Delivering high quality genomics-informed care to patients requires accurate test results whose clinical implications are understood. While other actors, including state agencies, professional organizations, and clinicians, are involved, this article focuses on the extent to which the federal agencies that play the most prominent roles — the Centers for Medicare and Medicaid Services enforcing CLIA and the FDA — effectively ensure that these elements are met and concludes by suggesting possible ways to improve their oversight of genomic testing.

We conducted a rapid review and quantitative summary of meta-analyses that have examined interventions which can be used by individuals during quarantine and social distancing to manage anxiety, depression, stress and subjective well-being. A literature search yielded 34 meta-analyses (total number of studies k = 1,390, n = 145,744) that were summarized. Overall, self-guided interventions showed small to medium effects in comparison to control groups. In particular, self-guided therapeutic approaches (including cognitive-behavioral, mindfulness, and acceptance-based interventions), selected positive psychology interventions, and (...) multi-component and activity-based interventions (music, physical exercise) showed promising evidence for effectiveness. Overall, self-guided interventions on average did not show the same degree of effectiveness as traditional guided individual or group therapies. There was no consistent evidence of dose effects, baseline differences and differential effectiveness of eHealth interventions. More research on the effectiveness of interventions in diverse cultural settings is needed. (shrink)

Moral distress names a widely discussed and concerning clinician experience. Yet the precise nature of the distress and the appropriate practical response to it remain unclear. Clinicians speak of their moral distress in terms of guilt, regret, anger, or other distressing emotions, and they often invoke them interchangeably. But these emotions are distinct, and they are not all equally fitting in the same circumstances. This indicates a problematic ambiguity in the moral distress concept that obscures its distinctiveness, its relevant circumstances, (...) and how individual clinicians and the medical community should practically respond to it. We argue that, in a range of situations that are said to be morally distressing, the characteristic emotion can be well‐understood in terms of what Bernard Williams calls “agent‐regret.” We show what can thereby be gained in terms of a less ambiguous concept and a more adequate ethical response to this distinctive and complex clinician experience. (shrink)

Noninvasive prenatal screening using cell-free DNA, which analyzes placental DNA circulating in maternal blood to provide information about fetal chromosomal disorders early in pregnancy and without risk to the fetus, has been hailed as a potential “paradigm shift” in prenatal genetic screening. Commercial provision of cell-free DNA screening has contributed to a rapid expansion of the tests included in the screening panels. The tests can include screening for sex chromosome anomalies, rare subchromosomal microdeletions and aneuploidies, and most recently, the entire (...) fetal genome. The benefits of this screening tool are generally framed, by both providers and commercial laboratories, as enhancing reproductive autonomy and choice by providing an earlier, simpler, and more accurate screening while potentially reducing the need for invasive follow-up testing. The majority of the literature has explored these issues empirically or conceptually from a European or North American vantage point, one that assumes normative priorities such as individual reproductive autonomy and the clinical availability of maternal health care or prenatal screening programs within which cell-free DNA screening is offered. While its implementation has raised both challenges and opportunities, very little is known about real-world experiences and the implications of the rapid introduction of cell-free DNA screening outside of North America and Europe, especially in low- and middle-income countries. To begin addressing this gap in knowledge, we organized a four-day international workshop to explore the ethical, legal, social, economic, clinical, and practical implications of the global expansion of cell-free DNA screening. We describe eight key insights that arose from the workshop. (shrink)

A main objective of this study is to assess the opinions of 50 behavioral health patients on selective control over their behavioral and physical health information. We explored patients' preferences regarding current consent models, what health information should be shared for care and research and whether these preferences vary based on the sensitivity of health information and/or the type of provider involved. The other objective of this study was to solicit opinions of 8 behavioral health providers on patient-driven granular control (...) of health information and potential impact on care.Electronic surveys were implemented at an outpatient Behavioral Health facility that provides care for behavioral health patients with non-serious mental illnesses. The Patient Survey included questions regarding patients' demographics and about their concerns and preferences for data sharing for care and research. The Provider Survey included questions about their view on the current consent process and perceptions on barriers and facilitators to implement patient-controlled granular consent models.This novel study provides valuable preliminary data that can help guide future studies to better understand privacy choices of this underrepresented patient group. (shrink)

Dementia is a growing issue at the end of life that presents unique challenges for advance care planning. Advance directives are a useful and important component of end-of-life planning, but standard advance directives have less utility in cases of loss of capacity due to dementia. An advance directive designed to specifically address end-of-life issues in the setting of dementia can provide patients with increased autonomy and caregivers with improved information about the desires of the individual in question. The Dartmouth Dementia (...) Directive is a dementia-specific advance directive, available online, that seeks to address common concerns of individuals who are planning for dementia-related end-of-life care. This directive was piloted in a community-based workshop, which provided important details and perspective on the best use of dementia-specific advance directives in the greater population. (shrink)

Extending new verbs is important in becoming a productive speaker of a language. Prior results show children have difficulty extending verbs when they have seen events with varied agents. This study further examines the impact of variability on verb learning and asks whether variability interacts with event complexity or differs by language. Children in the United States, China, Korea, and Singapore learned verbs linked to simple and complex events. Sets of events included one or three agents, and children were asked (...) to extend the verb at test. Children learning verbs linked to simple movements performed similarly across conditions. However, children learning verbs linked to events with multiple objects were less successful if those events were enacted by multiple agents. A follow-up study rules out an influence of event order. Overall, similar patterns of results emerged across languages, suggesting common cognitive processes support children's verb learning. (shrink)

Yarkoni's paper makes an important contribution to psychological research by its insightful analysis of generalizability. We suggest, however, that broadening research practices to include field research and the correlated use of both converging and complementary observations gives reason for optimism.

The following Acknowledgments were omitted in the original publication.

Over the last few decades there has been a phenomenal growth of interest in metaphor as a device which extends or revises our perception of the world. Clive Cazeaux examines the relationship between metaphor, art and science, against the backdrop of modern European philosophy and, in particular, the work of Kant, Heidegger and Merleau-Ponty. He contextualizes recent theories of the cognitive potential of metaphor within modern European philosophy and explores the impact which the notion of cognitive metaphor has on (...) key positions and concepts within aesthetics, epistemology and the philosophy of science. (shrink)

The Anthropocene, in which humankind has become a geological force, is a major scientific proposal; but it also means that the conceptions of the natural and social worlds on which sociology, political science, history, law, economics and philosophy rest are called into question. The Anthropocene and the Global Environmental Crisis captures some of the radical new thinking prompted by the arrival of the Anthropocene and opens up the social sciences and humanities to the profound meaning of the new geological epoch, (...) the 'Age of Humans'. Drawing on the expertise of world-recognised scholars and thought-provoking intellectuals, the book explores the challenges and difficult questions posed by the convergence of geological and human history to the foundational ideas of modern social science. If in the Anthropocene humans have become a force of nature, changing the functioning of the Earth system as volcanism and glacial cycles do, then it means the end of the idea of nature as no more than the inert backdrop to the drama of human affairs. It means the end of the 'social-only' understanding of human history and agency. These pillars of modernity are now destabilised. The scale and pace of the shifts occurring on Earth are beyond human experience and expose the anachronisms of 'Holocene thinking'. The book explores what kinds of narratives are emerging around the scientific idea of the new geological epoch, and what it means for the 'politics of unsustainability'. (shrink)

By reconsidering the theme of isolation in the philosophy of technology, and by drawing upon recent developments in social ontology, Lawson provides an account of technology that will be of interest and value to those working in a variety of different fields. Technology and Isolation includes chapters on the philosophy, history, sociology and economics of technology, and contributes to such diverse topics as the historical emergence of the term 'technology', the sociality of technology, the role of technology in social acceleration, (...) the relationship between Marx and Heidegger, and the relationship between technology and those with autism. The central contribution of the book is to provide a new ontology of technology. In so doing, Lawson argues that much of the distinct character of technology can be explained or understood in terms of the dynamic that emerges from technology's peculiar constitutional mix of isolatable and non-isolatable components. (shrink)

The journal Environmental Values is thirty years old. In this retrospective, as the retiring Editor-in-Chief, I provide a set of personal reflections on the changing landscape of scholarship in the field. This historical overview traces developments from the journal's origins in debates between philosophers, sociologists, and economists in the UK to the conflicts over policy on climate change, biodiversity/non-humans and sustainability. Along the way various negative influences are mentioned, relating to how the values of Nature are considered in policy, including (...) mainstream environmental economics, naïve environmental pragmatism, the strategic role of corporations, neoliberalism and eco-modernism/techno-optimism. At the same time core value debates around intrinsic value in Nature and instrumentalism remain relevant, along with how plural environmental values can be articulated and acted upon. Naturalness, human relations to non-humans, and Nature as other, remain central considerations. The broadening of issues covered by the journal (e.g. covering social psychology, sociology and political science), reflect the need to address both human behaviour and the structure of social and economic systems to confront ongoing social-ecological crises. (shrink)

This short theoretical paper elucidates a plausible theory about the Global Financial Crisis and the role of senior financial corporate directors in that crisis. The paper presents a theory of the Global Financial Crisis which argues that psychopaths working in corporations and in financial corporations, in particular, have had a major part in causing the crisis. This paper is thus a very short theoretical paper but is one that may be very important to the future of capitalism because it discusses (...) significant ways in which Corporate Psychopaths may have acted recently, to the detriment of many. Further research into this theory is called for. (shrink)

Bringing to light new facets in the philosophy of Emmanuel Levinas and William James, Megan Craig explores intersections between French phenomenology and American pragmatism.

This paper argues that the conditions of the Anthropocene render the four ontologies described by Philippe Descola obsolete, and begins the search for a fifth ontology that speaks to the meaning of...

People who speak up about the unpleasant realities of environmental degradation, capitalist exploitation and the growth economy are likely to be criticised for 'negative framing' - while corporations undermine truths by casting them as social constructs with no objective validity. Environmentalists increasingly conform to the idea of telling nice stories using abstract metaphors rather than seeking to identify, specify and name systemic problems and their causes. Psychological pressures faced by scientists and activists, and personal strategies for coming to terms with (...) and combating harsh realities, are themes that run through this issue of Environmental Values. This reveals the necessity of radical activism and the expression of a more general concern over ethics and justice as counters to the stiflingly narrow hegemonic economic discourse that prevails in official circles. (shrink)

In the 1830s and 1840s, the Hydrographic Office of the British Admiralty developed and oversaw one of the major state-run surveying projects of the nineteenth century. This involved a range of instruments whose circulation was increasingly regulated. Using extant museum collections and the correspondence of those involved, this article explores how such objects can be used to discuss both bureaucratic organization at a time of expanding government and the complex issues of sociability involved in hydrographic surveying. Surveying officers worked in (...) a context in which the propriety of property on public service was a pervasive question. Instruments might be given as gifts between officers, appropriated as recompense, absorbed as state property, and disputed between friends. The ownership, provision, and treatment of instruments in particular could be used to demonstrate an officer’s peculiar zeal or institutional neglect. To those outside the ship, what was understood as over-instrumentation became amusing spectacle. On board, their use was part of a deeply hierarchical order of work in regions of colonial and mercantile importance. In examining the relationships around these instruments of survey, the paper proposes a richer understanding of the material culture of hydrography in the early nineteenth century. (shrink)

Intro -- Introduction -- Chapter 1: "The best-laid plans of mice and men ..." -- Chapter 2: "Why won't you do what we think is best for you?" -- Chapter 3: How can I stop screwing up? -- Chapter 4: "Ouch!" -- Why did that backfire? -- Chapter 5: Scientific progress -- that's a good thing, right? -- Chapter 6: Surely trying to protect people can't be bad? -- Chapter 7: Can bad intentions turn out for the good? -- Chapter (...) 8: The upside -- unlooked for benefits -- Chapter 9: So -- how can we do good better? -- References. (shrink)

Persons with dementia often prefer to participate in decisions about their health care, but may be prevented from doing so because healthcare decision-making law facilitates use of advance directives or surrogate decision makers for persons with decisional impairments such as dementia. Federal and state disability law provide alternative decision-making models that do not prevent persons with mild to moderate dementia from making their own healthcare decisions at the time the decision needs to be made. In order to better promote autonomy (...) and wellbeing, persons with dementia should be accommodated and supported so they can make their own healthcare decisions. (shrink)

Some claim that a commitment to egalitarianism is in tension with support for reparations for historical injustice. This tension appears to arise insofar as egalitarianism is a forward-looking approach to justice: an approach that tells us what kind of world we should aim to build, where that world is not defined in terms of the decisions or actions of previous generations. Some have claimed that egalitarianism thereby renders reparations redundant. One popular option for egalitarians who aim to reject this thesis (...) is to insist that historical injustices demand reparations when they have caused present-day inequality. A promising alternative, skilfully defended by Alasia Nuti in Injustice and the Reproduction of History, is to argue that historical injustices stand in need of repair when they are reproduced into the present-day, such that some past and present injustices are in fact the same injustice. In this paper, I assess these egalitarian responses to the redundancy thesis. I find that Nuti’s account is equipped to reject this thesis, but that the same lines of reply can be adopted by proponents of the causal approach. I suggest that both approaches therefore be viewed as potential ways to conceptualise the relationship between historical injustice and our present normative circumstances; and that in choosing between them, we should understand ourselves to be engaged in an ameliorative project – a project that is guided by, and designed to help us to achieve, our legitimate purposes. (shrink)

The plain speaking of the new environmental movements places emphasis on an imminent ecological crisis, but the 'new' environmentalists appear to lack insight into what specific action is required, to what they stand in opposition and more generally the political and economic context within which they (as social movements) are operating. The fact is that political and economic elites around the world have long been taking 'environmental action', to protect not Nature but themselves, against environmentalists and environmental regulation. The papers (...) in this issue of Environmental Values set out a range of ethical arguments and concerns that bring corporate capitalism into question or oppose it, and reflect upon ethical responses to its ongoing infliction of harm on the innocent. They make it clear that conformity to the system that produced the crisis will not deliver the necessary revolutionary social ecological transformation. (shrink)

Moral distress has been characterised in the nursing literature as a major problem affecting nurses in all healthcare systems. It has been portrayed as threatening the integrity of nurses and ultimately the quality of patient care. However, nursing discourse on moral distress is not without controversy. The notion itself is conceptually flawed and suffers from both theoretical and practical difficulties. Nursing research investigating moral distress is also problematic on account of being methodologically weak and disparate. Moreover, the ultimate purpose and (...) significance of the research is unclear. In light of these considerations, it is contended that the notion of moral distress ought to be abandoned and that concerted attention be given to advancing inquiries that are more conducive to improving the quality and safety of moral decision-making, moral conduct and moral outcomes in nursing and healthcare domains. (shrink)

Shavelson and colleagues (2023) describe how medical aid-in-dying laws in the United States prohibit assistance in administering aid-in-dying medication. This prohibition distinguishes aid in dying...

This article reports on empirical research that establishes strong, positive, and significant correlations between the ethical issues of bullying and unfair supervision in the workplace and the presence of Corporate Psychopaths. The main measure for bullying is identified as being the witnessing of the unfavorable treatment of others at work. Unfair supervision was measured by perceptions that an employee's supervisor was unfair and showed little interest in the feelings of subordinates. This article discusses the theoretical links between psychopathy and bullying (...) and notes that little empirical evidence confirms the connection in management research. The sample of 346 Australian senior white collar workers used in the research is described as is the measure of behavior for identifying psychopaths. The findings are then presented and discussed showing that when Corporate Psychopaths are present in a work environment, the level of bullying is significantly greater than when they are not present. Further, that when Corporate Psychopaths are present, supervisors are strongly perceived as being unfair to employees and disinterested in their feelings. This article concludes that around 26% of bullying is accounted for by 1% of the employee population, those who are Corporate Psychopaths. (shrink)

In this study we use dual process theory of self-regulation to develop a framework that outlines the mediating and moderating mechanisms explaining the relationship between leader emotional exhaustion and leadership style (transformational leadership and abusive supervision). Using Glomb et al.’s (2011) framework, we identify empathy and negative emotion as mediators that are of particular importance for leaders. In addition, we propose that leader mindfulness moderates these processes to improve leadership style. Using a time-lagged survey of leaders (N = 505) we (...) found that leader empathy and negative emotion mediated the relationships between emotional exhaustion and leadership style. Furthermore, we found that leader mindfulness significantly moderated the indirect effect of leader emotional exhaustion on leadership style through negative emotion. However, leader mindfulness did not moderate the relationship between emotional exhaustion and empathy. Theoretical and practical implications are discussed. (shrink)

Pickering, Newton-Howes, and Young assert that the traditional view of decisional capacity, premised on assessing patients’ abilities to communicate, understand, appreciate,...

Moving sustainability towards flourishing for all implies a care for all and for the future. However, in this commentary I note that many corporate and political leaders do not care for others or the future because, embodying egotistical, ruthless, remorseless, and dishonest (psychopathic) characteristics, their concern is only for themselves. This commentary argues that toxic leadership and governance, in the form of corporate psychopathy and corporate psychopaths, are important barriers to achieving sustainability. Notably, and of relevance to this argument, the (...) embodiment of psychopathic traits can give people the ability to brazenly push themselves to the top, unimpeded by emotional distractions and thereby attain leadership. However, due to their deep indifference to corporate social responsibility and a readiness to falsify environmental impact reports, engage in faking corporate social responsibility and illegally dump toxic waste materials; the influence of such psychopathic leadership may be detrimental to sustainability and to flourishing for all. Leaders high in psychopathy will ignore or dismiss scientific evidence of unsustainable practices because they do not care about the future or about dismissing scientific evidence of detriments to the prospects for humanity. Accordingly toxic leadership and governance are arguably the critical factors in achieving a flourishing sustainability. The future of all life thus depends on who we choose as our leaders. (shrink)

This article examines the issues that are at stake in the current resurgence of interest in the subject of habit. We focus on the role that habit has played in conceptions of the relations between body and society, and the respects in which such conceptions have been implicated in processes of governance. We argue that habit has typically constituted a point of leverage for regulatory practices that seek to effect some realignment of the relations between different components of personhood – (...) will, character, memory and instinct, for example – in order to bring about a specific end. In reviewing its functioning in this regard across a range of modern disciplines – philosophy, psychology, sociology – we explore the tensions between its use and interpretation in different lineages: in particular, the Cartesian–Kantian/ravaisson–bergson–deleuze lineages. The article then identifies how these questions are addressed across the contributions collected in this special issue. (shrink)

What if anyone in Hell could take a bus trip to Heaven and stay there forever if they wanted to? In The Great Divorce C. S. Lewis again employs his formidable talent for fable and allegory. The writer finds himself in Hell boarding a bus bound for Heaven. The amazing opportunity is that anyone who wants to stay in Heaven, can. This is the starting point for an extraordinary meditation upon good and evil, grace and judgment. Lewis's revolutionary idea is (...) the discovery that the gates of Hell are locked from the inside. In Lewis's own words, "If we insist on keeping Hell (or even earth) we shall not see Heaven: if we accept Heaven we shall not be able to retain even the smallest and most intimate souvenirs of Hell.". (shrink)

Informed consent is the gateway to research participation. We report on the results of the formative evaluation that follows the electronic informed consent process for the All of Us Research Program. Of the nearly 250,000 participants included in this analysis, more than 95% could correctly answer questions distinguishing the program from medical care, the voluntary nature of participation, and the right to withdraw; comparatively, participants were less sure of privacy risk of the program. We also report on a small mixed-methods (...) study of the experience of persons of very low health literacy with All of Us informed consent materials. Of note, many of the words commonly employed in the consent process were unfamiliar to or differently defined by informants. In combination, these analyses may inform participant-centered development and highlight areas for refinement of informed consent materials for the All of Us Research Program and similar studies. (shrink)

This longitudinal case study reports on a charity in the UK which gained a new CEO who was reported by two middle managers who worked in the charity, to embody all or most of the ten characteristics within a measure of corporate psychopathy. The leadership of this CEO with a high corporate psychopathy score was reported to be so poor that the organisation was described as being one without leadership and as a lost organisation with no direction. This paper outlines (...) the resultant characteristics of the ensuing aimlessness and lack of drive of the organisation involved. Comparisons are made to a previous CEO in the same organisation, who was reportedly an authentic, effective and transformational leader. Outcomes under the CEO with a high corporate psychopathy score were related to bullying, staff withdrawal and turnover as effective employees stayed away from and/or left the organisation. Outcomes also included a marked organisational decline in terms of revenue, employee commitment, creativity and organisational innovativeness. The paper makes a contribution to both leadership and to corporate psychopathy research as it appears to be the first reported study of a CEO with a high corporate psychopathy score. (shrink)