Research shows that people often do not intervene to stop immoral action from happening. However, limited information is available on why people fail to intervene. Two preregistered studies (Ns = 248, 131) explored this gap in the literature by staging a theft in front of participants and immediately interviewing them to inquire about their reasons for intervening or not intervening. Across both studies, most participants did not try to stop the theft or even report it to the experimenter afterward. Furthermore, (...) many participants reported confusion and inattention as precursors to nonintervention, yielding insight into what inhibits moral courage. (shrink)

Imaginative resistance refers to cases in which one’s otherwise flexible imaginative capacity is constrained by an unwillingness or inability to imaginatively engage with a given claim. In three studies, we explored which specific imaginative demands engender resistance when imagining morally deviant worlds and whether individual differences in emotion predict the degree of this resistance. In Study 1 (N = 176), participants resisted the notion that harmful actions could be morally acceptable in the world of a narrative regardless of the author’s (...) claims about these actions but did not resist imagining that a perpetrator of harm could believe their actions to be morally acceptable. In Study 2 (N = 167) we replicated the findings of Study 1 and showed that imaginative resistance is greatest among participants who experience more negative affect in response to imagining harm and are lower in either trait anxiety or trait psychopathy. In Study 3 (N = 210) we show that this is the case even when the harms assessed include both low-severity (i.e., emotional harm) and high-severity (i.e., killing) cases. Thus, people’s moral beliefs constrain their ability to imagine hypothetical moral alternatives, although this ability systematically varies on the basis of stable individual differences in emotion. (shrink)

The philosopher Graham Harman argues that contemporary debates about the nature of reality as such, and about the nature of objects in particular, can be meaningfully applied to social theory and practice. With Immaterialism, he has recently provided a case-based demonstration of how this could happen. But social theorists have compelling reasons to oppose object-oriented social theory’s 15 principles. Fidelity to Harman’s aesthetic foundationalism, and his particular use of serial endosymbiosis theory as a mechanism of social change, constrain the very (...) practices which it is supposed to enable. However, social theory stands to benefit from object-oriented philosophy through what we call posthuman relationism – characterised as a commitment to the reality of the nonhuman, but not divorced from the human. The emphasis in object-oriented social theory on how objects withdraw from cognitive or affective capture and representation needs to be tempered by an equal focus on how objects appeal. (shrink)

The Theaetetus’s midwife metaphor contains a puzzling feature, often referred to as the “midwife paradox”: the physical midwives must have first given birth to their own children in order to have the necessary experience to practice their art. Socrates, however, seems to disavow having any children of his own and thus appears to be unqualified to practice philosophical midwifery. In this paper, I aim to dissolve the midwife paradox by arguing that it rests on problematic assumptions, namely, that Socrates never (...) gave birth to a child at all or the child of wisdom in particular, and that he is primarily an intellectual midwife. I offer a new interpretation of Socratic midwifery, arguing that what Socrates may have birthed in the past which qualifies him for midwifery is his virtuous recognition of his ignorance, and that this “epistemic virtue” is also the proximate goal of Socratic midwifery. (shrink)

Recent debates over the role of recognition by the community for one’s development and flourishing generally discuss community in a univocal sense: the way that recognition functions in particular communities is not fundamentally different from the way it functions in the larger community. They also tend to logically prioritize a fundamental human identity over particular religious, ethnic, or societal identities, which are understood to be secondary to, and derivative of, this basic identity. In his depiction of how communal recognition contributes (...) to individual selfhood, Søren Kierkegaard challenges these accounts by (1) differentiating between how communal recognition occurs in society in general and in one particular community, the Christian church and (2) questioning the idea that the self created in the former is more fundamental than that created in the latter. For Kierkegaard, one’s identities as both a Christian and a fully-developed self depend essentially on recognition by the Other: initially and fundamentally on recognition by God alone, and secondarily and derivatively on recognition by the human Other. (shrink)

Though we often “fear the worst”, worrying that unexpectedly bad things will happen, there are times when we “hope for the best”, imagining that unexpectedly good things will happen, too. The paper explores how the valence of the current situation influences people's imagining of unexpected future events when participants were instructed to think of “something unexpected”. In Experiment 1, participants (N = 127) were asked to report unexpected events to everyday scenarios under different instructional conditions (e.g., asked for “good” or (...) “bad” unexpected events), and manifested a strong negativity bias in response to non-valenced instructions (i.e., being asked to “think of the unexpected” with no valence given). They mainly reported quite “predictable” unexpected outcomes that were negative; however, a post-test (N = 31) showed that the scenarios used were predominantly positive. In Experiment 2 (N = 257), when participants were instructed to think of “something unexpected and bizarre”, under the same instructional manipulations as Experiment 1, this negativity bias was replicated. In Experiment 3, using a design in which positive/negative materials were matched (verified by a pre-test, N = 60), it was found that when participants (N = 102) were given negative scenarios, they reported more positive events than they do when they are given positive scenarios. Though responding still retained an overwhelming negative bias, this result provided some evidence for a weaker valence-countering strategy; that is, where a negative scenario can lead to positive unexpected events being mentioned, and a positive scenario leads to negative unexpected events being reported. The implications of these results for people's projections of unexpected futures in their everyday lives is discussed. (shrink)

Gestures are a special sort of action. They communicate the individual's moods and desires to the world and they operate under different psychological and cognitive constraints to other actions. The connections between gesture and language - spoken and signed - pose some fascinating questions. How intimately are gesture and language connected? Did one evolve from the other? To what extent are they similarly processed in the brain? In what ways are signed languages akin to spoken language and gestures? Gesture, Speech, (...) and Sign examines these questions, bringing together an international array of expertise to explore the origins, neurobiology, and uses of these three communication systems. A unique feature of the book is its discussion of how a greater understanding of these issues can be used to improve human-computer interactions. Designed to appeal to a multi-disciplinary audience Gesture, Speech, and Sign will be of interest to advanced students and researchers in neuroscience, psychology, linguistics, computer science, and those involved in deaf studies. (shrink)

Because of Paul’s egalitarianism evidenced in his concern for an inclusive salvation that did not discriminate against gentiles, it is widely assumed that Paul opposed all ethnic distinctions as contrary to the message of Christ. A close look at his letters, especially the letter to the Romans, shows that whilst Paul, because of his belief in the impartiality of God, argues against discrimination, he does differentiate clearly between Jew and Greek and does not oppose ethnic distinctions as such. What Paul (...) opposes is the hostility that emerges from a failure to recognize and accept the other in their distinctive identity. He is thus an advocate of social and cultural diversity rather than of uniformity. (shrink)

Background: Omalizumab, an anti-immunoglobulin E antibody, reduces exacerbations and symptoms in uncontrolled allergic asthma. The study objective was to estimate the costs and consequences of omalizumab compared to usual care from a US payer perspective. Methods: We estimated payer costs, quality-adjusted survival (QALYs), and the incremental cost-effectiveness ratio (ICER) of omalizumab compared to usual care using a state-transition simulation model that included sensitivity analyses. Every 2 weeks, patients could transition between chronic asthma and exacerbation health states. The best available evidence (...) informed the clinical and cost input estimates. Five years of omalizumab treatment followed by usual care was assumed to estimate a lifetime horizon. Omalizumab responders (60.5% of treated) were modeled as a separate scenario where nonresponders reverted back to usual care after 16 weeks of active treatment. Results: The mean lifetime discounted costs and QALYs were $83 400 and 13.87 for usual care and $174 500 and 14.19 for omalizumab plus usual care resulting in $287 200/QALY (95% interval: $219 300, $557 900). The ICER was $172 300/QALY when comparing omalizumab to usual care in the responder scenario. One-way sensitivity analyses indicated that the results were sensitive to the difference in treatment-specific utilities for the chronic state, exacerbation-associated mortality, omalizumab price, exacerbation rates, and response definition. Conclusions: The results suggest that adding omalizumab to usual care improves QALYs at an increase in direct medical costs. The cost-effectiveness of omalizumab is similar to other chronic disease biologics. The value increases when omalizumab response is used to guide long-term treatment. (shrink)

BackgroundCommunity engagement within biomedical research is broadly defined as a collaborative relationship between a research team and a group of individuals targeted for research. A Community Advisory Board is one mechanism of engaging the community. Within genomics research CABs may be particularly relevant due to the potential implications of research findings drawn from individual participants on the larger communities they represent. Within such research, CABs seek to meet instrumental goals such as protecting research participants and their community from research-related risks, (...) as well as intrinsic goals such as promoting the respect of participants and their community. However, successful community engagement depends on the degree to which CABs legitimately represent and engage with communities targeted for research. Currently, there is little literature describing the use of CABs in genomics research taking place in developing countries, and even less in the field of genomics research relating to mental illness. The aim of this article is to describe and consider the contributions made by a researcher-driven, population-specific CAB in a genomics of schizophrenia research project taking place in South Africa, from the perspective of the research team.DiscussionFour broad discussion topics emerged during the CAB meetings namely: 1) informed consent procedures, 2) recruitment strategies, 3) patient illness beliefs and stigma experiences, and 4) specific ethical concerns relating to the project. The authors consider these discussions in terms of their contributions to instrumental and intrinsic goals of community engagement.SummaryThe CAB gave valuable input on the consent processes and materials, recruitment strategies and suggested ways of minimizing the potential for stigma and discrimination. All of these contributions were of an instrumental nature, and helped improve the way in which the research took place. In addition, and perhaps more importantly, the CAB made a unique and important contribution relating to intrinsic functions such as promoting the respect and dignity of research participants and their community. This was particularly evident in ensuring sensitivity and respect of the community’s traditional beliefs about schizophrenia and its treatment, and in this way promoting a respectful relationship between the research team and the participants. (shrink)

Three main issues are of cardinal interest in this paper. The first issue relates to the canons of discourse—the parameters that inform and guide any discussion—in African philosophy. These canons are accepted in one form or the other by the philosophers who have actually formulated some of them and those who have devoted their academical careers to the promotion of the positive study of African philosophy. Consequently this paper should be viewed in the same light as C.E.M. Joad's A Critique (...) of Logical Positivism in which the “Great Tradition” in philosophy is classically expounded and defended against the onslaught of the philosophical exuberance and extraordinary claims of the logical positivists in the sense that it is a rejoinder to the attack on African philosophy by those who actually may want to be known as African logical neo-positivists. (shrink)

The question the author explores in this paper is whether Paul's stance on retaining one's ethnic identity which eventually was lost when the church became predominantly gentile was already lost by the time the letter to the Ephesians was written around 90 CE at the latest. The point is that Christ does not merely bring peace of mind, psychological well-being, but shalom, the total health and well-being of being right with God and finding peace even with enemies. It is a (...) real political and social peace that Christ enables and demands of those who truly belong to His kingdom. As Eph. 1-2 indicates, through the power of Christ hostility arising from difference can be turned into a cause of celebration of the blessings of God in Christ. (shrink)

This case describes an adolescent in a crisis of a chronic medical condition whose situation is complicated by substance abuse and mental illness. D. Micah Hester provides an analytic approach, teasing apart the multiple layers of medical, developmental, and moral issues at hand and describing possible responses and outcomes. Amy T. Campbell examines existing legal guidelines for adolescent decision making, arguing that greater space exists for clinical discretion in these matters than commonly thought. Cheryl D. Lew discusses the development (...) of agency in adolescent patients, the ideal of autonomous decision making in the context of impairment and chronic illness, and the obligation of healthcare teams to examine an adolescent patient’s decisions in relation to her identity. (shrink)

The aim of this systematic review was to summarize and assess the quality of asthma intervention health economic studies from 2002 to 2007, compare the study findings with clinical management guidelines, and suggest avenues for future improvement of asthma health economic studies. Forty of the 177 studies met our inclusion criteria. We assessed the quality of studies using The Quality of Health Economic Studies validated instrument (total score range: 0-100). Six studies (15%) had quality category 2, 26 studies (65%) achieved (...) quality category 3, and the remaining eight (20%) studies were scored as the highest quality level, category 4. Overall, the findings from this review are in line with the Global Initiative for Asthma clinical guidelines. Many asthma health economic studies lacked appropriate long term time horizons to match the chronic nature of the disease and suffered from using effectiveness measures that did not capture all disease related risks and benefits. We recommend that new asthma simulation models: be flexible to allow for long term time horizons, focus on using levels of asthma control in their structure, and estimate both long term asthma specific outcomes like well-controlled time as well as generic outcomes such as quality adjusted survival. (shrink)

Book reviewed in this article: Duties to Others. Edited by Courtney S. Campbell and B. Andrew Lustig.

This article sets out a descriptive typology of religious perspectives on legalized euthanasia—political advocacy, individual conscience, silence, embedded opposition, and formal public opposition—and then examines the normative basis for these perspectives through the themes of sovereignty, stewardship, and the self. It also explores the public relevance of these religious perspectives for debates over legalized euthanasia, particularly in the realm of public policy. Ironically, the moral discourse of religious traditions on euthanasia may gain public relevance at the expense of its religious (...) content. Nonetheless, religious traditions can provide a context of ultimacy and meaning to this debate, which is a condition for genuine pluralism. A table setting out the views of various denominations with regard to euthanasia is included. (shrink)

During a pandemic, where there is widespread human infection, various and varying measures are taken that are targeted at public health objectives. During the early stages of a pandemic, these objectives may focus on containing the disease and minimizing its spread, but they may switch to mitigation as the emergent infectious disease takes hold in a population. There has been considerable debate and elucidation of the ethical principles and framework for the various responses including the need to fast track research (...) and vaccine development. However, the measures imposed during a pandemic would have unintended and untoward effect on ongoing clinical research. For example, precautionary measures, such as social distancing, may hamper ongoing clinical research, because recruitment and participation of patients and healthy volunteers is a potential source of virus spread. In this paper, we argue that a framework is needed to ensure the continuity of such research. Such a framework that considers the pertinent issues would need the ‘buy in’ of the key stakeholders (policy makers, funding agencies, institutional authorities, researchers and subjects) to ensure that the issues that are ethically relevant to pandemic planning would not be neglected or overlooked. (shrink)

We not only own our bodies, we are our bodies. Can we simply alienate parts of them? Both a theology of stewardship and the principle of self‐ownership would seem to permit or even encourage us to do this.