Children and pregnant women are often excluded from clinical research. This has resulted in a paucity of evidence on how medicines work for fetuses, neonates, infants, and adolescents. It also raises bioethics, scientific, and public health concerns. For over half a century, doctors have prescribed medicines to children largely on the basis of how they work in adults, despite children’s varied physiologies and differences in how their bodies absorb and metabolize drugs. Regulations and legislation have led to an increase in (...) the number of pediatric studies and to better drug labeling. However, children at all stages of their lives often remain “therapeutic orphans” owing to insufficient evidence about how medicines work for them. (shrink)

Friesen et al. (2023) article explores tensions within institutional review boards (IRBs) when they aim both to protect participants from harm and to include under-represented populations in clinic...

Could an accreditation, certification, or rating mechanism help the pharmaceutical industry improve both its bioethical performance and its public reputation? Other industries have used such systems to assess, improve, distinguish, and demonstrate the quality of their services, processes, and products. These systems have also helped increase transparency, accountability, stakeholder confidence, and awareness of industry best practices. This article explains how market forces can be harnessed to recognize and promote better bioethical performance by pharmaceutical companies when there are good systems to (...) accredit, certify, or rate. It concludes with a review of relevant failures of credit-rating agencies — such as conflicts of interests and revolving-door practices — to illuminate some of the pitfalls of developing a bioethics accreditation, certification, or rating system for pharmaceutical companies. (shrink)

Timothy Murphy argues in his article “In Defense of Irreligious Bioethics” (2012) that the role of religion in normative bioethics should be limited and that a viable means for limiting its role (o...

In 1971, President Richard Nixon declared a “war against cancer,” stating that “the same kind of concentrated effort that split the atom and took man to the moon should be turned toward conquering this dread disease.” Nixon signed the National Cancer Act, and shortly thereafter the first national registry listing all ongoing clinical trials for cancer therapies was published by the National Cancer Institute. The registry was proposed by Mary Lasker (“a patroness and advocate of clinical research”) to help doctors (...) find open trials in which to enroll their patients and to help researchers maintain a steady supply of research participants. The registry appeared to be a win for doctors, patients, researchers, and pharmaceutical companies alike. However, it ended up exposing corrupt practices and tensions between ethics, the corporate need for profits, and public health goals. How did this happen? (shrink)

A novel Protocol Ethics Tool Kit (‘Ethics Tool Kit’) has been developed by a multi-stakeholder group of the Multi-Regional Clinical Trials Center of Brigham and Women9s Hospital and Harvard. The purpose of the Ethics Tool Kit is to facilitate effective recognition, consideration and deliberation of critical ethical issues in clinical trial protocols. The Ethics Tool Kit may be used by investigators and sponsors to develop a dedicated Ethics Section within a protocol to improve the consistency and transparency between clinical trial (...) protocols and research ethics committee reviews. It may also streamline ethics review and may facilitate and expedite the review process by anticipating the concerns of ethics committee reviewers. Specific attention was given to issues arising in multinational settings. With the use of this Tool Kit, researchers have the opportunity to address critical research ethics issues proactively, potentially speeding the time and easing the process to final protocol approval. (shrink)

Despite the burgeoning literature on professionalism in other health professions, psychology lags behind in the level of attention given to this core competency. In this article, we review definitions from other health professions and how they address professionalism. Next, we review how this competency evolved within health service psychology (HSP), and we propose a definition. We offer an approach for assessing professionalism within HSP. Consideration is given to strategies and methods for providing effective education and training in this multifaceted competency. (...) Finally, recommendations are made for creating a culture of professionalism within HSP and honoring psychology’s social contract with multiple publics. (shrink)

There is growing interest in tissue procurement for cancer research through autopsy. Establishing an autopsy/tissue donation programme for breast cancer research within an academic medical centre i...

We study the implications of model completeness of a theory for the effectiveness of presentations of models of that theory. It is immediate that for a computable model A\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\mathcal {A}$$\end{document} of a computably enumerable, model complete theory, the entire elementary diagram E\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$E$$\end{document} must be decidable. We prove that indeed a c.e. theory T is model complete if and only if there is a (...) uniform procedure that succeeds in deciding E\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$E$$\end{document} from the atomic diagram Δ\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\varDelta $$\end{document} for all countable models A\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\mathcal {A}$$\end{document} of T. Moreover, if every presentation of a single isomorphism type A\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\mathcal {A}$$\end{document} has this property of relative decidability, then there must be a procedure with succeeds uniformly for all presentations of an expansion \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$$$\end{document} by finitely many new constants. (shrink)

Increasingly, professionalism has been recognized as a core competency for health service professionals and is the domain in which vexing competence problems are observed in trainees. We begin by describing manifestations of problems of professionalism in accord with the values that fall within the rubric of this multifaceted construct. We provide an approach for evaluating problems of professionalism and discuss intervention for trainees with mild, moderate, or severe problems in this domain. We propose implications for training focused on enhancing the (...) culture of programs; bolstering the education, guidance, and mentoring provided related to professionalism; and encouraging best practices for addressing trainees with problems of professionalism. We conclude by sharing ideas about defining professionalism, identifying problems of professionalism, strengthening our approach to assessing professionalism and intervening when problems are evident, developing strategies for preventing professionalism problems, and ensuring that psychologists take seriously their responsibility to address professionalism concerns with colleagues. (shrink)

I reply to the excellent commentaries by Nancy Snow and Jennifer Cole Wright on my book, The Character Gap: How Good Are We? Topics discussed include the criteria of virtue, kinds of virtuous motives, vicious motivation and behavior, continence and incontinence, the possibility of widespread vice, and a recent meta-analysis of helping behavior.

It is well established that language production and comprehension are influenced by information status, for example, whether information is given, new, topical, or predictable, and many scholars suggest that an important component of information status is keeping track of what information is in common ground, and what is not. Information status affects both speakers' choices and how listeners interpret the speaker's meaning. Although there is a wealth of scholarly work on information status, there is no consensus on the mechanisms by (...) which it is used, and in fact relatively little discussion of the underlying representations and psycholinguistic mechanisms. Moreover, a major challenge to understanding information status is that its effects are notoriously variable. This study considers existing proposals about information status, focusing on two questions: how is it represented; and by what mechanisms is it used? I propose that it is important to consider whether representations and mechanisms can be classified as either explicit or emergent. Based on a review of existing evidence, I argue that information status representations are most likely emergent, but the mechanisms by which they are used are both explicit and emergent. This review provides one of the first considerations of information status processing across multiple domains. (shrink)

Internet-based health research is increasing, and often offers financial incentives but fraudulent behavior by participants can result. Specifically, eligible or ineligible individuals may enter the study multiple times and receive undeserved financial compensation. We review past experiences and approaches to this problem and propose several new strategies. Researchers can detect and prevent Internet research fraud in four broad ways: through the questionnaire/instrument ; through participants' non-questionnaire data and seeking external validation through computer information,, and 4) through study design. These approaches (...) each have pros and cons, and raise ethical, legal, and logistical questions, given that ethical tensions can emerge between preserving the integrity of research vs. protecting the privacy and confidentiality of study respondents. While past discussions concerning the ethics of online research have tended to focus on the participants' ability to trust the researchers, needs now arise to examine researchers' abilities to trust the participants. This analysis has several critical implications for future practice, policy, and research. (shrink)

Mill's discussion of ‘the internal sanction’ in chapter III of Utilitarianism does not do justice to his understanding of internal sanctions; it omits some important points and obscures others. I offer an account of this portion of his moral psychology of motivation which brings out its subtleties and complexities. I show that he recognizes the importance of internal sanctions as sources of motives to develop and perfect our characters, as well as of motives to do our duty, and I examine (...) in some detail the various ways in which these sanctions give rise to motivating desires and aversions. (shrink)

This chapter contains sections titled: I II III IV.

Government-sponsored school lunch programs have garnered attention from activists and policymakers for their potential to promote public health, sustainable diets, and food sovereignty. However, across country contexts, these programs often fall far short of their transformative potential. It is vital, then, to identify policies and organizing strategies that enable school lunch programs to be redesigned at the national scale. In this article, we use document analysis of historical newspapers and government data to examine the motivating factors and underlying conditions that (...) allowed South Korea’s universal free, eco-friendly school lunch program to become a tool for advancing social justice and ecological goals at the national scale. We analyze the socio-historical evolution and current status of the Korean school lunch program, combining the multi-level perspective with insights from environmental sociology and critical food studies, in order to shed light on the factors that enabled the program to become an innovative niche and articulate the opportunities and challenges it now faces. We identify the state-sponsored creation of what we call “precautionary infrastructure” as a key anchoring mechanism between the school food niche and agri-food regime. Precautionary infrastructure includes new supply chains, certification standards, and sourcing policies that provide a stable market for eco-friendly farms and small-scale producers, while minimizing the environmental health risks of school lunch by delivering organic and pesticide-free ingredients to on-site kitchens that serve free lunches to all students. This analysis offers insight into how public school-lunch programs can become protected niches that help drive sustainability transitions within agri-food systems. (shrink)

Camisha Russell has written a beautiful essay articulating why race and racism should be centered within bioethics. I agree with her assertion that Black Lives Matter (and the subsequent backlash t...

As the twin pandemics of COVID-19 and state violence against Black Americans dominated our national landscape in the spring of 2020, many in medicine, nursing, and public health made renewed calls...

[The Catcher in the Rye's] catalogue of characters, incidents, expressions could be extended indefinitely, all of them suggesting that Holden's sickness of soul is something deeper than economic or political, that his revulsion at life is not limited to social and monetary inequities, but at something in the nature of life itself - the decrepitude of the aged, the physical repulsiveness of the pimpled, the disappearance and dissolution of the dead, the terrors of sex, the hauntedness of human aloneness, the (...) panic of individual isolation. Headlines about Korea, Dean Acheson, and the cold war seem, if not irrelevant, essentially wide of the mark - if we define the mark as the heart and soul of Catcher. James E. Miller, Jr., author of "Henry James in Reality" and numerous books and articles on American literature, responds in this essay to Carol and Richard Ohmann's "Reviewers, Critics, and The Catcher in the Rye. The Ohmann's answer will appear in our summer issue. (shrink)

In a well-known passage in chapter V of On Liberty, J. S. Mill notes that while economic competition is generally socially beneficial and should be permitted, this “Free Trade” doctrine does not follow from the liberty or harm principle because “trade is a social act.” In a largely overlooked passage in chapter IV of the same essay, however, Mill contends that for society to coercively prohibit the practice of piecework – paying workers by the unit rather than by the hour (...) or day – does violate this principle. In this short note, I demonstrate that Mill's reasoning in these two passages is contradictory. (shrink)

If Christian ethics is to have an authentic connection to Jesus Christ, it is crucial to establish pedagogical objectives and best practices that are transformative. In this article, I examine how integrating Christian sexual ethics with Ignatian spirituality has fostered many students’ holistic growth and commitment to justice.

Understanding the moral right and wrong in the context of business practice has long captivated the attention of researchers and business leaders (Brenkert, 2019). Fueled by ethical failures recoun...

Quantum field theories containing massless particles are divergent not just in the ultraviolet but also in the infrared. Infrared divergences are typically regarded as less conceptually problematic than ultraviolet divergences because there is a cancellation mechanism that renders measurable physical observables such as decay rates and cross-sections infrared finite. In this article, I scrutinize the restriction to measurable physical observables that is required to arrive at infrared finite results. I argue that the restriction does not necessitate a retreat to operationalism (...) about the meaning of the theory, but it does call attention to underappreciated features of the infrared regime. (shrink)

In working his way through his complex conception of the relation of fiction and reality, [Henry] James thus found the unconscious moral dimension inextricably embedded within "realism" itself. In following the threads of realism back to consciousness itself, James invariably found there intertwined with its roots those aspects and elements that other theorists kept carefully separate. By exploring experience to its source, he found imagination. By following objective life from "out there" to conception, he found individual vision. By following the (...) seeming oneness of the passing show back to perception, he found infinite variation and multiplicity. By following the uncolored flux and flow of events to their embodiment in the fictional medium, he found coloration of personality. And by following the "felt life" back to the artist's "prime sensibility", James found there the "moral sense" and the "enveloping air of the artist's humanity"—that which gives "the last touch to the worth of a work." James E. Miller, Jr., professor of English at the University of Chicago, is the author of A Critical Guide to Leaves of Grass; Walt Whitman; F. Scott Fitzgerald: His Art and His Technique; J.D. Salinger; Theory of Fiction: Henry James; and numerous articles on American literature and education. He contributed "Catcher In and Out of History" to Critical Inquiry, Spring 1977. (shrink)

The rationality of concern for oneself has been taken for granted by the authors of western moral and political thought in a way in which the rationality of concern for others has not. While various authors have differed about the morality of self-concern, and about the extent to which such concern is rationally required, few have doubted that we have at least some special reasons to care for our selves, reasons that differ either in degree or in kind from those (...) we have to care for others. The rationality of prudence as traditionally conceived was thus taken to be threatened by Lockean accounts of personal identity. For taking a person’s identity through time to consist in psychological continuity is often thought to result in the numerical distinctness of his present and future selves, thus leaving his present self in the unsavoury position of having to ask, “Why care specially about my future self, if he won’t really be me?”. (shrink)

Previous research has shown that drawing improves short-term mood in children when used to distract from rather than express negative thoughts and feelings. The current study sought to examine how drawing might elevate mood in children ages 6–12 by examining the role played by absorption, enjoyment, and perceived competence as well as entering an imaginary world; and whether children spontaneously use drawing to distract from a sad mood. Across three studies, children were asked to think of a disappointing event. After (...) a sad mood induction, they drew for 5 min. Mood was measured before and after the mood induction and after drawing. Three main findings emerged. First, drawing to distract led to greater absorption and enjoyment than did drawing to express. Second, children’s mood improved equally when drawing imaginary and real scenes showing that the key ingredient is that the content of the drawings be distracting in nature. Third, drawing improved mood even when children were given no instructions on the content of their drawings and children were more likely to use drawing as a way to distract themselves from a sad mood. These studies help to define the characteristics of drawing activities that foster mood improvement in children and highlight the important role of the arts in emotion regulation. (shrink)

Martha A. Hall’s artists’ books documenting her experience of living with breast cancer offer future health professionals a unique opportunity to sit in the patient’s position of vulnerability and fear. Hall’s books have become a cornerstone of our medical humanities pedagogy at the Maine Women Writers Collection because of their emotional directness and their impact on readers. This essay examines the ways that Hall’s call for conversation with healthcare providers is enacted at the University of New England and provides a (...) model for how such works might be used at other educational institutions to encourage empathy between practitioners and patients by engaging in conversations about anger, fear, and other common reactions to life-threatening illness. We explore the unruly nature of Martha A. Hall’s narratives of illness and care, as well as how the form of the books themselves engages the reader in a deep relationship with Hall’s personal pain and her humanity itself. We explore, too, the cumulative effect of these powerful books on readers who handle them regularly, as we do in our roles as professor and archivist. (shrink)

In the fourteenth paragraph of the fifth chapter of Utilitarianism, J. S. Mill writes that ‘We do not call anything wrong, unless we mean to imply that a person ought to be punished in some way or other for doing it; if not by law, by the opinion of his fellow-creatures; if not by opinion, by the reproaches of his own conscience.’ I criticize the attempts of three commentators who have recently presented act-utilitarian readings of Mill – Roger Crisp, David (...) Brink, and Piers Norris Turner – to accommodate this passage. (shrink)

Religion is often understood to play a positive role in shaping moral attitudes among believers. We assessed the relationship between church members’ levels of felt connectedness to their respective congregations and perceived similarity in personal and congregational moral values, and whether there was a relationship between these and the amount of time spent in synchronous movement or singing during worship. The similarity between personal and perceived congregational moral importance was correlated with feelings of closeness to one’s congregation but not by (...) the amount of time spent in synchronous movement or singing. Differences in moral foundations scores and in moral importance of specific issues were found between different theological traditions. These findings demonstrate that, for churchgoers, there is a relationship between the use of music or synchronous movement in a church service and feelings of social bonding and there is also a relationship between the degree to which churchgoers identify with their church community and the degree to which they believe their priorities match those of their church. Furthermore, differences in theological tradition appear to be reflected in differences in moral values. (shrink)

Duchenne's muscular dystrophy (DMD), which affects 1/3500 live male births, involves a progressive degeneration of skeletal and cardiac muscle, leading to early death. The protein dystrophin is lacking in DMD and present, but defective, in the allelic, less severe, Becker muscular dystrophy and is also missing in the mdx mouse. Experiments on the mdx mouse have suggested two possible therapies for these myopathies. Implantation of normal muscle precursor cells (mpc) into mdx skeletal muscle leads to the conversion of dystrophin‐negative fibres (...) to ‐positive, with consequent improvement in muscle histology. Direct injectidn of dystrophin cDNA into skeletal or cardiac muscle also gives rise to dystrophin‐positive fibres. Although both appear promising, there are a number of questions to be answered and refinements to be made before either technique could be considered possible as treatments for myopathies in man. (shrink)

The aim of this book is to provide a collection of theoretical, conceptual, and empirical research on innovative and engaging practices, methods, and professional learning.