Both economists and psychologists are interested in understanding decision making under uncertainty. Yet, they rely on different concepts to analyse human behaviour: economists use economic preference parameters rooted in utility theory, while psychologists use personality traits to describe responses to uncertain situations. Using a large sample of university students, this study examines and contrasts five economic preference parameters and six psychological personality traits that are commonly used to study individuals’ attitudes towards uncertainty. A novelty of this paper is including both (...) the economic concept of ambiguity aversion as well as the personality trait of ambiguity intolerance. We find that standard economic preference measures based on incentivized choice tasks seem to capture rather different characteristics than psychological personality traits. In contrast, economic preference measures obtained from self-assessment questions appear more related to personality traits, especially ambiguity intolerance. (shrink)

Ethically challenging situations routinely arise in the course of illness and healthcare. However, very few studies have surveyed patients and family members about their experiences with ethically challenging situations. To address this gap in the literature, we surveyed patients and family members at three hospitals. We conducted a content analysis of their responses to open-ended questions about their most memorable experience with an ethical concern for them or their family member. Participants described 219 unique ethical experiences that spanned many of (...) the prevailing themes of bioethics, including the patient-physician relationship, end-of-life care, decision-making capacity, healthcare costs, and genetic testing. Participants focused on relational issues in the course of experiencing illness and receiving medical care and concerns regarding the patient-physician encounters. Many concerns arose outside of a healthcare setting. These data indicate areas for improvement for healthcare providers but some concerns may be better addressed outside of the traditional healthcare setting. (shrink)

There is a growing interest in non-invasive stimulation interventions as treatment strategies to improve functional outcomes and recovery after spinal cord injury. Repetitive transcranial magnetic stimulation is a neuromodulatory intervention which has the potential to reinforce the residual spinal and supraspinal pathways and induce plasticity. Recent reviews have highlighted the therapeutic potential and the beneficial effects of rTMS on motor function, spasticity, and corticospinal excitability modulation in SCI individuals. For this scoping review, we focus on the stimulation parameters used in (...) 20 rTMS protocols. We extracted the rTMS parameters from 16 published rTMS studies involving SCI individuals and were able to infer preliminary associations between specific parameters and the effects observed. Future investigations will need to consider timing, intervention duration and dosage that may depend on the stage, the level, and the severity of the injury. There is a need for more real vs. sham rTMS studies, reporting similar designs with sufficient information for replication, to achieve a significant level of evidence regarding the use of rTMS in SCI. (shrink)

In this target article by Morain and Largent (2023), the authors focus on an investigator’s duty to patient-subjects specifically regarding incidental or collateral findings within the context of e...

Background Currently there is increasing recognition of the need for research in developing countries where disease burden is high. Understanding the role of local factors is important for undertaking ethical research in developing countries. We explored factors relating to information and communication during the process of informed consent, and the approach that should be followed for gaining consent. The study was conducted prior to a family-based genetic study among people with podoconiosis (non-filarial elephantiasis) in southern Ethiopia. Methodology/Principal Findings We adapted (...) a method of rapid assessment validated in The Gambia. The methodology was entirely qualitative, involving focus-group discussions and in-depth interviews. Discussions were conducted with podoconiosis patients and non-patients in the community, fieldworkers, researchers, staff of the local non-governmental organisation (NGO) working on prevention and treatment of podoconiosis, and community leaders. We found that the extent of use of everyday language, the degree to which expectations of potential participants were addressed, and the techniques of presentation of information had considerable impact on comprehension of information provided about research. Approaching podoconiosis patients via locally trusted individuals and preceding individual consent with community sensitization were considered the optimal means of communication. Prevailing poverty among podoconiosis patients, the absence of alternative treatment facilities, and participants' trust in the local NGO were identified as potential barriers for obtaining genuine informed consent. Conclusions Researchers should evaluate the effectiveness of consent processes in providing appropriate information in a comprehensible manner and in supporting voluntary decision-making on a study-by-study basis. (shrink)

Responding to a major pandemic and planning for allocation of scarce resources under crisis standards of care requires coordination and cooperation across federal, state and local governments in tandem with the larger societal infrastructure. Maryland remains one of the few states with no state-endorsed ASR plan, despite having a plan published in 2017 that was informed by public forums across the state. In this article, we review strengths and weaknesses of Maryland’s response to COVID-19 and the role of the Maryland (...) Healthcare Ethics Committee Network in bridging gaps in the state’s response to prepare health care facilities for potential implementation of ASR plans. Identified “lessons learned” include: Deliberative Democracy Provided a Strong Foundation for Maryland’s ASR Framework; Community Consensus is Informative, Not Normative; Hearing Community Voices Has Inherent Value; Lack of Transparency & Political Leadership Gaps Generate a Fragmented Response; Pandemic Politics Requires Diplomacy & Persistence; Strong Leadership is Needed to Avoid Implementing ASR … And to Plan for ASR; An Effective Pandemic Response Requires Coordination and Information-Sharing Beyond the Acute Care Hospital; and The Ability to Correct Course is Crucial: Reconsidering No-visitor Policies. (shrink)

When there have been substantial failures by institutional leadership in their oversight responsibility to protect research integrity, the public should demand that these be recognized and addressed by the institution itself, or the funding bodies. This commentary discusses a case of research failures in developing genomic predictors for cancer risk assessment and treatment at a leading university. In its review of this case, the Office of Research Integrity, an agency within the US Department of Health and Human Services, focused their (...) report entirely on one individual faculty member and made no comment on the institution’s responsibility and its failure to provide adequate oversight and investigation. These actions missed an important opportunity to emphasize the institution’s critical responsibilities in oversight of research integrity and the importance of institutional transparency and accountability. (shrink)

Physicians who care for critically ill people with opioid use disorder frequently face medical, legal, and ethical questions related to the provision of life-saving medical care. We examine a complex medical case that illustrates these challenges in a person with relapsing injection drug use. We focus on a specific question: Is futility an appropriate and useful standard by which to determine provision of life-saving care to such individuals? If so, how should such determinations be made? If not, what alternative decisionmaking (...) framework exists? We determine that although futility has been historically utilized as a justification for withholding care in certain settings, it is not a useful standard to apply in cases involving people who use injection drugs for non-medical purposes. Instead, we are welladvised to explore each patient's situation in a holistic approach that includes the patient, family members, and care providers in the decision-making process. The scope of the problem illustrated demonstrates the urgent need to definitively improve outcomes in people who use injection drugs. Increasing access to high quality medication-assisted treatment and psychiatric care for individuals with opioid use disorder will help our patients achieve a sustained remission and allow us to reach this goal. (shrink)

This qualitative study describes the lived experience of physicians who work in communities that have experienced a public mass shooting. Semi-structured interviews were conducted with seventeen physicians involved in eight separate mass casualty shooting incidents in the United States. Four major themes emerged from constant comparative analysis: The psychological toll on physicians: “I wonder if I'm broken”; the importance of and need for mass casualty shooting preparedness: “[We need to] recognize this as a public health concern and train physicians to (...) manage it”; massive media attention: “The media onslaught was unbelievable”; and commitment to advocacy for a public health approach to firearm violence: “I want to do whatever I can to prevent some of these terrible events.”. (shrink)

Acts are functions from states of nature into finite-support distributions over a set of ‘deterministic outcomes’. We characterize preference relations over acts which have a numerical representation by the functional J(f)=min>∫u∘ f dP¦PϵC where f is an act, u is a von Neumann-Morgenstern utility over outcomes, and C is a closed and convex set of finitely additive probability measures on the states of nature. In addition to the usual assumptions on the preference relation as transitivity, completeness, continuity and monotonicity, we (...) assume uncertainty aversion and certainty-independence. The last condition is a new one and is a weakening of the classical independence axiom: It requires that an act f is preferred to an act g if and only if the mixture of f and any constant act h is preferred to the same mixture of g and h. If non-degeneracy of the preference relation is also assumed, the convex set of priors C is uniquely determined. Finally, a concept of independence in case of a non-unique prior is introduced. (shrink)

In contrast to attempts that have been made to measure the clarity of reporting of the methods of clinical trials in journal articles, we report here an attempt to measure the accuracy of methods reporting. We focus in this article on eligibility criteria as a test case for the reporting of clinical trial methods. We examined the reporting of eligibility criteria in the protocol, methods paper (if applicable), journal article, and Clinical Alert for articles appearing in print between January 1988 (...) and September 1994 for which a Clinical Alert had been issued. Eligibility criteria were further classified into five categories in order to examine the content of information loss, if any. On average, 82% of protocol eligibility criteria were reported in methods papers. Journal articles and Clinical Alerts fared somewhat worse: 63% of criteria were reported in journal articles, 19% in Clinical Alerts. In all three categories of medical communication, the reporting of criteria that defined the study disease tended to be complete; reporting of criteria relating to trial precision, patient safety, legal and ethical concerns, and administrative considerations, was not complete. We found that criteria for clinical trial eligibility are frequently under-reported in medical communications. Moreover, some of the criteria omitted are of considerable clinical importance. We suggest that in the design phase of clinical trials, proposed eligibility criteria be scrutinized closely. Those criteria that survive this scrutiny and that have clinical import must be reported upon fully and accurately when communicating trial results. (shrink)

A goal of living as well as possible is central to practice and research with young adults living with home mechanical ventilation (HMV). Significant effort has been put into conceptualizing and measuring the quality of life (QOL) as a proxy for living well. Yet, dominant understandings of QOL have been influenced by normative, ableist, and biomedical discourses about what constitutes a good life that, when applied in practice and systems with those living with HMV, can contribute to exclusion and constrain (...) opportunities to live well. Inquiry into what certain understandings of living well can do is critical to opening up possibilities to reimagine living well with HMV. This paper draws on findings from a critical narrative inquiry that explored the experiences of five young adults (ages 18–40 years) living with HMV. Data were co‐constructed virtually through an initial interview and photo‐elicitation using participant‐generated photographs. A critical narrative analysis of participants' stories made visible the ideological effects of ableist, biomedical, and individualist discourses and how the young adults reproduced and resisted these dominant discourses. Their stories further opened up possibilities for nurses and other healthcare providers to see living well and QOL differently. (shrink)

Current experimentations with approaches to restorative justice for adult offenders represents a compelling new direction in the criminal justice system. This book examines the values and challenges of restorative justice for adult offenders, victims and communities. The discussion is situated within current debate, available research, and the international literature. In canvassing the structure, content, and delivery of key Australian and New Zealand restorative justice programs for adult offenders, the distinguished authors offer critical analysis of the emergence and impact of program (...) developements for practitioners and professionals. This collection brings together stimulating and informed articles by experienced practitioners, leading academics and new researchers in the field. It also offers valuable insights into emerging restorative justice practice for adult offenders and provides a real alternative to the adversarial justice system. (shrink)

Gilboa and Schmeidler provide a paradigm for modelling decision making under uncertainty. Unlike the classical theory of expected utility maximization, case-based decision theory does not assume that decision makers know the possible 'states of the world' or the outcomes, let alone the decision matrix attaching outcomes to act-state pairs. Case-based decision theory suggests that people make decisions by analogies to past cases: they tend to choose acts that performed well in the past in similar situations, and to avoid acts (...) that performed poorly. It is an alternative to expected utility theory when both states of the world and probabilities are neither given in the problem nor can be easily constructed. The authors describe the general theory and its relationship to planning, repeated choice problems, inductive inference, and learning; they highlight its mathematical and philosophical foundations and compare it with expected utility theory as well as with rule-based systems. (shrink)

In part I of this paper, I argue that #MeToo testimony increases epistemic value for the survivor qua hearer when experiences like hers are represented by others; for society at large when false but dominant narratives about sexual violence and sexual harassment against women are challenged and replaced with true stories; and for the survivor qua teller when her true story is believed. In part II, I argue that the epistemic significance of #MeToo testimony compels us to consider the tremendous (...) and often unappreciated costs to the individual tellers, and the increased credibility they are owed in virtue thereof. (shrink)

This volume draws together a series of thirteen essays on ancient epistemology by Gail Fine. She discusses knowledge, belief, subjectivity, and scepticism in Plato, Aristotle, and the Pyrrhonian sceptics. They consider such questions as: is episteme knowledge? Is doxa belief? Do the ancientshave the notion of subjectivity? Do any of them countenance external world scepticism? Several essays compare these philosophers with one another, as well as with more recent discussions of knowledge, belief, subjectivity, and scepticism, asking how if at (...) all the ancient discussions of these topicsdiffer from more recent ones. In exploring these issues, the essays often make use of the distinction between concepts and conceptions, between an abstract account of something, and more determinate ways of filling it in. Together they compose a rich set of investigations, illuminating ancientperspectives on the central questions in epistemology. (shrink)

Do axiomatic derivations advance positive economics? If economists are interested in predicting how people behave, without a pretense to change individual decision making, how can they benefit from representation theorems, which are no more than equivalence results? We address these questions. We propose several ways in which representation results can be useful and discuss their implications for axiomatic decision theory.

Plato on Knowledge and Forms brings together a set of connected essays by Gail Fine, in her main area of research since the late 1970s: Plato's metaphysics and epistemology. She discusses central issues in Plato's metaphysics and epistemology, issues concerning the nature and extent of knowledge, and its relation to perception, sensibles, and forms; and issues concerning the nature of forms, such as whether they are universals or particulars, separate or immanent, and whether they are causes. A specially written (...) introduction draws together the themes of the volume, which will reward the attention of anyone interested in Plato or in ancient metaphysics and epistemology. (shrink)

This note argues that, under some circumstances, it is more rational not to behave in accordance with a Bayesian prior than to do so. The starting point is that in the absence of information, choosing a prior is arbitrary. If the prior is to have meaningful implications, it is more rational to admit that one does not have sufficient information to generate a prior than to pretend that one does. This suggests a view of rationality that requires a compromise between (...) internal coherence and justification, similarly to compromises that appear in moral dilemmas. Finally, it is argued that Savage's axioms are more compelling when applied to a naturally given state space than to an analytically constructed one; in the latter case, it may be more rational to violate the axioms than to be Bayesian. (shrink)

A nontechnical, concise, and rigorous introduction to the rational choice paradigm,focusing on basic insights applicable in fields ranging from economics to philosophy.

An interview with Gail Weiss concerning her interests and influences, especially the body and embodiment.

Helen Longino argues that the way to ensure scientific knowledge is objective is to have a diversity of scientific investigators. This is the best example of recent feminist arguments which hold that the real value of diversity is epistemic, and not political, but it only partly succeeds. In the end, Longino's objectivity amounts to intersubjective agreement about contextually based standards, and while her account gives us a good reason for wanting diversity in our scientific communities, this reason turns out to (...) be political. (shrink)

Meno's Paradox from Socrates to Sextus Gail Fine. sense that they consider the issues it raises; and they argue, against its conclusion, that inquiry is possible. Like Plato and Aristotle, they also explain what makes inquiry possible; and they do ...

Motivated ignorance is an incentivized absence of knowledge that arises in circumstances of unequal power relations, a self-protective non-knowing which frees individuals from having to reflect on the privileges they have in virtue of membership in a dominant social group. In philosophical discussions, the term “motivated ignorance” gets used interchangeably with “willful ignorance.” In the first half of this paper, using Charles Mills’ (2007) white ignorance as the defining case, I argue that this is a mistake. A significant swath of (...) cases of motivated ignorance are non-willful, or deep, following Rik Peels (2010). But in all cases, benefits accrued to some in virtue of their social position are gained and maintained at the expense of harms to others. In the second half of this paper, I argue that these harms are what ground attributions of culpability in cases of motivated ignorance and drive the normative requirement that the subject know better, so long as the facts in question are ordinarily and easily knowable (in a sense to be specified). Willfulness is not a necessary condition for culpability, even if it is a sufficient one. (shrink)

This paper is an attempt to achieve a moral understanding of recombinant DNA technology through an examination of the Biblical ban on the cross-breeding of species, as that ban was understood by traditional Jewish commentators. By paying close attention to the concept of natural law which some of those commentators employed in this connection, a nuanced response to the modern moral problem can be developed, which is immune to the standard arguments employed against those who rely upon natural law.

This article provides a theoretical and doctrinal explanation of how the but-for test links gains to the wrong that produced them. Gain-based damages cases focus on the gain resulting from the defendant’s tortious behaviour. In these cases, the contrastive aspect of the but-for test, requiring the factfinder to consider the hypothetical result that would have occurred had the right thing happened instead of the defendant’s wrongdoing, is not confined to the question of reasonability, as it is in negligence cases. Rather, (...) in gain-based damages cases, the factfinder faces the open-ended normative task of determining the hypothetically appropriate scenario that contrasts with the wrongdoing that happened in reality. For this reason, in gain-based damages cases, the normative sensitivity of the but-for test is revealed in full. The article explains how this sensitivity influences the result of the but-for test expressing the amount of gain causally attributed to the defendant’s wrongdoing. (shrink)

If social, political, and material transformation is to have a lasting impact on individuals and society, it must be integrated within ordinary experience. Refiguring the Ordinary examines the ways in which individuals' bodies, habits, environments, and abilities function as horizons that underpin their understandings of the ordinary. These features of experience, according to Gail Weiss, are never neutral, but are always affected by gender, race, social class, ethnicity, nationality, and perceptions of bodily normality. While no two people will experience (...) the ordinary in exactly the same way, the multiplicities, possibilities, overlaps, and limitations of day-to-day horizons are always intersubjectively constituted. Weiss turns her attention to changing the conditions and experiences of oppression from ordinary to extraordinary. This book is an impressive phenomenological, feminist reading of the complexities of human experience.M. V. Marder, University of Toronto, Feb. 2009. (shrink)