Development and targeting efforts by academic organizations to effectively promote research integrity can be enhanced if they are able to collect reliable data to benchmark baseline conditions, to assess areas needing improvement, and to subsequently assess the impact of specific initiatives. To date, no standardized and validated tool has existed to serve this need. A web- and mail-based survey was administered in the second half of 2009 to 2,837 randomly selected biomedical and social science faculty and postdoctoral fellows at 40 (...) academic health centers in top-tier research universities in the United States. Measures included the Survey of Organizational Research Climate (SORC) as well as measures of perceptions of organizational justice. Exploratory and confirmatory factor analyses yielded seven subscales of organizational research climate, all of which demonstrated acceptable internal consistency (Cronbach’s α ranging from 0.81 to 0.87) and adequate test–retest reliability (Pearson r ranging from 0.72 to 0.83). A broad range of correlations between the seven subscales and five measures of organizational justice (unadjusted regression coefficients ranging from 0.13 to 0.95) document both construct and discriminant validity of the instrument. The SORC demonstrates good internal (alpha) and external reliability (test–retest) as well as both construct and discriminant validity. (shrink)

Despite pronouncements about the inevitable diffusion of artificial intelligence and autonomous technologies, in practice, it is human behavior, not technology in a vacuum, that dictates how technology seeps into—and changes—societies. To better understand how human preferences shape technological adoption and the spread of AI-enabled autonomous technologies, we look at representative adult samples of US public opinion in 2018 and 2020 on the use of four types of autonomous technologies: vehicles, surgery, weapons, and cyber defense. By focusing on these four diverse (...) uses of AI-enabled autonomy that span transportation, medicine, and national security, we exploit the inherent variation between these AI-enabled autonomous use cases. We find that those with familiarity and expertise with AI and similar technologies were more likely to support all of the autonomous applications we tested (except weapons) than those with a limited understanding of the technology. Individuals that had already delegated the act of driving using ride-share apps were also more positive about autonomous vehicles. However, familiarity cut both ways; individuals are also less likely to support AI-enabled technologies when applied directly to their life, especially if technology automates tasks they are already familiar with operating. Finally, we find that familiarity plays little role in support for AI-enabled military applications, for which opposition has slightly increased over time. (shrink)

Young children, like adults, understand that human agents can flexibly choose different actions in different contexts, and they evaluate these agents based on such choices. However, little is known about children's tendencies to attribute the capacity to choose to robots, despite increased contact with robotic agents. In this paper, we compare 5‐ to 7‐year‐old children's and adults’ attributions of free choice to a robot and to a human child by using a series of tasks measuring agency attribution, action prediction, and (...) choice attribution. In morally neutral scenarios, children ascribed similar levels of free choice to the robot and the human, while adults were more likely to ascribe free choice to the human. For morally relevant scenarios, however, both age groups considered the robot's actions to be more constrained than the human's actions. These findings demonstrate that children and adults hold a nuanced understanding of free choice that is sensitive to both the agent type and constraints within a given scenario. (shrink)

ArgumentIn the United States, scientific knowledge is brought before the courts by way of testimony – the testimony of scientific experts. We argue that this expertise is best understoodfirstas related to the quality of the underlying scienceand thenin terms of who delivers it. Bloodstain pattern analysis (BPA), a contemporary forensic science, serves as the vaulting point for our exploration of objectivity as a metric for the quality of a science in judicial contexts. We argue that BPA fails to meet the (...) minimal standard set by Helen Longino’s social-procedural account of objectivity (1990, 2002). In light of some pressing issues for social-procedural accounts, we offer an infrastructural account of objectivity. This account offers what amounts to a friendly amendment to Longino’s account and adds to the ways in which we might analyze social-procedural objectivity. Finally, we address an issue that is pressing in the legal context: given that scientific knowledge is delivered by individuals, not communities, at least in U.S. courts, we (may) need a way to evaluate individual scientific and epistemic agents. We suggest a means for making this evaluation that is derived from our infrastructural account of objectivity. (shrink)

Web scraping involves using computer programs for automated extraction and organization of data from the Web for the purpose of further data analysis and use. It is frequently used by commercial companies, but also has become a valuable tool in epidemiological research and public health planning. In this paper, we explore ethical issues in a project that “scrapes” public websites of U.S. county jails as part of an effort to develop a comprehensive database to enhance HIV surveillance and improve continuity (...) of care for incarcerated populations. We argue that the well-known framework of Emanuel et al. provides only partial ethical guidance for the activities we describe, which lie at a complex intersection of public health research and public health practice. We suggest some ethical considerations from the ethics of public health practice to help fill gaps in this relatively unexplored area. (shrink)

BackgroundAssisted dying has wide support among the general population but there is evidence that those providing care for the dying may be less supportive. Senior doctors would be involved in implementing the proposed change in the law. We aimed to measure support for legalising physician assisted dying in a representative sample of senior doctors in England and Wales, and to assess any association between doctors' characteristics and level of support for a change in the law.MethodsWe conducted a postal survey of (...) 1000 consultants and general practitioners randomly selected from a commercially available database. The main outcome of interest was level of agreement with any change in the law to allow physician assisted suicide.ResultsThe corrected participation rate was 50%. We analysed 372 questionnaires. Respondents' views were divided: 39% were in favour of a change to the law to allow assisted suicide, 49% opposed a change and 12% neither agreed nor disagreed. Doctors who reported caring for the dying were less likely to support a change in the law. Religious belief was also associated with opposition. Gender, specialty and years in post had no significant effect.ConclusionMore senior doctors in England and Wales oppose any step towards the legalisation of assisted dying than support this. Doctors who care for the dying were more opposed. This has implications for the ease of implementation of recently proposed legislation. (shrink)

Traditional health sciences (including nursing) paradigms, conceptual models, and theories have relied heavily upon notions of the ‘person’ or ‘patient’ that are deeply rooted in humanistic principles. Our intention here, as a collective academic assemblage, is to question taken‐for‐granted definitions and assumptions of the ‘person’ from a critical posthumanist perspective. To do so, the cinematic works of filmmaker David Cronenberg offer a radical perspective to revisit our understanding of the ‘person’ in nursing and beyond. Cronenberg's work explores bodily transformation and (...) mutation, with the body as a fragile and malleable vessel. Cronenberg's work allows us to interrogate the body in all its complexity, contingency, and hybridity and provides avenues of rupture within current understandings of ‘the person’. Reinventing the definition of what it means to be human, critical posthumanism offers opportunities to both critique humanist theories and build affirmative futurities. Also drawing on the work of Deleuze and Guattari, specifically, their concept of becoming, we propose a critical posthumanist alternative to the conceptualization of the person in the health sciences, that of the becoming‐mutant, so frequently explored in Cronenberg's films. Such a conceptualization permits the inclusion of various technological interventions of the contemporary subject: The postperson. This position offers the health science disciplines a radical reconceptualization of the conceptual and theoretical approaches, extending beyond those trapped within the quagmire of humanistic principles. (shrink)

How does microbiota research impact our understanding of biological individuality? We summarize the interdisciplinary summer school on "Microbiota, Symbiosis and Individuality: Conceptual and Philosophical Issues" (July 2019), which was supported by a European Research Council starting grant project "Immunity, DEvelopment, and the Microbiota" (IDEM). The summer school centered around interdisciplinary group work on four facets of microbiota research: holobionts, individuality, causation, and human health. The conceptual discussion of cutting-edge empirical research provided new insights into microbiota and highlights the value of (...) incorporating into meetings experts from other disciplines, such as philosophy and history of science. (shrink)

Answering important public health questions often requires collection of sensitive information about individuals. For example, our understanding of how HIV is transmitted and how to prevent it only came about with people's willingness to share information about their sexual and drug-using behaviors. Given the scientific need for sensitive, personal information, researchers have a corresponding ethical and legal obligation to maintain the confidentiality of data they collect and typically promise in consent forms to restrict access to it and not to publish (...) identifying data.The interests of others, however, can threaten researchers' promises of confidentiality when legal demands are made to access research data. In some cases, the subject of the litigation is tightly connected to the research questions, and litigants' interest in the data is not surprising. Researchers conducting studies on tobacco or occupational or other chemical exposures, for example, are relatively frequent targets of subpoenas. (shrink)

We explain libertarian thought about family and children, including controversial issues in need of serious attention. To begin our discussion of marriage, we distinguish between procedural and substantive contractarian approaches to marriage, each endorsed by various libertarians. Advocates of both approaches agree that it is a contract that makes a marriage, not a license, but disagree about whether there are moral limits to the substance of the contract with only advocates of the substantive approach accepting such. Either approach, though, offers (...) advantages over the current licensing system, so we discuss paths from that to a contractarian system. We also discuss the concept of marriage itself, the ages of consent for marriage, sexual activity, and reproduction, as well as how marriages can be dissolved, and coercion that sometimes occurs in marriage. We then turn to children. We first discuss reproductive freedom and then discuss the moral relationship between children and parents, especially considering stewardship, propertarian, and best interests approaches (we also touch on anti-natalism). One of the biggest issues facing parents is how to properly raise and educate children; we discuss this in depth and consider the sort of schooling that should be offered in a free society. Since children lack the requisite ability to consent, they cannot choose their education; how to respond to this is of the utmost importance for libertarians. As we note, the same issue of consent looms large for many forms medical treatment of children. (shrink)

This article shares reflections from members of the community of philosophers of education in the United States and Canada who were invited to express their insights in response to the theme ‘Snaps...

Storytelling, art and craft can be considered aesthetic expressions of identities. Kalahari identities are not fixed, but fluid. Research with present-day Kalahari People regarding their artistic expression and places where it has been, and is still, practised highlights that these expressions are informed by spirituality. This article explores this idea via two Kalahari case studies: Water Stories recorded in the Upington, Kakamas area, as well as research on a specific rock engraving site at Biesje Poort near Kakamas. The importance of (...) the Kalahari People’s spiritual beliefs as reflected in these case studies and its significance regarding their identities and influence on social change and/or community development projects is discussed. The article thus highlights ways in which spirituality can be considered in relation to social change projects that are characterised by partnerships between local community, non-government and tertiary education representatives and researchers and that highlight storytelling as an integral part of people’s spirituality. (shrink)

The coronavirus disease-2019 (COVID-19) has caused shortages of life-sustaining medical resources, and future waves of the virus may cause further scarcity. The Yale New Haven Health System developed a triage protocol to allocate scarce medical resources during the COVID-19 pandemic, with the primary goal of saving the most lives possible, and a secondary goal of making triage assessments and decisions consistent, transparent, and fair. We outline the process of developing the protocol, summarize the protocol, and discuss the major ethical challenges (...) encountered, along with our answers to the challenges. These challenges include (1) the role of age and chronic comorbidities; (2) evaluating children and pregnant patients; (3) racial, ethnic, and socioeconomic disparities in health; (4) prioritization of healthcare workers; and (5) balancing clinical judgment versus protocolized assessments.We conclude with a review of the limitations of our protocol and the lessons learned. We hope that a robust public discussion of such protocols and the ethical challenges they raise will result in the fairest possible processes, less need for triage, and more lives saved during future waves of the pandemic and similar public health emergencies. (shrink)

Aims and hypothesesIn an environment of absolute silence, researchers have found many of their participants to perceive phantom sounds. With this between-subject experiment, we aimed to elaborate on these research findings, and specifically investigated whether–in line with the fear-avoidance model of tinnitus perception and reactivity–fear or level of perceived threat influences the incidence and perceptual qualities of phantom sound percepts in an anechoic room. We investigated the potential role of individual differences in anxiety, negative affect, noise sensitivity and subclinical hearing (...) loss. We hypothesized that participants who experience a higher level of threat would direct their attention more to the auditory system, leading to the perception of tinnitus-like sounds, which would otherwise be subaudible, and that under conditions of increased threat, narrowing of attention would lead to perceptual distortions.MethodsIn total, N = 78 normal-hearing volunteers participated in this study. In general, the study sample consisted of young, mostly female, university students. Their hearing was evaluated using gold-standard pure tone audiometry and a speech-in-noise self-test, which is a sensitive screening test to identify subclinical hearing loss. Prior to a four-minute stay in an anechoic room, we randomized participants block design-wise in a threat and no-threat condition. Participants in the threat condition were deceived about their hearing and were led to believe that staying in the room would potentially harm their hearing temporarily. Participants were asked whether they perceived sounds during their stay in the room and rated the perceptual qualities of sound percepts. They were also asked to fill-out standardized questionnaires measuring anxiety, affect and noise sensitivity. The internal consistency of the questionnaires used was verified in our study sample and ranged between α = 0.61 and α = 0.90.ResultsIn line with incidence rates reported in the literature, 74% of our participants reported having heard tinnitus-like sounds in the anechoic room. Speech-in-noise identification ability was comparable for both groups of participants. The experimental manipulation of threat was proven to be effective, as indicated by significantly higher scores on a Threat Manipulation Checklist among participants in the threat condition as compared to those in the no-threat condition. Nevertheless, participants in the threat condition were as likely to report tinnitus percepts as participants in the no-threat condition, and tinnitus percepts were not rated as being louder or more unpleasant as a function of level of threat. For participants who did experience tinnitus percepts, a higher level of threat was associated with a higher degree of experienced unpleasantness. These associations were absent in those who did not experience tinnitus. Higher negative affect was only slightly associated with higher ratings of tinnitus unpleasantness.ConclusionWhereas our threat manipulation was successful in elevating the level of fear, it did not contribute to a higher percentage of participants perceiving tinnitus-like sounds in the threat condition. However, higher levels of perceived threat were related to a higher degree of perceived tinnitus unpleasantness. The findings of our study are drawn from a rather homogenous participant pool in terms of age, gender, and educational background, challenging conclusions that are applicable for the general population. Participants generally obtained normophoric scores on independent variables of interest: they were low anxious, low noise-sensitive, and there was little evidence for the presence of subclinical hearing loss. Possibly, there was insufficient variation in scores to find effects. (shrink)

The COVID-19 pandemic has impacted data collection for longitudinal studies in developmental sciences to an immeasurable extent. Restrictions on conducting in-person standardized assessments have led to disruptive innovation, in which novel methods are applied to increase participant engagement. Here, we focus on remote administration of behavioral assessment. We argue that these innovations in remote assessment should become part of the new standard protocol in developmental sciences to facilitate data collection in populations that may be hard to reach or engage due (...) to burdensome requirements. We present a series of adaptations to developmental assessments and a detailed discussion of data analytic approaches to be applied in the less-than-ideal circumstances encountered during the pandemic-related shutdown. Ultimately, these remote approaches actually strengthen the ability to gain insight into developmental populations and foster pragmatic innovation that should result in enduring change. (shrink)

Do philosophic views affect job performance? The authors found that possessing a belief in free will predicted better career attitudes and actual job performance. The effect of free will beliefs on job performance indicators were over and above well-established predictors such as conscientiousness, locus of control, and Protestant work ethic. In Study 1, stronger belief in free will corresponded to more positive attitudes about expected career success. In Study 2, job performance was evaluated objectively and independently by a supervisor. Results (...) indicated that employees who espoused free will beliefs were given better work performance evaluations than those who disbelieve in free will, presumably because belief in free will facilitates exerting control over one’s actions. (shrink)

Background: Compassion fatigue is recognized as impacting the health and effectiveness of healthcare providers, and consequently, patient care. Compassion fatigue is distinct from “burnout.” Reliable measurement tools, such as the Professional Quality of Life scale, have been developed to measure the prevalence, and predict risk of compassion fatigue. This study reviews the prevalence of compassion fatigue among healthcare practitioners, and relationships to demographic variables. Methods: A systematic review was conducted using key words in MEDLINE, PubMed, and Ovid databases. Data were (...) extracted from a total of 71 articles meeting inclusion criteria, from studies measuring compassion fatigue in healthcare providers using a validated instrument. Quantitative and qualitative data were extracted and compiled by three independent reviewers into an evidence table that included basic study characteristics, study strength and quality determination, measurements of compassion fatigue, and general findings. Meta-analysis, where data allowed, was stratified by Professional Quality of Life version, heterogeneity was quantified, and pooled means were reported with 95% confidence interval. A table of major study characteristics and results was created. Ethical consideration: This paper contains no primary data obtained directly from research participants. Data obtained from previously published resources have been acknowledged within references. Psychological distress, particularly compassion fatigue, can be insidious, no health profession is immune, and may significantly impact the ability to provide care. Results: A total of 71 studies were included. Compassion fatigue was reported across all practitioner groups studied. Relationships to most demographic variables such as years of experience and specialty were either not statistically significant or unclear. Variability in reporting of Professional Quality of Life results was found. Interpretation: Compassion fatigue exists across diverse practitioner groups. Prevalence is highly variable, and its relationship with demographic, personal, and/or professional variables is inconsistent. Questions are raised about how to mitigate compassion fatigue. (shrink)

The practice of recontact in genomic medicine has the power to help rectify long‐standing inequities in genetic testing. However, if not delivered systematically, recontacting practices also have the potential to reinforce these same inequities. Recontact, which occurs when contact between a clinician and patient is reinitiated after a relationship has ended, is often in search of or in response to updated interpretation or results. Currently, recontact is happening in a patient‐driven and ad hoc manner, undermining its potential to benefit all (...) patients. In this paper, the authors position justice as an additional argument in favor of systematic recontact and an argument against the predominantly patient‐initiated model. They argue that patients from equity‐deserving groups should be early beneficiaries of an emerging responsibility to recontact patients. The authors share illustrative clinical vignettes and propose role‐specific and systems‐level solutions to rightfully position recontact as a tool to promote a more equitable clinical genomics future. (shrink)

Case-based instruction is a stable feature of ethics education, however, little is known about the attributes of the cases that make them effective. Emotions are an inherent part of ethical decision-making and one source of information actively stored in case-based knowledge, making them an attribute of cases that likely facilitates case-based learning. Emotions also make cases more realistic, an essential component for effective case-based instruction. The purpose of this study was to investigate the influence of emotional case content, and complementary (...) socio-relational case content, on case-based knowledge acquisition and transfer on future ethical decision-making tasks. Study findings suggest that emotional case content stimulates retention of cases and facilitates transfer of ethical decision-making principles demonstrated in cases. (shrink)

The effectiveness of case-based learning in ethics education varies widely regarding how cases are presented. Case process instruction may impact case-based ethics education to promote sensemaking processes, ethical sensemaking strategy use, and ethical decision making (EDM) quality. This study examined two teaching techniques, notes and review, and participants completed note-taking and review activities examining a case-based scenario during an ethics education course. Results suggest that providing case notes in outline form improves sensemaking processes, strategy use, and EDM quality. In addition, (...) combining processes of provided notes and passive review results in incremental, additive performance via certain ethical sensemaking strategies and EDM quality. (shrink)

The coronavirus disease (COVID-19) crisis provoked an organizational ethics dilemma: how to develop ethical pandemic policy while upholding our organizational mission to deliver relationship- and patient-centered care. Tasked with producing a recommendation about whether healthcare workers and essential personnel should receive priority access to limited medical resources during the pandemic, the bioethics department and survey and interview methodologists at our institution implemented a deliberative approach that included the perspectives of healthcare professionals and patient stakeholders in the policy development process. Involving (...) the community more, not less, during a crisis required balancing the need to act quickly to garner stakeholder perspectives, uncertainty about the extent and duration of the pandemic, and disagreement among ethicists about the most ethically supportable way to allocate scarce resources. This article explains the process undertaken to garner stakeholder input as it relates to organizational ethics, recounts the stakeholder perspectives shared and how they informed the triage policy developed, and offers suggestions for how other organizations may integrate stakeholder involvement in ethical decision-making as well as directions for future research and public health work. (shrink)

Herrera-Ferrá et al.’s (2023) attention to the cultural context of the neurorights movement contributes to the growing conversation on establishing neurorights in response to advancements in neuros...

Purpose Medical students receive a varying amount of training in medical ethics and are expected to navigate clinical ethical dilemmas innately. There is little literature on attempts to navigate ethical dilemmas experienced during early clinical experiences and whether current curricula prepare students for these dilemmas. This study explores the different ethical dilemmas experienced by medical students on their third-year clerkships and analyzes the factors, sources, and resolutions proposed by them.Methods From 2016 to 2018, third-year medical students completed a written assignment (...) to describe, analyze, and reflect on a clinical situation in which they experienced an ethical dilemma. They identified specific ethical dilemmas present, potential preventative and aftermath solutions, and reflected on their professional development from their experience. The research team utilized applied thematic analysis to identify themes and patterns in the data. A thematic matrix was utilized to examine similarities and differences across medical students.Results Of the 162 reflections, 144 (88.9%) students indicated an ethical dilemma that included issues related to autonomy and beneficence. Of these, 116 (71.6%) students found the two ethical principles in direct conflict. Students identified three common sources of this conflict: lack of communication; unclear understanding of clinical policies regarding family authority and psychiatric capacity; and medical negligence. Lastly, students suggested different solutions for dealing with and preventing this conflict.Conclusion Our findings suggest that an overwhelming number of students face ethical challenges when confronted with medical situations that raise conflicts between autonomy and beneficence. Their recommended solutions reveal an appeal among students to have tools and strategies in place to ease the need to make difficult decisions. Medical students might be better served by learning about the complexities of ethical decision-making and the likelihood of experiencing moral distress when they feel an inability to implement what they envision as the best solution. (shrink)

This book is a collection of articles on different aspects of university education in China since the late nineteenth century, addressing how far the ideal of modern university education, which has gradually been developed in the West since the age of European Enlightenment, was adopted or transformed by Chinese universities.

Cases have been employed across multiple disciplines, including ethics education, as effective pedagogical tools. However, the benefit of case-based learning in the ethics domain varies across cases, suggesting that not all cases are equal in terms of pedagogical value. Indeed, case content appears to influence the extent to which cases promote learning and transfer. Consistent with this argument, the current study explored the influences of contextual and personal factors embedded in case content on ethical decision-making. Cases were manipulated to include (...) a clear description of the social context and the goals of the characters involved. Results indicated that social context, specifically the description of an autonomy-supportive environment, facilitated execution of sensemaking processes and resulted in greater decision ethicality. Implications for designing optimal cases and case-based training programs are discussed. (shrink)

Opinion leaders within the community may lead debate on animal welfare issues and provide a path for information to their social networks. However, little is known about OLs’ attitudes, activities conducted to express their views about animal welfare and whether they are well informed, or not, about husbandry practices in the red meat industry. This study aimed to identify OLs in the general public and among producers and compare OLs and non-OLs’ attitudes, knowledge and actions to express their views about (...) the red meat industry. Two questionnaires, one for the Australian general public and one for Australian red meat producers, were developed to identify general attitudes. From these questionnaires, OLs were identified using a two-step cluster analysis. Subsequently, a sub-sample of 19 OLs participated in a follow-up phone interview. Results disclosed some clear OLs’ characteristics. Public OLs held more negative perceptions of the red meat industry and perceived they had more knowledge about husbandry procedures. However, their actual knowledge about animal husbandry was not different from non-OLs. Public OLs also used and trusted social and internet media more than did non-OLs. In the producer group, a large percentage of OLs were identified. Producer OLs had more actual knowledge about animal husbandry and engaged in more behaviours to express dissatisfaction with the industry than non-OLs. Unlike the public respondents, this group used conventional media more than social and internet media, and their levels of trust in all kinds of media were low. While there were clear differences, both groups believed that is important to increase communication and educate about farm practices. This may present an opportunity to develop an opinion leader intervention strategy where informed OLs could later disseminate accurate information to their social networks. Further studies should test if sustained and facilitated educational sessions between public and producer OLs can assist in increasing communication, knowledge and perhaps, may assist in achieving convergence of concerns and expectations between both groups. (shrink)

Russell articulates compelling reasons that bioethicists and health care professionals should take individual responsibility for deconstructing structural injustices in healthcare through in...

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

Los discursos públicos que circulan sobre las matemáticas y su aprendizaje determinan el modo en que las familias y los alumnos dan sentido a sus experiencias escolares. En Estados Unidos, estos discursos pueden desempeñar un papel importante en el desarrollo de la política educativa pública debido al compromiso de los consejos escolares públicos de escuchar las voces de la comunidad, así como al reciente (aunque no nuevo) aumento de la organización de grupos de padres conservadores bien financiados que trabajan para (...) mantener -y exacerbar- la desigualdad de oportunidades educativas que persiste en este país. En este trabajo analizamos el discurso público en torno al aprendizaje de las matemáticas en una reunión del consejo escolar local de la ciudad de Nueva York. Utilizando herramientas de análisis de la interacción, examinamos el discurso en torno a una propuesta para restablecer la selección basada en exámenes para la admisión en la escuela secundaria. Delineamos dos características clave de los supuestos de "sentido común" en torno al aprendizaje de las matemáticas que circularon en esta reunión -los estudiantes de matemáticas permanecen en una trayectoria de aprendizaje unidimensional, y con diferentes tasas de avance- e investigamos cómo estos supuestos jugaron en la construcción de un mundo figurado de "matemáticas escolarizadas". Argumentamos que las consecuencias que se derivan necesariamente de estos supuestos de sentido común construyen las matemáticas como jerárquicas y fijas, situando a los alumnos en una trayectoria de aprendizaje unidimensional. Por último, situamos este conjunto de supuestos emergentes en el proyecto racial neoliberal y consideramos las formas en que configuran una imaginación particular de la escolarización y las matemáticas bajo el neoliberalismo. (shrink)

Subjects enrolled in studies testing high risk interventions for incurable or progressive brain diseases may be vulnerable to deficiencies in informed consent, such as the therapeutic misconception. However, the definition and measurement of the therapeutic misconception is a subject of continuing debate. Our qualitative pilot study of persons enrolled in a phase I trial of gene transfer for Parkinson disease suggests potential avenues for both measuring and preventing the therapeutic misconception. Building on earlier literature on the topic, we developed and (...) tested an interview guide that focuses on how the subjects decided to participate, emphasizing the integration of subjects’ various statements that are relevant to assessing the therapeutic misconception, rather than evaluating them as isolated statements. The results indicate that a subject’s understanding of the purpose of research is best explored in juxtaposition to the subject’s motivation for participating. (shrink)

Checklists have been used to improve quality in many industries, including healthcare. The use of checklists, however, has not been extensively evaluated in clinical ethics consultation. This article seeks to fill this gap by exploring the efficacy of using a checklist in ethics consultation, as tested by an empirical investigation of the use of the checklist at a large academic medical system (Cleveland Clinic). The specific aims of this project are as follows: (1) to improve the quality of ethics consultations (...) by providing reminders to ethics consultants about process steps that are important for most patient-centered ethics consultations, (2) to create consistency in the ethics consultation process across the medical system, and (3) to establish an effective educational tool for trainers and trainees in clinical ethics consultation. The checklist was developed after a thorough literature review and an iterative process of revising and testing by a group of experienced ethics consultants. To pilot test the checklist, it was distributed to 46 ethics consultants. After a six-month pilot period in which ethics professionals used the checklist during their clinical activities, a survey was distributed to all of those who used the checklist. The 10-item survey examined consultants’ perceptions regarding the three aims listed above. Of the 25 survey respondents, 11 self-reported as experts in ethics consultation, nine perceived themselves to have mid-level expertise, and five self-reported as novices. The majority (68 percent) of all respondents, regardless of expertise, believed that the checklist could be a “helpful” or “very helpful” tool in the consultation process generally. Novices were more likely than experts to believe that the checklist would be useful in conducting consultations. The limitations of this study include: reduced generalizability given that this project was conducted at one medical system, utilized a small sample size, and used self-reported quality outcome measures. Despite these limitations, to the authors’ knowledge this is the first investigatation of the use of a checklist systematically to improve quality in ethics consultation. Importantly, our findings shed light on ways this checklist can be used to improve ethics consultation, including its use as an educational tool. The authors hope to test the checklist with consultants in other healthcare systems to explore its usefulness in different healthcare environments. (shrink)