The application of artificial intelligence and machine learning technologies in healthcare have immense potential to improve the care of patients. While there are some emerging practices surro...

Michael A. Petersa and Fazal Rizvib aBeijing Normal University, Beijing, PR China; bMelbourne University, Melbourne, Australia Our minds are still racing back and forth, longing for a return to ‘no...

Visual cortical prostheses (VCPs) have the potential to provide artificial vision for visually impaired persons. However, the nature and utility of this form of vision is not yet fully understood. Participants in the early feasibility trial for the Orion VCP were interviewed to gain insight into their experiences using artificial vision, their motivations for participation, as well as their expectations and assessments of risks and benefits. Analyzed using principles of grounded theory and an interpretive description approach, these interviews yielded six (...) themes, including: the irreducibility of benefit to device functionality, mixed expectations for short-term device functionality and long-term technological advancement of visual prostheses, and a broad range of risks, concerns, and fears related to trial participation. We argue that these narratives motivate a nuanced set of ethical considerations related to the complex relationship between functionality and benefit, the intersection of user experience with disability justice, and the import of expectations and indirect risks on consent. (shrink)

Cognitive Science, Volume 46, Issue 6, June 2022.

When applied in the health sector, AI-based applications raise not only ethical but legal and safety concerns, where algorithms trained on data from majority populations can generate less accurate or reliable results for minorities and other disadvantaged groups.

Russell articulates compelling reasons that bioethicists and health care professionals should take individual responsibility for deconstructing structural injustices in healthcare through in...

The coronavirus disease-2019 (COVID-19) has caused shortages of life-sustaining medical resources, and future waves of the virus may cause further scarcity. The Yale New Haven Health System developed a triage protocol to allocate scarce medical resources during the COVID-19 pandemic, with the primary goal of saving the most lives possible, and a secondary goal of making triage assessments and decisions consistent, transparent, and fair. We outline the process of developing the protocol, summarize the protocol, and discuss the major ethical challenges (...) encountered, along with our answers to the challenges. These challenges include (1) the role of age and chronic comorbidities; (2) evaluating children and pregnant patients; (3) racial, ethnic, and socioeconomic disparities in health; (4) prioritization of healthcare workers; and (5) balancing clinical judgment versus protocolized assessments.We conclude with a review of the limitations of our protocol and the lessons learned. We hope that a robust public discussion of such protocols and the ethical challenges they raise will result in the fairest possible processes, less need for triage, and more lives saved during future waves of the pandemic and similar public health emergencies. (shrink)

This letter addresses the editorial decision to publish the article, “Research on group differences in intelligence: A defense of free inquiry” (Cofnas, 2020). Our letter points out several critical problems with Cofnas's article, which we believe should have either disqualified the manuscript upon submission or been addressed during the review process and resulted in substantial revisions.

Against the backdrop of cultural and political ideals, this article highlights both the significance of mental health nursing in meeting population needs and the regulatory barriers that may be impeding its ability to adequately do so. Specifically, we consider how ambiguous notions of ‘proficiency’ in nurse education—prescribed by the regulator—impact the development of future mental health nurses and their mental health nursing identity. A key tension in mental health practice is the ethical‐legal challenges posed by sanctioned powers to restrict patients' (...) freedom at the same time as the desire (and obligation) to promote patients' self‐determined recovery. The genericism of the UK's Future Nurse Standards do little to prepare mental health nurses to navigate the tensions that ensue. This has consequences for nurses and patients alike, as both risk experiencing the distress and dissonance that attends giving or receiving poor care. We argue that more needs to be done to enable mental health nurses to define and articulate the nuances of the profession as part of becoming critical, thoughtful and confident practitioners. Educators can contribute to this mission by aligning curriculum, pedagogy and assessment to create meaningful opportunities for mental health nursing students to engage with the complexities of mental health nursing practice. Without this, the credibility of the profession will continue to be questioned; its future uncertain. (shrink)

The practice of recontact in genomic medicine has the power to help rectify long‐standing inequities in genetic testing. However, if not delivered systematically, recontacting practices also have the potential to reinforce these same inequities. Recontact, which occurs when contact between a clinician and patient is reinitiated after a relationship has ended, is often in search of or in response to updated interpretation or results. Currently, recontact is happening in a patient‐driven and ad hoc manner, undermining its potential to benefit all (...) patients. In this paper, the authors position justice as an additional argument in favor of systematic recontact and an argument against the predominantly patient‐initiated model. They argue that patients from equity‐deserving groups should be early beneficiaries of an emerging responsibility to recontact patients. The authors share illustrative clinical vignettes and propose role‐specific and systems‐level solutions to rightfully position recontact as a tool to promote a more equitable clinical genomics future. (shrink)

Background: Development of professional nursing values is critical within registered nurse–to–bachelor of science in nursing programs to prepare nurses for increasingly complex and diverse work environments. The results of previous studies have been inconsistent, with few studies focusing on online registered nurse–to–bachelor of science in nursing programs. In addition, little is known regarding the effectiveness of the educational methods used to support advancement of professional values and ethical practice. Objective: The object of this study was to gain an understanding of (...) nursing students’ attitudes and beliefs about professional values at entry and exit of an online registered nurse–to–bachelor of science in nursing program that includes a standalone ethics course and integrates American Nurses Association Code of Ethics provisions throughout the curriculum. Research design: For this one-group pretest–posttest, quasi-experimental design, longitudinal matched-pair data were gathered at program entry and exit using the Nurses Professional Values Scale–Revised. Participants and research context: In all, 119 students of an online registered nurse–to–bachelor of science in nursing program at a Midwest public university who completed entry and exit surveys between spring 2015 and spring 2018 were included in this study. Ethical considerations: This study was reviewed and determined to be exempt by the university’s institutional review board. Findings: The results showed a significant increase in total posttest scores when considering all participants. However, students who took the ethics course after the pretest demonstrated a significant increase in posttest scores, while students who took the ethics course prior to the pretest demonstrated a small increase that was not statistically significant. Significant increases were also found in the professionalism, activism, and trust factors. Discussion: This study supports previous study findings where students scored higher on caring and lower on activism and professionalism factors. The largest gains were made after completing the ethics course. Conclusion: The results suggest that requiring a standalone ethics course in the registered nurse–to–bachelor of science in nursing curriculum had a positive impact on self-reported professional values. (shrink)

The coronavirus disease (COVID-19) crisis provoked an organizational ethics dilemma: how to develop ethical pandemic policy while upholding our organizational mission to deliver relationship- and patient-centered care. Tasked with producing a recommendation about whether healthcare workers and essential personnel should receive priority access to limited medical resources during the pandemic, the bioethics department and survey and interview methodologists at our institution implemented a deliberative approach that included the perspectives of healthcare professionals and patient stakeholders in the policy development process. Involving (...) the community more, not less, during a crisis required balancing the need to act quickly to garner stakeholder perspectives, uncertainty about the extent and duration of the pandemic, and disagreement among ethicists about the most ethically supportable way to allocate scarce resources. This article explains the process undertaken to garner stakeholder input as it relates to organizational ethics, recounts the stakeholder perspectives shared and how they informed the triage policy developed, and offers suggestions for how other organizations may integrate stakeholder involvement in ethical decision-making as well as directions for future research and public health work. (shrink)

This grounded study investigated the negotiation of authorship by faculty members, graduate student mentors, and their undergraduate protégés in undergraduate research experiences at a private research university in the northeastern United States. Semi-structured interviews using complementary scripts were conducted separately with 42 participants over a 3 year period to probe their knowledge and understanding of responsible authorship and publication practices and learn how faculty and students entered into authorship decision-making intended to lead to the publication of peer-reviewed technical papers. Herein (...) the theoretical model for the negotiation of authorship developed through the analysis of these interviews is reported. The model identifies critical causal and intervening conditions responsible for the coping strategies faculty and students employ, which, in our study, appear to often produce unfortunate consequences for all involved. The undergraduate student researchers and their graduate student mentors interviewed in this study exhibited a limited understanding of authorship and the requirements for authorship in their research groups. The power differential between faculty and students, the students’ limited epistemic development, the busy-ness of the faculty, and the faculty’s failure to prioritize authorship have been identified as key factors inhibiting both undergraduate and graduate students from developing a deeper understanding of responsible authorship and publication practices. Implications for graduate education and undergraduate research are discussed, and strategies for helping all students to develop a deeper understanding of authorship are identified. (shrink)

In ‘Utility of Religion’, Mill argues that a wholly naturalistic religion of humanity would promote individual and social welfare better than supernatural religions like Christianity; in ‘Theism’, however, Mill defends the salutary effects of hope in an afterlife. While commentators have acknowledged this discrepancy, they have not examined the utilitarian value of what Mill terms ‘illusions’. In this essay, I explain Mill's case against the utility of supernatural religious belief and then argue that Mill cannot dismiss the utility of hope (...) in an ultimate justice since it need not pervert the intellect or morality. There are thus utilitarian grounds to support some supernatural illusions, which undermines Mill's defence of an exclusively naturalistic religion. I conclude with the suggestion that while the utility of religious belief leads Mill toward William James's view, they disagree about whether supernatural religious sentiment has any unique, intrinsic force. (shrink)

Several lines of evidence suggest that children born via Cesarean section are at greater risk for adverse health outcomes including allergies, asthma and obesity. Vaginal seeding is a medical procedure in which infants born by C-section are swabbed immediately after birth with vaginal secretions from the mother. This procedure has been proposed as a way to transfer the mother's vaginal microbiome to the child, thereby restoring the natural exposure that occurs during vaginal birth that is interrupted in the case of (...) babies born via C-section. Preliminary evidence indicates partial restoration of microbes. However, there is insufficient evidence to determine the health benefits of the procedure. Several studies, including trial, are currently underway. At the same time, in the clinic setting, doctors are increasingly being asked to by expectant mothers to have their babies seeded. This article reports on the current research on this procedure and the issues it raises for regulators, researchers, physicians, and patients. (shrink)

The “scarred villain” trope, where facial differences like scars signify moral corruption, is ubiquitous in film (e.g., Batman’s The Joker). Strides by advocacy groups to undermine the trope, however, suggest cinematic representations of facial differences could be improving with time. This preregistered study characterized facial differences in film across cultures (US vs. India) and time (US: 1980-2019, India: 2000-2019). Top-grossing films by country and decade were screened for characters with facial differences. We found that the scarred villain trope has actually (...) worsened with time, although in tandem with progress in also representing non-villainous characters with facial anomalies. Country of origin did not predict the presence of facial differences in villains or heroes. “Action” and “fantasy” movies were the most likely genres to depict villains with facial differences. Finally, villains’ facial differences crossed more facial subunits and were more likely to involve lips, chin, and mandible than when present in heroes. Our findings underscore the need for critical reflection on the role of cultural practices—even when seemingly innocuous—in shaping and maintaining negative biases against already stigmatized groups. (shrink)

Job burnout, organizational commitment, and work environment continue to be important areas of research to be studied in the realm of company employment and employee retention. Job burnout is the state of physical and emotional exhaustion and perceiving one’s profession as dull or overwhelming. Meanwhile, organizational commitment refers to the company’s attitude towards the organization and their employees, encompassing loyalty, moral responsibility, and their willingness to work. And lastly, work environment provides opportunities for employees to establish connections, develop skills, and (...) maximize their full potential in performing tasks. For the current study, researchers utilized descriptive-correlational research design to investigate the influence of Work Environment towards the job burnout and organizational commitment of BPO agents in selected companies in Bulacan, Philippines. Hence, Danish Psychosocial Work Environment Questionnaire (DPQ), Maslach Burnout Inventory - General Survey (MBI-GS), and the Three-Dimensional Model of Organizational Commitment Scale (ACS, NCS, CCS) were employed to properly assess the study's objectives. Multiple Linear Regression Analysis was performed to analyze the collected data. Based on the analysis, findings show that work environment has no significant influence on the job burnout and organizational commitment of BPO Agents. Furthermore, the results of this study were thoroughly evaluated, leading to an in-depth discussion. Based on the findings, recommendations were made to benefit the stakeholders of the study and contributeto the existing body of knowledge. (shrink)

We are addressing this letter to the editors of Philosophical Psychology after reading an article they decided to publish in the recent vol. 33, issue 1. The article is by Nathan Cofnas and is entitled “Research on group differences in intelligence: A defense of free inquiry” (2020). The purpose of our letter is not to invite Cofnas’s contribution into a broader dialogue, but to respectfully voice our concerns about the decision to publish the manuscript, which, in our opinion, fails to (...) meet a range of academic quality standards usually expected of academic publications. (shrink)

Physicians anecdotally report inquiring about incarcerated patients’ crimes and their length of sentence, which has potential implications for the quality of care these patients receive. However, there is minimal research on how a physician’s awareness of their patient’s crimes/length of sentence impacts physician behaviours and attitudes. We performed regression modelling on a 27-question survey to analyse physician attitudes and behaviours towards incarcerated patients. We found that, although most physicians did not usually try to learn of their patients’ crimes, they often (...) became aware of them. We observed associations between awareness of a patient’s crime and poor physician disposition towards their patients and between physicians’ poor dispositions and lower reported quality of care. These associations suggest that awareness of a patient’s crime may reduce quality of care by negatively impacting physicians’ dispositions towards their patients. Future quantitative and qualitative studies, for example, involving physician interviews and direct patient outcome assessments, are needed to confirm these findings and further uncover and address hurdles incarcerated patients face in seeking medical care. (shrink)

Funding organizations around the world are adopting open science policies, resulting in a pressing need for open science programs. In response to the 2011 decadal survey, NASA sought to expand and accelerate omics research, releasing its GeneLab Strategic Plan in 2014. GeneLab is an open science data repository and analysis portal for spaceflight and space-relevant omics data. GeneLab’s output has been outstanding, but its full potential as a way to transform space biology has not yet been achieved. NASA should pursue (...) the development of GeneLab as an open science platorm in earnest. (shrink)

Ms. P. is in the ICU with respiratory failure and sepsis. She has been on a ventilator for almost a week, and now has impending kidney failure. Her children, who have been taking turns at the bedsi...

Bullying often results in negative coping in victims, including an increased consumption of alcohol. Recently, however, an increase in alcohol use has also been reported among perpetrators of bullying. The factors triggering this pattern are still unclear. We investigated the role of empathy in the interaction between bullying and alcohol use in an adolescent sample (IMAGEN) at age 13.97 (±0.53) years (baseline (BL), N = 2165, 50.9% female) and age 16.51 (±0.61) years (follow-up 1 (FU1), N = 1185, 54.9% female). (...) General empathic distress served as a significant moderator of alcohol use in perpetrators (F9, 493 = 17.978, p < 0.01), which was specific for males and FU1. Male perpetrators, who are generally less sensitive to distress, might thus be more vulnerable to alcohol abuse. (shrink)

Previous studies have shown a robust bias to express the goal path over the source path when describing events. Motivated by linguistic theory, this study manipulated the causal structure of events and measured the extent to which adults and 3.5- to 4-year-old English-speaking children included the goal and source in their descriptions. We found that both children's and adults’ encoding of the source increased for events in which the source caused the motion of the figure compared to nearly identical events (...) in which the source played no such causal role. However, a goal bias persisted overall for both causal and noncausal motion events. These findings suggest that although the goal bias in language is highly robust, properties of the source influence its likelihood of being encoded in language, thus shedding light on how properties of an event can influence the mapping of event components into language. (shrink)

In this issue, we present two symposia on recent, influential books which have already sparked important research in philosophy and psychology. A common characteristic of these two very different b...

Researchers from diverse disciplines, including organismal and cellular physiology, sports science, human nutrition, evolution and ecology, have sought to understand the causes and consequences of the surprising variation in metabolic rate found among and within individual animals of the same species. Research in this area has been hampered by differences in approach, terminology and methodology, and the context in which measurements are made. Recent advances provide important opportunities to identify and address the key questions in the field. By bringing together (...) researchers from different areas of biology and biomedicine, we describe and evaluate these developments and the insights they could yield, highlighting the need for more standardisation across disciplines. We conclude with a list of important questions that can now be addressed by developing a common conceptual and methodological toolkit for studies on metabolic variation in animals. (shrink)

This article presents data from the Growing up with Media study related to the implementation of a risk reduction protocol that resulted in three groups of youth: low-risk youth (no flags), youth flagged because of violence involvement and not clinically referred; and flagged youth who were referred to a team clinician due to additional risk considerations. Data are from 3,979 US youth 14–15 years of age recruited through social media between October 2018-August 2019. Four in ten youth were flagged for (...) review. Findings suggest that this methodology of identifying and reviewing cases appears to be working as intended: Not only did referred youth have more flags than non-referred youth, but post-hoc analyses suggested that these youth also had higher rates of psychosocial problems (e.g., non-victimization adversity, substance use, and depressed mood). The implementation of a risk reduction protocol such as the one described in this article adds a layer of human subject protection beyond the more standard list of websites and hotlines provided to all participants in most studies. This protocol leads the way for future studies to recreate a similar process to address concerning responses collected from survey research. (shrink)

A proposed state administrative rule would have required medical ethicists to approve certain aspects of gender-affirming care. The authors argue the proposed rule lacked appropriate justification compared to other instances of state-mandated ethics oversight and would undermine trust, raise practical challenges, and send harmful messages to society, patients, and providers.

Everyone, it seems, is talking and arguing about Evidence-Based Practice. Those therapies and assessments designated as EBP increasingly determine what is taught, researched, and reimbursed in health care. But exactly what is it, and how do you do it? The second edition of Clinician's Guide to Evidence-Based Practices is the concise, practitioner-friendly guide to applying EBPs in mental health. Step-by-step it explains how to conduct the entire EBP process-asking the right questions, accessing the best available research, appraising the research, translating (...) that research into practice, integrating that research with clinician expertise and patient characteristics, evaluating the entire enterprise, attending to the ethical considerations, and when done, moving the EBP process forward by teaching and disseminating it. This book will help you:. Formulate useful questions that research can address. Search the research literature efficiently for best practices. Make sense out of the research morass, sifting wheat from chaff. Incorporate patient values and diversity into the selection of EBP. Blend clinician expertise with the research evidence. Translate empirical research into practice. Ensure that your clients receive effective, research-supported services. Infuse the EBP process into your organizational setting and training methods. Identify and integrate ethics in the context of EBP Coauthored by a distinguished quartet of clinicians, researchers, and a health care librarian, the Clinician's Guide has become the classic for graduate students and busy professionals mastering EBP. ". (shrink)

Advances in intracranial electroencephalography and neurophysiology have enabled the study of previously inaccessible brain regions with high fidelity temporal and spatial resolution. Studies of iEEG have revealed a rich neural code subserving healthy brain function and which fails in disease states. Machine learning, a form of artificial intelligence, is a modern tool that may be able to better decode complex neural signals and enhance interpretation of these data. To date, a number of publications have applied ML to iEEG, but clinician (...) awareness of these techniques and their relevance to neurosurgery, has been limited. The present work presents a review of existing applications of ML techniques in iEEG data, discusses the relative merits and limitations of the various approaches, and examines potential avenues for clinical translation in neurosurgery. One-hundred-seven articles examining artificial intelligence applications to iEEG were identified from 3 databases. Clinical applications of ML from these articles were categorized into 4 domains: i) seizure analysis, ii) motor tasks, iii) cognitive assessment, and iv) sleep staging. The review revealed that supervised algorithms were most commonly used across studies and often leveraged publicly available timeseries datasets. We conclude with recommendations for future work and potential clinical applications. (shrink)

Schooling fish, swarms of starlings, plodding wildebeest, and musicians all display impressive synchronization. To what extent do they use acoustic cues to achieve these feats? Could the acoustic cues used in movement synchronization be relevant to the treatment of movement disorders such as Parkinson's disease in humans? In this article, we build on the emerging view in evolutionary biology that the ability to synchronize movement evolved long before language, in part due to acoustic advantages. We use this insight to explore (...) potential mechanisms that explain why music therapy has beneficial effects for PD patients. We hypothesize that rhythmic auditory cues, particularly music, can stimulate neuronal and behavioral processes that ease the symptoms and potentially the causes of PD because the neural circuits used in auditory entrainment at individual and group levels are associated with dopamine production. We summarize current treatment of PD and outline how new insights from an evolutionary perspective could improve understanding and eventual treatment of movement disorders in humans. (shrink)

Lack of guidance and regulation for authorizing medical cannabis for conditions involving the health and neurodevelopment of children is ethically problematic as it promulgates access inequities, risk-benefit inconsistencies, and inadequate consent mechanisms. In two virtual sessions using participatory action research and consensus-building methods, we obtained perspectives of stakeholders on ethics and medical cannabis for children and youth. The sessions focused on the scientific and regulatory landscape of medical cannabis, surrogate decision-making and assent, and the social and political culture of medical (...) cannabis. We found that evidence-gathering and data dissemination, pressures on clinical relationships, and the lack of integration of culturally diverse perspectives and Indigenous knowledges were key areas of concern. Participants emphasized the importance of utilizing adaptive study designs, highlighted the importance of trust-building between clinicians, patients and caregivers, and discussed barriers including historical and ongoing stigmatization of medical cannabis. We conclude that continued public consultation and strength-based research that integrate diverse perspectives are critical steps forward. (shrink)

The purpose of this paper is to suggest that the current conversation about the relationship between capitalism and the poor assumes a story about business that is shopworn and outmoded. There are assumptions about business, human behavior, and language that are no longer useful in the twenty first century. Business needs to be understood as how we cooperate together to create value and trade. It is fundamentally about creating value for stakeholders. Human beings are not solely self-interested, but driven by (...) meaning, purpose, and the ability to cooperate. And, language is best understood as a tool, rather than a source of representation. Business and capitalism with these new assumptions can be realized by large and small businesses as not just about money and profits but as the creation of meaning within a prophetic framework. (shrink)

Introduction: Schools have become a primary setting for providing mental health care to youths in the U.S. School-based interventions have proliferated, but their effects on mental health and academic outcomes remain understudied. In this study we will implement and evaluate the effects of a flexible multidiagnostic treatment called Modular Approach to Therapy for Children with Anxiety, Depression, Trauma, or Conduct Problems on students' mental health and academic outcomes.Methods and Analysis: This is an assessor-blind randomized controlled effectiveness trial conducted across five (...) school districts. School clinicians are randomized to either MATCH or usual care treatment conditions. The target sample includes 168 youths referred for mental health services and presenting with elevated symptoms of anxiety, depression, trauma, and/or conduct problems. Clinicians randomly assigned to MATCH or UC treat the youths who are assigned to them through normal school referral procedures. The project will evaluate the effectiveness of MATCH compared to UC on youths' mental health and school related outcomes and assess whether changes in school outcomes are mediated by changes in youth mental health.Ethics and Dissemination: This study was approved by the Harvard University Institutional Review Board. We plan to publish the findings in peer-reviewed journals and present them at academic conferences.Clinical Trial Registration:ClinicalTrials.gov ID: NCT02877875. Registered on August 24, 2016. (shrink)

Nurses have an important role in preventing and responding to child abuse and neglect. This paper reports on nurses' perceptions of how organisational systems and hierarchies shaped their capacity to respond to child abuse and neglect. This is one of four key themes identified through an inductive analysis of data from a broader qualitative study that explored nurses' perceptions and experiences of keeping children safe. The study was guided by social constructionist theory, and data were collected through in‐depth interviews with (...) nurses working with children in Australia (n = 21). Key findings showed that nurses experienced many challenges to responding to child abuse, including difficulties sharing information, fear of making mistakes and inflexible systems of care. This was underpinned by an organisational ‘rule‐centred’ culture of following policies at the expense of maintaining an explicit focus on children's needs. These findings demonstrate first the importance of creative and flexible thinking from individual professionals, so policies are enacted with a clear child focus. Second, they highlight the need for leadership to enact organisational and systemic cultural change that maintains a genuinely child‐centred approach. (shrink)

In a letter to an imagined future reader a century from now – at the 2121 bicentennial of the birth of Paulo Freire, I argue for the potential of a framework of timescapes and a feminist, Freirean praxis of letter-writing to enrich Freirean studies. In the context of analysis of Freire’s other letter-writing praxes across his life, I reflect on my recent interviews with two of Freire’s family correspondents, both women, whose letters with him have been published: the first to (...) be granted by his niece Cristina Bruno Freire and the first interview for an English-language publication (this journal) with his cousin Nathercia Lacerda. I aim to center their voices on the occasion of this current centennial and highlight the continuing need for critical translation and archiving of this work within Freirean studies, as well as for these creative forms of resistance and modes and areas of inquiry. (shrink)

In vitro gametogenesis (IVG) might offer numerous research and clinical benefits. Some potential clinical applications of IVG, such as allowing opposite‐sex couples experiencing infertility to have genetically related children, have attracted support. Others, such as enabling same‐sex reproduction and solo reproduction, have attracted significantly more criticism. In this paper, we examine how different ethical principles might help us to draw lines and distinguish between ethically desirable and undesirable uses of IVG. We discuss the alleged distinction between therapeutic and non‐therapeutic uses (...) of assisted reproduction in the context of IVG, and show how it is both problematic to apply in practice and theoretically dubious. We then discuss how the ethical principles of reproductive justice and beneficence apply to IVG for opposite‐sex reproduction, same‐sex reproduction, and solo reproduction. We suggest that these principles generate strong reasons for the use of IVG for opposite‐sex and same‐sex reproduction, but not for solo reproduction. (shrink)

Causal selection has to do with the distinction we make between background conditions and “the” true cause or causes of some outcome of interest. A longstanding consensus in philosophy views causal selection as lacking any objective rationale and as guided, instead, by arbitrary, pragmatic, and non-scientific considerations. I argue against this position in the context of causal selection for disease traits. In this domain, causes are selected on the basis of the type of causal control they exhibit over a disease (...) of interest. My analysis clarifies the principled rationale that guides this selection and how it involves both pragmatic and objective considerations, which have been overlooked in the extant literature. (shrink)

As clinical trials end, little is understood about how participants exiting from clinical trials approach decisions related to the removal or post-trial use of investigational brain implants, such as deep brain stimulation (DBS) devices. This empirical bioethics study examines how research participants experience the process of exit from research at the end of clinical trials of implanted neural devices. Using a modified grounded theory study design, we conducted semi-structured, in-depth interviews with 16 former research participants from clinical trials of DBS (...) and responsive neurostimulation (RNS). Open-ended questions elicited motivations for joining the trial, understanding of study procedures at the time of initial informed consent, the process of exiting from research, and decisions about device removal or post-trial device use. Thematic analysis identified categories related to: limited preparedness for the end of research participation, straightforwardness of decisions to explant or keep the device, reconciling with the end of research participation, reconciling post-trial expectations, and achieving a sense of closure after exit from research. A preliminary theoretical model describes contextual factors influencing the process and experience of exit from research. Experiences of clinical trial participants should guide research practices to enhance the ethical design and conduct of clinical trials in DBS and other brain devices. (shrink)

In this paper, I identify a form of epistemic insensitivity that occurs when someone fails to make proper use of the epistemic tools at their disposal in order to bring their beliefs in line with epistemically relevant evidence that is available to them. I call this kind of insensitivity agential insensitivity because it stems from the epistemic behavior of an individual agent. Agential insensitivity can manifest as a failure to either attend to relevant and available evidence, or appropriately interpret evidence (...) that is attended to. The concept of agential insensitivity allows us to conceptualize the kind of not-knowing involved in forms of ignorance that are cultivated and maintained by individual agents, especially when this ignorance is enabled or encouraged by social structures. I use the skepticism about racial disparities in policing practices that is displayed by many white Americans as a lens for exploring this connection. Understanding agential insensitivity thus provides insight into both social and epistemic phenomena. (shrink)