critical factor in moral judgment, one that is not suspended even in moral dilemmas that explicitly stipulate outcomes. Features thought to underlie moral reasoning, such as intention, may operate, in part, by affecting the intuitive likelihood of outcomes, and, problematically, moral differences between scenarios may be confounded with non-moral intuitive probabilities. (shrink)

The shift from classical to relativistic physics significantly altered our conception of time. From a picture of space and time as autonomous concepts, and of reality as divided into moments of time, relativity theory introduced a picture of four-dimensional spacetime, and a 'static' or 'block universe' conception of time. This paper considers how exactly relativity theory clashes with our ordinary folk conception of time and what this ultimately means for how we should think about the nature of time.

For most of the past generation, clinicians have been taught to treat patients' pain until the patient says it is relieved. The opioid crisis has forced both clinicians and patients to reconsider that approach. This essay considers how Christians in particular might assume and seek to overcome their experiences of persistent pain. Wise and faithful responses to pain, especially chronic pain, can take their bearings from how early Christians made sense of the place of both medicine and suffering in a (...) faithful life. This results in not asking medicine to resolve persistent pain, especially not through the use of opioids. Resisting the impulse to medicalize chronic pain will require patience on the part of those who suffer, and both patience and fortitude on the part of the clinicians to whom they present. (shrink)

IntroductionConcussion is a growing public health concern. No uniformly established therapy exists; neurofeedback studies report treatment value. We use infralow frequency neuromodulation to remediate disabling neurological symptoms caused by traumatic brain injury and noted improved outcomes with a novel concussion protocol. Postconcussion symptoms and persistent postconcussion symptoms are designated timelines for protracted neurological complaints following TBI. We performed a retrospective study to explore effectiveness of ILF in PCS/PPCS and investigated the value of using this concussion protocol.MethodPatients with PCS/PPCS seen for (...) their first neurology office visit or received their first neurofeedback session between 1 August 2018 and 31 January 2021 were entered. Outcomes were compared following treatment as usual vs. TAU with ILF neurotherapy. The study cohort was limited to PPCS patients; the TAU+ILF group was restricted further to PPCS patients receiving at least 10 neurotherapy sessions. Within the TAU+ILF group, comparisons were made between those who trained at least 10 sessions using concussion protocol and those who trained for at least 10 sessions of ILF regardless of protocol.ResultsAmong our resultant PPCS cohort leading persistent neurological complaints were headache, memory impairment, and brain fog. PPCS patients in TAU+ILF+CP demonstrated greater net and percent improvement of symptoms compared to PPCS subjects in TAU. PPCS patients in TAU+ILF-CP trended toward significant symptom improvements compared to TAU, and TAU+ILF+CP trended toward greater efficacy than TAU+ILF-CP.ConclusionPPCS patients who received TAU+ILF+CP demonstrated significantly greater improvement as a group when compared to TAU. When used as an integrative modality to treatment as usual in managing patients with PPCS, ILF neuromodulation with use of concussion protocol provided significant symptom improvements. (shrink)

This paper provides an overview of the various dual-use concepts applied in national and international non-proliferation and anti-terrorism legislation, such as the Biological and Toxin Weapons Convention, the Chemical Weapons Convention and United Nations Security Council Resolution 1540, and national export control legislation and in relevant codes of conduct. While there is a vast literature covering dual-use concepts in particular with regard to life sciences, this is the first paper that incorporates into such discussion the United Nations Security Council Resolution (...) 1540. In addition, recent developments such as the extension of dual-use export control legislation in the area of human rights protection are also identified and reviewed. The discussion of dual-use concepts is hereby undertaken in the context of human- and/or national-security-based approaches to security. This paper discusses four main concepts of dual use as applied today in international and national law: civilian versus military, peaceful versus non-peaceful, legitimate versus illegitimate and benevolent versus malevolent. In addition, the usage of the term to describe positive technology spin-offs between civilian and military applications is also briefly addressed. Attention is also given to the roles civil society and research ethics may play in the governance of dual-use sciences and technologies. (shrink)

Question: Do clinicians providing abortion practicing in states that restrict abortion experience more moral distress than those practicing in states that protect abortion? -/- Findings: In this national, purposive survey study of 310 clinicians providing abortion, moral distress was elevated among all clinicians, with those practicing in restrictive states reporting higher levels of moral distress compared with those practicing in protective states. -/- Meaning: The findings suggest that structural changes addressing bans on necessary health care, such as federal protection for (...) abortion, are needed at institutional, state, and federal policy levels to address clinician moral distress. (shrink)

Psychologists and philosophers who pose moral dilemmas to understand moral judgment typically specify outcomes as certain to occur in them. This contrasts with real-life moral decision-making, which is almost always infused with probabilities (e.g., the probability of a given outcome if an action is or is not taken). Seven studies examine sensitivity to the size and location of shifts in probabilities of outcomes that would result from action in moral dilemmas. We find that moral judgments differ between actions that result (...) in an equal increase in probability of harm (equal size), but have different end-states (e.g., an increase in harm probability from 25% to 50% or from 50% to 75%). This deviation from expected value is robust under separate evaluation, and increases when the comparison between shifts is made explicit under simultaneous evaluation. Consistent with the centrality of perceived harm in some models of moral judgment, perceived harm partially mediates sensitivity to location of harm probability shift. Unlike for shifts in harm probabilities, participants are insensitive to the location of shifts in probability of beneficial outcomes. They are also insensitive to the location of shifts in probability of analogous monetary losses and gains, suggesting an asymmetry between harm and benefit in moral reasoning, as well as an asymmetry between moral and monetary decision-making more broadly. Implications for normative philosophical theory and moral psychological theory, as well as practical applications, are discussed. (shrink)

Researchers designing a clinical trial may be aware of disputed evidence of serious risks from previous studies. These researchers must decide whether and how to describe these risks in their model informed consent document. They have an ethical obligation to provide fully informed consent, but does this obligation include notice of controversial evidence? With ACCORD as an example, we describe a framework and criteria that make clear the conditions requiring inclusion of important controversial risks. The ACCORD model consent document did (...) not include notice of prior trials with excess death. We develop and explain a new standard labeled risk in equipoise. We argue that our approach provides an optimal level of integrity to protect the informational needs of the reasonable volunteers who agree to participate in clinical trials. We suggest language to be used in a model consent document and the informed consent discussion when such controversial evidence exists. (shrink)