From principles to principals: The new direction in medical ethics

Many alternatives or supplements to principalism seek to reconnect medical ethics with the thoughts, feelings, and motivations of the persons directly involved in ethically troublesome situations. This shift of attention, from deeds to doers, from principles to principals, acknowledges the importance of the moral agents involved in the situation — particular practitioners, patients, and families. Taking into account the subjective, lived experience of moral decision-making parallels recent efforts in the teaching of medicine to give the patient's subjectivity — his or her personal experience of being sick or disabled — epistemological parity with scientific medicine's objective, biomedically-oriented view of the person's sickness or disability.Moreover, the shift from principalism to principals signals a growing realization that ethical problems in the profession of medicine are inseparable from its practice. Philosophers and other humanists working in medicine should resist the temptation to institutionalize a professional role as solver of ethical problems, clarifier of values, or mediator of disputes and work instead to help practitioners practice medicine reflectively.     

Religious belief,ethics, biological principles and assisted conception

New reproductive technologies present ethical challenges to religious believers. In order to distinguish beneficial applications from harmful ones, believers should be guided by religious teachings and also be aware of current scientific knowledge. In this paper relevant spiritual principles from Baha'i writings are outlined and it is suggested that Christians and Muslims may identify similar principles in their own sacred texts and religious authorities. Medical procedures in assisted conception are also described, and it is explained that biological development from gametogenesis to birth is a continuum of processes rather than a series of events. It is suggested that ethical debates about the moral status of the embryo and related ethical issues do not lead to agreement on a single spiritually significant point in development, but in the current state of knowledge it can be argued that individuation at about fourteen days is of major significance. Striving for an absolute position should be avoided as scientific knowledge is relative and will change in the future.     

Evaluating scientific research: Belief,hindsight bias,ethics, and research evaluation

Students may exhibit two forms of cognitive biases, belief and hindsight bias, in evaluating a scientific experiment. Counter to disagreement, they may only believe an outcome that agrees with their belief to be more predictable in hindsight than foresight. The focus of this research is on the relationship between these biases. Students were queried about their dichotomous beliefs (learned vs. genetic) about behavior for an animal experiment and then assigned randomly to a no‐outcome or genetic outcome condition. With agreement between students' belief and outcome, the findings revealed hindsight bias (foreseeability) supported by the outcomes for surprise, disappointment, ethics, and research evaluation. With disagreement, hindsight bias was trumped along with perceiving the experiment as being less ethical and scientifically sound. Regardless of the outcome, students seem to adhere to their beliefs. Hence, students may believe that the outcome is inconsequential because it is obvious or contrary to their beliefs.     

Common morality, coherence, and the principles of biomedical ethics

The fifth edition of Beauchamp and Childress's Principles of Biomedical Ethics is distinguished by its emphatic embrace of common morality as the ultimate source of moral norms. This essay critically evaluates the fifth edition's discussion of common morality and, to a lesser extent, its treatment of coherence (both the model of ethical justification and the associated concept). It is argued that the book is overly accommodating of existing moral beliefs. The paper concludes with three suggestions for improving this leading text.     

Climate strength: a new direction for climate research

Climate strength was conceptualized within D. Chan's (1998) discussion of compositional models and the concept of culture strength from the organizational culture literature. Climate strength was operationalized in terms of within-group variability in climate perceptions-the less within-group variability, the stronger the climate. The authors studied climate strength in the context of research linking employee service climate perceptions to customer satisfaction. The hypothesis was tested that climate strength moderates the relationship between employee perceptions of service climate and customer satisfaction experiences. Partial support for the hypothesis was reported in both a concurrent and predictive (3-year) test across 118 branches of a bank. In the predictive study only the interaction of climate and climate strength predicted customer satisfaction. Implications for future research on climate and climate strength are discussed.     

A model for teaching research ethics

A model is described for implementing a program in research ethics education in the face of federal and institutional mandates and current resource, disciplinary, and infrastructure limitations. Also discussed are the historical background, content and evaluation process of the workshop at the heart of the program, which reaches a diverse group of over 250 students per year—from first-year graduate students in basic research labs to clinical fellows. The workshop addresses central issues in both everyday laboratory ethics and in larger societal questions. Goals include improving overall awareness of ethics guidelines and philosophy and enhancing skills in identifying and then analyzing the ethical components of situations. Pedagogies used and their effectiveness and that of the overall workshop and extended program are addressed. Programs like these have initiated a shift in the culture of basic research, which is a critical need given the current atmosphere.     

A model for teaching research ethics

A model is described for implementing a program in research ethics education in the face of federal and institutional mandates and current resource, disciplinary, and infrastructure limitations. Also discussed are the historical background, content and evaluation process of the workshop at the heart of the program, which reaches a diverse group of over 250 students per year—from first-year graduate students in basic research labs to clinical fellows. The workshop addresses central issues in both everyday laboratory ethics and in larger societal questions. Goals include improving overall awareness of ethics guidelines and philosophy and enhancing skills in identifying and then analyzing the ethical components of situations. Pedagogies used and their effectiveness and that of the overall workshop and extended program are addressed. Programs like these have initiated a shift in the culture of basic research, which is a critical need given the current atmosphere.     

Feminist and medical ethics: two different approaches to contextual ethics

Feminist ethics and medical ethics are critical of contemporary moral theory in several similar respects. There is a shared sense of frustration with, the level of abstraction and generality that characterizes traditional philosophic work in ethics and a common commitment to including contextual details and allowing room for the personal aspects of relationships in ethical analysis. This paper explores the ways in which context is appealed to in feminist and medical ethics, the sort of details that should be included in the recommended narrative approaches to ethical problems, and the difference it makes to our ethical deliberations if we add an explicitly feminist political analysis to our discussion of context. It is claimed that an analysis of gender is needed for feminist medical ethics and that this requires a certain degree of gener-ality, i. e. a political understanding of context.     

Toddlers can adaptively change how they categorize: same objects,same session,two different categorical distinctions

Two experiments demonstrate that 14‐ to 18‐month‐old toddlers can adaptively change how they categorize a set of objects within a single session, and that this ability is related to vocabulary size. In both experiments, toddlers were presented with a sequential touching task with objects that could be categorized either according to some perceptually salient dimension corresponding to a taxonomic distinction (e.g. animals vs. vehicles) or to some less obvious dimension (e.g. rigid vs. deformable). In each experiment, children with larger productive vocabularies responded to both dimensions, showing evidence of sensitivity to each way of categorizing the items. Children with smaller productive vocabularies attended only to the taxonomically related categorical grouping. These experiments confirm that toddlers can adaptively shift the basis of their categorization and highlight the dynamic interaction between the child and the current task in early categorization.     

Me, myself, and I: different recognition rates for three photo-IDs of the same person

In all contemporary societies, photo-identity documents are used routinely for person identification, but this process is surprisingly fallible. Here we show that this problem is not limited to the identification of specific photographs of a person, but transcends three identity cards of the same person with different images. These identity cards varied substantially from each other in how well they could be recognised but identification rates were generally poor. We also present a potential solution to this problem by demonstrating that person identification can be improved when several photographs of the same person are made available.     

Strangers at the benchside: research ethics consultation

Institutional ethics consultation services for biomedical scientists have begun to proliferate, especially for clinical researchers. We discuss several models of ethics consultation and describe a team-based approach used at Stanford University in the context of these models. As research ethics consultation services expand, there are many unresolved questions that need to be addressed, including what the scope, composition, and purpose of such services should be, whether core competencies for consultants can and should be defined, and how conflicts of interest should be mitigated. We make preliminary recommendations for the structure and process of research ethics consultation, based on our initial experiences in a pilot program.