BackgroundPatient skepticism concerning medical innovations can have major consequences for current public health and may threaten future progress, which greatly relies on clinical research.The primary objective of this study is to determine the variables associated with patient acceptation or refusal to participate in clinical research. Specifically, we sought to evaluate if distrust in pharmaceutical companies and associated psychosocial factors could represent a recruitment bias in clinical trials and thus threaten the applicability of their results.MethodsThis prospective, multicenter survey consisted in the (...) administration of a self-questionnaire to patients during a pulmonology consultation. The 1025 questionnaires distributed collected demographics, socio-professional and basic health literacy characteristics. Patients were asked to rank their level of trust for pharmaceutical companies and indicate their willingness to participate in different categories of research.Logistic regression was used to determine factors contributing to “trust” versus “distrust” group membership and willingness to participate in each category of research.ResultsOne thousand patients completed the survey, corresponding to a response rate of 97.5%. Data from 838 patients were analyzed in this study.48.3% of respondents declared that they trusted pharmaceutical companies, while 35.5% declared distrust. Being female, inactive in the employment market, and not-knowing the name of one’s disease are factors related to declared distrust. Distrust-group membership is associated with unwillingness to participate in certain categories of trials such as pre-marketing and industry-sponsored trials.ConclusionDistrust in pharmaceutical companies is associated with a specific patient profile and with refusal to participate in certain subcategories of trials. This potential recruitment bias may explain the under-representation of certain categories of patients such as women in pre-marketing drug trials. (shrink)

Non-Invasive Prenatal Testing is a technology which provides information about fetal genetic characteristics very early in pregnancy by examining fetal DNA obtained from a sample of maternal blood. NIPT is a morally complex technology that has advanced quickly to market with a strong push from industry developers, leaving many areas of uncertainty still to be resolved, and creating a strong need for health policy that reflects women’s social and ethical values. We approach the need for ethical policy-making by studying the (...) use of NIPT and emerging policy in the province of Ontario, Canada. Using an adapted version of constructivist grounded theory, we conducted interviews with 38 women who have had personal experiences with NIPT. We used an iterative process of data collection and analysis and a staged coding strategy to conduct a descriptive analysis of ethics issues identified implicitly and explicitly by women who have been affected by this technology. The findings of this paper focus on current ethical issues for women seeking NIPT, including place in the prenatal pathway, health care provider counselling about the test, industry influence on the diffusion of NIPT, consequences of availability of test results. Other issues gain relevance in the context of future policy decisions regarding NIPT, including funding of NIPT and principles that may govern the expansion of the scope of NIPT. These findings are not an exhaustive list of all the potential ethical issues related to NIPT, but rather a representation of the issues which concern women who have personal experience with this test. Women who have had personal experience with NIPT have concerns and priorities which sometimes contrast dramatically with the theoretical ethics literature. These findings suggest the importance of engaging patients in ethical deliberation about morally complex technologies, and point to the need for more deliberative patient engagement work in this area. (shrink)

The practice of viticulture in Israelite culture is the focus of Walsh's investigation. Viticulture, no less than drinking, marked the social sphere of Israelite practitioners, and so its details were often enlisted to describe social relations in the Hebrew Bible.

A review of the literature on corporate governance serves to demonstrate the applicability of many governance solutions to the university setting. Based on a review of university scandals, most of which are recent but some of which took place decades ago, it is possible to categorize them as follows: sex scandals, drugs, cheating, hazing, admissions and diplomas, on-the-job consumption, athletics, and murder. Several examples are provided in the paper, along with their impact on various stakeholders. The paper then discusses a (...) variety of solutions designed to either preempt the activities potentially leading to scandal, to deter them or to punish perpetrators. Some of these involve structural changes, institutional policies and procedures, fines, terminations, and sanctions. The paper emphasizes the proactive safeguards which govern and monitor to make sure that universities do not suffer on the back end and that their reputations do not suffer into the future. (shrink)

This article explores the ethical challenges of providing Medical Assistance in Dying (MAID) in a paediatric setting. More specifically, we focus on the theoretical questions that came to light when we were asked to develop a policy for responding to MAID requests at our tertiary paediatric institution. We illuminate a central point of conceptual confusion about the nature of MAID that emerges at the level of practice, and explore the various entailments for clinicians and patients that would flow from different (...) understandings. Finally, we consider the ethical challenges of building policy on what is still an extremely controversial social practice. While MAID is currently available to capable patients in Canada who are 18 years or older—a small but important subsection of the population our hospital serves—we write our policy with an eye to the near future when capable young people may gain access to MAID. We propose that an opportunity exists for MAID-providing institutions to reduce social stigma surrounding this practice, but not without potentially serious consequences for practitioners and institutions themselves. Thus, this paper is intended as a road map through the still-emerging legal and ethical landscape of paediatric MAID. We offer a view of the roads taken and considered along the way, and our justifications for travelling the paths we chose. By providing a record of our in-progress thinking, we hope to stimulate wider discussion about the issues and questions encountered in this work. (shrink)

There are clear associations between the overall quantity of input children are exposed to and their vocabulary acquisition. However, by uncovering specific features of the input that matter, we can better understand the mechanisms involved in vocabulary learning. We examine whether exposure to wh-questions, a challenging quality of the communicative input, is associated with toddlers' vocabulary and later verbal reasoning skills in a sample of low-income, African-American fathers and their 24-month-old children. Dyads were videotaped in free play sessions at home. (...) Videotapes were transcribed and reliably coded for sheer quantity of fathers' input as well as the number of wh-questions fathers produce. Children's productive vocabulary was measured at 24 months using the McArthur Bates Communicative Development Inventory MCDI, and children's verbal reasoning skills were measured 1 year later using the Bayley Scales of Infant Development. Results indicate that the overall quantity of father talk did not relate to children's vocabulary or reasoning skills. However, fathers' use of wh-questions related to both vocabulary and reasoning outcomes. Children's responses to wh-questions were more frequent and more syntactically complex, measured using the mean length of utterance, than their responses to other questions. Thus, posing wh-questions to 2-year-olds is a challenging type of input, which elicits a verbal response from the child that likely helps build vocabulary and foster verbal reasoning abilities. (shrink)

Doig, Meredith The promise from new Victorian Premier, Daniel Andrews, to make Victoria the 'education state' is welcome and timely.

This book addresses how Plato, Kant, and Iris Murdoch view the connection aesthetic experience has to morality. While offering an examination of Iris Murdoch’s philosophy, it analyses deeply the suggestive links between Plato’s and Kant’s philosophies. Meredith Trexler Drees considers not only Iris Murdoch’s concept of unselfing, but also its relationship with Kant’s view of Achtung and Plato’s view of Eros. In addition, Trexler Drees suggests an extended, and partially amended, version of Murdoch’s view, arguing that it is more (...) compatible with a religious way of life than Murdoch herself realized. This leads to an expansion of the overall argument to include Kant’s affirmation of religion as an area of life that can be improved through Plato’s and Murdoch’s vision of how being good and being beautiful can be part of the same life-task. (shrink)

A classic problem in cognitive science concerns how listeners perceive and understand speech as comprised of discrete words. We propose a Syllable Inference account of spoken word recognition and segmentation, under which alternative hierarchical models of syllables, words, and phonemes are dynamically posited from cues that include current and past speech rate, with a goal of maximal prediction of sensory input. Three experiments using the Visual World eye‐tracking paradigm provide evidence supporting our proposal.

In their summary and critique, Gamble, Gamble, and Pruski mischaracterise both the central arguments and the primary objectives of our original paper. Our paper does not provide an ethical justification for paediatric Medical Assistance in Dying by comparing it with other end of life care options. In fact, it does not offer arguments about the permissibility of MAID for capable young people at all. Instead, our paper focuses on the ethical questions that emerged as we worked to develop a policy (...) for responding to MAID requests at our tertiary paediatric institution. Following the Supreme Court of Canada’s recent decriminalisation of MAID, our hospital needed to answer immediate on-the-ground questions such as: ‘What are we going to do if an 18-year-old patient in our care requested MAID today, as is now their legal right? How should we protect their privacy? What is the best way to ensure patients are informed when making these decisions?’ On these important questions, Gamble, Gamble, and Pruskiare silent. (shrink)

Communication is an important component in the construction of workplace identities, including leader and group identities. Micro-level analysis of everyday workplace discourse provides valuable insights into the way leadership is constructed and how workplace culture is created, maintained, and changed. In this context, leaders and managers are inevitably significant and influential participants, with a crucial impact on workplace culture. Drawing on audio and video data collected in 12 meetings of an IT department, the analysis demonstrates ways in which two leaders, (...) who succeed each other in the role of Director, reinforce and shape the culture of the workplace in which they operate. While both leaders claim teamwork as an important cultural value for their teams, their respective instantiations of teamwork are rather different. To explore the leaders' effect on the culture of their department, this investigation of leadership change examines ways in which the leaders manage regular workplace meetings and how they contribute to workplace humour. The analysis provides detailed evidence of the ways in which a change in leadership style can create the conditions for a change in the culture of a community of practice. (shrink)

This research examined how and why group membership diminishes the attribution of mind to individuals. We found that mind attribution was inversely related to the size of the group to which an individual belonged . Mind attribution was affected by group membership rather than the total number of entities perceived at once . Moreover, mind attribution to an individual varied with the perception that the individual was a group member. Participants attributed more mind to an individual that appeared distinct or (...) distant from other group members than to an individual that was perceived to be similar or proximal to a cohesive group . This effect occurred for both human and nonhuman targets, and was driven by the perception of the target as an entitative group member rather than by the knowledge that the target was an entitative group member. (shrink)

Epistemic Modality Epistemic modality is the kind of necessity and possibility that is determined by epistemic constraints. A modal claim is a claim about how things could be or must be given some constraints, such as the rules of logic, moral obligations, or the laws of nature. A modal … Continue reading Epistemic Modality →.

Intellectual interest in epistemic bubbles and echo chambers has grown exponentially over the past two decades. This is largely because many assume, in light of recent events, that these phenomena are morally, socially, politically, and epistemically problematic. But are we justified in simply assuming that epistemic bubbles and echo chambers are inherently epistemically problematic? Perhaps surprisingly, numerous philosophers have recently argued that epistemic bubbles and echo chambers are not intrinsically epistemically problematic. Nevertheless, I argue, this trend is mistaken. Epistemic bubbles (...) and echo chambers are all intrinsically epistemically problematic, such that we should try to escape them, if we find ourselves in them. Crucially, there are two senses in which we might identify epistemic bubbles and echo chambers as being intrinsically epistemically problematic, as opposed to “good.” After distinguishing between these senses, I demonstrate that, even if there is a sense in which epistemic bubbles can in principle be “good,” all epistemic bubbles are epistemically problematic in the sense that is ultimately relevant to the question of whether we ought to stay in epistemic bubbles or to try to get out of them. (shrink)

_Wittgenstein, Mind and Meaning_ offers a provocative re-reading of Wittgenstein's later writings on language and mind, and explores the tensions between Wittgenstein's ideas and contemporary cognitivist conceptions of the mental. This book addresses both Wittgenstein's later works as well as contemporary issues in philosophy of mind. It provides fresh insight into the later Wittgenstein and raises vital questions about the foundations of cognitivism and its wider implications for psychology and cognitive science.

Psychological ownership may be judged differently or similarly for self and others. Potential differences in how ownership is evaluated by actors and observers raise important questions about the concept of ownership (what is Mine, Ours, and Theirs) and how to resolve conflicting perceptions.

Geary's emphasis on hunting ignores the possible importance of other human activities, such as scavenging and gathering, in the evolution of spatial abilities. In addition, there is little evidence that links spatial abilities and math skills. Furthermore, such links have little practical importance given the small size of most differences and girls' superior performance in mathematics classrooms.

Discussions of both personal responsibility and the importance of trust in health-care settings are increasingly prominent in the bioethics literature. In this paper I link the two discussions and argue that health policies that include personal responsibility ought to address climates of social trust. Trust is a social good that is not always fairly distributed. Disadvantaged social groups often face default distrust. I suggest that agent-centered models in which responsibilities are negotiated do a better job of repairing social distrust than (...) authoritative models in which responsibilities are assigned. Attending to climates of trust, distrust, or antitrust is essential for addressing health inequalities. (shrink)

Discussions of both personal responsibility and the importance of trust in health-care settings are increasingly prominent in the bioethics literature. In this paper I link the two discussions and argue that health policies that include personal responsibility ought to address climates of social trust. Trust is a social good that is not always fairly distributed. Disadvantaged social groups often face default distrust. I suggest that agent-centered models in which responsibilities are negotiated do a better job of repairing social distrust than (...) authoritative models in which responsibilities are assigned . Attending to climates of trust, distrust, or antitrust is essential for addressing health inequalities. (shrink)

This book develops and empirically tests a social theory of political participation. It overturns prior understandings of why some people vote more often than others. The book shows that the standard demographic variables are not proxies for variation in the individual costs and benefits of participation, but for systematic variation in the patterns of social ties between potential voters. Potential voters who move in larger social circles, particularly those including politicians and other mobilizing actors, have more access to the flurry (...) of electoral activity prodding citizens to vote and increasing political discussion. Treating voting as a socially defined practice instead of as an individual choice over personal payoffs, a social theory of participation is derived from a mathematical model with behavioral foundations that is empirically calibrated and tested using multiple methods and data sources. (shrink)