On the fragility of medical virtue in a neoliberal context: the case of commercial conflicts of interest in reproductive medicine

Social, political, and economic environments play an active role in nurturing professional virtue. Yet, these environments can also lead to the erosion of virtue. As such, professional virtue is fragile and vulnerable to environmental shifts. While physicians are often considered to be among the most virtuous of professional groups, concern has also always existed about the impact of commercial arrangements on physicians’ willingness and capacity to enact their professional virtues. This article examines the ways in which commercial arrangements have been negotiated to secure medical virtue from real or perceived threats of erosion. In particular, we focus on the concern surrounding conflicts of interest arising from commercial arrangements that have developed as a result of neoliberal economic and social policies. The deregulation of medical markets and privatization of services have produced new commercial relationships that are often misunderstood by patients, publics, and physicians themselves. ‘Conflicts of interest’ policies have been introduced in an attempt to safeguard ethical conduct and medical practice. However, a number of virtue ethicists have critiqued these policies as inadequate for securing virtue. We examine the ways in which commercial arrangements have been seen to impact upon medical virtue, both historically and in the context of modern medicine (using the example of fertility services in Australia). We then describe and critique current efforts to restore clinical virtue through both conflict of interest policies and through virtue ethics. Finally, we suggest some possible ways of addressing the corrosive effects of neoliberalism on medical virtue.     

When and how forgiving benefits victims: Post‐transgression offender effort and the mediating role of deservingness judgements

For all the well‐established benefits of forgiveness for victims, when and how is forgiving more likely to be beneficial? Three experimental studies found that forgiving is more likely to be beneficial when victims perceived reparative effort by offenders such that offenders deserve forgiveness. Deservingness judgements were elicited by manipulating post‐transgression offender effort (apology/amends). When offenders apologized (Study 1; recall paradigm) or made amends (Study 2; hypothetical paradigm) and were forgiven—relative to transgressors who did not apologize/make amends but were still forgiven—forgiving was beneficial. These findings—that deserved forgiveness is more beneficial for victims than undeserved forgiveness—were replicated when forgiving itself was also manipulated (Study 3). Moreover, Study 3 provided evidence to indicate that if a victim forgives when it is not deserved, victim well‐being is equivalent to not forgiving at all. Of theoretical and practical importance is the mediating effect of deservingness on relations between post‐transgression offender effort and a victim's personal consequences of forgiving.     

Social influences on unconscious plagiarism and anti-plagiarism

People are more likely to unconsciously plagiarise ideas from a same-sex partner than a different-sex partner, and more likely to unconsciously plagiarise if recalling alone rather than in the presence of their partner [Macrae, C. N., Bodenhausen, G. V., & Calvini, G. (1999). Contexts of cryptomnesia: May the source be with you. Social Cognition, 17, 273–297. doi:10.1521/soco.1999.17.3.273]. Two sets of experiments explore these phenomena, using extensions of the standard unconscious plagiarism paradigm. In Experiment 1A participants worked together in same- or different-sex dyads before trying to recall their own ideas or their partner's ideas. More source errors were evident for same-sex dyads (Experiment 1A), but this effect was absent when participants recalled from both sources simultaneously (Experiment 1B). In Experiment 2A, participants recalled ideas from a single source either alone or in the presence of the partner, using an extended-recall task. Partner presence did not affect the availability of ideas, but did reduce the propensity to report them as task compliant, relative to a partner-present condition. Simultaneous recall from both sources removed this social effect (Experiment 2B). Thus social influences on unconscious plagiarism are apparent, but are influenced by the salience of the alternate source at retrieval.     

Boundaries in the practice of humanistic counselling

The multifaceted concept of boundary is used to describe the ground rules, quality and type of therapeutic relationship in a humanistic form of counselling that develops some of the principles of Carl Rogers and blends them with principles from psychodynamic practice. The concept of boundaries is first discussed in relation to its usages and practical consequences. An analysis of some core principles and assumptions about boundaries that guide the communicative psychotherapy approach of Robert Langs leads into a comparison with person-centred counselling. The aim is to develop a middle path for humanistic practice along more formal lines, involving a more fluid understanding of relationships and precise use of counselling principles. This also involves finding aspects of agreement between the psychodynamic and humanistic styles of working, by omitting some concepts and practices and identifying areas of common ground. Several comments on practice are made by comparing the two perspectives. The concept of boundary enables counsellors of all schools to think about points of similarity and difference. Finally, the notion of boundary itself is critiqued, and intersubjectivity is proposed as a potentially more meaningful term.     

T. V. Moore’s (1939)Cognitive Psychology

Thomas Verner Moore published a book calledCognitive Psychology in 1939, almost 30 years before Neisser’s (1967) more familiar and far more influential work. Although it covers most of the standard topics found in current cognitive psychology textbooks, and even anticipated several current trends, Moore’s text is not cited by any of the major histories of the “cognitive revolution” or any current cognitive textbook. We provide a brief sketch of Moore’s academic life and summarize several of his papers that are still cited. After describing the psychologies prevalent in 1939, we compare Moore’s text with two contemporary works, Woodworth (1938) and McGeoch (1942). We conclude by comparing the older text with Neisser’s and by offering several reasons why the book is virtually unknown.     

Effects of high-pass and low-pass spatial filtering on face identification

If face images are degraded by block averaging, there is a nonlinear decline in recognition accuracy as block size increases, suggesting that identification requires a critical minimum range of object spatial frequencies. The identification of faces was measured with equivalent Fourier low-pass filtering and block averaging preserving the same information and with high-pass transformations. In Experiment 1, accuracy declined and response time increased in a significant nonlinear manner in all cases as the spatial-frequency range was reduced. However, it did so at a faster rate for the quantized and high-passed images. A second experiment controlled for the differences in the contrast of the high-pass faces and found a reduced but significant and nonlinear decline in performance as the spatial-frequency range was reduced. These data suggest that face identification is preferentially supported by a band of spatial frequencies of approximately 8-16 cycles per face; contrast or line-based explanations were found to be inadequate. The data are discussed in terms of current models of face identification.     

Managing Attitudes Toward High Achievers: The Influence 0f Group Discussion

For a variety of cultural, contextual, and interpersonal reasons, individual achievement often meets with potentially demotivating resistance from the group. In groups of between three and seven members, 397 psychology and social work students, in East and Northern Australian cities (Newcastle and Darwin), indicated their attitudes toward high achievers before, during, and after a group consensus task. In each location, and at both individual and group levels of analysis, initially slightly pro-achiever attitudes, following discussion of the issues, became polarized. Such changes, across diverse settings and groups, indicate that group discussion may be a robust tool, both for empowering teams and encouraging support for individual initiative.     

Component problems in dichotic listening

The experiments reported examined monitoring for semantically defined targets whilst concurrently shadowing (Experiment I) or listening silently (Experiment II). The word lists for monitoring were either visual or auditory. Monitoring and shadowing accuracy showed less interference when presentation was bimodal than when it was dichotic. However, monitoring latency and recognition memory for shadowed material did not show this effect. It is argued that these data reveal the existence of a number of different sources of potential difficulty in dichotic listening situations and the nature of these is discussed.