Ethical codes help guide the methods of research that involves samples gathered from ?at-risk? populations. The current article reviews general as well as specific ethical principles related to gathering informed consent from partner violent offenders mandated to outpatient treatment, a group that may be at increased risk of unintentional coercion in behavioral sciences research due to court mandates that require outpatient treatment without the ethical protections imbued upon prison populations. Recommendations are advanced to improve the process of informed consent within (...) this special population and data supporting the utility of the recommendations in a sample 70 partner violent offenders are provided. Data demonstrate that participants were capable of comprehending all essential elements of consent. (shrink)

This volume reaches beyond the controversy surrounding the teaching and learning of evolution in the United States, specifically in regard to the culture, politics, and beliefs found in the Southeast. The editors argue that despite a deep history of conflict in the region surrounding evolution, there is a wealth of evolution research taking place—from biodiversity in species to cultural evolution and human development. In fact, scientists, educators, and researchers from around the United States have found their niche in the South, (...) where biodiversity is high, culture runs deep, and the pace is just a little bit slower. (shrink)

Background Pragmatic randomized controlled trials are designed to evaluate the effectiveness of interventions in real-world clinical conditions. However, these studies raise ethical issues for researchers and regulators. Our objective is to identify a list of key ethical issues in pragmatic RCTs and highlight gaps in the ethics literature. Methods We conducted a scoping review of articles addressing ethical aspects of pragmatic RCTs. After applying the search strategy and eligibility criteria, 36 articles were included and reviewed using content analysis. Results Our (...) review identified four major themes: 1) the research-practice distinction; 2) the need for consent; 3) elements that must be disclosed in the consent process; and 4) appropriate oversight by research ethics committees. 1) Most authors reject the need for a research-practice distinction in pragmatic RCTs. They argue that the distinction rests on the presumptions that research participation offers patients less benefit and greater risk than clinical practice, but neither is true in the case of pragmatic RCTs. 2) Most authors further conclude that pragmatic RCTs may proceed without informed consent or with simplified consent procedures when risks are low and consent is infeasible. 3) Authors who endorse the need for consent assert that information need only be disclosed when research participation poses incremental risks compared to clinical practice. Authors disagree as to whether randomization must be disclosed. 4) Finally, all authors view regulatory oversight as burdensome and a practical impediment to the conduct of pragmatic RCTs, and argue that oversight procedures ought to be streamlined when risks to participants are low. Conclusion The current ethical discussion is framed by the assumption that the function of research oversight is to protect participants from risk. As pragmatic RCTs commonly involve usual care interventions, the risks may be minimal. This leads many to reject the research-practice distinction and question the need for informed consent. But the function of oversight should be understood broadly as protecting the liberty and welfare interest of participants and promoting public trust in research. This understanding, we suggest, will focus discussion on questions about appropriate ethical review for pragmatic RCTs. (shrink)

Neural cell adhesion molecules of the immunoglobulin superfamily are important components of the network of guidance cues and receptors that govern axon growth and guidance during development. For neural cell adhesion molecule L1, the combined application of human genetics, knockout mouse technology, and cell biology is providing fundamental insight into the role of L1 in mediating neuronal differentiation. Disease-causing mutations as well as mouse models of L1 disruption can now be used to examine the relevance of L1 binding specificities and (...) signal transduction pathways that have been observed in vitro. BioEssays 20:668–675, 1998.© 1998 John Wiley & Sons Inc. (shrink)

How does Hume determine what qualities of the mind count as virtues and what qualities count as vices? By what standard, for example, does Hume dismiss the so-called “monkish virtues”? Hume’s commentators have proposed various possibilities for the standard of virtue, among them the general point of view and the usefulness/agreeableness of qualities. I consider the case for these standards and argue that Hume contends ultimately that consensus decides controversial questions about the status of virtues and vices. I try especially (...) to show that while the usefulness of any quality is not a means by which we can identify virtues or vices, it can be relevant to moral evaluations in so far as it influences what people tend to approve of. (shrink)

BackgroundChildhood adversity is linked to adverse health in adulthood. One posited mechanistic pathway is through physiological responses to acute stress. Childhood adversity has been previously related to both exaggerated and blunted physiological responses to acute stress, however, less is known about the psychological mechanisms which may contribute to patterns of physiological reactivity linked to childhood adversity.ObjectiveIn the current work, we investigated the role of challenge and threat stress appraisals in explaining relationships between childhood adversity and cortisol reactivity in response to (...) an acute stressor.MethodsUndergraduate students completed an online survey that included general demographic information and the Risky Families Questionnaire 24 h before a scheduled lab visit. In the lab, a research assistant collected a baseline salivary cortisol sample. Following the baseline period, participants were read instructions for the Trier Social Stress Test, a validated psychological lab stressor. Next, they completed a challenge vs. threat task appraisal questionnaire and completed the speech and math portion of the TSST. Twenty minutes following the start of the TSST, a second salivary sample was collected to measure changes in salivary cortisol following the TSST.ResultsLinear regression analyses adjusted for age, sex, childhood socioeconomic status, and baseline cortisol levels, showed childhood adversity associated with changes in cortisol levels [B = –0.29 t = –2.35, p = 0.02, R2=0.07]. Linear regression analyses controlling for age, sex, and childhood SES showed childhood adversity associated with both challenge [B = –0.52 t = –5.04, p < 0.001, R2=0.24] and threat [B = 0.55 t = 5.40, p < 0.001, R2=0.27] appraisals. Significant indirect effects of childhood trauma on cortisol reactivity were observed through challenge appraisals [B = –0.01 ], and threat appraisals [B = –0.01 ].ConclusionChildhood adversity may contribute to blunted cortisol reactivity, a pattern of response which is linked to obesity, addiction, and other behavior-related diseases. Our findings suggest that this relationship is in part a product of stress appraisals. (shrink)

In this article I argue that vanity, the desire for and delight in the favorable opinion of others, plays a fundamental role in Hume's account of moral motivation. Hume says that vanity and virtue are inseparable, though he does not explicitly say how or why this should be. I argue that Hume's account of sympathy can explain this alliance. In resting moral sentiment on sympathy, Hume gives a fundamental role to vanity as it becomes either a mediating motive to virtue (...) or else strengthens the otherwise weak motive of moral sentiment. (shrink)

The relevance of double effect for end-of-life decision-making has been challenged recently by a number of scholars. The principal reason is that opioids such as morphine do not usually hasten death when administered to relieve pain at the end of life; therefore, no secondary “double” effect is brought about. In my article, I argue against this view, showing how the doctrine of double effect is relevant to the administration of opioids at the end of life. I contend that the prevailing (...) view suffers from a misunderstanding of the nature of double effect, which includes application to risking a grave harm. (shrink)

One finds in the systems of natural languages some explicit means of elaborating not only upon the directness of the causal relationship believed to exist between two events X and Y (i.e. some means of specifying just how inevitably event X gives or gave rise to event Y), but also some manner of indicating just who or what is understood to be the primary instigator of the caused event. The goal of the present paper is to explore these notions in (...) detail and arrive at a formal, logic-based means of capturing them. (shrink)

ObjectivesTo describe reporting of informed consent in pragmatic trials, justifications for waivers of consent and reporting of alternative approaches to standard written consent. To identify factors associated with (1) not reporting and (2) not obtaining consent.MethodsSurvey of primary trial reports, published 2014–2019, identified using an electronic search filter for pragmatic trials implemented in MEDLINE, and registered in ClinicalTrials.gov.ResultsAmong 1988 trials, 132 (6.6%) did not include a statement about participant consent, 1691 (85.0%) reported consent had been obtained, 139 (7.0%) reported a (...) waiver and 26 (1.3%) reported consent for one aspect (eg, data collection) but a waiver for another (eg, intervention). Of the 165 trials reporting a waiver, 76 (46.1%) provided a justification. Few (53, 2.9%) explicitly reported use of alternative approaches to consent. In multivariable logistic regression analyses, lower journal impact factor (p=0.001) and cluster randomisation (p<0.0001) were significantly associated with not reporting on consent, while trial recency, cluster randomisation, higher-income country settings, health services research and explicit labelling as pragmatic were significantly associated with not obtaining consent (all p<0.0001).DiscussionNot obtaining consent seems to be increasing and is associated with the use of cluster randomisation and pragmatic aims, but neither cluster randomisation nor pragmatism are currently accepted justifications for waivers of consent. Rather than considering either standard written informed consent or waivers of consent, researchers and research ethics committees could consider alternative consent approaches that may facilitate the conduct of pragmatic trials while preserving patient autonomy and the public’s trust in research. (shrink)

The aim of this investigation is to explore the role of argumentation schemes in enthymeme reconstruction. This aim is pursued by studying selected cases of incomplete arguments in natural language discourse to see what the requirements are for filling in the unstated premises and conclusions in some systematic and useful way. Some of these cases are best handled using deductive tools, while others respond best to an analysis based on defeasible argumentations schemes. The approach is also shown to work reasonably (...) well for weak arguments, a class of arguments that has always been difficult to analyze without the principle of charity producing a straw man. (shrink)

Quality and service improvement (QSI) research employs a broad range of methods to enhance the efficiency of healthcare delivery. QSI research differs from traditional healthcare research and poses unique ethical questions. Since QSI research aims to generate knowledge to enhance quality improvement efforts, should it be considered research for regulatory purposes? Is review by a research ethics committee required? Should healthcare providers be considered research participants? If participation in QSI research entails no more than minimal risk, is consent required? The (...) lack of consensus on answers to these questions highlights the need for ethical guidance. Three distinct approaches to classifying QSI research in accordance with existing ethical principles and regulations can be found in the literature. In the first approach, QSI research is viewed as distinct from other types of healthcare research and does not require regulation. In the second approach, QSI research falls within regulatory guidelines but is exempt from research ethics committee review. In the third approach, QSI research is deemed to be part of the learning healthcare system and, as such, is subject to a different set of ethical principles entirely. In this paper, we critically assess each of these views. While none of these approaches is entirely satisfactory, we argue that use of the ethical principles governing research provides the best means of addressing the numerous questions posed by QSI research. (shrink)

There is a growing trend among some physicians, psychiatrists, bioethicists, and other mental health professionals not to treat physician-assisted suicide (PAS) as suicide. The grounds for doing so are that PAS fundamentally differs from other suicides. Perhaps most notably, in 2017 the American Association of Suicidology argued that PAS is distinct from the behavior that their organization seeks to prevent. This paper compares and contrasts suicide and PAS in order to see how much overlap there is. Contrary to the emerging (...) view that emphasizes their differences, I argue that there is significant overlap such that we ought not to separate PAS into its own category, making it diverge from how we think about and address suicide more generally. I start by examining several prominent theories of suicide and argue that PAS fits squarely within them. I then examine several apparent differences between PAS and other kinds of suicide and argue that these differences are merely apparent or they do not justify treating PAS as a fundamentally different kind of thing from suicide. (shrink)

Next SectionIt is commonly proposed that artifacts cannot be understood without reference to human intentions. This fact, I contend, has relevance to the use of artifacts in intentional action. I argue that because artifacts have intentions embedded into them antecedently, when we use artifacts we are sometimes compelled to intend descriptions of our actions that we might, for various reasons, be inclined to believe that we do not intend. I focus this argument to a specific set of artifacts, namely, medical (...) devices, before considering an extended application to emergency contraceptive devices. Although there is some debate about whether emergency contraception has an abortifacient effect, I argue that if there is an abortifacient effect, then the effect cannot normally be a side effect of one’s action. (shrink)

We develop conceptions of arguments and of argument types that will, by serving as the basis for developing a natural classification of arguments, benefit work in artificial intelligence. Focusing only on arguments construed as the semantic entities that are the outcome of processes of reasoning, we outline and clarify our view that an argument is a proposition that represents a fact as both conveying some other fact and as doing so wholly. Further, we outline our view that, with respect to (...) arguments that are propositions, (roughly) two arguments are of the same type if and only if they represent the same relation of conveyance and do so in the same way. We then argue for our conceptions of arguments and argument types, and compare them to alternative positions. We also illustrate the need for, and some of the strengths of, our approach to classifying arguments through an examination of aspects of two prominent and recent attempts to classify arguments using argumentation schemes, namely those of M. Kienpointner and D. Walton. Finally, we clarify how our conception of arguments and of argument types can assist in developing an exhaustive classification of arguments. (shrink)

Essential to the doctrine of double effect is the idea that agents are prohibited from intending evil as a means to a good end. I argue in this paper that some recent accounts of intention from proponents of double effect cannot sustain this prohibition on harmful means. I outline two ways to gerrymander intention that mark these accounts. First, intention is construed in such a way that an agent intends only those states of affairs that she cares about or finds (...) motivating for their own sake. Second, intention is construed in such a way that what counts as intended is determined sufficiently by the agent’s beliefs. (shrink)

Situationists contend that virtue ethics is empirically inadequate. However, it is my contention that there is much confusion over what “empirical adequacy” or “empirical inadequacy” actually means in this context. My aim in this paper is to clarify the meanings of empirical adequacy in order to see to what extent virtue ethics might fail to meet this standard. I argue that the situationists frequently misconstrue the empirical commitments of virtue ethics. More importantly, depending on what we mean by empirical adequacy, (...) either virtue ethics has no need to be empirically adequate or where it does have such a need, the psychological evidence fails to show that it is empirically inadequate. An additional contribution the paper intends to make is to provide a more detailed discussion of the explanatory nature of virtue ethics. (shrink)

This paper builds upon a critically clarified statement of the triune brain concept to set out the conflict systems neurobehavioral model. The model defines the reciprocal algorithms of behavior from evolved brain structure. The algorithms are driven by subjectively experienced behavioral tension as the self‐preservational programming, common to our ancestral vertebrates, frequently tugs and pulls against the affectional program‐ming of our mammalian legacy. The yoking of the dual algorithmic dynamic accounts for the emergence of moral and spiritual consciousness as manifested (...) in the universal norm of reciprocity and in the work of such thinkersas Martin Buber and Paul Tillich. (shrink)

The debate about physician-assisted suicide has long been entwined with the nature of the doctor–patient relationship. Opponents of physician-assisted suicide insist that the traditional goals of medicine do not and should not include intentionally bringing about or hastening a patient’s death, whereas proponents of physician-assisted suicide argue that this practice is an appropriate tool for doctors to relieve a patient’s suffering. In this article, I discuss these issues in light of the relevance of a Christian account of the doctor–patient relationship. (...) I argue that Christians typically object to assist suicide independently of the doctor–patient relationship. I argue that a focus on the Christian virtues of charity, compassion, and humility helps to explain why doctors should not assist their patients in suicide. (shrink)

BackgroundChildhood abuse increases risk for high levels of distress in response to future stressors. Interpersonal social support is protective for health, particularly during stress, and may be particularly beneficial for individuals who experienced childhood abuse.ObjectiveInvestigate whether childhood abuse predicts levels of posttraumatic stress disorder (PTSD) symptoms related to the COVID-19 pandemic, and test whether the perceived availability of social companionship preceding the pandemic moderates this relationship.MethodsDuring Phase 1, adults (N= 120; AgeM[SD] = 19.4 [0.94]) completed a retrospective measure of childhood (...) adversity along with a measure of perceived availability of opportunities for social engagement immediately preceding the pandemic. Two weeks after the COVID-19 pandemic declaration, participants completed the Impact of Event Scale-Revised (IES-R) with respect to the pandemic. Hierarchical linear regression analyses examined the interaction between childhood abuse and the perceived availability of social companionship preceding the pandemic as a predictor of PTSD symptoms.ResultsAdjusting for covariates, the interaction between childhood abuse and perceived availability of others to engage with before the onset of the pandemic was a significant predictor of IES-hyperarousal (β = −0.19,t= −2.06,p= 0.04, ΔR2= 0.032, CI: [−0.31 to −0.01]).ConclusionLevels of perceived opportunities for social companionship before the pandemic associates with levels of hyperarousal related to the pandemic, particularly for individuals who experienced high levels of childhood abuse. More research is needed to understand how to mitigate the higher levels of distress related to the pandemic for these individuals in order to reduce risk for future psychiatric disorders. (shrink)

Hume says that sympathy is the source of our moral feeling of approval for useful qualities. But does Hume give the same psychological explanation of our approval of immediately agreeable qualities as he does to our approval of useful qualities? Does he trace our moral approbation of immediately agreeable qualities to sympathy? Some commentators, including Rachel Cohon and Don Garrett, argue that he does not. Let us call this view the ‘narrow view’ of sympathy in contrast to the ‘wide view’ (...) of sympathy, which holds that sympathy is required for every moral sentiment. There is indeed some apparent textual evidence in Hume’s work that seems to support the narrow view. My aim in this paper is to examine that evidence and show how it is merely apparent, in particular by showing how a number of passages can be and are misread. I thus want to argue indirectly for the wide view. (shrink)

Recent work at the intersection of moral philosophy and the philosophy of psychology has dealt mostly with Aristotelian virtue ethics. The dearth of scholarship that engages with Hume’s moral philosophy, however, is both noticeable and peculiar. Hume's Moral Philosophy and Contemporary Psychology demonstrates how Hume’s moral philosophy comports with recent work from the empirical sciences and moral psychology. It shows how contemporary work in virtue ethics has much stronger similarities to the metaphysically thin conception of human nature that Hume developed, (...) rather than the metaphysically thick conception of human nature that Aristotle espoused. It also reveals how contemporary work in moral motivation and moral epistemology has strong affinities with themes in Hume’s sympathetic sentimentalism. (shrink)

The current paper provides an overview of treatment noncompliance at various points in the treatment pathway, especially with respect to treatment for Pelvic-floor Dysfunction. The effects of noncompliance on healthcare are considered, and examples of supporting patients psychologically to increase compliance are discussed. An outline of a method to identify costs of non-compliance, and where such costs most intensely impact the healthcare system, is provided. It is suggested that psychological support is effective in terms of increased compliance and improved healthcare (...) economics. The model is presented for PFD, but the principles developed can be generalised to many aspects of healthcare. (shrink)

This paper examines and evaluates from a Christian perspective the common Christian presumption against pleasing people, which is roughly the idea that Christians should not be motivated by or delight in the favorable opinion of others. I argue that several ways of saving the idea that Christians can blamelessly care what others think about them are misguided or insufficient. I contend that the most important way to save this idea is by drawing attention to concern for the opinions of others (...) in the context of a social role. (shrink)

Introduction 1.1 GOALS This book is devoted to an in-depth investigation of some of the properties of Logical Form (LF). In particular, the primary aim of ...