Subjects classified visible 2-digit numbers as larger or smaller than 55. Target numbers were preceded by masked 2-digit primes that were either congruent (same relation to 55) or incongruent. Experiments 1 and 2 showed prime congruency effects for stimuli never included in the set of classified visible targets, indicating subliminal priming based on long-term semantic memory. Experiments 2 and 3 went further to demonstrate paradoxical unconscious priming effects resulting from task context. For example, after repeated practice classifying 73 as larger (...) than 55, the novel masked prime 37 paradoxically facilitated the “larger” response. In these experiments task context could induce subjects to unconsciously process only the leftmost masked prime digit, only the rightmost digit, or both independently. Across 3 experiments, subliminal priming was governed by both task context and long-term semantic memory. (shrink)

The aim of UK-REACH (“The United Kingdom Research study into Ethnicity And COVID-19 outcomes in Healthcare workers”) is to understand if, how, and why healthcare workers (HCWs) in the United Kingdom (UK) from ethnic minority groups are at increased risk of poor outcomes from COVID-19. In this article, we present findings from the ethical and legal stream of the study, which undertook qualitative research seeking to understand and address legal, ethical, and social acceptability issues around data protection, privacy, and information (...) governance associated with the linkage of HCWs’ registration data and healthcare data. We interviewed 22 key opinion leaders in healthcare and health research from across the UK in two-to-one semi-structured interviews. Transcripts were coded using qualitative thematic analysis. Participants told us that a significant aspect of Big Data research in public health is varying drivers of mistrust—of the research itself, research staff and funders, and broader concerns of mistrust within participant communities, particularly in the context of COVID-19 and those situated in more marginalised community settings. However, despite the challenges, participants also identified ways in which legally compliant and ethically informed approaches to research can be crafted to mitigate or overcome mistrust and establish greater confidence in Big Data public health research. Overall, our research indicates that a “Big Data Ethics by Design” approach to research in this area can help assure (1) that meaningful community and participant engagement is taking place and that extant challenges are addressed, and (2) that any new challenges or hitherto unknown unknowns can be rapidly and properly considered to ensure potential (but material) harms are identified and minimised where necessary. Our findings indicate such an approach, in turn, will help drive better scientific breakthroughs that translate into medical innovations and effective public health interventions, which benefit the publics studied, including those who are often marginalised in research. (shrink)

"The premise of the Jewish attitude toward illness is that living is sacred, that good health enables us to live a fully religious life, and that disease is an evil. Any effective therapy is permitted, even if it conflicts with Jewish law. To bring about healing is a responsibility not only of the person who is ill and of the professional caregivers, but also of the loved ones, and of the larger circle of family, friends, and community." "Illness and Health (...) in the Jewish Tradition is an anthology of traditional and modern Jewish writings that highlights these basic principles."--BOOK JACKET.Title Summary field provided by Blackwell North America, Inc. All Rights Reserved. (shrink)

Physiologically accurate mouse models of cancer are critical in the pre‐clinical development of novel cancer therapies. However, current standardized animal‐housing temperatures elicit chronic cold‐associated stress in mice, which is further increased in the presence of tumor. This cold‐stress significantly impacts experimental outcomes. Data from our lab and others suggest standard housing fundamentally alters murine physiology, and this can produce altered immune baselines in tumor and other disease models. Researchers may thus underestimate the efficacy of therapies that are benefitted by immune (...) responses. A potential mediator, norepinephrine, also underlies stress pathways common in mice and humans. Therefore, research into mechanisms connecting cold‐stress and norepinephrine signaling with immune depression in mice could highlight new combination therapies for humans to simultaneously target stress while stimulating anti‐tumor immunity. (shrink)

In the article “Principled Conscientious Provision: Referral Symmetry and Its Implications for Protecting Secular Conscience,” Abram L. Brummett, Tanner Hafen, and Mark C. Navin reject what they call the “referral asymmetry” in U.S. conscientious objection law in medicine, which recognizes rights of conscientiously objecting physicians to withhold referrals for medical interventions but does not (yet) recognize rights of physicians to make referrals for medical interventions to which they are morally committed but to which their health care institutions are morally opposed. (...) This commentary concentrates on a second asymmetry, namely, the relationship of a health care provider's referral or nonreferral to the medical standard of care. The commentary argues that this second asymmetry seems to require action more appropriately recognized as civil disobedience than conscientious provision of referral. (shrink)

Abstract“Conscientious provision” refers to situations in which clinicians wish to provide legal and professionally accepted treatments prohibited within their (usually Catholic) health care institutions. It mirrors “conscientious objection,” which refers to situations in which clinicians refuse to provide legal and professionally accepted treatments offered within their (usually secular) health care institutions. Conscientious provision is not protected by law, but conscientious objection is. In practice, this asymmetry privileges conservative religious or moral values (usually associated with objection) over secular moral values (usually (...) associated with provision). In this article, we first argue for a legal right to one kind of conscientious provision: referral for procedures prohibited at Catholic hospitals. We then argue that a premise in that argument—the principle of comparably trivial institutional burdens—justifies legal protections for some additional forms of conscientious provision that include, for example, writing prescriptions for contraception or medical abortions. However, this principle cannot justify legal protections for other forms of conscientious provision, for instance, the right to perform surgical abortions or gender-affirming hysterectomies at Catholic hospitals. (shrink)

Moral pluralism poses a foundational problem for secular clinical ethics: How can ethical dilemmas be resolved in a context where there is disagreement not only on particular cases, but further, on...

In a recent paper in Psychological Science, Kouider and Dupoux reported obtaining unconscious Stroop priming only when subjects had partial awareness of the masked distractor words . Kouider and Dupoux conjectured that semantic priming occurs only when such partial awareness is present. The present experiments tested this conjecture in an affective categorization priming task that differed from Kouider and Dupoux’s in using masked distractors that subjects had practiced earlier as visible words. Experiment 1 showed priming from practiced words when subjects (...) had no partial awareness of those words. Experiment 2 showed that, in the absence of partial awareness, practiced words yielded priming but not-practiced words did not. Experiment 3 corroborated Experiment 1 and 2s results using a different test of partial awareness. These results suggest that unconscious processing of subword elements drives masked semantic priming by practiced words. (shrink)

Volume 20, Issue 3, March 2020, Page 50-52.

Robert Card has proposed a reasonability view of conscientious objection that asks providers to state the reasons for their objection for evaluation and approval by a review board. Jason Marsh has challenged Card to provide explicit criteria for what makes a conscientious objection reasonable, which he claims will be too difficult a task given that such objections often involve contentious metaphysical or religious claims. Card has responded by outlining standards by which a conscientious objection could be judged reasonable. In this (...) paper, I extend Marsh’s critique to key concepts in the standards outlined by Card such as abortifacient, harm, emergency, and discrimination, showing they can be given radically different interpretations given different metaphysical or religious presumptions. To resolve these conflicting interpretations, a reasonability view of conscientious objection will need more than the criteria outlined by Card, it will need the resources to evaluate the reasonability of metaphysical or religious claims. (shrink)

According to a standard account of patient decision-making capacity, patients can provide ethically valid consent or refusal only if they are able to understand and appreciate their medical c...

A paradox has always lingered at the heart of secular clinical ethics: How are ethicists to provide moral guidance in a pluralistic society? I want to thank all the commentary authors for being suc...

The target article by Kyle Fritz draws attention to the asymmetry debate, an under-analyzed issue within the broader debate over the proper role of physician conscience in healthcare. The as...

A collection of dramatic accounts about doctors who have faced the moral dilemma of choosing between obeying rules and doing what is best for a patient offers insight into the essential principles of medical ethics and their impact on ...

The claim that visually masked, unidentifiable words are analyzed at the level of whole word meaning has been challenged by recent findings indicating that instead, analysis occurs mainly at the subword level. The present experiments examined possible limits on subword analysis. Experiment 1 obtained semantic priming from pleasant- and unpleasant-meaning subliminal words in which no individual letter contained diagnostic information about a word’s evaluative valence; thus analysis must operate on information more complex than that contained in individual letters. Experiments 2 (...) and 3 showed that analysis must operate on information more complex than that represented by individual bigrams or trigrams . These findings suggest that while subliminal priming is driven by subword analysis, the effective units of analysis are distributed widely across at least short words. (shrink)

Abstract:In this manuscript, we start with a real life account of an Ob/Gyn experience with a young patient from the childfree movement requesting permanent sterilization. A narrative ethics approach invites the reader to experience the encounter in an immersive way for this growing issue. This approach allows readers to reflect on their reaction to the patient and consider how that can affect other patient encounters. Additionally, it explores the stigma these young patients encounter making a permanent decision to never have (...) children. In the commentary, we explore the ethical issues in this case including why we question the permanent decision to refrain from having children. We also discuss informed consent and patient education along with the various approaches to physician-patient relationships with an emphasis on shared decision making, which allows space for both patient and physician to question and reason through their health decisions. (shrink)

ABSTRACTThis research investigated whether precues engage proactive control to reduce emotional interference during speech production. A picture-word interference task required participants to name target pictures accompanied by taboo, negative, or neutral distractors. Proactive control was manipulated by presenting precues that signalled the type of distractor that would appear on the next trial. Experiment 1 included one block of trials with precues and one without, whereas Experiment 2 mixed precued and uncued trials. Consistent with previous research, picture naming was slowed in (...) both experiments when distractors were taboo or negative compared to neutral, with the greatest slowing effect when distractors were taboo. Evidence that precues engaged proactive control to reduce interference from taboo distractors was found in Experiment 1. In contrast, mixing precued trials in Experiment 2 resulted in no taboo cueing benefit. These results suggest that item-level proactive control can b... (shrink)

We argue that the American Society for Bioethics and Humanities has endorsed a facilitation approach to clinical ethics consultation that asserts that bioethicists can offer moral recommendations that are well-grounded in bioethical consensus. We claim that the closest thing the field currently has to a citable, nationally endorsed bioethical consensus are the 22 Core References used to construct the questions for the Healthcare Ethics Consultant-Certified (HEC-C) exam. We acknowledge that the Core References reflect some important points of bioethical consensus, but (...) note they are unwieldy, repetitive, and sometimes inconsistent on important issues faced by clinical ethicists. In this article, we draw carefully qualified inspiration from the Ethical and Religious Directives for Catholic Health Care Services (ERDs) to argue for the creation of a concise, nationally endorsed bioethical consensus document on moral issues commonly faced in clinical ethics, what we call the Standardized Ethical Guidelines for Secular Health Care Services (SEGs). We observe that such a document would better meet the expectations of stakeholders, clinical ethicists, and their trainees who desire moral recommendations grounded in a clearly articulated bioethical consensus, and we defend the SEGs from some common objections. (shrink)

We respond to Autumn Fiester’s critique that our proposed bioethical consensus project amounts to “ethical hegemony,” and evaluate her claim that ethicists should restrict themselves to “mere process” recommendations. We argue that content recommendations are an inescapable aspect of clinical ethics consultation, and our primary concern is that, without standardization of bioethical consensus, our field will vacillate among appeals to the disparate claims in the 22 “Core References,” unsustainable efforts to defend value-neutral process recommendations, or become a practice of Lone (...) Ranger clinical ethicists. We contend that a consensus document that captures the basic moral commitments of patients and careproviders is the next step in the professional evolution of our field. (shrink)

We are grateful for the engagement of our colleagues with our thesis: conscientious objection to aggressive interventions for likely permanently unconscious patients is ethically permissible. In li...

Responding to volatile criticisms frequently leveled at Leo Strauss and those he influenced, the prominent contributors to this volume demonstrate the profound influence that Strauss and his students have exerted on American liberal democracy and contemporary political thought. By stressing the enduring vitality of classic books and by articulating the theoretical and practical flaws of relativism and historicism, the contributors argue that Strauss and the Straussians have identified fundamental crises of modernity and liberal democracy.

Some physicians refuse to perform life-sustaining interventions, such as tracheostomy, on patients who are very likely to remain permanently unconscious. To explain their refusal, these clinicians often invoke the language of “futility”, but this can be inaccurate and can mask problematic forms of clinical power. This paper explores whether such refusals should instead be framed as conscientious objections. We contend that the refusal to provide interventions for patients very likely to remain permanently unconscious meets widely recognized ethical standards for the (...) exercise of conscience. We conclude that conscientious objection to tracheostomy and other life-sustaining interventions on such patients can be ethical because it does not necessarily constitute a form of invidious discrimination. Furthermore, when a physician frames their refusal as conscientious objection, it makes transparent the value-laden nature of their objection and can better facilitate patient access to the requested treatment. (shrink)

In this paper, we argue that providers who conscientiously refuse to provide legal and professionally accepted medical care are not always morally required to refer their patients to willing providers. Indeed, we will argue that refusing to refer is morally admirable in certain instances. In making the case, we show that belief in a sweeping moral duty to refer depends on an implicit assumption that the procedures sanctioned by legal and professional norms are ethically permissible. Focusing on examples of female (...) genital cutting, clitoridectomy and ‘normalizing’ surgery for children with intersex traits, we argue that this assumption is untenable and that providers are not morally required to refer when refusing to perform genuinely unethical procedures. The fact that acceptance of our thesis would force us to face the challenge of distinguishing between ethical and unethical medical practices is a virtue. This is the central task of medical ethics, and we must confront it rather than evade it. There are no data in this work. (shrink)