Ethical implications in the allocation of scarce medical resources in Poland

The health care system in Poland is undergoing major change and it is possible that these changes could affect clinical research. Therefore, the situation of funding of health care is important for the future of medical research in this country. Some questions relevant in this field will be addressed. Since funds for health care and scientific research remain inadequate, their allocation raises moral, economic, legal and organisational dilemmas. The clinical aspects of resource allocation also include physicians’ responsibilities towards their patients. Scientific research, clinical medicine, and clinical research have a common denominator: they rely on trust. The physician should be a fiduciary of the patient as well as being a researcher for the benefit of the patient and for society. Some physicians and researchers, despite unethical conduct, escape disclosure and punishment, but decision-makers who wrongly allocate funds for health care and research are never held accountable for their actions. An earlier version of this paper was presented at a symposium, Scientific Misconduct: An International Perspective, organised by The Medical University of Warsaw, 16 November, 1998.     

Physico-mathematics and the search for causes in Descartes’ optics—1619–1637

One of the chief concerns of the young Descartes was with what he, and others, termed “physico-mathematics”. This signalled a questioning of the Scholastic Aristotelian view of the mixed mathematical sciences as subordinate to natural philosophy, non explanatory, and merely instrumental. Somehow, the mixed mathematical disciplines were now to become intimately related to natural philosophical issues of matter and cause. That is, they were to become more ’physicalised’, more closely intertwined with natural philosophising, regardless of which species of natural philosophy one advocated. A curious, short-lived yet portentous epistemological conceit lay at the core of Descartes’ physico-mathematics—the belief that solid geometrical results in the mixed mathematical sciences literally offered windows into the realm of natural philosophical causation—that in such cases one could literally “see the causes”. Optics took pride of place within Descartes’ physico-mathematics project, because he believed it offered unique possibilities for the successful vision of causes. This paper traces Descartes’ early physico-mathematical program in optics, its origins, pitfalls and its successes, which were crucial in providing Descartes resources for his later work in systematic natural philosophy. It explores how Descartes exploited his discovery of the law of refraction of light—an achievement well within the bounds of traditional mixed mathematical optics—in order to derive—in the manner of physico-mathematics—causal knowledge about light, and indeed insight about the principles of a “dynamics” that would provide the laws of corpuscular motion and tendency to motion in his natural philosophical system.     

Grey Matter: Ambiguities and Complexities of Ethics in Research

Ethical dilemmas are often not discussed in the dissemination of educational research. While the ethical guidelines for research seem clear at first glance, a closer look at the intimate nature of qualitative research reveals that there are many ambiguities or ‘grey’ areas where researchers must rely on their personal value systems. This article discusses the challenges faced by an experienced educator, although novice researcher, in considering the ethical parameters of her own research with adolescents with hearing loss. In particular, the grey ethical areas identified by the researcher include: (a) vulnerable population; (b) researcher role confusion; (c) consent; (d) privacy, confidentiality, and anonymity; as well as (e) the nature of risk. Based on the author’s own reflections on beginning the research process, the article presents possible pitfalls and ways of overcoming the possibility of becoming immobilized by the ethical enigmas of research.     

The Priest’s Husband

Clergy self-concepts provide an important resource for research into the psychosocial pressures that often breed domestic tension and marital discord in ministerial families. More than 30 years ago the Journal of Religion and Health published (15:3, 1976) Platt and Moss’s initial study of clergy families, research focused on the self-perceptions of the wives of Episcopal priests. That investigation explored some of the intrapsychic ingredients and interpersonal concerns of these women. Oden now concentrates on clergy spouses from a different vantage—the historically recent phenomenon of the Episcopal priest’s husband. This article grows out of the first formal study of such a growing parochial reality. Husbands of priests present novel issues because there has never been anyone like them before. They are men who will inevitably find themselves confronted by congregational expectations that can modify their self-concepts and retailer their marriages, “for better or for worse”.     

Intercultural (Mis)Communication: Why Would You “Out” Me in Class?

This paper conceptualizes Hopson’s notion of crash moments by exploring an intercultural interaction (between an individual who identifies as heterosexual and another who identifies as homosexual) within a graduate classroom by drawing on cultural schema theory and critical incident analysis. Ultimately, this paper deconstructs a communication breakdown through a self-reflexive process in which the researcher was “outed” (someone else disclosed the sexual orientation of a lesbian, gay, bisexual or transgendered individual in a public setting) by a classmate—which the researcher deems as a problematic occurrence, making the incident critical and fitting for analysis within an intercultural communication context. This paper also considers the complexities of sexual identity negotiation as an African American female lesbian at a Historically Black College/University.     

Beyond Darwinism’s Eclipse: Functional Evolution,Biochemical Recapitulation and Spencerian Emergence in the 1920s and 1930s

During the 1920s and 1930s, many biologists questioned the viability of Darwin’s theory as a mechanism of evolutionary change. In the early 1940s, and only after a number of alternatives were suggested, Darwinists succeeded to establish natural selection and gene mutation as the main evolutionary mechanisms. While that move, today known as the neo-Darwinian synthesis, is taken as signalling a triumph of evolutionary theory, certain critical problems in evolution—in particular the evolution of animal function—could not be addressed with this approach. Here I demonstrate this through reconstruction of the evolutionary theory of Joseph Needham (1900–1995), who pioneered the biochemical study of evolution and development. In order to address such problems, Needham employed Herbert Spencer’s principles of emergence and Ernst Haeckel’s theory of recapitulation. While Needham did not reject Darwinian theory, Spencerian and Haeckelian frameworks happened to better fit his findings and their evolutionary relevance. He believed selectionist and genetic approaches to be important but far from sufficient for explaining how evolutionary transformations occur.     

Recommendations for Research Success: One Investigator’s Perspective

This article is a personal reflection by an investigator with over 25 years of funding from the National Institutes of Health (NIH). The article: (1) highlights research opportunities for psychologists at the NIH outside of the traditional mental health arena; (2) provides specific recommendations to individual investigators to enhance their likelihood of obtaining NIH funding; (3) specifies needed changes in psychology’s research education and training programs to prepare the next generation of psychologists for research success; and (4) asks the Association of Psychologists in Academic Health Centers to play a lead role in both research training and advocacy. This article is based on a presentation given at the 3rd national conference of the Association of Psychologists in Academic Health Centers in May of 2007 in Minneapolis, Minnesota.     

At Arm’s Length? Applied Social Science and its Sponsors

The article deals with trust in applied social science research in the light of applied researchers’ increased dependence on project funding. Taking Norway as a case study it shows how the societal organization of research funding has implications for scientific freedom and ultimately for the confidence we have in research. The article gives an account of various ways the sponsors can influence on applied social science research and discusses the legitimacy of different limitations on scientific freedom. The article concludes with proposals for how the challenges to scientific freedom posed by the research funding framework can be addressed structurally, as well as on the level of the research community.     

Human nature and cognitive–developmental niche construction

Recent theories in cognitive science have begun to focus on the active role of organisms in shaping their own environment, and the role of these environmental resources for cognition. Approaches such as situated, embedded, ecological, distributed and particularly extended cognition look beyond ‘what is inside your head’ to the old Gibsonian question of ‘what your head is inside of’ and with which it forms a wider whole—its internal and external cognitive niche. Since these views have been treated as a radical departure from the received view of cognition, their proponents have looked for support to similar extended views within (the philosophy of) biology, most notably the theory of niche construction. This paper argues that there is an even closer and more fruitful parallel with developmental systems theory and developmental niche construction. These ask not ‘what is inside the genes you inherited’, but ‘what the inherited genes are inside of’ and with which they form a wider whole—their internal and external ontogenetic niche, understood as the set of epigenetic, social, ecological, epistemic and symbolic legacies inherited by the organism as necessary developmental resources. To the cognizing agent, the epistemic niche presents itself not just as a partially self-engineered selective niche, as the niche construction paradigm will have it, but even more so as a partially self-engineered ontogenetic niche, a problem-solving resource and scaffold for individual development and learning. This move should be beneficial for coming to grips with our own (including cognitive) nature: what is most distinctive about humans is their developmentally plastic brains immersed into a well-engineered, cumulatively constructed cognitive–developmental niche.     

A secular age? Reflections on Taylor and Panikkar

During the last few years two major volumes have been published, both greatly revised versions of earlier Gifford Lectures: Charles Taylor’s A Secular Age (2007) and Raimon Panikkar’s The Rhythm of Being (2010). The two volumes are similar in some respects and very dissimilar in others. Both thinkers complain about the glaring blemishes of the modern, especially the contemporary age; both deplore above all a certain deficit of religiosity. The two authors differ, however, both in the details of their diagnosis and in their proposed remedies. Taylor views the modern age—styled as “secular age”—as marked by a slide into secular agnosticism, into “exclusive humanism”, and above all into an “immanent frame” excluding theistic “transcendence”. Although sharing the concern about “loss of meaning”, Panikkar does not find its source in the abandonment of (mono)theistic transcendence; on the contrary, both radical transcendence and agnostic immanence are responsible for the deficit of genuine faith. For him, recovery of faith requires an acknowledgment of our being in the world, as part of the “rhythm of being” happening in a holistic or “cosmotheandric” mode. In classical Indian terminology, while Taylor’s emphasis on the transcendence-immanence tension reflects ultimately a dualistic perspective (dvaita), Panikkar’s holistic notion of the rhythm of being captures the core of Advaita Vendanta.     

Remembering (Short-Term) Memory: Oscillations of an Epistemic Thing

This paper provides an interpretation of Hans-J?rg Rheinberger’s notions of epistemic things and historical epistemology. I argue that Rheinberger’s approach articulates a unique contribution to current debates about integrated HPS, and I propose some modifications and extensions of this contribution. Drawing on examples from memory research, I show that Rheinberger is right to highlight a particular feature of many objects of empirical research (“epistemic things”)—especially in the contexts of exploratory experimentation—namely our lack of knowledge about them. I argue that this analysis needs to be supplemented with an account of what scientists do know, and in particular, how they are able to attribute rudimentary empirical contours to objects of research. These contours are closely connected to paradigmatic research designs, which in turn are tied to basic methodological rules for the exploration of the purported phenomena. I suggest that we engage with such rules in order to develop our own normative (epistemological) categories, and I tie this proposal to the idea of a methodological naturalism in philosophy of science.     

Where creeds meet incredulity: educational research in a post-utopian age

In contrast to Jean-Francois Lyotard’s classic warning, postmodern society in the United States seems increasingly influenced by metanarratives—religious metanarratives. This article examines the implications of this religious resurgence for educational researchers. It offers a competing analysis of the postmodern that draws on Harold Bloom, Slavoj ŽiŽek and others to identify the gnostic elements in contemporary religiosity, both in Europe and the United States. This competing reading of postmodern religiosity suggests a reframing of Lyotard’s paralogy—research that searches for instabilities in the framework of knowledge. Drawing examples from recent educational research, I will argue for ways in which researchers can better engage religion in their work.The author would like to thank the anonymous reviewer who brought to his attention additional texts and debates about this highly interdisciplinary topic.     

The Perverse Effects of Competition on Scientists’ Work and Relationships

Competition among scientists for funding, positions and prestige, among other things, is often seen as a salutary driving force in U.S. science. Its effects on scientists, their work and their relationships are seldom considered. Focus-group discussions with 51 mid- and early-career scientists, on which this study is based, reveal a dark side of competition in science. According to these scientists, competition contributes to strategic game-playing in science, a decline in free and open sharing of information and methods, sabotage of others’ ability to use one’s work, interference with peer-review processes, deformation of relationships, and careless or questionable research conduct. When competition is pervasive, such effects may jeopardize the progress, efficiency and integrity of science.     

The Impact of Behaviors upon Burnout Among Parish-Based Clergy

Burnout has an important impact upon the professional satisfaction of clergy. Identifying protective behaviors that may prevent against burnout is important for the long-term emotional health of individual clergy as well as the wider church. This research reports findings among 358 parish-based clergy that identifies the prevalence of burnout and correlates this data with demographic risk factors and protective behaviors. Clergy who met criteria for burnout were younger, identified themselves as being depressed and unsatisfied with their spiritual life, and have endured a traumatic church placement. This research also suggests that having a variety of interests and activities outside of one’s vocation may protect against burnout. In particular, behaviors that enhance relationships—such as seeking mentors and attending retreats—as well as pursuing outside activities—such as regular exercise and scholarly reading—protect against burnout. Further implications for the wider church are discussed.     

It’s in your nature: a pluralistic folk psychology

I suggest a pluralistic account of folk psychology according to which not all predictions or explanations rely on the attribution of mental states, and not all intentional actions are explained by mental states. This view of folk psychology is supported by research in developmental and social psychology. It is well known that people use personality traits to predict behavior. I argue that trait attribution is not shorthand for mental state attributions, since traits are not identical to beliefs or desires, and an understanding of belief or desire is not necessary for using trait attributions. In addition, we sometimes predict and explain behavior through appeal to personality traits that the target wouldn’t endorse, and so could not serve as the target’s reasons. I conclude by suggesting that our folk psychology includes the notion that some behavior is explained by personality traits—who the person is—rather than by beliefs and desires—what the person thinks. Consequences of this view for the debate between simulation theory and theory theory, as well as the debate on chimpanzee theory of mind are discussed.     

What is an emotional feeling? Lessons about affective origins from cross-species neuroscience

Cross-species affective neuroscience aspires to provide an evidence-based foundation for understanding the primary-process emotional networks that concurrently control instinctual emotional actions and affective feelings—direct emotional circuit mediated ‘rewards’ and ‘punishments’. In humans and other mammals, the ancestral subcortical regions of the brain are central to such affective BrainMind functions (a monistic term, here used synonymously with MindBrain, depending on stylistic needs). Although these circuits cannot be ‘identical’ across species (that would be incompatible with evolutionary principles) they are sufficiently similar, anatomically, neurochemically and functionally, to allow animal brain research to illuminate (yield testable predictions) about homologous human mind functions. Primal emotional feelings (affects) are inbuilt value functions of the brain that energize and inform the rest of the mental apparatus about basic survival values, thereby promoting secondary-process learning/memory functions and tertiary-process cognitive thinking-ruminative functions, yielding bottom-up evolutionary controls that ultimately allow top-down regulatory controls. As we envision how such “nested” hierarchies—two-way paths of causality—reflecting both bottom-up and top-down functions—we will need disciplined distinctions between cognitions and emotions at the primary-process level, while also accepting total interpenetrance of cognitions and affects at the tertiary-process level of MindBrain organization. This allows full and synergistic integration of basic and dimensional approaches to emotions. Here the primal emotional networks, so critically important for understanding ‘human-nature’ and psychiatric disorders, are discussed didactically in ways that can minimize dilemmas that non-evolutionary, non-hierarchical perspectives are subject to in modern emotion research.     

The essential process in a family of measurement models

Five members of the Rasch family of latent trait models which have appeared more or less independently in the literature are brought together and identified as one model. In addition to sharing the distinguishing characteristic of the dichotomous Rasch model—separable person and item parameters and hence sufficient statistics—all five models share a common algebraic form and have as their basic element the fundamental process defined by Rasch's simple logistic expression. In these models, the sufficient statistics for person and item parameters are counts of events constructed to be indicative of the variable being measured, and the measures they enable are ‘fundamental’.     

The Cultural Community: An Husserlian Approach and Reproach

What types of unity and disunity belong to a group of people sharing a culture? Husserl illuminates these communities by helping us trace their origin to two types of interpersonal act—cooperation and influence—though cultural communities are distinguished from both cooperative groups and mere communities of related influences. This analysis has consequences for contemporary concerns about multi- or mono-culturalism and the relationship between culture and politics. It also leads us to critique Husserl’s desire for a new humanity, one that is rational, cooperatively united, and animated by a universal philosophical culture. Reflecting on culture, a spiritually shaped and shared domain of the world, draws us to reflect also on ourselves as social and rational animals, and to ask, what should we reasonably hope for—and aim for—in a human culture that expresses and supports our shared lives of reason? Aristotle is used for occasional comparisons and contrasts.     

Privation theories of pain

Most modern writers accept that a privation theory of evil should explicitly account for the evil of pain. But pains are quintessentially real. The evil of pain does not seem to lie in an absence of good. Though many directly take on the challenges this raises, the metaphysics and axiology of their answers is often obscure. In this paper I try to straighten things out. By clarifying and categorizing the possible types of privation views, I explore the ways in which privationists about evil are—or should or could be—privationists about pain’s evil.     

Transformation of flow in rehabilitation: The role of advanced communication technologies

Authentic rehabilitation requires the active participation of patients and their involvement with opportunities for action and development. Within this framework, in this article we outline the possibility of using two emerging computing and communication technologies—ambient intelligence (AmI) and virtual reality (VR)—for a new breed of rehabilitative and clinical applications based on a strategy defined astransformation of flow. Transformation of flow is a person’s ability to exploit an optimal (flow) experience to identify and use new and unexpected psychological resources as sources of involvement. We identify the feeling ofpresence—the feeling of being in a world that exists outside oneself—as the theoretical link between the technology and rehabilitation. AmI and VR are used to trigger broad empowerment processes induced by a strong sense of presence, leading to greater agency and control over one’s actions and environment.