The protection of patients’ rights in clinical trials

The Helsinki Declaration is a very important document regarding the protection of patients’ rights in clinical trials and one of the fundamental sources of operational principles for every ethics committee. Although they have been updated, the international guidelines for ethics committees continually fail to address certain issues pertaining to the protection of patients’ rights in clinical trials. These issues include, most significantly, the method of electing ethics committees (a free, secret ballot should be preferred to direct appointment), the avoidance of conflict of interest during the election of ethics committee members, and the necessary insurance coverage for the participants of clinical trials. Polish law should, on the other hand, be developed in such way as to not limit the effectiveness of ethics committees in protecting patients’ rights in clinical trials. The ideal solution would be to draft a uniform law concerning not only clinical trials, but all medical experiments. The opinions of experts who have been reviewing medical research projects for several years may prove to be especially valuable in this setting. This paper was presented at the 6th International Bioethics Conference on the subject of ‘The Responsible Conduct of Basic and Clinical Research’, held in Warsaw, Poland, 3–4 June 2005. The author is Chairman, Bioethics Committee of the Warsaw Regional Chamber of Physicians and Dentists.     

The mentor and the trainee in academic clinical medicine

Medicine is a scientific discipline, but it is sometimes difficult to separate what is scientific and what is a clinical, practical activity. Man is the object, but he is always the subject of medical research and therefore these two elements become closely bound together by a thread of moral interdependencies. Every mentor of a young academic and all institutions dealing with the teaching of and research into medicine must understand multidimensional, multifaceted, and multilevel aspects of their activity and give them due regard in the educational process. The educational mission of an academic institution and of the teacher working there may be summed up in one phrase: Teach thinking! At the same time, the task of a school and the individual mentor is to teach the student to distinguish personal freedom from a lack of the feeling of responsibility. The medieval principle “Universitas magistrorum et scholarium”, and thus the corporation, the community of teachers and students, has not lost any of its relevance and value today. The situation is, in its far-reaching consequences, tragic in which the “insufficiently tutored teach”. Both physician and teacher, and especially physician-teacher, are not only professions, but also callings. This paper was presented at the 6th International Bioethics Conference on the subject of ‘The Responsible Conduct of Basic and Clinical Research’, held in Warsaw, Poland, 3–4 June 2005.     

Using a metaperspective to clarify the structural-narrative debate in family therapy

The debate in family therapy between structural and narrative therapists often seems irreconcilable. Drawing from work in theoretical sociology that identifies the basic structure of existing social theory, a metaperspective is introduced to clarify a discussion between leading figures in the debate. Disparate views of family interactions are examined in terms of more fundamental disagreements about the center of attention in therapy. Narrative and structural modes of presentation are examined as separate traditions that could not be further apart conceptually. Efforts to identify common ground are discussed in terms of more significant differences that are minimized by drawing out similarities. This analysis provides a framework for standing outside entrenched arguments to see more clearly the unique contributions of each approach.     

Consumption of sexual dialogue and content on television and adolescent sexual outcomes: multiethnic findings

The purposes of this study were to examine group differences in sexual media consumption and to explore how well adolescents' sexual attitudes and behavior can be explained by viewing of sexually suggestive dialogue (SD) and explicit sexual content (SC) in television media. Participants were 473 male and female high school adolescents who were racially, economically, and age diverse. Television viewing was coded for SD and SC. Both length of time spent watching SD and SC and explicitness of the SD and SC to which adolescents were exposed were factored into the coding scheme. In this sample, SD and SC consumption varied by subgroup and explained variance in some sexual attitudes and behavior variables but not others, and in some demographic subgroups but not others.     

Taxometric Investigation of PTSD: data from two nationally representative samples

Current psychiatric nosology depicts posttraumatic stress disorder (PTSD) as a discrete diagnostic category. However, only one study has examined the latent structure of PTSD, and this study suggested that PTSD may be more accurately conceptualized as an extreme reaction to traumatic life events rather than a discrete clinical syndrome. To build on the existing literature base, the present research examined the latent structure of posttraumatic stress reactions by applying three taxometric procedures (MAXEIG, MAMBAC, and L-Mode) to data collected from large nationally representative samples of women (ns = 2684 and 3033) and adolescents (n = 3775). Results consistently provided evidence for a dimensional PTSD solution across samples and statistical procedures. These findings have important implications for the theory, assessment, and investigation of posttraumatic stress reactions.     

Acting intentionally and the side-effect effect

The concept of acting intentionally is an important nexus where theory of mind and moral judgment meet. Preschool children's judgments of intentional action show a valence-driven asymmetry. Children say that a foreseen but disavowed side effect is brought about "on purpose" when the side effect itself is morally bad, but not when it is morally good. This is the first demonstration in preschoolers that moral judgment influences judgments of whether something was done on purpose (as opposed to judgments of purpose influencing moral judgment). Judgments of intentionality are usually assumed to be purely factual. That these judgments are sometimes partly normative-even in preschoolers-challenges current understanding. Young children's judgments regarding foreseen side effects depend on whether the children process the idea that the character does not care about the side effect. As soon as preschoolers effectively process the theory-of-mind concept "not care that P," children show the side-effect effect.     

Stigma as ego depletion: how being the target of prejudice affects self-control

This research examined whether stigma diminishes people's ability to control their behaviors. Because coping with stigma requires self-regulation, and self-regulation is a limited-capacity resource, we predicted that individuals belonging to stigmatized groups are less able to regulate their own behavior when they become conscious of their stigmatizing status or enter threatening environments. Study 1 uncovered a correlation between stigma sensitivity and self-regulation; the more Black college students were sensitive to prejudice, the less self-control they reported having. By experimentally activating stigma, Studies 2 and 3 provided causal evidence for stigma's ego-depleting qualities: When their stigma was activated, stigmatized participants (Black students and females) showed impaired self-control in two very different domains (attentional and physical self-regulation). These results suggest that (a) stigma is ego depleting and (b) coping with it can weaken the ability to control and regulate one's behaviors in domains unrelated to the stigma.     

Modeling human performance in statistical word segmentation

The ability to discover groupings in continuous stimuli on the basis of distributional information is present across species and across perceptual modalities. We investigate the nature of the computations underlying this ability using statistical word segmentation experiments in which we vary the length of sentences, the amount of exposure, and the number of words in the languages being learned. Although the results are intuitive from the perspective of a language learner (longer sentences, less training, and a larger language all make learning more difficult), standard computational proposals fail to capture several of these results. We describe how probabilistic models of segmentation can be modified to take into account some notion of memory or resource limitations in order to provide a closer match to human performance.     

The Effect of Challenge and Threat Appraisals Under Evaluative Presence

Four studies were conducted to examine whether cognitive appraisals, manipulated through task instructions, would moderate social‐facilitation effects. In Study 1, participants in the challenge condition performed better on a mental arithmetic task when the experimenter was present. Conversely, participants in the threat condition performed worse when the experimenter was present. Study 2 extended these findings across 2 math tasks that varied in degree of difficulty. The pattern of performance data failed to support prior drive theories and provided support for a unique contribution of cognitive appraisals in explaining social‐facilitation effects. Study 3 validated the appraisal manipulations by using multiple measures of cognitive appraisals. Finally, Study 4 offered increased validity by replicating the performance data using an anagram task.