Perinatal substance abuse and human subjects research: are privacy protections adequate?

Privacy incursions in the clinical care of substance abusing pregnant women have gained lay and professional attention recently as the result of a high-profile Supreme Court finding in Ferguson vs City of Charleston et al. In March, 2001 the Supreme Court determined that nonconsensual drug screening of pregnant women by clinicians in a public hospital violated the women's Fourth Amendment rights to be secure against unreasonable search and seizure. Coercive or punitive policy approaches to perinatal substance abuse are often based on mistaken assumptions about the nature of addiction and the outcomes of punitive interventions. Much attention has been given to efforts to criminalize pregnancy for drug using women, and civil laws are also coming under increasing scrutiny. Although no state has passed a law criminalizing pregnancy and drug use, an estimated 250 women in more than 30 states have been prosecuted around the country on theories of "fetal abuse." A growing number of states (eighteen to date) have amended their civil child welfare laws to address specifically the subject of a woman's drug use during pregnancy. No one has examined how these laws and social policies could affect research that includes pregnant and parenting women; women (and their families) who stand to lose a great deal should their drug use be brought to the attention of child welfare or criminal justice authorities. We examine the adequacy of current protective mechanisms, such as federal certificates of confidentiality, in protecting research subjects (and investigators) who may be subject to punitive civil or criminal sanctions. We determine that current protective mechanisms may be insufficient to protect research subjects and that investigators and IRB members are often ignorant of the risks imposed by punitive policy approaches to perinatal substance abuse or fall prey to the same mistaken assumptions that inform punitive policies. We conclude that investigators and IRB members have a moral responsibility to understand local, state and national policies and laws governing perinatal substance abuse. Investigators and IRB members should balance the harms of punitive interventions against the protections that may, or may not be afforded to prospective research subjects as well as the prospective benefits, individual and social, of the research. In situations where criminal or punitive policies are in effect, investigators and IRB members should consider whether adequate protections can be achieved. In the context of inadequate protections, potential risks to prospective research subjects and their families may outweigh the individual or social benefits that accrue from the research. Clinical researchers are professionally obligated to work toward amending laws and policies that are not in the best interests of prospective research subjects.     

The Impact of Gender and Setting on Perceptions of Others' Ethics

In this article we explore how differences in gender and setting affect individuals' perceptions of others' ethics. We examine 4 hypotheses: first, that men would be perceived as more utilitarian in their ethics and women would be perceived as more formalist; second, individuals would be perceived to be more utilitarian in work settings than in nonwork settings; third, women would be more accurate in their perceptions of others' ethics; fourth, both men and women would be more accurate in their perceptions of women's ethics. Results strongly support the first, refute the second, modestly support the third, and support the fourth. Overall, the data suggest that men and women share very similar perceptions of own-gender and other-gender ethics. However, these shared perceptions are often quite inaccurate.     

Brain activation and the phonological loop: the impact of rehearsal

Brain activation studies offer valuable techniques for exploring human cognition to complement behavioral measures and several studies report a wide range of neuroanatomical networks activated during verbal immediate memory. Behavioral investigations have shown use of multiple cognitive strategies across and within individuals, although aggregate data appear to reflect a common cognitive function. Variation in cognitive strategies could result in aggregate activation patterns that are relatively widespread and difficult to interpret. Imaging data (fMRI) from six participants instructed to use subvocal rehearsal showed significant left hemisphere activation in the inferior parietal gyrus and inferior and middle frontal gyri, a pattern of activation more clearly focused than in previous brain activation studies of immediate verbal serial ordered recall. Our results should be relatively free of the influence of other mental operations, and emphasise the importance of considering which cognitive strategies might give rise to focused or to diverse patterns of brain activation.     

Philosophy, Polemics, Education

In this paper I wish to comment upon the use of polemical argument in philosophy of education and education. Like Foucault, I believe that a whole morality is at stake because polemical argument obfuscates the search for truth at the expense of truth and the other’s veracity, integrity and dignity. The use of polemics is illustrated by two arguments. The first general argument is taken from an attack upon Albert Camus by the British writer Colin Wilson. The second more particular example is taken from attacks in New Zealand by the State Department of Education upon the educational ideas of the novelist and educator Sylvia Ashton-Warner. Finally I discuss how polemics might be countered in education.

The effect of early visual deprivation on the development of face processing

We evaluated the importance of early visual input for the later development of expertise in face processing by studying 17 patients, aged 10 to 38 years, treated for bilateral congenital cataracts that deprived them of patterned visual input for the first 7 weeks or more after birth. We administered five computerized tasks that required matching faces on the basis of identity (with changed facial expression or head orientation), facial expression, gaze direction and lip reading. Compared to an age–matched control group, patients’ recognition of facial identity was impaired significantly when there was a change in head orientation (e.g. from frontal to tilted up), and tended to be impaired when there was a change in facial expression (e.g. from happy to surprised). Patients performed normally when matching facial expression and direction of gaze (e.g. looking left or right), and in reading lips (e.g. pronouncing ‘u’ or ‘a’). The results indicate that visual input during early infancy is necessary for the normal development of some aspects of face processing, and are consistent with theories postulating the importance of early visual experience (de Schonen & Mathivet, 1989; Johnson & Morton, 1991) and separate neural mediation of different components of face processing (Bruce & Young, 1986).     

A user-interactive graphics-based computer system for analysis of the EEG

Computer technology provides a powerful high-resolution tool for the analysis and understanding of the electroencephalogram (EEG). A system of user-interactive graphics-based computer programs analyzing the power spectral density (PSD), coherence, and phase-angle relationships of the EEG is described, along with the mathematical algorithms used. The analytic variables inherent in coherence analysis are reviewed. These variables include choices of sampling parameters, auto- and cross-spectral algorithms, smoothing techniques, and use of the γ²(f) or γ(f) value for coherence. These variables in the analysis itself have a net interactive effect on the calculated results that often makes comparability of data across studies impossible. Thus, it is proposed that studies include a graph showing the authors’ derived coherence values for a set of standard test signals to enhance scientific communication.