Beneficent clinical usage of placebos has been a problem for the application of Kant’s deontology in medical ethics, which, in its strictest form, rejects deception universally. Some defenders of deontology have countered this by arguing placebos can be used by a physician without necessarily being deceptive. In this paper we argue that such a manipulation of Kant’s absolutism is not credible, and therefore, that we should look beyond deontology in our consideration of placebo usage in clinical practice. We conclude that (...) Kant’s deontology cannot be made compatible with placebo use in clinical practice due to the primacy it affords to the principle of autonomy. (shrink)

This self-contained introduction to natural language semantics addresses the majortheoretical questions in the field. The authors introduce the systematic study of linguistic meaningthrough a sequence of formal tools and their linguistic applications. Starting with propositionalconnectives and truth conditions, the book moves to quantification and binding, intensionality andtense, and so on. To set their approach in a broader perspective, the authors also explore theinteraction of meaning with context and use (the semantics-pragmatics interface) and address some ofthe foundational questions, especially in connection (...) with cognition in general. They also introducea few of the most accessible and interesting ideas from recent research to give the reader a bit ofthe flavor of current work in semantics. The organization of this new edition is modular; after theintroductory chapters, the remaining material can be covered in flexible order. The book presupposesno background in formal logic (an appendix introduces the basic notions of set theory) and only aminimal acquaintance with linguistics. This edition includes a substantial amount of completely newmaterial and has been not only updated but redesigned throughout to enhance itsuser-friendliness. (shrink)

How do Dutch people let each other know that they disagree? What do they say when they want to resolve their difference of opinion by way of an argumentative discussion? In what way do they convey that they are convinced by each other’s argumentation? How do they criticize each other’s argumentative moves? Which words and expressions do they use in these endeavors? By answering these questions this short essay provides a brief inventory of the language of argumentation in Dutch.

What is the point of language? If we begin with that abstract question, we may be tempted towards a high-minded answer: “People say things to get other people to come to know things that they didn't know before” (Stalnaker, 2002, 703). The point is truth, knowledge, communication. If we begin with a concrete question, “What has language to do with race?” we find a different point: to attack, spread hatred, create racial hierarchy. The mere practice of racial categorization is controversial: (...) are race terms natural or social kind terms? What does categorization do to the categorized? (Outlaw, 1990; Omi and Winant, 1994; Appiah, 1996; Andreason, 1998; Kitcher, 1999; Zack, 2002; Haslanger, 2008; Glasgow, 2009). But there is worse than mere categorization to contend with. (shrink)

History and current affairs show that words matter - and change - because they are woven into our social and political lives. Words are weapons wielded by the powerful; they are also powerful tools for social resistance and for reimagining and reconfiguring social relations. Illustrated with topical examples, from racial slurs and sexual insults to preferred gender pronouns, from ethnic/racial group labels to presidential tweets, this book examines the social contexts which imbue words with potency. Exploring the role of language (...) in three broad categories - establishing social identities, navigating social landscapes, and debating social and linguistic change - Sally McConnell-Ginet invites readers to examine critically their own ideas about language and its complicated connections to social conflict and transformation. Concrete and timely examples vividly illustrate the feedback loop between words and the world, shedding light on how and why words can matter. (shrink)

“Female sexual dysfunction” is the type of contested disease that has sparked concern about the role of the pharmaceutical industry in medical science. Many policies have been proposed to manage industry influence without carefully evaluating whether the proposed policies would be successful. We consider a proposal for incorporating citizen stakeholders into scientific research and show, via a detailed case study of the pharmaceutical regulation of flibanserin, that such programs can be co-opted. In closing, we use Holman’s asymmetric arms race framework (...) as a tool for evaluating policies in industry-funded science. (shrink)

BackgroundMoral distress (MD) is an emotional and psychological response to morally challenging dilemmas. Moral distress is experienced frequently by nurses in the intensive care unit (ICU) and can result in emotional anguish, work dissatisfaction, poor patient outcomes, and high levels of nurse turnover. Opportunities to discuss ethically challenging situations may lessen MD and its associated sequela.ObjectiveThe purpose of this project was to develop, implement, and evaluate the impact of nursing ethics huddles on participants’ MD, clinical ethics knowledge, work satisfaction, and (...) patient care among ICU nurses.Sample and SettingThe sample, 32 nurses from three ICU settings in an 800-bed tertiary academic medical center, participated in six nursing ethics huddles over a two-month period.MethodsAlvita K. Nathaniel’s Theory of Moral Reckoning guided development of the nursing ethics huddle process.1 The Moral Distress Thermometer was administered at three data points: baseline level of MD, and pre- and post-huddle to determine changes in the subjects’ level of MD.2 Focused content analysis was used to analyze qualitative responses from questionnaires about the subjects’ perception of the effect of the huddles on work satisfaction and patient care. Knowledge attainment was evaluated via open-ended short-answer questions.ResultsOverall, use of nurse-ethicist-led nursing ethics huddles was associated with improved quality of work life, patient care, and clinical ethics knowledge. The change in pre- and post-nursing ethics huddles MD scores was statistically significant (p < 0.0001). (shrink)

Linear mixed-effect models (LMMs) are being increasingly widely used in psychology to analyse multi-level research designs. This feature allows LMMs to address some of the problems identified by Speelman and McGann ( 2013 ) about the use of mean data, because they do not average across individual responses. However, recent guidelines for using LMM to analyse skewed reaction time (RT) data collected in many cognitive psychological studies recommend the application of non-linear transformations to satisfy assumptions of normality. Uncritical adoption of (...) this recommendation has important theoretical implications which can yield misleading conclusions. For example, Balota et al. ( 2013 ) showed that analyses of raw RT produced additive effects of word frequency and stimulus quality on word identification, which conflicted with the interactive effects observed in analyses of transformed RT. Generalized linear mixed-effect models (GLMM) provide a solution to this problem by satisfying normality assumptions without the need for transformation. This allows differences between individuals to be properly assessed, using the metric most appropriate to the researcher's theoretical context. We outline the major theoretical decisions involved in specifying a GLMM, and illustrate them by reanalysing Balota et al.'s datasets. We then consider the broader benefits of using GLMM to investigate individual differences. (shrink)

:This article considers recent ethical topics relating to medical AI. After a general discussion of recent medical AI innovations, and a more analytic look at related ethical issues such as data privacy, physician dependency on poorly understood AI helpware, bias in data used to create algorithms post-GDPR, and changes to the patient–physician relationship, the article examines the issue of so-called robot doctors. Whereas the so-called democratization of healthcare due to health wearables and increased access to medical information might suggest a (...) positive shift in the patient-physician relationship, the physician’s ‘need to care’ might be irreplaceable, and robot healthcare workers might be seen as contributing to dehumanized healthcare practices. (shrink)

This article explores how neutralisation can explain people's lack of commitment to buying Fair Trade products, even when they identify FT as an ethical concern. It examines the theoretical tenets of neutralisation theory and critically assesses its applicability to the purchase of FT products. Exploratory research provides illustrative examples of neutralisation techniques being used in the FT consumer context. A conceptual framework and research propositions delineate the role of neutralisation in explaining the attitude-behaviour discrepancies evident in relation to consumers' FT (...) purchase behaviour, providing direction for further research that will generate new knowledge of consumers' FT purchase behaviour and other aspects of ethical consumer behaviour. (shrink)

Fieldworkers (FWs) are community members employed by research teams to support access to participants, address language barriers, and advise on culturally appropriate research conduct. The critical role that FWs play in studies, and the range of practical and ethical dilemmas associated with their involvement, is increasingly recognised. In this paper, we draw on qualitative observation and interview data collected alongside a six month basic science study which involved a team of FWs regularly visiting 47 participating households in their homes. The (...) qualitative study documented how relationships between field workers and research participants were initiated, developed and evolved over the course of the study, the shifting dilemmas FWs faced and how they handled them. Even in this one case study, we see how the complex and evolving relationships between fieldworkers and study participants had important implications for consent processes, access to benefits and mutual understanding and trust. While the precise issues that FWs face are likely to depend on the type of research and the context in which that research is being conducted, we argue that appropriate support for field workers is a key requirement to strengthen ethical research practice and for the long term sustainability of research programmes. (shrink)

Digressions in argumentative discussion are a kind of failure of relevance. Examination of what actual cases look like reveals several properties of argumentative relevance: (1) The informational relevance of propositions to the truth value of a conclusion should be distinguished from the pragmatic relevance of argumentative acts to the task of resolving a disagreement. (2) Pragmatic irrelevance is a collaborative phenomenon. It does not just short-circuit reasoning; it encourages a failure to take up the demands of an argumentative task. (3) (...) Pragmatic irrelevance can occur not simply by the absence of a connection between what is said and some standpoint in dispute, but also by the presence of a connection between what is said and a competing use of the information. (4) Pragmatic relevance must be accomplished through communicative action. (shrink)

In this debate-format book, four philosophers--Joshua Glasgow, Sally Haslanger, Chike Jeffers, and Quayshawn Spencer--articulate contrasting views on race. Each author presents a distinct viewpoint on what race is, and then replies to the others, offering theories that are clear and accessible to undergraduates, lay readers, and non-specialists, as well as other philosophers of race.

Customarily patient advocacy is argued to be an essential part of nursing, and this is reinforced in contemporary nursing codes of conduct, as well as codes of ethics and competency standards governing practice. However, the role of the nurse as an advocate is not clearly understood. Autonomy is a key concept in understanding advocacy, but traditional views of individual autonomy can be argued as being outdated and misguided in nursing. Instead, the feminist perspective of relational autonomy is arguably more relevant (...) within the context of advocacy and nurses’ work in clinical healthcare settings. This article serves to highlight and problematise some of the assumptions and influences around the perceived role of the nurse as an advocate for patients in contemporary Western healthcare systems by focusing on key assumptions concerning autonomy inherent in the role of the advocate. (shrink)

ABSTRACT:We combine prior research on ethical decision-making in organizations with a rational choice theory of corporate crime from criminology to develop a model of corporate offending that is tested with a sample of U.S. managers. Despite demands for increased sanctioning of corporate offenders, we find that the threat of legal action does not directly affect the likelihood of misconduct. Managers’ evaluations of the ethics of the act, measured using a multidimensional ethics scale, have a significant effect, as do outcome expectancies (...) that result from being associated with the misconduct but not facing formal sanctions. The threat of formal sanctions appears to operate indirectly, influencing ethical evaluations and outcome expectancies. Obedience to authority also affects illegal intentions, with managers reporting higher prospective offending when they are ordered to engage in misconduct by a supervisor. (shrink)

We recognize a paradox of power and promise in the context of legislative and organizational changes in nurse regulation which poses constraints on nursing's capacity to bring voice and influence to pressing matters of healthcare and public policy. The profession is at an important crossroads wherein leaders must be well informed in political, economic and legislative trends to harness the profession's power while also navigating forces that may put at risk its central mission to serve society. We present a critical (...) policy analysis of the impact of recent regulatory trends on what the International Council of Nurses considers nursing's three ‘pillars’ – the profession of nursing, socioeconomic welfare of nurses and nurse regulation. Themes surfacing from this analysis include regulatory discontinuity, a tightening of regulatory control, and an increasingly managerial governance culture. These themes illuminate insights and strategies required to renew and revitalize the social mandate of our profession amidst a climate of urgency in the questioning of nurse scholars with respect to the future of the profession. At this historic juncture, nurses must clearly understand the implications of legislative and organizational regulatory changes to ensure the profession contributes to full capacity in achieving health and health equity globally. (shrink)

Under multistakeholderism, private philanthropic foundations have played an increasingly influential role in global development. As part of which, foundations have promoted what we call “privatization creep” (i.e., mainstreaming market-centric solutions to development). Sidelining redistributive approaches altogether, “privatization creep” favours profit-making over everything else, doing little to “save the world.”.

With the advent of legalized medical assistance in dying [MAiD] in Canada in 2016, nursing is facing intriguing new ethical and theoretical challenges. Among them is the concept of conscientious objection, which was built into the legislation as a safeguard to protect the rights of healthcare workers who feel they cannot participate in something that feels morally or ethically wrong. In this paper, we consider the ethical complexity that characterizes nurses' participation in MAiD and propose strategies to support nurses' moral (...) reflection and imagination as they seek to make sense of their decision to participate or not. Deconstructing the multiple and sometimes conflicting ethical and professional obligations inherent in nursing in such a context, we consider ways in which nurses can sustain their role as critically reflective moral agents within a context of a relational practice, serving the diverse needs of patients, families, and communities, as Canadian society continues to evolve within this new way of engaging with matters of living and dying. (shrink)

What does it mean to ‘drop out’ of therapy? Many definitions of ‘dropout’ have been proposed, but the most widely accepted is the client ending treatment without agreement of their therapist. However, this is in some ways an external criterion that does not take into account the client’s experience of therapy, or reasons for ending it prematurely. This study aimed to identify whether there were more meaningful categories of dropout than the existing dropout definition, and to test whether this refined (...) categorisation of dropout was associated with clinical outcomes. This mixed-methods study used a subset of data from the IMPACT trial, which investigated psychological therapies for adolescent depression. Adolescents were randomly allocated to a treatment arm (Brief Psychosocial Intervention; Cognitive-Behavioural Therapy; Short-Term Psychoanalytic Psychotherapy). The sample for this study comprised 99 adolescents, aged 11-17 years. 32 were classified as having dropped out of treatment and participated in post-therapy qualitative interviews about their experiences of therapy. For 26 dropout cases, the therapist was also interviewed. 67 cases classified as having completed treatment were included to compare their outcomes to dropout cases. Interview data for dropout cases were analysed using ideal type analysis. Three types of dropout were constructed: ‘dissatisfied’ dropout, ‘got-what-they-needed’ dropout, and ‘troubled’ dropout. ‘Dissatisfied’ dropouts reported stopping therapy because they did not find it helpful. ‘Got-what-they-needed’ dropouts reported stopping therapy because they felt they had benefitted from therapy. ‘Troubled’ dropouts reported stopping therapy because of a lack of stability in their lives. The findings indicate the importance of including the perspective of clients in definitions of drop out, as otherwise there is a risk that the heterogeneity of 'dropout' cases may mask more meaningful distinctions. Clinicians should be aware of the range of issues experienced by adolescents in treatment that lead to disengagement. Our typology of dropout may provide a framework for clinical decision-making in managing different types of disengagement from treatment. (shrink)

: We criticize a view of maternity that equates the natural with the genetic and biological and show how such a practice overdetermines the maternal body and the maternal experience for women who are mothers through adoption and ART (Assisted Reproductive Technologies). As an alternative, we propose a new framework designed to rethink maternal bodies through the lens of feminist embodiment. Feminist embodied maternity, as we call it, stresses the particularity of experience through subjective embodiment. A feminist embodied maternity emphasizes (...) the physical relations of the subjective lived-body rather than the genetic or biological connections. Instead of universalizing claims about the maternal body, embodied maternity looks to communicable experiences and empathetic understanding. (shrink)

There has been considerable interest in the literature about how professions operate in both the private and public interest. This paper examines this issue in the context of the enforcement of the professional code of conduct of a particular professional accounting association. The paper explores whether certain enforcement actions of the association suggest behaviour motivated at least partially by private interest. It then considers whether the consequences of such behaviour or practices are troubling.

This paper presents an analysis of conversational actions and category relations exhibited in an episode of argument between a brother and sister during a family meal. The paper is based on two sets of auspices: on a conversation analytic concern with the interconnection between the sequential and categorical ‘layers’ of organization to which parties to talk-in-interaction are demonstrably oriented, and on ‘Sacks’ Conjecture’ regarding children’s culture and adult—child ‘culture contact’. In terms of these auspices, the analysis shows that the children (...) use both sequential and categorical cultural resources to produce their argument. To adapt a concept of Garfinkel’s — the documentary method of interpretation — the category relationship between the children is the underlying matter that the sequential particulars are used to reflexively document and constitute. Specifically, through the sequentially organized particulars of degradation and resistance the children recognizably and reflexively constitute their category relationship. (shrink)

For Ordinary Language philosophy, at issue is the use of the expressions of language, not expressions in and of themselves. So, at issue is not, for example, ordinary versus (say) technical words; nor is it a distinction based on the language used in various areas of discourse, for example academic, technical, scientific, or lay, slang or street discourses – ordinary uses of language occur in all discourses. It is sometimes the case that an expression has distinct uses within distinct discourses, (...) for example, the expression ‘empty space’. This may have both a lay and a scientific use, and both uses may count as ordinary; as long as it is quite clear which discourse is in play, and thus which of the distinct uses of the expression is in play. Though connected, the difference in use of the expression in different discourses signals a difference in the sense with which it is used, on the Ordinary Language view. One use, say the use in physics, in which it refers to a vacuum, is distinct from its lay use, in which it refers rather more flexibly to, say, a room with no objects in it, or an expanse of land with no buildings or trees. However, on this view, one sense of the expression, though more precise than the other, would not do as a replacement of the other term; for the lay use of the term is perfectly adequate for the uses it is put to, and the meaning of the term in physics would not allow speakers to express what they mean in these other contexts. (shrink)

Influences on the perception of affordances (i.e., opportunities for actions) have been primarily studied by manipulating the functional morphology of the body. However, affordances are not just determined by the functional morphology of the perceiver, but also by the physiological state of the perceiver. States of anxiety have been shown to lead to marked changes in individuals’ physiological state and their behaviour. To assess the influence of emotional state on affordance perception, the perception of action capabilities in near space was (...) examined after participants completed an anxiety-provoking task. Anxiety was induced immediately prior to tasks that assessed participants' perceived reaching ability in Experiment 1, grasping ability in Experiment 2, and the ability to pass their hands through apertures in Experiment 3. Results indicated that those participants who experienced changes in anxiety underestimated their reaching, grasping, and passing ability compared to non-anxious participants. In other words, anxious participants were more conservative in their estimations of their action capabilities. These results suggest that anxiety influences the perception for affordances in near space and are consistent with the notion that anxiety induces withdrawal behaviours. (shrink)

Canadian nursing practice has been profoundly influenced by the legalization of medical assistance in dying in 2016, requiring that nurses navigate new and sometimes highly challenging experiences. Findings from our longitudinal studies of nurses' experiences suggest that these include deep emotional responses to medical assistance in dying, an urgency in orchestrating the perfect death, and a high degree of relational impact, both professionally and personally. Here we propose a theoretical explanation for these experiences based upon a relational ontology. Drawing upon (...) the work of Wildman, we understand a relational ontology to be one in which relationships are more fundamentally central than the conceptual entities that provide the context to practice. It is in a relationship that conceptual entities, and their affiliated values, are created and recreated. Seen as causal, relationships have ontological status, with important implications for how we consider the concepts of death, suffering, and time in this context. From a conceptual perspective, suffering is primarily self‐defined based upon personal histories, time reflects the potential remaining until death, and death is primarily biological and amoral, although social discourses of a good and bad death surround the death trajectory. However, within a relational ontology of medical assistance in dying, these understandings shift. Death becomes primarily social rather than biological, suffering is shared, and time until death is now clearly delimited. Accordingly, nurses assume a profound responsibility for influencing outcomes that are authentically person‐centered. These understandings provide important insights into nurses' experiences, enabling us to recognize the causal effects, both intended and unintended, of nurses' relational practices amidst the complexities of assisted death. Drawing on such a perspective, we find implications for how we provide spaces for nurses to reflect on, and have conversations about, their experiences with some of the greatest mysteries of life—death, suffering, and time. (shrink)

This paper draws on classical theories of wisdom to explore the organisational impact of nurses on Australian general practice. Between 2004 and 2008, numbers of general practice nurses doubled, the most rapid influx of nurses into any Australian workplace over the decade. Using data from the Australian General Practice Nurses Study, we argue that nurses had a positive impact because they introduced techne at the organisational level and amplified phronesis in clinical activities. In its Hippocratic formulation, techne refers to a (...) field of definable knowledge, which is purposeful and useful and requires mastery of rational principles. Nursing, with its focus on system and accountability, brought techne out of the GP’s consulting room and into the general practice as a whole. Nurses also exemplify phronesis, an Aristotelian virtue connoting a reasoned and honourable capacity to make judgements: the practical wisdom that defines the interaction between clinician and patient in general practice. At a time of significant GP shortage, doctors and nurses began to collaborate around their more complex and time-consuming patients, leading to a deepening of phronesis in the workplace. By bringing techne to bear on the organisation, and complementing and enhancing phronesis, nurses propel organisational wisdom in general practices. (shrink)

The purpose of this qualitative case study is to understand and critique the gendered political processes in the search for an athletic director following a merger between men’s and women’s intercollegiate athletic departments in a U.S. university. Semi-structured interviews were used to ask 55 athletic department stakeholders their perceptions of the search process and associated politics. Findings indicated gendered political activities occurred along gender-affiliated departmental lines. Political strategies contributed to gendered processes favoring certain masculinities and male candidates in the search (...) for an athletic director. While gender equity was an important consideration in the search process, because of the controversial nature of the merger and the politics expressed, the belief that hiring a man was essential to the merger’s success was widely accepted by many stakeholder groups. The findings are positioned in the critical management and sport literature. This research contributes to our understanding of the complexity of gender relations and provides insight into the gendered political processes that inform leadership searches. (shrink)

The notion of social capital focuses attention on social connectedness within communities and the ways that this connectedness may affect health and well‐being. There are many competing definitions of social capital but most suggest that it involves trust, social networks and reciprocity within communities, not necessarily geographically defined. The usefulness of social capital and related theories that help in understanding the function of nurses in rural communities are explored in this paper. Nurses and health service planners are becoming increasingly aware (...) of the potential contribution of community nurses in rural and/or remote areas, as evidenced in the development of nurse practitioners. Through their interrelational role and status in rural communities, nurses are often ‘immersed’ or ‘embedded’ in the social networks that make up the fabric of rural life and may therefore be important contributors to social capital. For a concept such as social capital to be useful in nursing research, it must have distinct attributes, delineated boundaries, and well‐described preconditions and outcomes in multiple contexts. (shrink)

What's wrong with high executive pay? Beyond envy, is some issue of justice or fairness at stake? And what can anyone do about it? (A lot, as it turns out.).

"What is sexist oppression?" "What should be done about it?" Organized around these questions, Theorizing Feminisms: A Reader provides an overview of theoretical feminist writing about the quest for gender justice. Incorporating both classic and cutting-edge material, the reader takes into account the full diversity of women, highlighting the effects of race, ethnicity, nationality, class, sexuality, and religion on women's experience. Theorizing Feminisms is organized into four sections and includes fifty-four essays. The first section introduces several basic concepts commonly employed (...) when thinking about sexism--oppression, social construction, essentialism, intersectionality, gender, race, and class--and also raises questions about the perspective and legitimacy of the theorist. The second section surveys three approaches that attempt to characterize in a general way the source of injustice toward women: humanist feminism ("the sameness approach"), gynocentric feminism ("the difference approach"), and dominance feminism. Offering an alternate perspective, the third section introduces two "localizing" approaches, grounded in postmodernism and identity politics, respectively. Skeptical of theories that attempt to analyze social phenomena across history and culture, authors in this section challenge, rather than answer, the text's organizing questions. The final section explores the relationship of feminist theory to three liberatory projects--postcolonialism, neo-materialism, and queer theory--that do not characterize themselves as feminist, yet take gender as a significant category of analysis. Each section opens with an introduction and each essay is followed by helpful study questions. The majority of the essays are presented in their entirety. Theorizing Feminisms underscores the strong connection between feminist theory and practice by including essays that illustrate important political inspirations or applications of each theoretical approach. It also presents versions of the same approach from various points in history, revealing feminist theory to be dynamic and evolving, rather than static. Ideal for interdisciplinary courses in feminist theory, this volume will also serve as an invaluable reference for current and future generations of theorists. (shrink)

(1991). Grant‐maintained schools: Making a difference without being really different 1 . British Journal of Educational Studies: Vol. 39, No. 4, pp. 409-424.

Juxtaposing distinct approaches to gesture in order to explore the ways in which they at once shape and are influenced by culture, the contributors examine the works of writers Henri Michaux and Stphane Mallarm, photographers Henri Cartier ...

The ‘between Wars’ period in England in the early twentieth century was extraordinary, philosophically. It was marked by a profusion of new, controversial, and revolutionary ideas. Developments in formal logic, the rise of the method of ‘analysis’, and logical atomism were already changing the face of philosophy in England. From this mix emerged two distinctive views about language and its connection to philosophical methodology: one championing the concept of an ideal language; and one rejecting this and favoring appeal to ordinary (...) language. The origin of both views is to be found in the (earlier and later) work of Ludwig Wittgenstein. In this paper, I will examine the emergence of these views in relation to one another: an ideal language conception represented by A.J. Ayer in his Language, Truth and Logic, and the reaction against this conception in the early phases of ordinary language philosophy, in particular in the work of John Wisdom. (shrink)

Previous research has demonstrated that attitudes are a primary determinant of intention to gamble on electronic gaming machines consistent with the Theory of Reasoned Action. This paper aims to address how biases in judgment can contribute to attitudes and subsequently behavior, including maladaptive problematic gambling behavior. We take a novel approach by viewing overconfidence in one’s understanding of how outcomes are determined on EGMs as an indication of cognitive distortions. The novelty of this paper is further increased as we compare (...) attitudes to existing EGMs with novel EGMs which include a skill component, referred to as skill-based gaming machines, which enables a better controlled comparison between actual and perceived skill. In Study 1, 232 US-based participants were recruited online who were shown various slot machines and SGMs and asked a series of questions about perceived skill and chance in determining outcomes to assess their understanding, then were asked their confidence in their understanding, attitudes toward the machines and they completed the Problem Gambling Severity Index. In Study 2, 246 Australian participants were recruited through community and university student samples; they attended a laboratory where they were randomly allocated to play a real EGM or SGM without money and completed the same measures as in Study 1. In Study 2, participants were randomly told that the outcomes on the machine they would play were determined entirely by chance, skill, or a mixture of both. In both studies, our findings suggest that there are more extreme values in overconfidence in how EGMs work, whereas individuals are more similar in their confidence in understanding SGMs. We also find a relationship between overconfidence in EGM understanding and positive attitudes toward EGMs, but no such relationship with SGMs. There was no impact from controlling for demographics, problem gambling severity, or labeling of machines on these relationships. (shrink)