We report the identification of a recurrent, 520-kb 16p12.1 microdeletion associated with childhood developmental delay. The microdeletion was detected in 20 of 11,873 cases compared with 2 of 8,540 controls and replicated in a second series of 22 of 9,254 cases compared with 6 of 6,299 controls. Most deletions were inherited, with carrier parents likely to manifest neuropsychiatric phenotypes compared to non-carrier parents. Probands were more likely to carry an additional large copy-number variant when compared to matched controls. The clinical (...) features of individuals with two mutations were distinct from and/or more severe than those of individuals carrying only the co-occurring mutation. Our data support a two-hit model in which the 16p12.1 microdeletion both predisposes to neuropsychiatric phenotypes as a single event and exacerbates neurodevelopmental phenotypes in association with other large deletions or duplications. Analysis of other microdeletions with variable expressivity indicates that this two-hit model might be more generally applicable to neuropsychiatric disease. © 2010 Nature America, Inc. All rights reserved. (shrink)

The American Medical Association enacted its Code of Ethics in 1847, the first such national codification. In this volume, a distinguished group of experts from the fields of medicine, bioethics, and history of medicine reflect on the development of medical ethics in the United States, using historical analyses as a springboard for discussions of the problems of the present, including what the editors call "a sense of moral crisis precipitated by the shift from a system of fee-for-service medicine to a (...) system of fee-for-system medicine, better known as 'managed care.'" The authors begin with a look at how the medical profession began to consider ethical issues in the 1800s and subsequent developments in the 1900s. They then address the sociological, historical, ethical, and legal aspects of the practice of medicine. Later chapters discuss current and future challenges to medical ethics and professional values. Appendixes display various versions of the AMA's Code of Ethics as it has evolved over time. Contributors: George J. Annas, J.D., M.P.H., Arthur Isak Applbaum, Ph.D., Robert B. Baker, Ph.D., Chester R. Burns, M.D., Ph.D., Arthur L. Caplan, Ph.D., Alexander Morgan Capron, J.D., Christine K. Cassel, M.D., Linda L. Emanuel, M.D., Ph.D., Eliot L. Freidson, Ph.D., Albert R. Jonsen, Ph.D., Stephen R. Latham, J.D., Ph.D., Susan E. Lederer, Ph.D., Florencia Luna, Ph.D., Edmund D. Pellegrino, M.D., Charles E. Rosenberg, Ph.D., Mark Siegler, M.D., Rosemary A. Stevens, Ph.D., Robert M. Tenery, Jr., M.D., Robert M. Veatch, Ph.D., John Harley Warner, Ph.D., Paul Root Wolpe, Ph.D. (shrink)

This paper traces an expanded ethical perspective for youth and community work (YCW) practice in response to the climate and biodiversity crises. Discussing ecological ethics, we problematise the liberal humanist emphasis on utilitarianism and reject it as inappropriate for YCW in these times. Instead, we argue for an ecocentric practice ethic which intrinsically values the non-human world. To advance an ecocentric ethical perspective for YCW we draw on decolonial and posthuman theory. Inspired by a Freirean dialogical approach, we apply these (...) theoretical domains as lenses to problematise YCW practice, seeking a generative dialogue between perspectives. Through this, we identify three emergent tasks for ecocentric YCW: (a) thinking and acting beyond the individual; (b) cultivating reciprocal care and connection and (c) practicing critical pedagogies of place. This third element builds on YCW's social pedagogic tradition and provides a practical means to incorporate ecocentric ideas into practice. We conclude that, given the unprecedented implications of climate crises and biodiversity collapse, a YCW ethics that does not consider these implications for young people is insufficient for the context of practice today. Enacting an ecocentric YCW ethics requires ongoing collective praxis and dialogue between young people, practitioners, educators, managers and students. (shrink)

This study examines the effects of demographic characteristics on ethical perceptions. While earlier research has produced conflicting results regarding the predictive power of these variables, significant and definite insights were obtained with proper controls. The following predictors of ethical attitudes are examined: age, gender, marital status, education, dependent children status, region of the country and years in business, while controlling for job status. A nation-wide random sample of employees was used in obtaining a response rate of fifty-three percent (total n (...) of 423). Indices of aspects of business ethical attitudes were constructed using factor analysis. Linear multiple regression analysis indicated the significant predictive variables. Age was found to be a most-significant predictor. Older workers had stricter interpretations of ethical standards. Gender and region predicted attitudes about job-discrimination practices only, with women and persons from the Midwest most strongly opposed to the practice. All the other variables proved to be unreliable ethics predictors. (shrink)

In their analysis Childress et al. (2023) suggest that withdrawal of extracorporeal membrane oxygenation (ECMO) over a patient’s dissent is not justified by existing ethical arguments. The alternat...

This paper examines the strengths and weaknesses of one of science's most pervasive and flexible metaprinciples;optimalityis used to explain utility maximization in economics, least effort principles in physics, entropy in chemistry, and survival of the fittest in biology. Fermat's principle of least time involves both teleological and causal considerations, two distinct modes of explanation resting on poorly understood psychological primitives. The rationality heuristic in economics provides an example from social science of the potential biases arising from the extreme flexibility of (...) optimality considerations, including selective search for confirming vidence, ex post rationalization, and the confusion of prediction with explanation. Commentators are asked to reflect on the extent to which optimality is an organizing principle of nature, a set of relatively unconnected techniques of science, a normative principle for rational choice and social organization, a metaphysical way of looking at the world, or something else still. (shrink)

This study examined the historical perspectives of eleven emergent bilingual and bilingual students at two middle schools. Data analysis revealed that the participants’ perspectives on U.S. history reflected three schematic narrative templates focused on nation-building, equality, and discrimination. The participants primarily employed the (in)equality narratives when discussing aspects of U.S. history directly linked to their identities. The findings add to the extant research on student historical perspectives and use of schematic narrative templates. The findings further suggest that engaging (emergent) bilingual (...) students in examining multiple perspectives and conducting critical history inquiry can contribute to notions of culturally and linguistically responsive social studies instruction. (shrink)

ARCHIVES INTERNATIONALES D'HISTOIRE DES IDEES INTERNATIONAL ARCHIVES OF THE HISTORY OF IDEAS 33 PAUL J. OLSCAMP The Moral Philosophy of George Berkeley ..

Complex clinical ethics cases require a blend of compassion, sensitivity, and tenacity in order to navigate the hard work required of stakeholders. Each person comes to the table with rich historie...

Despite an abundance of academic conferences, clinical ethicists lacked a forum to share innovative practices with peers and to generate solutions to common challenges. Organizers of the first Clinical Ethics Un-Conference developed a working event centered on active participation and problem solving through peer learning, with the goal of improving realworld practice. Registrants included 95 individuals from 64 institutions. Attendees were surveyed immediately after the Un-Conference, and again eight months later. After eight months, 85 percent (n = 33/39) of the (...) survey respondents reported that they found the event “highly impactful” or “some-what impactful” to their clinical practice, and 23 attendees reported that they had implemented ideas or projects inspired by the event. Three sets of best practice guidelines and four white papers were published from the event. As the field of clinical ethics continues to advance and evolve, this working event format offers an innovative, disruptive alternative to a traditional conference format and may serve as a model for future efforts aimed at improving real-world clinical ethics practice. (shrink)

Background and Aims Progress towards validating amyloid beta as an early indicator of Alzheimer’s disease (AD) heightens the need for evaluation of stakeholders’ perspectives of the benefits and harms of preclinical testing in asymptomatic individuals. Methods Investigators conducted and analyzed 14 semi-structured interviews with family members of patients diagnosed with AD. Results Participants reported benefits, including the potential to seek treatment, make lifestyle changes, and prepare for cognitive impairment. Participants identified harms, including social harms, adverse life decisions, and psychological harms. (...) Nine participants reported either a “positive global perspective” or a “positive global perspective (qualified).” Conclusion Results from this study characterized stakeholders’ perspectives on the potential benefits and harms of clinical use of preclinical testing for AD. Investigators used data from this study to develop a framework that contributes to ongoing discussions that will evaluate widespread adoption of preclinical testing and will inform future research. (shrink)

This exploration of a notorious mathematical problem is the work of the man who discovered the solution. Written by an award-winning professor at Stanford University, it employs intuitive explanations as well as detailed mathematical proofs in a self-contained treatment. This unique text and reference is suitable for students and professionals. 1966 edition. Copyright renewed 1994.

Language plays a central role in human life. However, the term 'language' as defined in the language sciences of the 20th century and the traditions these have drawn on, have arguably, limited our thinking about what language is and does. The two inter-linked volumes of Thibault's study articulate crucially important aspects of an emerging new perspective shift on language - the Distributed Language view - that is now receiving more and more attention internationally. Rejecting the classical view that the fundamental (...) architecture of language can be localized as a number of inter-related levels of formal linguistic organization that function as the coded inputs and outputs to each other, the distributed language view argues that languaging behaviour is a bio-cultural organisation of process that is embodied, multimodal, and integrated across multiple space-time scales. Thibault argues that we need to think of human languaging as the distinctively human mode of our becoming and being selves in the extended human ecology and the kinds of experiencing that this makes possible. Paradoxically, this also means thinking about language in non-linguistic ways that break the grip of the conventional meta-languages for thinking about human languaging. Thibault's book grounds languaging in process theory: languaging and the forms of experience it actualizes is always an event, not a thing that we 'use'. In taking a distinctively interdisciplinary approach, the book relates dialogical theories of human sense-making to the distributed view of human cognition, to recent thinking about distributed language, to ecological psychology, and to languaging as inter-individual affective dynamics grounded in the subjective lives of selves. In taking this approach, the book considers the coordination of selves in social encounters, the emergent forms of self-reflexivity that characterise these encounters, and the implications for how we think of and live our human sociality, not as something that is mediated by over-arching codes and systems, but as emerging from the endogenous subjectivities of selves when they seek to coordinate with other selves and with the situations, artefacts, social institutions, and technologies that populate the extended human ecology. The two volumes aim to bring our understanding of human languaging closer to human embodiment, experience, and feeling while also showing how languaging enables humans to transcend local circumstances and thus to dialogue with cultural tradition. Volume 1 focuses on the shorter timescales of bodily dynamics in languaging activity. Volume II integrates the shorter timescales of body dynamics to the longer cultural-historical timescales of the linguistic and cultural norms and patterns to which bodily dynamics are integrated. (shrink)

Clinical ethicists encounter the most emotionally eviscerating medical cases possible. They struggle to facilitate resolutions founded on good reasoning embedded in compassionate care. This book fills the considerable gap between current texts and the continuing educational needs of those actually facing complex ethics consultations in hospital settings. 28 richly detailed cases explore the ethical reasoning, professional issues, and the emotional aspects of these impossibly difficult consultations. The cases are grouped together by theme to aid teaching, discussion and professional growth. The (...) cases inform any reader who has a keen interest in the choices made in real-life medical dilemmas as well as the emotional cost to those who work to improve the situations. On a more advanced level, this book should be read by ethics committee members who participate in ethics consultations, individual ethics consultants, clinicians who seek education about complex clinical ethics cases, and bioethics students. (shrink)

In 1971 John Rawls's A Theory of Justice transformed twentieth-century political philosophy, and it ranks among the most influential works in the history of the subject. This volume marks the 50th anniversary of the book's publication by offering a multi-faceted exploration of this important work.

Patients living with chronic pain require appropriate access to opioid therapy along with improved access to pain care and additional therapeutic options. It's both medically reasonable and ethical to consider opioid therapy as a treatment option in the management of chronic, non-cancer pain for a subset of patients with severe pain that is unresponsive to other therapies, negatively impacts function or quality of life, and will likely outweigh the potential harms. This paper will examine opioid therapy in the setting of (...) the opioid epidemic, why critics feel that the CDC guideline has resulted in harsh consequences for patients and their physicians, and the rationale for opioid therapy as a means of providing ethical and compassionate pain care. (shrink)

Does self-awareness amplify or dampen the intensity of emotional experience? Early research argued that self-awareness makes emotional states salient, resulting in greater emotional intensity. But these studies induced a standard for emotional intensity, confounding the salience of the emotional state with the self-regulation effects of self-awareness. Three experiments suggest high self-awareness can dampen the intensity of emotional experience in the absence of this confound. In Study 1, participants were led to feel sad in the presence or absence of a mirror; (...) a standard for emotionality was or was not induced. High self-awareness amplified sadness when there was a standard for emotionality; it dampened sadness when there was no standard. Additional experiments using a self-novelty writing task (Study 2) and a mirror (Study 3) showed that self-awareness can also dampen positive affect. A fourth study found that trait private self-consciousness did not affect emotional intensity after controlling for the effects of neuroticism. The intersections of self-focused attention and emotional experience are discussed. (shrink)

A framework is presented for studying ethical conduct in public accounting practice. Four levels of analysis are distinguished: individual, local office, multi-office firm and professional institute. Several propositions are derived from the framework and discussed: (1) The effects of ethical vs. unethical behavior on an accountant's prospects for advancement are asymmetrical in nature; (2) the way individuals perceive or frame the decision problem at hand will make an ethical response more or less likely; (3) the economic incentives present in competitive (...) markets influence the work goals of firms and offices, and lead to ethical dilemmas for individuals; and (4) initiatives at the firm or institute level aimed at compliance with professional ethical standards will by themselves have little effect on individual ethical behavior. Research into ethical behavior of practitioners will capture self-conscious and biased responses unless it is designed so as to permit indirect observation and recording of spontaneous comments. To assure valid research findings, practitioners should be interviewed and their motives assessed indirectly. A longitudinal approach is recommended, beginning with students who are choosing an accounting career. Two types of questions for use in these interviews are described. (shrink)

The sensible response to conflicts of interest is impaired by misconceptions and sloppy usage of terminology. Apparent and potential are widely misused modifiers for conflicts. Excessive legislative focus on financial interests limits understanding of the scope and significance of researchers' conflicts of interest. There is no moral or ethical failing in having a conflict of interest; the problem occurs when conflicts are not disclosed appropriately and when conflicts are allowed to bias research, teaching, or practice. Avoidance and prevention should be (...) applied to bias, not conflicts. (shrink)

This article has two objectives. First, and in particular, it seeks to reinterpret the ostracism procedure of early democratic Athens. Since Aristotle, this has been understood as a rational, political weapon of collective defense, intended to expel from Athens a disproportionately powerful individual. In this article, by putting emphasis on themateriality, gestures, and location of ostraka-casting, I propose instead that the institution can more fruitfully be understood as a ritual enactment of civic unity. Second, and more generally, I hope to (...) explore the frames within which early Athenian democracy is placed: while Greek kingship and tyranny (i.e. “primitive” polities) have been very successfully explored through anthropological and cross-cultural comparison, Greek democracy for the most part has remained in the domains of the institutional historian and political theorist. Taking a phenomenological and comparative approach, this article asks how the citizens of early democratic Athens experienced and comprehended their new sovereignty and the invented procedures of mass decision-making through which it was expressed. (shrink)

Conflicts of interest have an erosive effect on trust in science, damaging first the attitude of the public toward scientists and their research, but also weakening the trusting interdependence of scientists. Disclosure is recognized as the key tool for management of conflicts, but rules with sanctions must be improved, new techniques for avoidance of financial conflicts by alternative funding of evaluative research must be sought, and there must be new thinking about institutional conflicts of interest. Our profession is education, and (...) both the public and research professionals of all ages would benefit from greater understanding of how science should and does work. (shrink)

Byrne & Russon's target article displays all the difficulties encountered when one fails to take a methodological behaviourist approach to imitation. Their conceptual apparatus is grounded in a mixture of introspection and folk psychology. Their distinction between action-level and program-level imitation falters on goal imputation for sequential acts. In an alternative gradient descent model, behaviour can be simulated as a frustration/satisfaction gradient descent in the animal's “potentiality space,” as defined by knowledge, inventiveness, and the surrounding environment.

This brief but comprehensive introduction to French author Blaise Pascal provides an overview of his life and works and examines the major themes in his writings.

Probabilistic predictions of future risk govern much of society: healthcare, genetics, social media, national security, and finance. Both policy-makers and private companies are increasingly working to design institutional structures that seek to manage risk by controlling the behavior of citizens and consumers, using new technologies of predictive control that comb through past data to predict and shape future action. These predictions not only control social institutions but also shape individual character and forms of practical reason. Risk-based decision theory shifts people's (...) relationships to the future through knowledge of possible dangers and foregone opportunities, thus inspiring anxious solicitude and deceptive hopes for total security. This book uses virtue ethics to analyze these problems and to suggest ways to enjoy these technologies' positive benefits while constraining their dangerous aspects through a better understanding of practical reasoning and a theological analysis of our responsibility for future risks. (shrink)

_Exploring Religious Diversity_ analyzes the philosophical questions raised by the fact that many religions in the world often appear to contradict each other in doctrine and practice. Analyzes the philosophical questions raised by the fact that many religions in the world often appear to contradict each other in doctrine and practice. Evaluates the fundamental philosophical underpinnings of the debates between religious and non-religious approaches to religious diversity. Contains a glossary that defines the book's key technical terms and how they are (...) related to one another. (shrink)

Abstract:The Analects and the Mencius are among the most influential early Confucian texts. They emphasize the importance of moral self-cultivation. The individual is expected to identify what is good, and freely choose it regardless of their internal predispositions or external conditions. Curiously, in their philosophical frameworks they do not posit anything outside of contingencies. This means there is no non-contingency-based notion of "good" or "agency." This paper contributes to the current discourse by explaining how morality and agency can be possible (...) in a completely contingent system. Instead of positing a pregiven principle, self, will, or even capacity for agency, I will argue that Confucian texts assume that morality and agency emerge out of contingencies. As such, morality and agency are categorically distinct from contingencies, and are thereby able to reflect on them, without being ultimately sourced from any power outside of contingencies. (shrink)

ABSTRACTPrevious research has outlined high anxiety in connection with gamma modulation, identifying that gamma-band activity correlates with processing of threat perception, attention...

This article attempts to motivate a reorientation of ethical analysis of conscientious objection by physicians. First, it presents an illustrative case from a hospital emergency department for context. Then, it criticizes the standard pro- and anti-CO arguments. It proposes that the fault in standard approaches is to focus on the ethics of the physician’s behavior, and a better way forward on this issue is to ask how the party against whom the physician exercises the CO ought to respond. It connects (...) this question with recent trends in physician employment models, which suggest that CO may become a potential source of conflict in the future. The article then develops a relational account of CO that extends James Childress’ insights about the nature of CO in “Appeals to Conscience”. This relational account characterizes CO as a two-place relation between conscientious objector and expectant party, in which the conscientious objector makes a request of the expectant party, which has implications that will be welcome and unwelcome for both the pro- and anti-CO camps. Finally, the paper applies this relational account of CO to the case when the physician is an employee. This application demonstrates that it is highly context dependent whether or not an employer should accede to the CO requests of physician–employees. (shrink)

This paper examines relationships between accountants’ personal values and their moral reasoning. In particular, we hypothesize that there is an inverse relationship between accountants’ “Conformity” values and principled moral reasoning. This investigation is important because the literature suggests that conformity with rule-based standards may be one reason for professional accountants’ relatively lower scores on measures of moral reasoning (Abdolmohammadi et al. J Bus Ethics 16 (1997) 1717). We administered the Rokeach Values Survey (RVS) (Rokeach: 1973, The Nature of Human Values (...) (The Free Press, New York)) and the Defining Issues Test (DIT) (Rest: 1979, Development in Judgment Moral Issues (University of Minnesota Press, Minneapolis, MN)) to164 graduating accounting students enrolled in capstone courses at two universities in the Northeastern United States. As potential entrants into the accounting profession, these subjects bring their values and moral reasoning to bear on attitudes and behaviors in the workplace. We find a highly significant inverse relationship between “Conformity” values and principled moral reasoning (i.e., those who prefer Conformity values have lower levels of moral reasoning). However, we also find that accounting students as a group do not prefer Conformity values above other values such as Self-actualization and Idealism, and we find positive relationships between Self-actualization and Idealism values and moral reasoning. Implications for values and ethics research are discussed. (shrink)

Disillusionment is acknowledged to be a painful process with important personal and social consequences. However, scientific conceptualisations of the experience are inconsistent. Across four studies, we examined whether lay conceptions of disillusionment produce a consistent pattern of features. In Study 1 (N = 204), we extracted 19 features of disillusionment from open-ended participant definitions. In Study 2 (N = 131), participants rated the centrality of these features and indicated that features such as discovery, disappointment, and loss, were highly representative, while (...) features such as hopelessness, orientation, and truth, were more peripheral. In two further studies, we used experimental designs to test the diagnosticity of these features. In Study 3 (N = 155), participants rated vignettes descriptions as more disillusioning when they were based on more, rather than less, prototypical disillusionment features. Given that disappointment is a feature of disillusionment, we conducted Study 4 (N = 60) to test whether the extracted features effectively distinguish disillusionment from disappointment. Overall, we found evidence to suggest that disillusionment contains a consistent set of features, and represents a state of negative epistemic affect associated with the violation of core assumptions. These results create avenues for research on disillusionment, its antecedents and its consequences. (shrink)

This essay places contemporary efforts to understand and respond to the crisis of physician burnout in historical perspective, proposing that the origins of such efforts lie in nineteenth century concerns over “nervous exhaustion,” well before the term “physician burnout” was coined by social scientists in the early 1970s. Only very recently, however, have physician-scholars started to bring more sophisticated tools to bear in conceptualizing the problem, moving from a “systems approach” to the most recent efforts to frame the issue as (...) a problem of corporate culture. The essay proposes that these different approaches to physician burnout illustrate the changing self-images of the medical profession over the last century and a half. Because such self-images are embedded in normative assumptions, contextualizing physician burnout in these terms reveals the crisis to be as much social and political as professional. (shrink)

This chapter contains sections titled: Works cited Additional recommendations by editors.

Focusing on the self as a normative construct, I consider how and why the self, not the group, is ontologically fundamental. Selves live in communities or societies of selves. The intrinsic normativity of the self and the actions the self performs constitute the grounds on which people fashion coherent narratives about themselves and seek to display themselves to others in ways that conform to their narratives. People bond with, care for, and invest in each other as distinctive selves that they (...) can coordinate with in a vast range of different activities and practices together with the conflicts and tensions between these activities and practices that define their political nature. The persistence or otherwise of the activities and projects that selves participate in is dependent on other activities and practices that lend their support and cooperation (or otherwise) to them. Activities and projects are therefore interdependent in ways that are more or less democratic. Selves-in-activities actively maintain, contest, and change these activities and projects. Political activity is thus seen as the processes of maintaining, contesting, and changing both selves-in-activities and the relations between activities. (shrink)