Andrew von Hirsch, Past or Future Crimes: Deservedness and Dangerousness in the Sentencing of Criminals New Brunswick, N.J.: Rutgers University Press, 1985, 220 pp.

The “learning health care system” is being heralded as offering great potential for improving the quality and cost-worthiness of medical care by closely integrating the care of patients with the accumulation of aggregate data that can guide evidence-based medicine. By using electronic medical records, routine patient care and administrative data will be available for systematic observational studies. With the aid of these electronic medical records, quality-improvement studies of institutional practices and pragmatic, comparative effectiveness randomized trials of individual treatments could become (...) standard features of the medical care environment in the LHS. In this.. (shrink)

A simple model for the description of atomic and ionic species with spectra exhibiting a quantum defect is solved using the Lie algebra su(1, 1). The quantum defect of bound states is related to the phase shift of scattering states. The resonances are discussed in terms of the nonunitary representations of this algebra.

Thirty-two years ago W. V. Quine proposed a definition of 'logical truth' that has been widely repeated and reprinted. Quine himself seems to have recognized that this definition is wrong in detail; in section 1 we eliminate this fault. What has perhaps been less widely observed is that, in abandoning the model-theoretic account of logical truth in favor of a "substitutional" account, Quine's definition swells the ranks of the logical truths and makes the classification of a sentence as a logical (...) truth dependent both on the interpretation of its extralogical words and on the extralogical vocabulary available in the language. (shrink)

Part 1 of this exploratory study demonstrated that for terminal, instrumental, and work values, supervisors could only accurately assess the extent to which their terminal values are congruent with their employees, whereas, employees could only accurately describe degrees of alignment with their supervisors' work values. Thus, supervisors appear to possess conscious awareness of the terminal values held by their employees and employees similarly possess conscious awareness of their supervisors' work values. Part 2 of the study examined what each of these (...) two parties might do with their conscious knowledge concerning value congruence with the other member. Supervisor ratings and employee self-ratings concerning employee job performance, citizenship, climate fit, working relationship (LMX), and other issues, were correlated with supervisor terminal value congruence estimates and employee work value congruence estimates respectively. For supervisors, only one significant finding was noted, indicating a positive relationship between the supervisors' awareness of terminal value congruence with the employee and the supervisors' estimate of the employee's potential for future promotion. For employees, seven hypotheses received support demonstrating relationships between the employees' awareness of supervisor/employee work value congruence and self-ratings of work behaviours, citizenship behaviours, volunteerism behaviours, work climate behaviours, work climate attitudes, work climate organizational-wide attitudes, and the supervisor/employee working relationship. Implications for management and future research are discussed. (shrink)

Although informed consent is important in clinical research, questions persist regarding when it is necessary, what it requires, and how it should be obtained. The standard view in research ethics is that the function of informed consent is to respect individual autonomy. However, consent processes are multidimensional and serve other ethical functions as well. These functions deserve particular attention when barriers to consent exist. We argue that consent serves seven ethically important and conceptually distinct functions. The first four functions pertain (...) principally to individual participants: (1) providing transparency; (2) allowing control and authorization; (3) promoting concordance with participants' values; and (4) protecting and promoting welfare interests. Three other functions are systemic or policy focused: (5) promoting trust; (6) satisfying regulatory requirements; and (7) promoting integrity in research. Reframing consent around these functions can guide approaches to consent that are context sensitive and that maximize achievable goals. (shrink)

Subjects enrolled in studies testing high risk interventions for incurable or progressive brain diseases may be vulnerable to deficiencies in informed consent, such as the therapeutic misconception. However, the definition and measurement of the therapeutic misconception is a subject of continuing debate. Our qualitative pilot study of persons enrolled in a phase I trial of gene transfer for Parkinson disease suggests potential avenues for both measuring and preventing the therapeutic misconception. Building on earlier literature on the topic, we developed and (...) tested an interview guide that focuses on how the subjects decided to participate, emphasizing the integration of subjects’ various statements that are relevant to assessing the therapeutic misconception, rather than evaluating them as isolated statements. The results indicate that a subject’s understanding of the purpose of research is best explored in juxtaposition to the subject’s motivation for participating. (shrink)

The present study examines the use of metadiscourse in English and Chinese research article introductions in the field of educational psychology. The corpus for this study comprises 40 introductions of research articles – 20 Chinese and 20 English – in the field of educational psychology. Hyland’s model of metadiscourse has been employed as the analytical framework for the present study. The similarities and differences in the use of metadiscourse between the two sets of texts are looked at from a socio-cultural (...) point of view. The findings of the present study provide some insights into the teaching and learning of academic English writing for Chinese ESL students. (shrink)

Bioethicists have long been concerned that seriously ill patients entering early phase (‘phase I’) treatment trials are motivated by therapeutic benefit even though the likelihood of benefit is low. In spite of these concerns, consent forms for phase I studies involving seriously ill patients generally employ indeterminate benefit statements rather than unambiguous statements of unlikely benefit. This seeming mismatch between attitudes and actions suggests a need to better understand research ethics committee members’ attitudes toward communication of potential benefits and risks (...) of early phase studies to potential subjects. We surveyed the members of two U.S. research ethics committees using a phase I gene transfer study scenario, and compared the results to a previous survey of potential subjects’ perceptions and attitudes toward benefit and risk for the same protocol. The results show that there is indeed a gap between the subjects’ perceptions and the committee members’ views on what is appropriate to be communicated to research subjects. This discrepancy is the product of both the commonly assumed optimism of the subjects and to a “protective pessimism” of the research ethics committee members. We discuss this discrepancy using “frameworks of trust” and demonstrate the need to incorporate these frameworks into the existing model of informed consent. (shrink)

In a curious turn of phrase that he offered to a particular congregation, Augustine claims that a belch became the Gospel: “Ipsa ructatio euangelium est.” The reference comes at the end of a longer digression in Sermon (s.) 341 [Dolbeau 22] about how John the Evangelist, a fisherman, came to produce his Gospel, namely he belched out what he drank in. The use of a mundane word like ructare in an oration concerning a divine being contravenes a rhetorical prohibition known (...) as tapinosis. This kind of speech was prohibited in ancient oratory because it humiliated the subject of the declamation, and this was especially problematic if the subject was divine. According to Augustine’s reading of scripture, if the divine willfully chose to be humiliated in order to teach humility to others by example, then the person delivering a speech about the divine could contravene this oratorical vice. This article argues that Augustine does precisely that in s. 341 by examining the reasons for Augustine’s use of the terms ructare and iumentum. Specifically, it traces their usage in various Latin texts from Cicero to Plautus to the Psalms. It argues that the virtue of humility is manifest in the very language which Augustine deploys all along the way. (shrink)

BackgroundHealthcare professionals are exposed to advertisements for prescription drugs in medical journals. Such advertisements may increase prescriptions of new drugs at the expense of older treatments even when they have no added benefits, are more harmful, and are more expensive. The publication of medical advertisements therefore raises ethical questions related to editorial integrity.MethodsWe conducted a descriptive cross-sectional study of all medical advertisements published in the Journal of the Danish Medical Association in 2015. Drugs advertised 6 times or more were compared (...) with older comparators: comparative evidence of added benefit; Defined Daily Dose cost; regulatory safety announcements; and completed and ongoing post-marketing studies 3 years after advertising.ResultsWe found 158 medical advertisements for 35 prescription drugs published in 24 issues during 2015, with a median of 7 advertisements per issue. Four drug groups and 5 single drugs were advertised 6 times or more, for a total of 10 indications, and we made 14 comparisons with older treatments. We found: ‘no added benefit’ in 4 of 14 comparisons, ‘uncertain benefits’ in 7, and ‘no evidence’ in 3 comparisons. In no comparison did we find evidence of ‘substantial added benefit’ for the new drug; advertised drugs were 2 to 196 times more expensive per Defined Daily Dose; 11 safety announcements for five advertised drugs were issued compared to one announcement for one comparator drug; 20 post-marketing studies were requested for the advertised drugs versus 10 studies for the comparator drugs, and 7 studies assessed both an advertised and a comparator drug at 3 year follow-up.Conclusions and relevanceIn this cross-sectional study of medical advertisements published in the Journal of the Danish Medical Association during 2015, the most advertised drugs did not have documented substantial added benefits over older treatments, whereas they were substantially more expensive. From January 2021, the Journal of the Danish Medical Association no longer publishes medical advertisements. (shrink)

Subjects enrolled in studies testing high risk interventions for incurable or progressive brain diseases may be vulnerable to deficiencies in informed consent, such as the therapeutic misconception. However, the definition and measurement of the therapeutic misconception is a subject of continuing debate. Our qualitative pilot study of persons enrolled in a phase I trial of gene transfer for Parkinson disease suggests potential avenues for both measuring and preventing the therapeutic misconception. Building on earlier literature on the topic, we developed and (...) tested an interview guide that focuses on how the subjects decided to participate, emphasizing the integration of subjects’ various statements that are relevant to assessing the therapeutic misconception, rather than evaluating them as isolated statements. The results indicate that a subject’s understanding of the purpose of research is best explored in juxtaposition to the subject’s motivation for participating. (shrink)

Three experiments with preschool- and young school-aged children (N = 75 and 53) explored the kinds of relations children detect in samples of instances (descriptive problem) and how they generalize those relations to new instances (inferential problem). Each experiment initially presented a perfect biconditional relation between two features (e.g., all and only frogs are blue). Additional examples undermined one of the component conditional relations (not all frogs are blue) but supported another (only frogs are blue). Preschool-aged children did not distinguish (...) between supported and undermined relations. Older children did show the distinction, at least when the test instances were clearly drawn from the same population as the training instances. Results suggest that younger children’s difficulties may stem from the demands of using imperfect correlations for predictions. Older children seemed sensitive to the inferential problem of using samples to make predictions about populations. (shrink)

We introduce the _character lens_ perspective to account for stable patterns in the way that individuals make sense of and construct the ethical choices and situations they face. We propose that the way that individuals make sense of their present experience is an enduring feature of their broader moral character, and that differences between people in ethical decision-making are traceable to upstream differences in the way that people disambiguate and give meaning to their present context. In three studies, we found (...) that individuals with higher standing on moral character (operationalized as a combination of Honesty-Humility, Guilt Proneness, and Moral Identity Centrality) tended to construe their present context in more moral or ethical terms, and this difference in moral recognition accounted for differences in the ethical choices they made. Moreover, individuals with higher levels of moral character maintained high levels of moral recognition even as pressure to ignore moral considerations increased. Accordingly, this work unifies research on moral character, moral recognition, sensemaking, and judgment and decision-making into a person-centered account of ethical decision-making, highlighting the way decision-makers actively and directly shape the choice contexts to which they must respond. (shrink)

Major disasters and public health emergencies constantly test the nation's resolve to rally and recover from tragedy. Public health crises stemming from prolonged threats like the 2009/2010 H1N1 influenza pandemic require sustained preparedness and response over many months. Even shorter-duration events, like tornados, earthquakes, or hurricanes, leave lasting impacts for which full recovery may take years. Telling examples include the displacement of thousands of persons across the Gulf Coast states following Hurricane Katrina in 2005 and difficulties obtaining basic housing and (...) services that persisted in the Northeast months after Hurricane Sandy in 2012. Whether the result of natural disasters, infectious disease outbreaks, bioterrorism, or other causes, these events can change the societal landscape in affected regions.Despite the challenges of recovery across populations stemming from national or regional emergencies, Americans have consistently supported those directly affected. (shrink)

BackgroundHIV cure research involving cell and gene therapy has intensified in recent years. There is a growing need to identify ethical standards and safeguards to ensure cell and gene therapy (CGT) HIV cure research remains valued and acceptable to as many stakeholders as possible as it advances on a global scale.MethodsTo elicit preliminary ethical and practical considerations to guide CGT HIV cure research, we implemented a qualitative, in-depth interview study with three key stakeholder groups in the United States: (1) biomedical (...) HIV cure researchers, (2) bioethicists, and (3) community stakeholders. Interviews permitted evaluation of informants’ perspectives on how CGT HIV cure research should ethically occur, and were transcribed verbatim. We applied conventional content analysis focused on inductive reasoning to analyze the rich qualitative data and derive key ethical and practical considerations related to CGT towards an HIV cure.ResultsWe interviewed 13 biomedical researchers, 5 community members, and 1 bioethicist. Informants generated considerations related to: perceived benefits of CGT towards an HIV cure, perceived risks, considerations necessary to ensure an acceptable benefit/risk balance, CGT strategies considered unacceptable, additional ethical considerations, and considerations for first-in-human CGT HIV cure trials. Informants also proposed important safeguards to developing CGT approaches towards an HIV cure, such as the importance of mitigating off-target effects, mitigating risks associated with long-term duration of CGT interventions, and mitigating risks of immune overreactions.ConclusionOur study identified preliminary considerations for CGT-based HIV cure across three key stakeholder groups. Respondents identified an ideal cure strategy as one which would durably control HIV infection, protect the individual from re-acquisition, and eliminate transmission to others. Known and unknown risks should be anticipated and perceived as learning opportunities to preserve and honor the altruism of participants. Preclinical studies should support these considerations and be transparently reviewed by regulatory experts and peers prior to first-in-human studies. To protect the public trust in CGT HIV cure research, ethical and practical considerations should be periodically revisited and updated as the science continues to evolve. Additional ethics studies are required to expand stakeholder participation to include traditionally marginalized groups and clinical care providers. (shrink)

Different types of consent are used to obtain human biospecimens for future research. This variation has resulted in confusion regarding what research is permitted, inadvertent constraints on future research, and research proceeding without consent. The National Institutes of Health Clinical Center's Department of Bioethics held a workshop to consider the ethical acceptability of addressing these concerns by using broad consent for future research on stored biospecimens. Multiple bioethics scholars, who have written on these issues, discussed the reasons for consent, the (...) range of consent strategies, and gaps in our understanding, and concluded with a proposal for broad initial consent coupled with oversight and, when feasible, ongoing provision of information to donors. This article describes areas of agreement and areas that need more research and dialogue. Given recent proposed changes to the Common Rule, and new guidance regarding storing and sharing data and samples, this is an important and tim.. (shrink)

Donors to biobanks are typically asked to give blanket consent, allowing their donation to be used in any research authorized by the biobank. This type of consent ignores the evidence that some donors have moral, religious, or cultural concerns about the future uses of their donations – concerns we call “non-welfare interests”. The nature of non-welfare interests and their effect on willingness to donate to a biobank is not well understood. In order to better undersand the influence of non-welfare interests, (...) we surveyed a national sample of the US population using a probability-based internet panel. Logistic regression models assessed the demographic and attitudinal characteristics associated with participants’ willingness to give consent for unspecified future uses of their donation when presented with 7 research scenarios that raised possible non-welfare interest concerns. Most people had non-welfare interests that significantly affect their willingness to donate to a biobank using blanket consent. Some non-welfare interests are associated with subgroups but others are not. A positive attitude toward biomedical research in general was associated with increased willingness to donate, while concerns about privacy and being African American were associated with decreased willingness. Non-welfare interests matter and can diminish willingness to donate to a biobank. Our data suggest that trust in research promotes willingness to donate. Ignoring non-welfare interests could erode this trust. Donors’ non-welfare interests could be accommodated through greater transparency and easier access to information about the uses of donations. (shrink)

Im Jahre 1998 verblüfften Andy Clark und David Chalmers die philosophische Gemeinschaft mit der so genannten These des erweiterten Geistes, die im Kern besagt, dass kognitive Systeme nicht-biologische Komponenten enthalten können und sich damit über die Grenzen biologischer Organismen hinaus erstrecken können. Die These wird seitdem nicht nur von Philosophen, sondern auch von Kognitions- und Neurowissenschaftlern intensiv und kontrovers diskutiert. In den Beiträgen, die in dem vorliegenden ersten deutschsprachigen Band zur These des erweiterten Geistes versammelt sind, werden u.a. die folgenden (...) Fragen behandelt: Was soll es heißen, dass der Geist nicht (nur) im Kopf ist? In welchem Sinne könnte er erweitert sein, und welche Möglichkeiten der Erweiterung gibt es? Welche Zusammenhänge bestehen zwischen Geist und Kognition sowie zwischen Kopplung und Konstitution? Was genau besagt der von Clark und Chalmers vorgebrachte aktive Externalismus? Welche Bedeutung hat die These des erweiterten Geistes für repräsentationalistische und für funktionalistische Theorien des Geistes sowie für Theorien kollektiver Intentionalität und sozialer Kognition? Welche Anwendungen der These könnte es geben? (shrink)