Implicit biases involve associations outside conscious awareness that lead to a negative evaluation of a person on the basis of irrelevant characteristics such as race or gender. This review examines the evidence that healthcare professionals display implicit biases towards patients. PubMed, PsychINFO, PsychARTICLE and CINAHL were searched for peer-reviewed articles published between 1st March 2003 and 31st March 2013. Two reviewers assessed the eligibility of the identified papers based on precise content and quality criteria. The references of eligible papers were (...) examined to identify further eligible studies. Forty two articles were identified as eligible. Seventeen used an implicit measure, to test the biases of healthcare professionals. Twenty five articles employed a between-subjects design, using vignettes to examine the influence of patient characteristics on healthcare professionals’ attitudes, diagnoses, and treatment decisions. The second method was included although it does not isolate implicit attitudes because it is recognised by psychologists who specialise in implicit cognition as a way of detecting the possible presence of implicit bias. Twenty seven studies examined racial/ethnic biases; ten other biases were investigated, including gender, age and weight. Thirty five articles found evidence of implicit bias in healthcare professionals; all the studies that investigated correlations found a significant positive relationship between level of implicit bias and lower quality of care. The evidence indicates that healthcare professionals exhibit the same levels of implicit bias as the wider population. The interactions between multiple patient characteristics and between healthcare professional and patient characteristics reveal the complexity of the phenomenon of implicit bias and its influence on clinician-patient interaction. The most convincing studies from our review are those that combine the IAT and a method measuring the quality of treatment in the actual world. Correlational evidence indicates that biases are likely to influence diagnosis and treatment decisions and levels of care in some circumstances and need to be further investigated. Our review also indicates that there may sometimes be a gap between the norm of impartiality and the extent to which it is embraced by healthcare professionals for some of the tested characteristics. Our findings highlight the need for the healthcare profession to address the role of implicit biases in disparities in healthcare. More research in actual care settings and a greater homogeneity in methods employed to test implicit biases in healthcare is needed. (shrink)

The genetically manipulated organism crisis demonstrated that technological development based solely on the law of the marketplace and State protection against serious risks to health and safety is no longer a warrant of ethical acceptability. In the first part of our paper, we critique the implicitly individualist social-acceptance model for State regulation of technology and recommend an interdisciplinary approach for comprehensive analysis of the impacts and ethical acceptability of technologies. In the second part, we present a framework for the analysis (...) of impacts and acceptability, devised—with the goal of supporting the development of specific nanotechnological applications—by a team of researchers from various disciplines. At the conceptual level, this analytic framework is intended to make explicit those various operations required in preparing a judgement about the acceptability of technologies that have been implicit in the classical analysis of toxicological risk. On a practical level, we present a reflective tool that makes it possible to take into account all the dimensions involved and understand the reasons invoked in determining impacts, assessing them, and arriving at a judgement about acceptability. (shrink)

ObjectiveTo identify the ethical challenges associated with the development and implementation of new tuberculosis drugs and diagnostics.MethodsTwenty-three semi-structured qualitative interviews conducted between December 2015 and September 2016 with programme administrators, healthcare workers, advocates, policymakers, and funders based in the Americas, Europe, and Africa. Interviews were analysed using thematic analysis.ResultsDivergent interests and responsibilities, coupled with power imbalances, are a primary source of ethical challenges; the uncertain risk profiles of new drugs present an additional one. Although this challenge can be partially mitigated (...) through stringent pharmacovigilance, respondents highlighted that high-burden countries tend to lack the resources to facilitate safe implementation. Increased advocacy and community engagement are considered an ethical imperative for future TB development and implementation.ConclusionsThis project helps identify some of the ethical challenges of new TB technologies. It demonstrates that investigating ethical challenges through qualitative research is one way to apprehend the difficulty of implementing new TB technologies. Addressing this difficulty will require that those in positions of power reconsider their interests in relation to disempowered communities.Policy implicationsEfforts to build consensus regarding what values should underpin the global governance of TB research, prevention, and care are essential to facilitate the ethical implementation of new TB technologies. (shrink)

Drawing on the work of Foucault and Western confessional writings, this book challenges the transhistorical and commonsense views of confession as an innate impulse resulting in the psychological liberation of the confessing subject. Instead, confessional desire is argued to be contingent and constraining, and alternatives to confessional subjectivity are explored.

Awareness growth—coming to entertain propositions of which one was previously unaware—is a crucial aspect of epistemic thriving. And yet, it is widely believed that orthodox Bayesianism cannot accommodate this phenomenon, since that would require employing supposedly defective catch-all propositions. Orthodox Bayesianism, it is concluded, must be amended. In this paper, I show that this argument fails, and that, on the contrary, the orthodox version of Bayesianism is particularly well-suited to accommodate awareness growth. For it entails what I call the refinement (...) view, which allows us to capture that awareness growth consists in the increase of one’s capacity of discernment. (shrink)

Au cours de la guerre froide, les organisations internationales, notamment celles du système de l’ONU, sont des tribunes instrumentalisées par les deux superpuissances pour se mettre en valeur. C’est le cas de l’UNESCO. Le discours de la cosmonaute soviétique Valentina Terechkova en 1966 est la première prise de parole d’une femme soviétique dans cette enceinte. Terechkova, qui a été la première femme au monde à effectuer, en 1963, un vol dans l’espace, utilise la tribune de l’UNESCO pour introduire des enjeux (...) de genre dans le cadre des relations internationales marquées par le contexte de guerre froide. Au-delà des rapports de force entre États marqués par la bipolarisation du monde, elle tente d’exprimer des arguments à prétention universaliste en faveur des droits des femmes et du développement, tout en produisant un discours à rhétorique typiquement soviétique. (shrink)

This article examines how non-linear time and circularity are deployed in the historical novel Nehanda, written by Zimbabwean author Yvonne Vera. Using Adriana Cavarero’s work on inclination...

« Pricer », « marketer », « auto-fixing », curation, diffusion, réflexivité : cet article explore quelques-uns des innombrables ruses par lesquelles la raison de l’art jongle avec les valeurs du marché. Des travaux de Claude Rutault et Ben Kinmont servent de contre-exemples à certaines tendances dominantes.

Multimodal prehabilitation is increasingly recognized as an important component of the pre-operative pathway in oncology. It aims to optimize physical and psychological health through delivery of a series of tailored interventions including exercise, nutrition, and psychological support. At the core of this prescription is a need for considerable health behavior change, to ensure that patients are engaged with and adhere to these interventions and experience the associated benefits. To date the prehabilitation literature has focused on testing the efficacy of devised (...) exercise and nutritional interventions with a primary focus on physiological and mechanistic outcomes with little consideration for the role of behavioral science, supporting individual behavior change or optimizing patient engagement. Changing health behavior is complex and to maximize success, prehabilitation programs should draw on latest insights from the field of behavioral science. Behavioral science offers extensive knowledge on theories and models of health behavior change to further advance intervention effectiveness. Similarly, interventions developed with a person-centered approach, taking into consideration individual needs and preferences will increase engagement. In this article, we will provide an overview of the extent to which the existing prehabilitation literature incorporates behavioral science, as well as studies that have explored patient's attitudes toward prehabilitation. We will go on to describe and critique ongoing trials in a variety of contexts within oncology prehabilitation and discuss how current scientific knowledge may be enhanced from a behavioral science perspective. We will also consider the role of “surgery schools” and detail practical recommendations that can be embedded in existing or emerging clinical settings. (shrink)

Youth is a critical period in the development of maladaptive eating behaviors. Previous systematic reviews suggest the etiological significance of parent-child relationships for the onset of disordered eating in youth, but less is known about the role of parenting styles. This rapid scoping review aimed to identify whether research supports the role of parenting styles in the development of disordered eating symptoms among youths. Sixteen studies, retrieved from three databases, met the inclusion criteria: original studies, published in English, examined the (...) effect of parenting styles on cognitive and behavioral disordered eating outcomes, among young people up to 18 years of age. Studies supported an association between various youth disordered eating symptoms such as unhealthy weight control behaviors, and experiences of adverse parenting styles characterized by high levels of control and low levels of responsiveness. Associations between adverse parenting styles and youth disordered eating were frequently indirect and differed depending on the sex of the parent and offspring. Synthesis of findings was limited due to variation in the operationalization and measurement of parenting styles, family context and disordered eating across studies. Longitudinal and standardized research is required to better understand the dynamic associations between parenting styles and youth disordered eating. Implications for family-based care in clinical practice are discussed. (shrink)

t. 1. Codes et comités d'éthique -- t. 2. L'expérience québécoise.

The influence of physician judgment on the disclosure, competency, understanding, voluntariness, and decision aspects of informed consent for bone marrow transplantation are described. Ethical conflicts which arise from the amount and complexity of the information to be disclosed and from the barriers of limited time, patient anxiety and lack of prior relationship between patient and physician are discussed. The role of the referring physician in the decision-making is considered. Special ethical issues which arise with use of healthy related bone marrow (...) donors are discussed, as is the physician's discretion in raising questions of competency. It is concluded that in this setting, regardless of the theoretical goals of the physician, patients appear to utilize informed consent discussions to assess their capacity to trust the physician rather than as a time to weigh the large amount of relevant data. The conscientious physician best serves the patient with recommendation of the best medical alternative rather than with attempts to remain neutral. (shrink)

English summary: Jean-Francois Revel (1924-2006) was an essential intellectual and author of the twentieth century. His work explored the ideological sources that fed the various forms of totalitarianism, from Communism to Islamism. The present biography sheds light on the multiple aspects of this combative thought couched in the will affirm the principals of both economic and political liberal democracy. French description: Loin de n'avoir ete qu'un polemiste de talent, Jean-Francois Revel (1924-2006) a ete, de Pourquoi des philosophes? (1957) a L'Obsession (...) antiamericaine (2002), l'auteur d'une oeuvre de premiere importance, jalonnee par de fracassants succes populaires et internationaux. Allant bien au-dela du seul engagement anticommuniste, la force et la singularite intellectuelles de sa pensee n'avaient jamais, jusqu'ici, fait l'objet d'une synthese exhaustive qui aurait permis d'en eclairer la place dans l'histoire contemporaine des idees - une beance que le present ouvrage vient enfin combler. Avant tout anime par la passion des faits, ce philosophe s'est constamment employe a pourfendre et a deconstruire les impostures ideologiques dont se sont nourries les diverses tentations totalitaires qui ont marque le XXe siecle, jusque sous leurs recents avatars de l'islamisme et de l'antiracisme devoye. Philippe Boulanger, dans cette passionnante biographie intellectuelle, expose les etapes successives et les multiples aspects de cette pensee de combat qui trouve son unite profonde dans la volonte de reaffirmer sans concession l'insigne valeur des principes d'une democratie liberale, en economie comme en politique. Chaque jour qui passe semble en rappeler l'intempestive et remarquable pertinence. (shrink)

This article shares lessons-learned by the Center for Values in International Development (C4V) over nearly five years. It notes entrenched resistance by the US Agency for International Development (USAID) of any definition of ‘ethics’ beyond legal and regulatory compliance with government financial, procurement, and programming standards. Among practitioner organizations and firms, incorporation of international development ethics is generally viewed as naïve, out of touch with the highly competitive development ‘market’, and hence unnecessary. The article ends with a call to action (...) to coordinate and create mechanisms, provide funding and forums, and significantly improve collaboration between international development ethicists in academic circles, with international development and humanitarian response practitioners. (shrink)

This commentary argues the case for developmental psychopathology in understanding social learning. Informed by work on “epistemic disruption,” we have described difficulties with social learning associated with many forms of psychopathology. Epistemic disruption manifests in an inability to move between innovation and conformity, and arises from poor mentalizing, which generates difficulties in identifying social cues that trigger the correct stance.

The authors of the Target article, Shen and colleagues (2024) argue that there is a need for an ethical framework to help analyze when it is appropriate to return individualized research results (I...

In this short note we prove that a definable set X over is superstable only if.

The culmination of three decades of studying and treating survivors of adult onset trauma, _Wounded by Reality_ is the first systematic attempt to differentiate adult onset trauma from childhood trauma, with which it is frequently confused. When catastrophic events overtake adult lives, they often scar the psyche in ways that psychodynamically oriented clinicians struggle to understand. For Ghislaine Boulanger, the enormous challenge of working with these patients is unsurprising. Survivors of major catastrophe, whether a natural disaster, a life-threatening assault, (...) a serious accident, or an act of terrorism, experience a near-fatal disruption of fundamental aspects of self experience. The sense of agency, of affectivity, of bodily integrity, the capacity for self-reflection, the sense of time, and the ability to relate to others - all are called into question. (shrink)

Bioethics scholarship considering the possibility of gestating an embryo to full term in an artificial womb (ectogenesis) often overstates the capacities of current technologies and underestimates the barriers to the development of full ectogenesis. Moreover, this debate causes harm by (1) neglecting more immediate problems in the development of artificial wombs, (2) treating abortion as a “problem with a technological solution,” bolstering anti-abortion rhetoric, and (3) presuming the stability of women’s reproductive rights. The ectogenesis conversation must consider anticipated uses of (...) the technology (neonatal intensive care) and acknowledge the immediate context (recognizing abortion as essential healthcare and existing reproductive inequities). (shrink)

In 1977 Michel Foucault contemplated the idea of punishing rape only as a crime of violence, while in 1978 he argued that non-coercive sex between adults and minors should be decriminalized entirely. Feminists have consistently criticized these suggestions by Foucault. This paper argues that these feminist responses have failed to sufficiently understand the theoretical motivations behind Foucault's statements on sex-crime legislation reform, and will offer a new feminist appraisal of Foucault's suggestions.

La question de l’ennemi et de la guerre chez Rosenzweig est importante non seulement pour comprendre l’auteur, mais aussi son œuvre : L’Étoile de la Rédemption. Avec la relation d’hostilité, la temporalité rédemptrice basée sur le commandement d’amour s’affronte au problème des rapports qu’ont le judaïsme et le christianisme avec la guerre et le nationalisme.

Arts and Humanities in Higher Education, Ahead of Print. Despite the growing interest of academia in public outreach, little is known about what university students, among who are future researchers, take away from their academic education in terms of research dissemination opportunities. In this study, we analyzed social science students’ discourses on creative dissemination practices in relation to standardized dissemination practices. Our findings reveal that student’s conceptions of creative research dissemination are diverse and influenced by varying perceptions of knowledge, the (...) public, and creativity. Discourses on CRD are also strongly linked with values such as innovation and impact on society, but the concrete meaning of these values often remains undefined. We propose rethinking the academic context at the educational level so it offers a platform for multimodal formats of research dissemination. This would require encouraging students to take a stance toward how they envision a progressive academic future. (shrink)

This is the first volume to apply insights from the material turn in philosophy to the study of play and games. At a time of renewed interest in analogue gaming, as scholars are looking beyond the digital and virtual for the first time since the inception of game studies in the 1990s, Material Game Studies not only supports the importance of the turn to the analogue, but proposes a materiality of play more broadly. Recognizing the entanglement of physical materiality with (...) cultural meaning, the authors in this volume apply a range of theoretical approaches, from material eco-criticism to animal studies, to examine games and play as existing within worlds of matter. Different chapters focus on the material properties of board, card and role-playing games, how they are designed and made, how they are touched and played with, and how they connect with other human and nonhuman things. Bringing together international scholars, Material Game Studies defines a new field of material game studies and demonstrates how it is a valuable addition to wider debates about the material turn and the place of embodied humans in a material world. (shrink)

The fractious but potentially fruitful dialogue between legal history and legal theory has been the subject of much recent scholarly attention. Despite this, instances of meaningful engagement over the role of history in legal theorising remain scarce. This is particularly true in respect of normative theorising—the difficult but crucial tasks of critiquing and reforming law—where history is frequently considered to play a relativising role that threatens to destabilise strong evaluation. In this article, I argue that in order to advance the (...) dialogue it is essential to look beyond disciplinary differences and instead focus on the divide between immanence and transcendence, which arises within and also between legal history and legal theory. Reorienting our attention in this way discloses important sources of dissonance but also points towards significant opportunities for cooperation; it is therefore an essential first step in the pursuit of meaningful dialogue, either critical or collaborative. (shrink)

C’est en Corée du Sud que le sport électronique est né et s’est développé de la façon la plus spectaculaire, contribuant à la visibilité du pays auprès de la communauté internationale des joueurs. Cet article questionne la catégorisation sportive du jeu vidéo en Corée, en esquissant ses dimensions économiques, les circonstances historiques de sa mise en place, et en la confrontant à la pluralité des discours locaux.Electronic sports first emerged in South Korea, where their development has been the most spectacular, (...) contributing to the country’s notoriety in the international video gaming community. In this article, we investigate South Korea’s classification of video gaming as a sport, discussing its economic dimensions, the historical circumstances in which it emerged and comparing it with the different types of local discourse. (shrink)

Les deux dernières décennies ont été marquées dans les pays occidentaux par d’importants changements culturels dans les domaines de la sexualité et de la parenté. En France, les évolutions législatives telles que le vote du pacte civil de solidarité (pacs) en 1999 et l’ouverture du mariage aux individus de même sexe en 2013, ainsi que les polémiques et les mouvements d’opposition qu’elles ont suscités, témoignent des profondes mutations à l’œuvre dans nos systèmes de parenté et nos modes de c...

In response to two trenchant objections, radical subjective Bayesianism has been widely rejected. In this paper, I seek, if not to rehabilitate subjectivism, at least to show its critic what is attractive about the position. I argue that what is at stake in the subjectivism/anti-subjectivism debate is not, as is commonly thought, which norms of rationality are true, but rather, the conception of rationality that we adopt: there is an alternative approach to the widespread telic approach to rationality, which I (...) call the poric approach, on which subjectivism is an attractive position. I then argue that the poric approach—and therefore subjectivism—cannot be easily dismissed. (shrink)

Background Implicit biases are present in the general population and among professionals in various domains, where they can lead to discrimination. Many interventions are used to reduce implicit bias. However, uncertainties remain as to their effectiveness. -/- Methods We conducted a systematic review by searching ERIC, PUBMED and PSYCHINFO for peer-reviewed studies conducted on adults between May 2005 and April 2015, testing interventions designed to reduce implicit bias, with results measured using the Implicit Association Test (IAT) or sufficiently similar methods. (...) -/- Results 30 articles were identified as eligible. Some techniques, such as engaging with others’ perspective, appear unfruitful, at least in short term implicit bias reduction, while other techniques, such as exposure to counterstereotypical exemplars, are more promising. Robust data is lacking for many of these interventions. -/- Conclusions Caution is thus advised when it comes to programs aiming at reducing biases. This does not weaken the case for implementing widespread structural and institutional changes that are multiply justified. (shrink)