The question of whether clinical ethics consultants may engage in patient advocacy in the course of consultation has not been addressed, but it highlights for the field that consultants? allegiances, and the boundaries of appropriate professional practice, must be better understood. I consider arguments for and against patient advocacy in clinical ethics consultation, which demonstrate that patient advocacy is permissible, but not central to the practice of consultation. I then offer four recommendations for consultants who engage in patient advocacy, and (...) consider the implications of this issue for the field.1. (shrink)

A major obstacle to broad support of clinical ethics consultation is suspicion regarding the nature of the moral expertise it claims to offer. The suspicion seems to be confirmed when the field fails to make its moral expertise explicit. In this vacuum, critics suggest the following:Clinical ethics consultation's legitimacy depends on its ability to offer an expertise in moral matters.Expertise in moral matters is knowledge of a singular moral truth which applies to everyone.The claim that a clinical ethics consultant can (...) offer knowledge of a singular moral truth in virtue of her professional training is absurd, false, or gravely immoral.Therefore,The field is illegitimate. (shrink)

Alan Westin’s work Privacy and Freedom remains foundational to the field of privacy, and Westin is frequently cited for his definition of privacy as control over personal information. However, Westin’s full definition of privacy is much more complex than this statement, describing four states of privacy (solitude, intimacy, anonymity, and reserve) that one achieves through physical or psychological means. The “claim” of privacy involves negotiating a balance between a desire for disclosure and social participation and a desire for withdrawal into (...) one of the “states” of privacy. Influencing this adjustment process are social norms (and surveillance to enforce social norms), environmental conditions, and the curiosity of others. In this Article, I draw upon this complexity in order to reread Westin’s definition of privacy as a claim of control over personal information and use this rereading to understand how the law should protect and promote privacy in the twenty-first century. I argue that the law should focus on securing meaningful privacy choices rather than on individual control over personal information. Meaningful choice requires that our informational infrastructure, and the social practices that it enables, make states of privacy available for choice along with the means of attaining them. To enable such meaningful individual choice, we need to shift our attention from a focus on individuals to a more systemic focus on our public norms and built infrastructure. Otherwise we risk protecting a narrow understanding of individual control, while ignoring a more general and systematic erosion of privacy. (shrink)

A subcommittee of the American Association of University Professors has published a report, “Research on Human Subjects: Academic Freedom and the Institutional Review Board” , which argues that institutional review board oversight may pose a threat to academic freedom, and that a different oversight model based on departmental review would both maintain subject protection and eliminate the threat. But the report does not demonstrate that IRBs pose a threat to academic freedom, and using departmental oversight may not sufficiently protect human (...) subjects of research, could introduce other problems, and would itself pose threats to academic freedom. Instead, some alternative methods of streamlining IRB oversight for certain types of research would better address the practical problems currently encountered. (shrink)

Contemporary biomedical ethics and environmental ethics share a common ancestry in Aldo Leopold's and Van Rensselaer Potter's initial broad visions of a connected biosphere. Over the past five decades, the two fields have become strangers. Public health ethics, a new subfield of bioethics, emerged from the belly of contemporary biomedical ethics and has evolved over the past 25 years. It has moved from its traditional concern with the tension between individual autonomy and community health to a wider focus on social (...) justice and solidarity. Public health has a broad focus that includes individual, community, and environmental health. Public health ethics attends to these broad commitments reflected in the increasing concern with the connectedness of health of individuals to the health of populations, to the health of animals, to the health of the environment; it is well situated to reconnect all three “fields” of ethics to promote a healthier planet. (shrink)

Women working in the sciences face obstacles at virtually every step along their career paths. From subtle slights to blatant biases, deep systemic problems block women from advancing or push them out of science and technology entirely. Women in Science Now examines solutions to this persistent gender gap, offering new perspectives on how to make science more equitable and inclusive for all. This book shares stories and insights of women from a range of backgrounds working in various disciplines, illustrating the (...) journeys that brought them to the sciences, the challenges they faced along the way, and the important contributions they have made to their fields. Lisa M. P. Munoz combines these narratives with a wealth of data to illuminate the size and scope of the challenges women scientists face, while highlighting research-based solutions to help overcome these obstacles. She presents groundbreaking studies in social psychology and organizational behavior that are informing novel approaches for combating historic and ongoing inequities. Through a combined focus on personal experiences and social-science research, this timely book provides both a path toward greater gender equity and an inspiring vision of science and scientists. (shrink)

The attempt to critique the profession of clinical ethics consultation by establishing the impossibility of ethics expertise has been a red herring. Decisions made in clinical ethics cases are almost never based purely on moral judgments. Instead, they are all-things-considered judgments that involve determining how to balance other values as well. A standard of justified decision-making in this context would enable us to identify experts who could achieve these standards more often than others, and thus provide a basis for expertise (...) in clinical ethics consultation. This expertise relies in part on what Richard Zaner calls the “expert knowledge of ethical phenomena”. (shrink)

Validation of a biomarker-based medical product development tool or clinical test is an evidentiary process that must be tailored to the proposed use. Appropriate data and analyses are needed to demonstrate that the biomarker meets analytical and clinical performance criteria consistent with favorable benefit: risk balance.

As has become tradition, executive directors of United States’ presidential bioethics committees offer reflections about their experience shortly after the orderly shutdown of the commission staff. After the records are filed according to government records regulations; after all the staff members, who are hired into temporary positions that must be renewed every two years, have secured permanent employment; after preparations are made to ensure that the next commission staff (should there be one) has a budget and standard operating procedures in (...) order to begin its work in a timely manner; after the lights are turned out for the last time, the executive director makes the final climb up the stairs into the sunlight and reflects on the whirlwind. There is much about my work with the Presidential Commission for the Study of Bioethical Issues that deserves comment, but one aspect of the commission that has been especially valuable to me is its work to educate the nation on bioethical issues. This is, moreover, a contribution in which the commission staff was central, and it is one that, as an ethics educator myself, I will cherish deeply. (shrink)

Volume 19, Issue 9, September 2019, Page 44-45.

We describe our efforts to address theoretical opportunities and methodological challenges that arose in the context of our ethnographic investigation of research labs in four different fields of bioengineering science. The multiyear study compared the common and specific features of four sites of interdisciplinary practice and aimed to analyze personal and collective goals, problem formulations, methods, technologies, and social organization within each lab. In the second phase of the study we sought to inform curriculum development for biomedical engineering from the (...) ethnographic study, with the broader goal of positioning students to engage in the kind of thinking scientists actually do. Evaluating thinking in action posed considerable challenges, and required us to develop an approach to assessing the extent to which students enrolled in the new course were “thinking like a biomedical engineer.” Our principal point of emphasis for this chapter is that honest confrontation of the challenges of ethnographic study of science practice must lead to caution, yet that ethnographic study of science enables innovative adaptations of methods and can yield vital insights into psychological dimensions of science, including interdisciplinary science. (shrink)

Journal of Philosophy of Education, EarlyView.

Patients and surgeons participate in shared decision making when they make healthcare decisions together, taking into account the patient’s goals, values, and preferences. Surgical treatment is pursued when the potential benefits outweigh the risks, the burdens of treatment are acceptable, and no other alternatives are more appropriate for meeting the patient’s goals of care. Acute care surgical problems require shared decision making, often with constraining factors that include the time-sensitive and life-threatening nature of acute surgical disease, absence of a patient’s (...) decision-making capacity, and lack of a preexisting relationship between the patient and surgeon. These factors may create ethical challenges for acute care surgeons who care for these patients. (shrink)

This paper presents an analysis of emotional and affectively toned discourse in biomedical engineering researchers’ accounts of their problem solving practices. Drawing from our interviews with scientists in two laboratories, we examine three classes of expression: explicit, figurative and metaphorical, and attributions of emotion to objects and artifacts important to laboratory practice. We consider the overall function of expressions in the particular problem solving contexts described. We argue that affective processes are engaged in problem solving, not as simply tacked onto (...) reasoning but as integral to it. The examples we present illustrate the close relation of emotion to problem solving and experimentation; they also implicate social and cultural dimensions of emotion expression. The analysis underscores a need to consider emotional expression to be intimately and importantly tied to the cognitive achievements and social negotiations of laboratory practices. (shrink)

The cognitive revolution in the 1950s and 1960s led researchers to view the human mind--like a computer--as an information-processing system that encodes, represents, and stores information and is constrained by limits on hardware and software. The emergence of new behavioral, computational, and neuroscience methodologies, has deeply expanded psychologists' understanding of the workings of the infant, child, and adult mind. One result is that research has focused on mechanisms of change, over developmental time, in the information-processing mind.In this book, Lisa (...) Oakes, Cara Cashon, Marianella Casasola, and David Rakison bring together the recent findings and theories about the origins and early development of the information-processing mind, and provide insight into the future directions in the study of infant perception and cognition. The contributors represent a wide-range of research areas in the study of infant perception and cognition, who emphasize the use of diverse methodological techniques to address key questions about development. Their chapters demonstrate how the combination of historical perspectives on the information-processing approach to cognition and recent advances in behavioral, computational, and neuroscience approaches to cognition has contributed to our understanding of how abilities ranging from visual attention to face processing to object categorization have developed during infancy. Across this broad range of topics, it is clear that much of our modern understanding of infant perceptual and cognitive development emerges from the foundation of classic information-processing models of development, such as that of Leslie B. Cohen. The recent advances illustrated in this book show how researchers have built on this foundation to uncover the mechanisms that drive developmental change. (shrink)

In this commentary we suggest that Fincher & Thornhill's (F&T's) parasite-stress theory of social behaviors and attitudes can be extended to mating behaviors and preferences. We discuss evidence from prior correlational and experimental studies that support this claim. We also reanalyze data from two of those studies using F&T's new parasite stress measures.

Ethical considerations from both the clinical and public health perspectives have been used to examine whether it is ethically permissible to mandate the seasonal influenza vaccine for healthcare workers (HCWs). Both frameworks have resulted in arguments for and against the requirement. Neither perspective resolves the question fully. By adding components of justice to the argument, I seek to provide a more fulsome ethical defence for requiring seasonal influenza immunisation for HCWs. Two critical components of a just society support requiring vaccination: (...) fairness of opportunity and the obligation to follow democratically formulated rules. The fairness of opportunity is informed by Rawls’ two principles of justice. The obligation to follow democratically formulated rules allows us to focus simultaneously on freedom, plurality and solidarity. Justice requires equitable participation in and benefit from cooperative schemes to gain or profit socially as individuals and as a community. And to be just, HCW immunisation exemptions should be limited to medical contraindications only. In addition to the HCWs fiduciary duty to do what is best for the patient and the public health duty to protect the community with effective and minimally intrusive interventions, HCWs are members of a just society in which all members have an obligation to participate equitably in order to partake in the benefits of membership. (shrink)

Confronting any science studies or learning sciences researcher in the 21st century is the reality of interdisciplinary science. New hybrid fields1 collaboratively build new concepts, combine models from two or more disciplines and forge inter-reliant relationships among specialists with different skill sets to solve new problems. This paper emerges from our recognition that inescapable psychological factors, including identity dynamics, must be described and analyzed in order to better understand the social and cognitive practices specific to interdisciplinary science. In analysis of (...) the foundations and opportunities for an... (shrink)

Despite increased interest in “intuition” within cognitive psychology, the conceptual framework of this notion remains problematic. This paper argues that conceptual shortcomings stem from a tendency to ignore the philosophical heritage of intuition or to dismiss the relevance of this heritage to contemporary theory. The paper outlines major understandings of intuition within psychology and prominent philosophical traditions, highlighting important points of inconsistency in these and examining consequences of the inconsistency. It also considers psychological conceptions of intuition that more readily overlap (...) with philosophical accounts and offers some suggestions toward a more philosophically informed notion of intuition relevant to contemporary psychological theory. (shrink)

In their article “The Bioethics of Environmental Injustice: Ethical, Legal, and Clinical Implications of Unhealthy Environments,” Ray and Cooper (2024) invite us to prioritize environmental health...

The development of physical theory is one of our greatest intellectual achievements. Its products--the currently prevailing theories of physics, astronomy, and cosmology--have proved themselves to possess intrinsic beauty and to have enormous explanatory and predictive power. This anthology of primary readings chronicles the birth and maturation of five such theories (the heliocentric theory, the electromagnetic field theory, special and general relativity, quantum theory, and the big bang theory) in the words of the scientists who brought them to life. It is (...) the first historical account that captures the rich substance of these theories, each of which represents a fascinating story of the interplay of evidence and insight--and of dialogue among great minds. Readers sit in with Copernicus, Kepler, and Galileo as they overturn the geocentric universe; observe the genius of Faraday and Maxwell as they "discover" the electromagnetic field; look over Einstein's shoulder as he works out the details of relativity; listen in as Einstein and Bohr argue for the soul of quantum mechanics in the Completeness Debate; and watch as Hubble and others reveal the history of the universe. The editors' approach highlights the moments of discovery that rise from scientific creativity, and the presentation humanizes the scientific process, revealing the extent to which great scientists were the first to consider the philosophical implications of their work. But, most significantly, the editors offer this as their central thesis: although each was ushered in by a revolution, and each contains counterintuitive elements that delayed its acceptance, these five theories exhibit a continuous rational development that has led them to a permanent place in the worldview of science. Accessible to the general reader yet sufficiently substantive that working scientists will find value in it, The Tests of Time offers an intimate look into how physical theory has been developed, by the brilliant people who have developed it. (shrink)

The Presidential Commission for the Study of Bioethical Issues was created by President Obama in 2009 to identify and promote policies and practices that ensure scientific research, health care delivery, and technological innovation are conducted in socially and ethically responsible manners. The bioethics commission is an independent and thoughtful group of experts who advises the President and, in so doing, strives to educate the nation on bioethical issues. As part of the effort to promote policies and practices ensuring the ethical (...) conduct of research, innovation, and health care delivery, the bioethics commission staff, in consultation with commission members, has used the bioethics commission reports to develop pedagogical materials for traditional and nontraditional educational settings. The goal is to use contemporary issues addressed by the bioethics commission to support teaching of bioethics ideas, principles, and theories across the major areas of study and practice. (shrink)

Volume 20, Issue 10, October 2020, Page 61-63.

Abram Brummett and Christopher Ostertag offer critiques of my argument that clinical ethics consultants have expertise but are not “ethics experts”. My argument begins within our less-than-ideal world and asks what a justification of a clinical ethics consultation recommendation might look like under those conditions. It is a challenge to what could be called an “inflationary” position on ethics expertise that requires agreement on or rational proof of metaethical facts about the values at stake in clinical ethics consultation. Brummett and (...) Ostertag critique three distinct steps in the argument. Two of those I have a brief answer for, and an assessment of the third demonstrates that Brummett and Ostertag do not consider the premise upon which I based my account. Instead, they assert a counter-premise without argument, which at best results in a stalemate between our two accounts. However, the reasons supporting my premise still seem to me to be stronger, so I am in the end unconvinced by their critiques. (shrink)

What about Confucian bioethics should compel our interest? Apart from the fact that Confucianism grounds the belief system of a great number of people, a Confucian bioethics poses a profound challe...

Reviews the role of intuition or an analogous concept within several divergent philosophical systems and argues that the salient feature common to various accounts of intuition is its non-inferential status. As such, it is argued to be highly relevant to contemporary theory. The paper offers several examples of points of compatibility with contemporary theory, including perception of social affordances, the apprehension linguistic rules and the construction of social norms. In claiming specific ways in which the concept of intuition is relevant (...) to contemporary theoretical psychology, the paper moves toward developing a more comprehensive and historically informed framework for intuition than is currently offered. It also underscores the historical underpinnings of contemporary debates. 2012 APA, all rights reserved). (shrink)