Ensuring diversity within the healthcare sector is essential for improving team dynamics and ultimately patient outcomes. Diversity among medical students is fundamental to embody this philosophy. With the demand for diversity in the admissions process gaining traction, the authors expanded this conversation to the editorial boards (EBs) of Medical Student Journals (MSJs). The authors designed a cross-sectional study to evaluate the diversity status of EBs of MSJs under gender, geographic, and socioeconomic parameters using the Journal Diversity Index (JDI). Relevant information (...) regarding the journal characteristics and the editorial board members (EBMs) of systematically screened journals was sequentially extracted along with job roles, which were later categorized into eight categories. Chi-squared test was applied to study the association between gender of the editor and the global distribution of the journal. Out of 22 included journals, 90.9% were published by institutions based in high-income countries (HICs). On regional analysis, none of the journals originated from “South Asia,” “Latin America and the Caribbean,” and “Middle East and North Africa”. Disparity in gender representation of EBMs became more prominent in senior roles. Additionally, 78.8% EBMs belonged to HICs. Regional analysis of EBMs revealed 83% belonging to the Global North. This disparity was seen across all editorial job roles. A greater disparity was seen among editors from the Global South with men comprising 66.4% of the total editors (p<0.001). On JDI, 95.5% journals demonstrated poor diversity. Moreover, 72.7% and 77.3% journals had all members of the EB belonging to the same region and the same country income level respectively. As EBs of MSJs offer opportunities for further advancement, networking, and promotion, a commitment to prioritizing diversity, equity, and inclusion accompanied by development and implementation of actionable plans and allocation of sufficient resources should be given precedence. (shrink)

_K. al-Manām_ by Ibn Abī al-Dunyā is a compendium of 350 Muslim dream narratives in Arabic. The English introduction examines the function of dreams in classical Arabic literature with a focus on dreams as a means of edification.

Bioethicists influence practices and policies in medicine, science, and public health. However, little is known about bioethicists’ views. We recently surveyed 824 U.S. bioethicists on a wide range of ethical issues, including topics related to abortion, medical aid in dying, and resource allocation, among others. We also asked bioethicists about their demographic, religious, academic, and professional backgrounds. We find that bioethicists’ normative commitments predict their views on bioethical issues. We also find that, in important ways, bioethicists’ views do not align (...) with those of the U.S. public: for instance, bioethicists are more likely than members of the public to think abortion is ethically permissible but are less likely to believe compensating organ donors is. Our demographic results indicate the field of bioethics is far less diverse than the U.S. population—less diverse even than other academic disciplines—suggesting far more work needs to be done to build an inclusive field. (shrink)

This article argues that Marcus Argentarius' epigram on Myro's dead grasshopper and cicada ( Anth. Pal. 7.364) provides an obscene interpretation of Anyte's model ( Anth. Pal. 7.190) by transforming Myro's paignia ("playthings") into sex toys. Like Catullus (2, 3), he builds on Meleager's eroticization of Anyte's poem in Anth. Pal. 7.195, 196, 207, as well as Herodas Mimiambs 6 and 7, which combine the themes of metapoetic dildos, female poets, and the Demeter/Persephone myth. Finally, I show that an acrostic (...) ( ALIA, 7.364.1–4, "fruitless, idle") ties together the poem's erotic and metapoetic themes. (shrink)

This article tells the story of the oil and gas origins of the Gaia hypothesis, the theory that the Earth is a homeostatic system. It shows how Gaia’s key assumption—that the climate is a fundamentally stable system, able to withstand perturbations—emerged as a result of a collaboration between the theory’s progenitor, James Lovelock, and Royal Dutch Shell in response to Shell’s concerns about the effects of its products on the climate. The article explains how Lovelock elaborated the Gaia hypothesis and (...) gave it evidential depth through a series of Royal Dutch Shell-funded research projects meant to identify organisms whose biological activities might double as climate-regulating mechanisms. The article goes on to show how this research subsequently laid the foundation for a distinct genre of climate change denialism, in which corporations sowed doubt not by denying the phenomenon of global warming but by naturalizing it. (shrink)

A short, concise book in favor of honoring doubt and admitting when the answer is: I don’t know. From the acclaimed author of No Book but the World and 2019's searing new novel Strangers and Cousins. In a tight, enlightening narrative, Leah Hager Cohen explores why, so often, we attempt to hide our ignorance, and why, in so many different areas, we would be better off coming clean. Weaving entertaining, anecdotal reporting with eye-opening research, she considers both the ramifications (...) of and alternatives to this ubiquitous habit in arenas as varied as education, finance, medicine, politics, warfare, trial courts, and climate change. But it’s more than just encouraging readers to confess their ignorance—Cohen proposes that we have much to gain by embracing uncertainty. Three little words can in fact liberate and empower, and increase the possibilities for true communication. So much becomes possible when we honor doubt. (shrink)

The need for greater privacy protections in the United States has never been greater. In their work, “Ethical Responsibilities for Companies That Process Personal Data”, McCoy et al. (2023) correct...

Hierarchical Bayesian models (HBMs) provide an account of Bayesian inference in a hierarchically structured hypothesis space. Scientific theories are plausibly regarded as organized into hierarchies in many cases, with higher levels sometimes called ‘paradigms’ and lower levels encoding more specific or concrete hypotheses. Therefore, HBMs provide a useful model for scientific theory change, showing how higher‐level theory change may be driven by the impact of evidence on lower levels. HBMs capture features described in the Kuhnian tradition, particularly the idea that (...) higher‐level theories guide learning at lower levels. In addition, they help resolve certain issues for Bayesians, such as scientific preference for simplicity and the problem of new theories. *Received July 2009; revised October 2009. †To contact the authors, please write to: Leah Henderson, Massachusetts Institute of Technology, 77 Massachusetts Avenue, 32D‐808, Cambridge, MA 02139; e‐mail: lhenders@mit.edu. (shrink)

These essays engage Jin Y. Park’s recent translation of the work of Kim Iryŏp, a Buddhist nun and public intellectual in early twentieth-century Korea. Park’s translation of Iryŏp’s Reflections of a Zen Buddhist Nun was the subject of two book panels at recent conferences: the first a plenary session at the annual meeting of the Society for Asian and Comparative Philosophy and the second at the Eastern Division of the American Philosophical Association on a group program session sponsored by the (...) International Society for Buddhist Philosophy. This exchange also includes a response from Park. (shrink)

Most public and non-profit organisations that fund health research provide the majority of their funding in the form of grants. The calls for grant applications are often untargeted, such that a wide variety of applications may compete for the same funding. The grant review process therefore plays a critical role in determining how limited research resources are allocated. Despite this, little attention has been paid to whether grant review criteria align with widely endorsed ethical criteria for allocating health research resources. (...) Here, we analyse the criteria and processes that ten of the largest public and non-profit research funders use to choose between competing grant applications. Our data suggest that research funders rarely instruct reviewers to consider disease burden or to prioritise research for sicker or more disadvantaged populations, and typically only include scientists in the review processes. This is liable to undermine efforts to link research funding to health needs. (shrink)

BackgroundThe main purpose of this study was to describe the latent structure of pregnancy perception by investigating the role of risks and medical examinations in pregnancy perception across the sexes and pregnancy status.MethodsStudy 1 developed a questionnaire based on the responses of 29 young adults on their perception of pregnancy. Study 2 consisted of distributing the questionnaire among 290 participants.ResultsThe statistical clustering analysis revealed three major clusters of pregnancy perceptions: “evaluative,” “physio-medical,” and “future considerations,” each of them encompassing several meaningful (...) sub-clusters. This structure of pregnancy perceptions supports Beck and Beck-Gernsheim’s modernization approach. Negative emotions toward pregnancy were related to social cognitions, whereas thoughts about risks were included in the medical sub-cluster. After reliability analyses, comparisons of scale scores revealed that women experienced more positive emotions, thought more about physical symptoms and about future issues compared to men.ConclusionPregnant participants felt less ambivalence toward pregnancy, thought more about risks and medical examinations and less about parents’ duties than non-pregnant participants. (shrink)

The authors respond to a letter by Mitchell Berger in the March‐April 2024 issue of the Hastings Center Report concerning their essay “Securing the Trustworthiness of the FDA to Build Public Trust in Vaccines.”.

Two of the most influential theories about scientific inference are inference to the best explanation and Bayesianism. How are they related? Bas van Fraassen has claimed that IBE and Bayesianism are incompatible rival theories, as any probabilistic version of IBE would violate Bayesian conditionalization. In response, several authors have defended the view that IBE is compatible with Bayesian updating. They claim that the explanatory considerations in IBE are taken into account by the Bayesian because the Bayesian either does or should (...) make use of them in assigning probabilities to hypotheses. I argue that van Fraassen has not succeeded in establishing that IBE and Bayesianism are incompatible, but that the existing compatibilist response is also not satisfactory. I suggest that a more promising approach to the problem is to investigate whether explanatory considerations are taken into account by a Bayesian who assigns priors and likelihoods on his or her own terms. In this case, IBE would emerge from the Bayesian account, rather than being used to constrain priors and likelihoods. I provide a detailed discussion of the case of how the Copernican and Ptolemaic theories explain retrograde motion, and suggest that one of the key explanatory considerations is the extent to which the explanation a theory provides depends on its core elements rather than on auxiliary hypotheses. I then suggest that this type of consideration is reflected in the Bayesian likelihood, given priors that a Bayesian might be inclined to adopt even without explicit guidance by IBE. The aim is to show that IBE and Bayesianism may be compatible, not because they can be amalgamated, but rather because they capture substantially similar epistemic considerations. 1 Introduction2 Preliminaries3 Inference to the Best Explanation4 Bayesianism5 The Incompatibilist View : Inference to the Best Explanation Contradicts Bayesianism5. 1 Criticism of the incompatibilist view6 Constraint - Based Compatibilism6. 1 Criticism of constraint - based compatibilism7 Emergent Compatibilism7. 1 Analysis of inference to the best explanation7. 1. 1 Inference to the best explanation on specific hypotheses7. 1. 2 Inference to the best explanation on general theories7. 1. 3 Copernicus versus Ptolemy7. 1. 4 Explanatory virtues7. 1. 5 Summary7. 2 Bayesian account8 Conclusion. (shrink)

The claim that listening to extreme music causes anger, and expressions of anger such as aggression and delinquency have yet to be substantiated using controlled experimental methods. In this study, 39 extreme music listeners aged 18–34 years were subjected to an anger induction, followed by random assignment to 10 min of listening to extreme music from their own playlist, or 10 min silence (control). Measures of emotion included heart rate and subjective ratings on the Positive and Negative Affect Scale (PANAS). (...) Results showed that ratings of PANAS hostility, irritability, and stress increased during the anger induction, and decreased after the music or silence. Heart rate increased during the anger induction and was sustained (not increased) in the music condition, and decreased in the silence condition. PANAS active and inspired ratings increased during music listening, an effect that was not seen in controls. The findings indicate that extreme music did not make angry participants angrier; rather, it appeared to match their physiological arousal and result in an increase in positive emotions. Listening to extreme music may represent a healthy way of processing anger for these listeners. (shrink)

There has been considerable puzzlement over how to respond to higher-order evidence. The existing dilemmas can be defused by adopting a ‘two-dimensional’ representation of doxastic attitudes which incorporates not only substantive uncertainty about which first-order state of affairs obtains but also the degree of conviction with which we hold the attitude. This makes it possible that in cases of higher-order evidence the evidence sometimes impacts primarily on our conviction, rather than our substantive uncertainty. I argue that such a two-dimensional representation (...) is naturally developed by making use of imprecise probabilities. (shrink)

Psychological studies show that the beliefs of two agents in a hypothesis can diverge even if both agents receive the same evidence. This phenomenon of belief polarisation is often explained by invoking biased assimilation of evidence, where the agents’ prior views about the hypothesis affect the way they process the evidence. We suggest, using a Bayesian model, that even if such influence is excluded, belief polarisation can still arise by another mechanism. This alternative mechanism involves differential weighting of the evidence (...) arising when agents have different initial views about the reliability of their sources of evidence. We provide a systematic exploration of the conditions for belief polarisation in Bayesian models which incorporate opinions about source reliability, and we discuss some implications of our findings for the psychological literature. (shrink)

In a world surrounded by smart objects from sensors to automated medical devices, the ubiquity of ‘smart’ seems matched only by its lack of clarity. In this article, we use our discussions with expert stakeholders working in areas of implantable medical devices such as cochlear implants, implantable cardiac defibrillators, deep brain stimulators and in vivo biosensors to interrogate the difference facets of smart in ‘implantable smart technologies’, considering also whether regulation needs to respond to the autonomy that such artefacts carry (...) within them. We discover that when smart technology is deconstructed it is a slippery and multi-layered concept. A device’s ability to sense and transmit data and automate medicine can be associated with the ‘sting’ of autonomy being disassociated from human control as well as affecting individual, group, and social environments. (shrink)

Solid organ transplant has revolutionized the treatment of certain diseases, providing hope where there were once only terminal diagnoses. Yet transplantation is ethically fraught, chiefly because...

In his recent article “Ethical Criteria for Health-Promoting Nudges: A Case-by-Case Analysis,” Bart Engelen (2019) develops a useful framework for evaluating health-related nudges in an attempt to...

In many countries, health technology assessment organizations determine the economic value of new drugs and make recommendations regarding appropriate pricing and coverage in national health systems. In the US, recent policy proposals aimed at reducing drug costs would link drug prices to six countries: Australia, Canada, France, Germany, Japan, and the UK. We reviewed these countries’ methods of HTA and guidance on price and coverage recommendations, analyzing methods and guidance documents for differences in the methodologies HTA organizations use to conduct (...) their evaluations and considerations they use when making recommendations. We found important differences in the methods, interpretations of HTA findings, and condition-specific carve-outs that HTA organizations use to conduct evaluations and make recommendations. These variations have ethical implications because they influence the recommendations of HTA organizations, which affect access to the drug through national insurance and price negotiations with manufacturers. The differences in HTA approaches result from the distinct political, social, and cultural contexts of each organization and its value judgments. New cost-containment policies in the US should consider the ethical implications of the HTA reviews that they are considering relying on to negotiate drug prices and what values should be included in US pricing policy. (shrink)

In When Clinical Trials Compete: Prioritizing Study Recruitment, Gelinas et al tackle an important issue—study non-completion—and draw conclusions with which we largely agree. Most importantly, we accept that setting priorities among competing research studies is necessary and should be informed by ethical analysis. We disagree with the conclusion of Gelinas et al that this priority setting should take place at the level of the individual research institution. At a minimum, they should consider other actors who might be better suited for (...) this role instead of—or alongside—the institutions that host research. Our view is motivated by three main considerations. First, research institutions have significant latitude to promote their own interests, and there is reason to suspect that their interests do not closely align with the interests of the public. Thus, asking research institutions to set research priorities may result in the selection of studies with suboptimal social value. Second, a large proportion of clinical trials recruits participants at multiple institutions.1 If each institution sets its own priorities, we can expect discrepancies between the priorities set by partner institutions. These discrepancies may delay and discourage collaborative research projects. Finally, we suspect that a great deal of recruitment competition occurs between, rather than within, research institutions. Setting priorities only at …. (shrink)

This paper describes a holistic approach and an interdisciplinary curriculum in enhancing critical thinking and education for democracy at the junior-high schools and highschools levels. The curriculum includes academic subjects such as the humanities, sciences, social sciences and art. The aim of this curriculum is not to teach an additional lesson in history, political sciences, art, etc., but to fostercritical thinking and democratic behavior. The theoretical framework has two bases. The first derives from eighteenth century rationalism and scientific thinking, while (...) the second is from the Industrial Revolution of the nineteenth century. Both produced social economies and a political structure of mass democracy. The focal point here is that critical thinking is a prerequisite for the existence of democratic values and principles in a post-modern society. The program integrates McPeck’s strategies on the conception of critical thinking and the dialectic technique of Richard Paul. The curriculum is designed forone or two semesters (14 to 28 meetings). It is built in a modular fashion, in which each subject stands on its own and is presented by various lecturers from different domains. The curriculum was implemented in junior high and high schools in Haifa and vicinity."It is this consensus around liberal democracy as the final form of government that I have called “the end of history.”(Fukuyama, F (1990) in Fortune, January 15, 1990, p. 75). (shrink)

BackgroundFunctional neurodiagnostics could allow researchers and clinicians to distinguish more accurately between the unresponsive wakefulness syndrome and the minimally conscious state. It remains unclear how it informs surrogate decision-making.ObjectiveTo explore how the next of kin of patients with disorders of consciousness interpret the results of a functional neurodiagnostics measure and how/why their interpretations influence their attitudes towards medical decisions.Methods and SampleWe conducted problem-centered interviews with seven next of kin of patients with DOC who had undergone a functional HD-EEG examination at (...) a neurological rehabilitation center in Germany. The examination included an auditory oddball paradigm and a motor imagery task to detect hidden awareness. We analyzed the interview transcripts using structuring qualitative content analysis.ResultsRegardless of the diagnostic results, all participants were optimistic of the patients’ meaningful recovery. We hypothesize, that participants deal with the results of examinations according to their belief system. Thus, an unfavorable evaluation of the patient’s state had the potential to destabilize the participant’s belief system. To re-stabilize or to prevent the destabilization of their belief system, participants used different strategies. Participants accepted a “positive” HD-EEG result since it stabilized their belief system.ConclusionWe hypothesize, that a group of next of kin of patients with DOC deals with functional neurodiagnostics results on the basis of the result’s value and their high hope that the patient will recover meaningfully. A psychological mechanism seems to moderate the impact of functional neurodiagnostics on surrogate treatment decisions. (shrink)

The no miracles argument is one of the main arguments for scientific realism. Recently it has been alleged that the no miracles argument is fundamentally flawed because it commits the base rate fallacy. The allegation is based on the idea that the appeal of the no miracles argument arises from inappropriate neglect of the base rate of approximate truth among the relevant population of theories. However, the base rate fallacy allegation relies on an assumption of random sampling of individuals from (...) the population which cannot be made in the case of the no miracles argument. Therefore the base rate fallacy objection to the no miracles argument fails. I distinguish between a “local” and a “global” form of the no miracles argument. The base rate fallacy objection has been leveled at the local version. I argue that the global argument plays a key role in supporting a base-rate-fallacy-free formulation of the local version of the argument. (shrink)

Epistemic injustice sits at the intersection of ethics, epistemology, and social justice. Generally, this philosophical term describes when a person is wrongfully discredited as a knower; and within the clinical space, epistemic injustice is the underlying reason that some patient testimonies are valued above others. The following essay seeks to connect patterns of social prejudice to the clinical realm in the United States: illustrating how factors such as race, gender identity, and socioeconomic status influence epistemic credence and associatively, the quality (...) of healthcare a person receives. After describing how epistemic injustice disproportionately harms already vulnerable patients, I propose a narrative therapy intervention. This intervention can help providers re-frame their relationships with patients, in such that they come to view patients as valuable sources of unique knowledge. Though I identify this intervention as a valuable step in addressing clinical epistemic injustice, I call upon medical educators and practitioners to further uplift the voices, perspectives, and stories of marginalized patients. (shrink)

This study investigated the multidimensional structure of judgements of emotional appropriateness, the degree to which an observer judges a target's emotion to conform to observer-valued expectations for emotion in that context. Participants (N=169) were shown one of two brief video clips of an actor either showing anger or neutral expressions in an anger-evoking situation of either low, medium, or high severity. Participants rated the target's emotion on the Perception of Emotion Appropriateness Rating Scale (PEARS), which taps observers’ perceptions of a (...) target's emotional appropriateness for a specific situation. We found that appropriateness ratings are comprised of three factors, assessment of Type Present (type of emotion in expression); Type Absent (missing key emotions); and Intensity (intensity with which the emotion is felt or expressed). Results are discussed in terms of the usefulness of a multidimensional conceptualisation of emotional appropriateness. (shrink)

Journal of Political Philosophy, EarlyView.

Critics generally agree that Statius’Silvae2.4, a poem about a dead parrot dedicated to Statius’ patron Atedius Melior, is modelled closely on Ovid'sAmores2.6, a poem about Corinna's dead parrot. In particular, many read Statius’ poem as picking up on the metapoetic strand in the Ovidian model, in which the parrot may be interpreted as a poet-figure, though they also note that Statius’ poem shows more of a concern for the tensions involved in a poet's relationship to his patron. I agree with (...) this general interpretation of the poem and its metapoetic aspect; however, there are some oddities about the dead parrot and its relationship to itsdominusthat have not been fully explained by theories that equate the parrot with either Statius or a non-specific Flavian poet-figure and thedominuswith Atedius Melior or a similar patron-figure. For instance, why is the parrot dead, and why does Statius write an epicedium for it that is similar in tone to the epicedia for dead people inSilvae2? Why is the parrot's relationship to its master an ambiguous one such that his cage can be described as a prison, and the master's grief over the parrot's death is never specifically mentioned? Finally, why does the parrot speak the name of Caesar instead of Atedius Melior, the friend of Statius to whom the poem is dedicated? (shrink)

We present approaches to the semantics and pragmatics of information structure which centre on Questions Under Discussion. Questions, explicit or implicit, are seen as structuring discourse, and information structural marking is seen as reflecting that underlying discourse structure. Our presentation of the model is largely cast in terms of extensions of Roberts’s analysis, which is itself related to Rooth’s Alternative Semantics and Hamblin’s approach to the semantics of questions. We present the model in terms of a range of constraints that (...) relate information structure to discourse structure, notably constraints on the ‘Relevance’ of utterances, on the ‘Congruence’ of answers to questions, and on the ‘Availability’ of discourse antecedents. We discuss the application of the approach to the interpretation of focus and some cases of contrastive topics, to discourse structure, to the interpretation of focus sensitive operators, and to certain cases of presupposition projection. (shrink)

In this paper, we study discourses of emotion management on the reality television show Survivor. We analyze segments of the program that feature emotionally charged interactional moments and examine how these interactions are interwoven with contestants’ confessional interviews and framed by the narrator’s introductions of the segments. In a two part analysis, we first analyze the talk produced by the contestants and the host as individual texts, using a discourse analytic perspective that focuses on the details of the talk itself. (...) We then consider the ways the talk constitutes a series of layered texts and analyze these texts, using a discourse analytic approach that attends to macro-level and critical perspectives. We conclude that Survivor largely reinforces dominant cultural discourses of emotion management as strategic interactional practice that allow a person to be competitive. Furthermore, the analysis links performances of emotion management to representations of specific aspects of contestants’ social identities. (shrink)

We respond to open peer commentaries on our target article, "Health Research Priority Setting: The Duties of Individual Funders".

Investigations of data-centered efforts in advocacy and activism are often cast in terms of a narrative of opposition between grassroots activists working through and with data, and corporations or institutions whose actions data might expose. The boundaries are, however, not so distinct in practice. Indeed, one outcome of successful advocacy efforts for opening big data to the public is that the activists may find themselves drawn into the institutions they critique or view as impediments in order to actualize those efforts (...) from the inside. Drawing on an ongoing ethnographic investigation of urban data initiatives inside city government, we explore the productive ambivalences of activism and advocacy that arise when those with data activist ideals find themselves operating within the government structure. (shrink)

In this article, the author draws from ethnographic field work with Mexican migrants in southwestern Montana, an emerging rural settlement of the Mountain West, to analyze the ways in which context of reception affects gender relations. The author constructs the analysis by looking at gender in terms of three primary elements of migrant incorporation: employment, geography, and culture. The author finds that in Montana traditional gender relations are typically fortified or reintroduced through the migration process, often to the detriment of (...) women. Yet women remain optimistic about their lives because they believe that in Montana they can be better mothers, providing safety and opportunities for their children that they could not provide elsewhere. The data challenge theorizing from urban settlements and highlight the significance of context of reception for constructions of gender and women’s experiences of power. (shrink)

The paradigm of rights, established throughout the academic, policy and migrant activism arenas, governs the protection of vulnerable migrant workers against abuse. To what extent this approach has achieved social justice for the migrant worker in the current global political economy climate is, however, uncertain. In analyzing the use of rights in migrant activism in Hong Kong, this paper shows the limitation of rights in the migrant experience at the same time as it shows how a new paradigm based on (...) the Capablities Approach could provide a more appropriate framework from which to achieve social justice for the migrant worker. (shrink)

State Medicaid programs have proposed closed formularies to limit spending on drugs. Closed formularies can be justified when they enable spending on other socially valuable aims. However, it is still necessary to justify guidelines informing formulary design, which can be done through a process of decision making that includes the public. This article examines criticisms that Medicaid closed formularies limit deliberation about decisions that affect drug access and unfairly disadvantage poor patients. Although unfairness to poor patients is a risk, it (...) is not a problem unique to Medicaid, since private insurance programs have also implemented closed formularies. (shrink)