Background The ethical governance of Artificial Intelligence (AI) in health care and public health continues to be an urgent issue for attention in policy, research, and practice. In this paper we report on central themes related to challenges and strategies for promoting ethics in research involving AI in global health, arising from the Global Forum on Bioethics in Research (GFBR), held in Cape Town, South Africa in November 2022. Methods The GFBR is an annual meeting organized by the World Health (...) Organization and supported by the Wellcome Trust, the US National Institutes of Health, the UK Medical Research Council (MRC) and the South African MRC. The forum aims to bring together ethicists, researchers, policymakers, research ethics committee members and other actors to engage with challenges and opportunities specifically related to research ethics. In 2022 the focus of the GFBR was “Ethics of AI in Global Health Research”. The forum consisted of 6 case study presentations, 16 governance presentations, and a series of small group and large group discussions. A total of 87 participants attended the forum from 31 countries around the world, representing disciplines of bioethics, AI, health policy, health professional practice, research funding, and bioinformatics. In this paper, we highlight central insights arising from GFBR 2022. Results We describe the significance of four thematic insights arising from the forum: (1) Appropriateness of building AI, (2) Transferability of AI systems, (3) Accountability for AI decision-making and outcomes, and (4) Individual consent. We then describe eight recommendations for governance leaders to enhance the ethical governance of AI in global health research, addressing issues such as AI impact assessments, environmental values, and fair partnerships. Conclusions The 2022 Global Forum on Bioethics in Research illustrated several innovations in ethical governance of AI for global health research, as well as several areas in need of urgent attention internationally. This summary is intended to inform international and domestic efforts to strengthen research ethics and support the evolution of governance leadership to meet the demands of AI in global health research. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:The Amazons: Lives and Legends of Warrior Women across the Ancient World by Adrienne MayorAlison KeithAdrienne Mayor. The Amazons: Lives and Legends of Warrior Women across the Ancient World. Princeton: Princeton University Press, 2014. xiv + 519 pp. Cloth, $29.95.Adrienne Mayor is a historian of classical folklore and ancient science and the author of several books whose subjects lie at the intersection of classical myth and (...) ancient history with archaeology and the history of science: an exploration of monsters and heroes in the repertoire of classical myth as a response to the discovery of fossils in The First Fossil Hunters (Princeton 2000); a wide-ranging collection of evidence for biological and chemical warfare in the ancient world, Greek Fire, Poison Arrows, and Scorpion Bombs (New York: Overlook Press, 2003); and a sympathetic biography of Mithradates VI Eupator of Pontus in The Poison King: The Life and Legend of Mithradates, Rome’s Deadliest Enemy (Princeton 2009); as well as an investigation of indigenous North Americans’ accounts of fossils, in Fossil Legends of the First Americans (Princeton 2005). Like her earlier volumes, The Amazons brings together an extraordinarily wide array of evidence, uncovered through prodigious research across such diverse fields as classical mythology, ancient history, and contemporary archaeology of the central Asian steppes, and the results are presented with her trademark narrative brio. As with these earlier volumes, moreover, Mayor has an agenda in The [End Page 174] Amazons: here she seeks the historical reality that lies behind the ancient Greek myths of barbarian warrior women; and she finds it in the recent archaeological discoveries of female warriors interred on the central Asian steppes from the Caucasus to western China.Mayor sets out her premise in a prologue that takes its bearing from the myth of Atalanta, whom she dubs “the Greek Amazon” (1–13): her project is to investigate where the Greeks might have encountered real women warriors like Atalanta, capable of besting men in footraces, on the battlefield, and in the hunt. Her study falls into four parts: Part 1 (17–59) asks, “Who were the Amazons?” and identifies ancient Scythia, with its many horse-riding and horse-herding nomadic tribes, as the homeland of the Amazons. Part 2 (63–246) surveys the archaeological and scientific evidence for female warriors among the nomadic tribes of the central Asian steppes in prehistoric and historic times. In this section, Mayor considers the evidence afforded by the bones of buried nomad warriors misidentified as male (because of the weaponry and horses accompanying the burial) when they were originally excavated but recently recognized as female as a result of newer scientific techniques of examination (chap. 4); the body armor found in the steppe graves, in a discussion which has recourse to comparative ethnography, yielding a rich history of breast suppression (chap. 5); the tattooing practices of the historical nomadic tribes of the steppes in relation to the iconography of Amazons’ tunics and leggings on classical vase paintings (chap. 6); ancient accounts of Amazons’ dress (chap. 7), including their partiality for trousers (chap. 12), sexuality and reproduction (chap. 8), drugs, dance and music (chap. 9), hunting technologies (chap. 11), weapons and warfare (chap. 13), all in relation to the archaeological and historical evidence of steppe women’s practices in these arenas. She even presses into service ethnolinguistics in order to argue that the names of the Amazons can be traced back to a common origin in the Eurasian steppes (chap. 14; cf. Appendix of Names of Amazons and Warrior Women in Ancient Literature and Art from the Mediterranean to China). In Part 3 (249–353), Mayor turns back to “Amazons in Greek and Roman Myth, Legend, and History.” Here she retells the most famous Amazon myths, of Hippolyte and Heracles [sic] (chap. 15), Antiope and Theseus (chap. 16), Penthesilea and Achilles (chap. 18), and the Athenian Amazonomachy (chaps. 17, 19); and classical accounts of their historical counterparts—the dalliance of Thalestris and Alexander the Great (chap. 20) and the love of Hypsicratea and Mithradates (chap. 21). Part 4 (358–429) abandons the Hellenocentric perspective of Part 3 to investigate the evidence for Amazonian women “Beyond the Greek World... (shrink)

Philosophers have developed three theories of luck: the probability theory, the modal theory, and the control theory. To help assess these theories, we conducted an empirical investigation of luck attributions. We created eight putative luck scenarios and framed each in either a positive or a negative light. Furthermore, we placed the critical luck event at the beginning, middle, or end of the scenario to see if the location of the event influenced luck attributions. We found that attributions of luckiness were (...) significantly influenced by the framing of the scenario and by the location of the critical event. Positively framing an event led to significantly higher lucky ratings than negatively framing the same exact event. And the closer a negative event was placed toward the end of a scenario, the more unlucky the event was rated. Overall, our results raise the possibility that there is no such thing as luck and thereby pose serious challenges to the three prominent theories of luck. We instead propose that luck may be a cognitive illusion, a mere narrative device used to frame stories of success or failure. (shrink)

Disaster research has grown in scope and frequency. Research in the wake of disasters and during humanitarian crises – particularly in resource-poor settings – is likely to raise profound and unique ethical challenges for local communities, crisis responders, researchers, and research ethics committees. Given the ethical challenges, many have questioned how best to provide research ethics review and oversight. We contribute to the conversation concerning how best to ensure appropriate ethical oversight in disaster research and argue that ethical disaster research (...) requires of researchers and RECs a particular sort of ongoing, critical engagement which may not be warranted in less exceptional research. We present two cases that typify the concerns disaster researchers and RECs may confront, and elaborate upon what this ongoing engagement might look like – how it might be conceptualized and utilized – using the concept of real-time responsiveness. The central aim of RTR, understood here as both an ethical ideal and practice, is to lessen the potential for research conducted in the wake of disasters to create, perpetuate, or exacerbate vulnerabilities and contribute to injustices suffered by disaster-affected populations. Well cultivated and deployed, we believe that RTR may enhance the moral capacities of researchers and REC members, and RECs as institutions where moral agency is nurtured and sustained. (shrink)

This article explores two very different forms in which immoral conduct was problematized over the course of the 19th century. It does this by contrasting the sexual purity politics of the Vice Society and the medicalization of morality as `moral insanity'. Early in the century the Vice Society promoted coercive legislation with the aim of `suppressing vice'. From mid-century, moral insanity theories sought to grapple with vice by disaggregating `moral' from other forms of insanity. These two movements had quite distinct (...) and incompatible lines of development; and they never overtly engaged with each other. The article makes its key argument by demonstrating the way in which such dissimilar trajectories came together towards the end of the century in the `moral hygiene' movement, mobilizing discourses of `degeneration' (and `feeblemindedness') with projects promoting sexual purity. (shrink)

Summary It has often been repeated that Wollstonecraft was not read for a century after her death in 1797 due to the negative impact of her husband William Godwin's Memoirs of the Author of a Vindication of the Rights of Woman (1798) on her posthumous reputation. By providing the first full-scale reception history of Wollstonecraft in continental Europe in the long nineteenth century—drawing on rare book research, translations of understudied primary sources, and Wollstonecraft scholarship from the nineteenth century to the (...) present—this article applies a revised Rezeptionsgeschichte approach to tracing her intellectual influence on the woman question and organised feminism in Europe. Although the Memoirs and post-revolutionary politics everywhere dampened and even drove underground the reception of her persona and ideas in the first decades of the nineteenth century, Wollstonecraft's reception in nineteenth-century continental Europe, like the United States, was more positive and sustained in comparison to the public backlash she faced as a ‘fallen woman’ in her homeland of Britain through the bulk of the Victorian era. (shrink)

It is generally accepted that farmers manage a complex farm system. In this article we seek answers to the following questions. How do farmers perceive and understand their farm system? Are they sufficiently aware of their farm system that they are able to represent it in the form of a map? The research reported describes how causal mapping was applied to sheep/beef farmers in New Zealand and shows that farmers can create maps of their farm systems in ways that allow (...) expression of both individual maps and the formation of group maps which represent the general character of farm systems. A group map was made for all the farmers studied and for subgroups using conventional, integrated, and organic management systems. The results are discussed in terms of the depth of meaning associated with individual elements of the map, map complexity and the limitations of causal mapping. Causal mapping has the potential to contribute to our knowledge of how farmers see their farm systems, and this can benefit farmers and other stakeholders concerned with the management of farms and their economic and environmental performance. (shrink)

This article considers the development of nurse-led services as a part of a pilot study and explores the therapeutic nature of the role of the nurse. In particular it suggests a need for reconsideration of the fundamental values of nurse-led care in the context of changing organizational culture. Within the UK there has been pressure from policy makers to extend the role of the specialist nurse and create new nursing roles, shifting the boundaries between professional health groups. The philosophy of (...) nurse-led initiatives has therefore been driven mainly from a service redesign and clinical need standpoint rather than necessarily focusing on enhancing patients’ experience and the changes in organizational culture required to achieve this. While several studies have focused on the safety, comparative cost and comparative patient outcomes in nurse-led care in relation to traditional or doctor-led care, little attention has been given to the changing organizational values underlying the nursing role. Exploring this context is essential if new nursing roles are to provide more than relief for bottlenecks in the system and also meet their potential for providing patient centred and innovative models of care. (shrink)

Locked inpatient units are an increasing phenomenon, introduced in response to unforseen abscondences and suicides of patients. This paper identifies some value issues concerning the practice of locked psychiatric inpatient units. Broad strategies, practicalities and ethical matters that must be considered in inpatient mental health services are also explored. The authors draw on the published research and commentary to derive relevant information to provide to patients and staff regarding the aims and rationales of locked units. Further debate is warranted in (...) relation to best practice. Inpatient staff need to be aware of their practice values, be able to access education and supervision and negotiate apparent contradictions. Further patient/clinician focused enquiry is necessary to mitigate the negative and stigmatising effects of locked mental health units. (shrink)

Understanding terrestrial carbon metabolism is critical because terrestrial ecosystems play a major role in the global carbon cycle. Furthermore, humans have severely disrupted the carbon cycle in ways that will alter the climate system and directly affect terrestrial metabolism. Changes in terrestrial metabolism may well be as important an indicator of global change as the changing temperature signal. Improving our understanding of the carbon cycle at various spatial and temporal scales will require the integration of multiple, complementary and independent methods (...) that are used by different research communities. Tools such as air sampling networks, inverse numerical methods, and satellite data allow us to study the strength and location of the global- and continental-scale carbon sources and sinks. Bottom-up studies provide estimates of carbon fluxes at finer spatial scales and examine the mechanisms that control fluxes at the ecosystem, landscape, and regional scales. Bottom-up approaches include comparative and process studies that provide the necessary mechanistic information to develop and validate terrestrial biospheric models. An iteration and reiteration of top-down and bottom-up approaches will be necessary to help constrain measurements at various scales. We propose a major international effort to coordinate and lead research programs of global scope of the carbon cycle. (shrink)

Advancements in fetal assessment and therapeutic intervention in medical practice and clinical research call for corresponding progress in regulatory and ethical guidance. In “A new ethical framewo...

RESUMEN El presente trabajo describe los cambios estratégicos del Centro de Inmunología y Productos Biológicos de la Universidad de Ciencias Médicas de Camagüey que contribuyen a la formación profesional, la investigación y los servicios científico técnicos. Recoge los resultados obtenidos desde el 2015 hasta el 2017. Los referentes teóricos permiten un acercamiento epistémico que facilita la relación con el conocimiento y la creación de concepciones para abordar los problemas de salud. El centro tiene cuatro proyectos asociados a programas y 11 (...) institucionales. Se posee 2,7 publicaciones por autor y 18 participaciones en eventos, de ellos, ocho internacionales. Se perfecciona un sistema de gestión de la calidad, nueve servicios científico-técnicos, diversos servicios a la docencia y proyectos de investigaciones. Se aprovecha el potencial que genera el proceso de auto-organización del trabajo colectivo, para un mejor funcionamiento, sinergia y sustentabilidad de la gestión de una unidad de desarrollo e innovación. ABSTRACT The present work describes the strategic changes of the Center of Immunology and Biological Products of the University of Medical Sciences of Camagüey that contributes to the professional training, the investigation and the technical-scientist services. It gathers the results obtained from 2015 to 2017. The theoretical bases allow an epistemic approach that facilitates the relation with the knowledge and the creation of conceptions to tackle the health problems. The center has four projects associated with programs and 11 institutional ones. There are possessed 2.7 publications per author and 18 participations in events, of them, eight international ones. Scientist - technical staff perfects a system of management of the quality, nine services, diverse services to the teaching and projects of investigations. One makes use of the potential that generates the auto-organization process of collective work, for a better functioning, synergy and sustainability of the management of a unit of development and innovation. (shrink)

The standard foil for recent theories of hope is the belief-desire analysis advocated by Hobbes, Day, Downie, and others. According to this analysis, to hope for S is no more and no less than to desire S while believing S is possible but not certain. Opponents of the belief-desire analysis argue that it fails to capture one or another distinctive feature or function of hope: that hope helps one resist the temptation to despair;2 that hope engages the sophisticated capacities of (...) human agency, such as planning;3 or that hope involves the imagination in ways desire need not.4 Here, I focus on the role of imagination in hope, and discuss its implications for hope’s relation to practical commitment or end-setting. (shrink)

What exactly is hope and how does it influence our decisions? In How We Hope, Adrienne Martin presents a novel account of hope, the motivational resources it presupposes, and its function in our practical lives. She contends that hoping for an outcome means treating certain feelings, plans, and imaginings as justified, and that hope thereby involves sophisticated reflective and conceptual capacities. Martin develops this original perspective on hope--what she calls the "incorporation analysis"--in contrast to the two dominant philosophical conceptions (...) of hope: the orthodox definition, where hoping for an outcome is simply desiring it while thinking it possible, and agent-centered views, where hoping for an outcome is setting oneself to pursue it. In exploring how hope influences our decisions, she establishes that it is not always a positive motivational force and can render us complacent. She also examines the relationship between hope and faith, both religious and secular, and identifies a previously unnoted form of hope: normative or interpersonal hope. When we place normative hope in people, we relate to them as responsible agents and aspire for them to overcome challenges arising from situation or character. Demonstrating that hope merits rigorous philosophical investigation, both in its own right and in virtue of what it reveals about the nature of human emotion and motivation, How We Hope offers an original, sustained look at a largely neglected topic in philosophy. (shrink)

ABSTRACTThe standard view in philosophy of mind is that the way to understand the difference between perception and misperception is in terms of accuracy. On this view, perception is accurate while...

This article defends a theory of diffuse attention and distinguishes it from focal attention. My view is motivated by evidence from psychology and neuroscience, which suggests that we can deploy visual selective attention in at least two ways: by focusing on a small number of items, or by diffusing attention over a group of items taken as a whole. I argue that diffuse attention is selective and can be object‐based. It enables a subject to select an object to guide behavior, (...) albeit in a different way than focusing does. (shrink)

Attention seems to raise a problem for pure representationalism, the view that phenomenal content supervenes on representational content. The problem is that shifts of attention sometimes seem to bring about a change in phenomenal content without a change in representational content. I argue that the representationalist can meet this challenge, but that doing so requires a new view of the representational content of perception. On this new view, the representational content of perception is always relative to a way of attending. (...) I call this the attention-indexed view of perceptual content. (shrink)

Appreciation and gratitude get good press: They are central virtues in many religious and secular ethical frameworks, core in positive psychology research, and they come highly recommended by the self‐improvement set. Generally, appreciation and gratitude feature as good things, in popular consciousness. Of course, on an Aristotelian model, the belief that these are virtues implies they are something people can get right or wrong. This paper examines bad appreciation and bad gratitude, characterizing forms of appreciation and gratitude at the center (...) of some major social norms and practices, and demonstrating that they mask familiar oppressive expectations and power relations. (shrink)

The vocabulary of wine is large and exceptionally vibrant -- from straight-forward descriptive words like "sweet" and "fragrant", colorful metaphors like "ostentatious" and "brash", to the more technical lexicon of biochemistry. The world of wine vocabulary is growing alongside the current popularity of wine itself, particularly as new words are employed by professional wine writers, who not only want to write interesting prose, but avoid repetition and cliche. The question is, what do these words mean? Can they actually reflect the (...) objective characteristics of wine, and can two drinkers really use and understand these words in the same way?In this second edition of Wine and Conversation, linguist Adrienne Lehrer explores whether or not wine drinkers (both novices and experts) can in fact understand wine words in the same way. Her conclusion, based on experimental results, is no. Even though experts do somewhat better than novices in some experiments, they tend to do well only on wines on which they are carefully trained and/or with which they are very familiar. Does this mean that the elaborate language we use to describe wine is essentially a charade? Lehrer shows that although scientific wine writing requires a precise and shared use of language, drinking wine and talking about it in casual, informal setting with friends is different, and the conversational goals include social bonding as well as communicating information about the wine. Lehrer also shows how language innovation and language play, clearly seen in the names of new wines and wineries, as well as wine descriptors, is yet another influence on the burgeoning and sometimes whimsical world of wine vocabulary. (shrink)

In cases of identity crowding, a subject consciously sees items in a figure, even though they are presented too closely together for her to shift attention to each item. Block uses such cases to challenge the view that attention is necessary for consciousness. I argue that in identity crowding cases, subjects really do attend to the items. Specifically, they attend to the figure as a global object that contains the individual items as parts. To support this view, I provide evidence (...) that attention can be directed to a global object or a local object. My response helps to defend the view that attention is necessary for conscious perception. (shrink)

George Lakoff (2016) discusses how emotion metaphors reflect the discrete bodily states associated with each emotion. The analysis raises questions about the context for and frequency of use of emotion metaphors and, indeed, emotion labels (e.g., “angry”), per se. An assumption implicit to most theories of emotion is that emotion language is just another channel through which people express ongoing emotion states. Drawing from recent evidence that labeling ongoing emotions reduces their intensity, we propose that a primary function of emotion (...) language is regulatory rather than expressive. (shrink)

Rapid advancements in large language models (LLMs) have renewed interest in the question of whether consciousness can arise in an artificial system, like a digital computer. The general consensus is that LLMs are not conscious. This paper evaluates the main arguments against artificial consciousness in LLMs and argues that none of them show what they intend. However strong our intuitions against artificial consciousness are, they currently lack rational support.

The increasing use of opioid treatment agreements has prompted debate within the medical community about ethical challenges with respect to their implementation. The focus of debate is usually on the efficacy of OTAs at reducing opioid misuse, how OTAs may undermine trust between physicians and patients and the potential coercive nature of requiring patients to sign such agreements as a condition for receiving pain care. An important consideration missing from these conversations is the potential for racial bias in the current (...) way that OTAs are incorporated into clinical practice and in the amount of physician discretion that current opioid guidelines support. While the use of OTAs has become mandatory in some states for certain classes of patients, physicians are still afforded great leeway in how these OTAs are implemented in clinical practice and how their terms should be enforced. This paper uses the guidelines provided for OTA implementation by the states of Indiana and Pennsylvania as case studies in order to argue that giving physicians certain kinds of discretion may exacerbate racial health disparities. This problem cannot simply be addressed by minimising physician discretion in general, but rather by providing mechanisms to hold physicians accountable for how they treat patients on long-term opioid therapy to ensure that such treatment is equitable. There are no data in this work. (shrink)

I argue for adopting a conception of obligation that is broader than the conception commonly adopted by moral philosophers. According to this broader conception, the crucial marks of an obligatory action are, first, that the reasons for the obliged party to perform the action include an exclusionary reason and, second, that the obliged party is the appropriate target of blaming reactive attitudes, if they inexcusably fail to perform the obligatory action. An obligation is directed if the exclusionary reason depends on (...) the relationship between the obliged person and the person to whom they owe the obligatory action, and the latter person is positioned to personally blame the obligated person for inexcusably failing to perform the obligatory action. Some direc- ted obligations are not owed as a matter of right, and the person to whom the obligatory action is owed is the only person positioned to blame nonperformance. Other directed obligations are owed as a matter of right, and people who are not part of the relationship grounding the obligation nevertheless are also positioned to (impersonally) blame non-performance. Only the rights-based form of directed obligation has received signifi- cant attention from moral philosophers, yet the former—which is at the heart of what I call “personal bonds”—is a pervasive and significant theme of our ordinary interpersonal lives. (shrink)

Fact-finding hearings may be held to determine disputed allegations of domestic violence in child contact cases in England and Wales, and can play a vital role for mothers seeking protection and autonomy from violent fathers. Drawing on the author’s empirical study, this article examines the implications for the holding of fact-finding hearings of judges’ and professionals’ understandings of domestic violence and the extent to which they perceive it to be relevant to contact. While more judges and professionals are developing their (...) understanding of domestic violence, the ambit of when and how it is considered relevant to contact has grown increasingly narrow, which suggests that many disputed allegations of domestic violence are disregarded and women and children continue to be put at risk from violent fathers. This bifurcated approach is likely to have significant implications for recent developments in this area of family law which are considered in this article. (shrink)

How do we encourage patients to be hopeful without exploiting their hope? A medical researcher or a pharmaceutical company can take unfair advantage of someone's hope by much subtler means than simply giving misinformation. Hope shapes deliberation, and therefore can make deliberation better or worse, by the deliberator's own standards of deliberation.

In lieu of an abstract, here is a brief excerpt of the content:I Had Never Heard Someone Use That Word BeforeAdrienne Feller NovickThe patient was dying. As the social worker, I had arranged the meeting and sat shoulder to shoulder with the family and the attending physician in the small nondescript room. The family was grief-stricken and asked intelligent questions as they made difficult decisions about end-of-life care for their loved one. The doctor spoke with gentle kindness, acknowledging their difficult (...) decision as he completed the neon pink Medical Orders for Life Sustaining Treatment (MOLST) form and left the room. I was tangled up with emotions; I felt relieved that the meeting had gone smoothly, sad for the patient and family, and in awe of the doctor for his ability to lead the difficult conversation. I stayed behind to ask the family if there was anything I could do to help them. [End Page E4]Before I could speak, the patient's wife turned to me and said, "I am so glad that k--- left the room." (Using a derogatory word for a person of the Jewish faith). My brain began processing the statement. I am a Jewish woman. Did I hear that right? Did she say what I think she said? Should I say something? I froze, and time seemed to stop. She was looking at me expectantly, waiting for a response. Her face reminded me of someone waiting for the other person to return a "high five." I was flooded with emotion. A succession of thoughts ran through my head, everything from being rude in response or getting physical. I did neither. I said nothing. I smiled and left the room feeling like I had been gut-punched.I was in denial. I made excuses for the wife; she was stressed. I kept thinking I must not have heard her correctly and that I was overreacting. I continued to work with the family as though nothing had happened until the patient died five days later. I felt ashamed and never told anyone about what happened. I regretted not saying anything. I replayed the conversation in my mind and felt depressed and angry. Inside I felt complicit for not speaking up, but I had no words. I assumed bias in healthcare was rare. I did nothing.Years later, after I completed a patient visit in the Intensive Care Unit (ICU), I observed a group of surgical residents doing rounds. The attending welcomed me to join this valuable clinical learning experience. As the group approached the next bed, the patient pointed to one resident and loudly said, "I don't want a doctor who looks like that to come near me." I gasped aloud and froze, waiting to see what would happen next. The attending looked directly at the patient and said calmly, "We are all here to help you. That is not an appropriate thing for you to say." Then, he turned to the resident and nodded, directing them to resume their bedside assessment. The patient mumbled something inaudibly and said nothing.To my astonishment, the doctor acknowledged the microaggression (a microaggression is a statement, action, or incident regarded as discrimination), addressed the issue, respectfully supported the resident, created a safe space for everyone on the healthcare team and resumed quality patient care without missing a beat. He modeled a strategy to address patient bias and taught a valuable skill. This was a learning moment for me. It helped me refocus my past experience and provided me with a useful strategy to address bias in the future.As a member of the medical ethics consultation service, I listen, provide support, and aid in challenging communications. I had the opportunity to model the communication strategy I acquired in the ICU. The medical ethics team was consulted for a patient refusing treatment. The patient was disrespectful to healthcare team members, cursing at nurses and residents, using ethnic slurs, and saying he "would rather die than let one of them touch him. I entered the patient's room with the healthcare team, introduced myself, and explained the reason for my visit. The patient defiantly agreed he had used slurs, saying he wanted to go home. I continued, everyone here... (shrink)