Patient Autonomy and Quality of Care in Telehealthcare

Telemedicine is a complex field including various applications and target groups. Especially telehealthcare is seen by many as a means to revolutionize medicine. It gives patients the opportunity to take charge of their own health by using self-tracking devices and allows health professionals to treat patients from a distance. To some, this means an empowerment of patient autonomy as well as an improvement in the quality of care. Others state the dangers of depersonalization of medicine and the pathologization of daily life. This paper examines the ethical implications of telehealthcare, focusing on patient autonomy and quality of care by analyzing metareviews, randomized controlled trials and narrative ethical analyses on the topic. As a result, we conclude that the technically enhanced encounter between patients and health professionals may mean an empowerment of patient autonomy when it goes along with a personal relationship based on trust, assistance and support. When it comes to the quality of care, telehealthcare may lead to an improvement as long it is adopted to the patient’s individual needs.     

Anticipatory Uncertainty: How Academic and Industry Researchers in the Life Sciences Experience and Manage the Uncertainties of the Research Process Differently

The institutional contexts of research increasingly require researchers to anticipate their productivity and the uncertainties inherent in their research. This applies to both academic researchers and to researchers in start-up companies. This creates a specific kind of uncertainty, anticipatory uncertainty, that we define as the state of being uncertain as to whether research processes will be productive in a specific time frame and along situated definitions of good performance. In the life sciences, this anticipatory uncertainty is experienced and managed differently, depending on how research is organized and the cultural resources available in specific institutional contexts. In biotechnology companies, there is a readiness to embrace dynamic changes in both research strategies and the organization of work in response to new developments in the progress of the overall research agenda. In academia, the ability of research groups to react with similar flexibility seems significantly constrained by the individual attribution of research work and credit, and the correspondingly high level of individual anticipatory uncertainty. This raises questions about how far the current organization of academic research allows epistemic uncertainty to be embraced and corresponding risks to be taken, rather than safe questions to be pursued.     

Task effects, performance levels, features, configurations, and holistic face processing: A reply to Rossion

A recent article in Acta Psychologica (“Picture-plane inversion leads to qualitative changes of face perception” by Rossion [Rossion, B. (2008). Picture-plane inversion leads to qualitative changes of face perception. Acta Psychologica (Amst), 128(2), 274-289]) criticized several aspects of an earlier paper of ours [Riesenhuber, M., Jarudi, I., Gilad, S., & Sinha, P. (2004). Face processing in humans is compatible with a simple shape-based model of vision. Proceedings of the Royal Society of London B (Supplements), 271, S448-S450]. We here address Rossion’s criticisms and correct some misunderstandings. To frame the discussion, we first review our previously presented computational model of face recognition in cortex [Jiang, X., Rosen, E., Zeffiro, T., Vanmeter, J., Blanz, V., & Riesenhuber, M. (2006). Evaluation of a shape-based model of human face discrimination using FMRI and behavioral techniques. Neuron, 50(1), 159-172] that provides a concrete biologically plausible computational substrate for holistic coding, namely a neural representation learned for upright faces, in the spirit of the original simple-to-complex hierarchical model of vision by Hubel and Wiesel. We show that Rossion’s and others’ data support the model, and that there is actually a convergence of views on the mechanisms underlying face recognition, in particular regarding holistic processing.     

Advocating Worker Justice

Catholic moral theology possesses a number of tools that can be employed to promote worker justice. Some of these tools, such as Catholic social teaching on solidarity and workers’ rights, have been used to this end before. However, advocates of workers’ rights have seldom utilized other concepts, such as cooperation in evil, scandal, and evangelization. This essay provides a theoretical introduction to several tools in the “toolkit” of Catholic ethicists, engaging contemporary scholarship on them. It then applies the concepts to two cases in order to demonstrate their usefulness in the struggle for worker justice. Both cases involve Catholic universities, which means the ethical concepts introduced from the Catholic moral tradition should have normative status for these institutions. The first case entails a divestment campaign at the University of Notre Dame. The second case confronts the unjust treatment of adjunct faculty members at Catholic colleges and universities.     

The effects of parental scaffolding on preschoolers' executive function

The present study explores the effects of parental scaffolding of children's problem solving on the development of executive function (EF). Eighty-two children were assessed at 2, 3, and 4 years of age on a variety of EF tasks and, at ages 2 and 3, on a problem-solving puzzle with which parents offered structured assistance (i.e., scaffolding). Unlike previous studies of parental scaffolding, children's EF was examined at each time point. Scaffolding at age 3 was found to have a direct effect on EF at age 4. Furthermore, scaffolding at age 2 had an indirect on EF at age 4 through the child's verbal ability at age 3.     

Predicting adolescents' parent–child relationship quality from parental personality,marital conflict and adolescents' personality

Longitudinal influences on the relationships between parents and their adolescent children in 175 Austrian families were analysed with data from three measurement points over a time span of 18 years. We investigated the influences of parental personality, marital conflict and adolescents' personality on the father–child and mother–child relationships separately. Inconsistent with previous theories and empirical findings, we found almost no associations between parental personality and parent–child relationships. Marital conflict was associated with only the father–child relationship. Children's personality showed the most consistent associations with the parent–child relationship. Our data support the theory of dynamic interactionism, which postulates an interdependency of personality factors and social relationships.     

Social Freezing in Medical Practice. Experiences and Attitudes of Gynecologists in Germany

Surveys of the German public have revealed a high acceptance of social freezing, i.e. oocyte conservation without medical indication. Up to now, there are no investigations available on the experiences and attitudes of health professionals towards social freezing. Between August 2015 and January 2016, we surveyed gynecologists Germany-wide on the topic social freezing. Five gynecologists specialized in reproductive medicine and five office-based gynecologists in standard care were chosen for the survey. The survey was conducted with an explorative, qualitative research design. The demand for social freezing in Germany is low. With regard to their fertility age, most women attend consultations too late, they have only little previous knowledge and false expectations. The gynecologists consider it the duty of society and politics to provide for the compatibility of family and work. They relate late parenthood to disadvantages primarily for the children. A majority of the gynecologists interviewed tend to advise natural reproduction. Social freezing is often mistaken as a kind of fertility insurance. Thus, it is necessary that physicians inform women early about the possibilities and limitations of social freezing. In the first place, social freezing is not a medical or medical-ethical topic. Women consider the method as a possibility to ensure the compatibility of family and work. This compatibility should be mostly perceived as a political topic. It cannot be a medical task to solve this issue. In fact, a debate in society as a whole is necessary that includes all relevant actors.