Wakefield’s harmful dysfunction analysis of disorder and the problem of defining harm to nonsentient organisms

Theoretical Medicine and Bioethics - This paper criticizes Jerome Wakefield’s harmful dysfunction analysis (HDA) of disorder by arguing that the conceptual linkage it establishes between the...     

Adapting to fill the void: Dynamic group coordination as a function of differing domain roles and instrumentality

In groups, member coordination is influenced by a complex set of factors including who has what knowledge (which implies who is responsible for different task domains) as well as the differing incentives associated with performing within those domains. We show that the distribution of members' expert roles interacts with the desirability of different task domains to impact member perceptions of the task, coordination, and performance. Group members who have expertise in a highly desirable domain (i.e., key experts) perceive the task differently than members who do not and report that their approach to the task is determined to a greater extent by an attention to capturing highly desirable contributions for the group than do other members. Furthermore, when a group lacks a key expert, groups divide the work involved within a highly desirable domain across multiple members. This results in the group doing well in the highly desirable domain itself, but overlooking other domains and performing poorly, overall. We discuss the theoretical implications of this research as well as its practical applications.     

More emotional facial expressions during episodic than during semantic autobiographical retrieval

There is a substantial body of research on the relationship between emotion and autobiographical memory. Using facial analysis software, our study addressed this relationship by investigating basic emotional facial expressions that may be detected during autobiographical recall. Participants were asked to retrieve 3 autobiographical memories, each of which was triggered by one of the following cue words: happy, sad, and city. The autobiographical recall was analyzed by a software for facial analysis that detects and classifies basic emotional expressions. Analyses showed that emotional cues triggered the corresponding basic facial expressions (i.e., happy facial expression for memories cued by happy). Furthermore, we dissociated episodic and semantic retrieval, observing more emotional facial expressions during episodic than during semantic retrieval, regardless of the emotional valence of cues. Our study provides insight into facial expressions that are associated with emotional autobiographical memory. It also highlights an ecological tool to reveal physiological changes that are associated with emotion and memory.     

CRISPR/Cas9 genome editing – new and old ethical issues arising from a revolutionary technology

Although germline editing has been the subject of debate ever since the 1980s, it tended to be based rather on speculative assumptions until April 2015, when CRISPR/Cas9 technology was used to modify human embryos for the first time. This article combines knowledge about the technical and scientific state of the art, economic considerations, the legal framework and aspects of clinical reality. A scenario will be elaborated as a means of identifying key ethical implications of CRISPR/Cas9 genome editing in humans and possible ways of dealing with them. Unlike most other discussions of CRISPR/Cas9 germline editing, which are generally based on deontological arguments, the focus in this case will be on a consequentialistic argument against certain applications of germline and somatic editing that takes not only the potential benefits and risks but also socioeconomic issues into consideration. The practical need for an indication catalogue, guidelines for clinical trials, and for funding of basic research will be pointed out. It will be argued that this need for regulatory action and discussion does not stem primarily from the fact that CRISPR/Cas9 germline editing is revolutionary in terms of its ethical implications and potential for human therapy, although this is the prevailing view in the current discussion. Understanding the value and interest dependency of arguments put forward by different stakeholders and learning from past debates related to similar technologies might prove a fruitful method of reaching judgments and decisions that come closer to a consensus upon which society as a whole can agree - which after all should be the true goal of an ethical debate and of bioethics.     

Evaluation into the relationship: Reflections on new trends in evaluation,assessment, and classification

From a clinical and psychoanalytically informed point of view, the process of evaluation is mainly concerned with the formation of a working alliance with the infant. Assessment is, therefore, considered as a process that cannot be applied in a systematic way, regardless of the situation. On the contrary, it is based upon transference and countertransference, which guides the clinician, along with the infant's behavior and reactions, during the consultation. From this perspective, evaluation should always have some therapeutic impact. Paradoxically, this therapeutic action is linked with the suspension of diagnostic process for a period of time. The prognosis and treatment planning is mostly based upon the evaluation of change during the expended assessment period. The more serious the situation, the longer the assessment to determine why the infant is at risk, what are the positive aspects of the situation, and what are the ways to reach the infant through the relationship with the parents. © 1997 Michigan Association for Infant Mental Health     

An integrated device to evaluate a driver’s functional state

In the field of cognitive ergonomics, research on car drivers requires multimodal in-vehicle systems for recording not only driving-related behavior, but also contextual information from their surroundings. In addition, reliable information concerning a driver’s functional state should be obtained. In this article, we describe an integrated device simultaneously recording specific physiological data, video recordings of the driver and environment, parameters from the vehicle, and contextual data. Physiological signals from the autonomic nervous system provide objective and quantitative information on the driver’s alertness and his/her ability to process specific driving-related stimuli or other nonspecific information. Consequently, recorded physiological responses can be related to individual driving events. Electrodermal and cardiac activities are sensitive to time-dependent variations in arousal level and to certain external stimuli, so there is great interest in studying drivers’ behavior via measured physiological signals that have been established as suitable behavioral indicators. The present integrated device is capable of processing the relevant indices from raw measured data in real time.     

Genetics and personality affect visual perspective in autobiographical memory

Major depression is associated with a decrease of 1st person (versus 3rd person) visual perspective in autobiographical memory, even after full remission. This study aimed to examine visual perspective in healthy never-depressed subjects presenting with either genetic or psychological vulnerability for depression. Sixty healthy participants performed the Autobiographical Memory Test with an assessment of visual perspective. Genetic vulnerability was defined by the presence of at least one S or L_G allele of the polymorphism of the serotonin-transporter-linked promoter region (5-HTTLPR). Psychological vulnerability was defined by high scores of harm avoidance measured by the Temperament and Character Inventory. Life stress exposure, depressive mood, rumination, and familial history of depression were assessed through standardized procedures. Visual perspective for positive memories was independently predicted by both harm avoidance and a gene by environment interaction between the 5-HTTLPR polymorphism and life stress exposure. Visual perspective and vulnerability for depression may share some biological bases.     

Religious Values in Clinical Practice are Here to Stay

Research to date has shown that health professionals often practice according to personal values, including values based on faith, and that these values impact medicine in multiple ways. While some influence of personal values are inevitable, awareness of values is important so as to sustain beneficial practice without conflicting with the values of the patient. Detecting when own personal values, whether based on a theistic or atheistic worldview, are at work, is a daily challenge in clinical practice. Simultaneously ethical guidelines of tone-setting medical associations like American Medical Association, the British General Medical Council and Australian Medical Association have been updated to encompass physicians’ right to practice medicine in accord with deeply held beliefs. Framed by this context, we discuss the concept of value-neutrality and value-based medical practice of physicians from both a cultural and ethical perspective, and reach the conclusion that the concept of a completely value-neutral physician, free from influence of personal values and filtering out value-laden information when talking to patients, is simply an unrealistic ideal in light of existing evidence. Still we have no reason to suspect that personal values, whether religious, spiritual, atheistic or agnostic, should hinder physicians from delivering professional and patient-centered care.