Medical Evidence and Virtue Ethics: A Commentary on Zarkovich and Upshur

Theoretical Medicine and Bioethics -     

Reliability among Senior Managers of the Marlowe–Crowne Short-Form Social Desirability Scale

The majority of scholarly management studies are based on self-report surveys. Consequently, the need to control for social desirability response is important, although few management studies in fact include the use of relevant scales commonly incorporated in psychology research. The full Marlowe–Crowne scale is disaffectingly long for senior-manager sample usage, so one of its short forms is more practical. However, the reliability of the most popular of these, the Strahan–Gerbasi scale, has not been tested with senior-manager samples. This study tests the scale amongst several senior-manager samples and finds it consistently lacks adequate reliability and unidimensionality.     

Teaching pigeons to commit base-rate neglect

Whereas humans display base-rate neglect in a behavioral analogue of the base-rate problem, pigeons have been shown to behave optimally in a comparable task, appropriately weighting base-rate and case-cue information. Previous studies have shown that prior experience may interfere with optimal decisions for human subjects, a result consistent with the position that poor and illogical decisions often follow from the misapplication of learned rules. The present study shows that pigeons will also display base-rate neglect if given extensive pretraining with informative case cues. Two experiments with pigeons, in a matching-to-sample procedure designed to mimic the classic base-rate problem, show that pigeons display base-rate neglect after extensive pretraining with the matching task.     

Novel visual stimuli activate a population of neurons in the primate orbitofrontal cortex

Neurons were found in the rhesus macaque anterior orbitofrontal cortex that respond to novel but not to familiar visual stimuli. Some of these neurons responded to all novel stimuli, and others to only a subset (e.g., to novel faces). The neurons have no responses to familiar reward- or punishment-associated visual stimuli, nor to taste, olfactory or somatosensory inputs. The responses of the neurons typically habituated with repeated presentations of a novel stimulus, and five presentations each 1s was the median number for the response to reach half-maximal. The neurons did not respond to stimuli which had been novel and shown a few times on the previous day, indicating that the neurons were involved in long-term memory. The median latency of the neuronal responses was 120 ms. The median spontaneous firing rate was 1.3 spikes/s, and the median response to novel visual stimuli was 6.0 spikes/s. These findings indicate that the long-term memory for visual stimuli is information that is represented in a region of the primate anterior orbitofrontal cortex.     

Perception of place-of-articulation information in natural speech by monkeys versus humans

Four monkeys and 6 humans representing five different native languages were compared in the ability to categorize natural CV tokens of /b/ versus /d/ produced by 4 talkers of American English (2 male, 2 female) in four vowel contexts (/i, e, a, u/). A two-choice "left/right" procedure was used in which both percentage correct and response time data were compared between species. Both measures indicated striking context effects for monkeys, in that they performed better for the back vowels /a/ and /u/ than for the front vowels /i/ and /e/. Humans showed no context effects for the percentage correct measure, but their response times showed an enhancement for the /i/ vowel, in contrast with monkeys. Results suggest that monkey perception of place of articulation is more dependent than human perception on the direction of the F2 onset transitions of syllables, since back-vowel F2s differentiate /b/ and /d/ more distinctively. Although monkeys do not provide an accurate model of the adult human in place perception, they may be able to model the preverbal human infant before it learns a more speech-specific strategy of place information extraction.     

Dilemmas in military medical ethics since 9/11

The attack on the United States by terrorists on 9/11 and the war with Iraq have raised new ethical questions for the military and for military physicians (Herman 2002; Elshtain 2003). How and when attacks may occur now is less predictable. Planes have been hijacked, and persons dressed as civilians may carry bombs to blow themselves and others up. These dangers pose an increased threat, and, thus, there is a need for new defensive measures. How far these measures should go is, however, greatly open to debate. One of the most difficult ethical question raised for the military and military doctors by these developments is what interrogation methods are permissable when questioning captured terrorists. The licitness of different interrogation practices is, however, only one of the ethical problems potentially encountered by military physicians now having to treat terrorists and POWs. The following discussion presents the major concerns regarding this and other issues.     

Uptake of Cardiac Screening and Genetic Testing Among Hypertrophic and Dilated Cardiomyopathy Families

Cardiomyopathy is a genetically and clinically heterogeneous, life threatening disease which affects people of all ages. Recent guidelines provide recommendations for cardiac screening and genetic testing in at-risk relatives, but the uptake and impact of these measures in the United States is unknown. This is a single institution retrospective study that characterizes the uptake of cardiac screening and genetic testing for relatives of a cohort of 57 probands with hypertrophic (HCM) and dilated cardiomyopathy (DCM) who underwent both clinical evaluation and genetic testing. Cardiac screening was indicated for 302 relatives. One hundred and seventy-three (57 %) completed cardiac screening. Forty of the 57 probands were mutation positive and genetic testing was indicated for 213 relatives. Eighty-four (39 %) completed genetic testing. The uptake of cardiac surveillance was greater than the uptake of genetic testing (p?<?0.0001) among relatives of mutation positive probands. Within the group of at-risk, asymptomatic relatives of probands, cardiac screening and genetic testing were positive in 25 % and 40 % of cases, respectively. These data demonstrate the important role and utility of cascade cardiac screening and genetic testing in the care of patients and families with HCM or DCM. The approach to cardiac screening and genetic testing should be family-specific and requires expertise in the genetics of cardiomyopathy.