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971.
Ryan?M?AntielEmail author Farr?A?Curlin Katherine?M?James Jon?C?Tilburt 《Philosophy, ethics, and humanities in medicine : PEHM》2013,8(1):13
Introduction
Physicians vary in their moral judgments about health care costs. Social intuitionism posits that moral judgments arise from gut instincts, called “moral foundations.” The objective of this study was to determine if “harm” and “fairness” intuitions can explain physicians’ judgments about cost-containment in U.S. health care and using cost-effectiveness data in practice, as well as the relative importance of those intuitions compared to “purity”, “authority” and “ingroup” in cost-related judgments.Methods
We mailed an 8-page survey to a random sample of 2000 practicing U.S. physicians. The survey included the MFQ30 and items assessing agreement/disagreement with cost-containment and degree of objection to using cost-effectiveness data to guide care. We used t-tests for pairwise subscale mean comparisons and logistic regression to assess associations with agreement with cost-containment and objection to using cost-effectiveness analysis to guide care.Results
1032 of 1895 physicians (54%) responded. Most (67%) supported cost-containment, while 54% expressed a strong or moderate objection to the use of cost-effectiveness data in clinical decisions. Physicians who strongly objected to the use of cost-effectiveness data had similar scores in all five of the foundations (all p-values?>?0.05). Agreement with cost-containment was associated with higher mean “harm” (3.6) and “fairness” (3.5) intuitions compared to “in-group” (2.8), “authority” (3.0), and “purity” (2.4) (p?<?0.05). In multivariate models adjusted for age, sex, region, and specialty, both “harm” and “fairness” were significantly associated with judgments about cost-containment (OR?=?1.2 [1.0-1.5]; OR?=?1.7 [1.4-2.1], respectively) but were not associated with degree of objection to cost-effectiveness (OR?=?1.2 [1.0-1.4]; OR?=?0.9 [0.7-1.0]).Conclusions
Moral intuitions shed light on variation in physician judgments about cost issues in health care.972.
Shaun?Stevenson B?Lynn?Beattie Richard?Vedan Emily?Dwosh Lindsey?Bruce Judy?IllesEmail author 《Philosophy, ethics, and humanities in medicine : PEHM》2013,8(1):15
The meaningful consideration of cultural practices, values and beliefs is a necessary component in the effective translation of advancements in neuroscience to clinical practice and public discourse. Society’s immense investment in biomedical science and technology, in conjunction with an increasingly diverse socio-cultural landscape, necessitates the study of how potential discoveries in neurodegenerative diseases such as Alzheimer disease are perceived and utilized across cultures. Building on the work of neuroscientists, ethicists and philosophers, we argue that the growing field of neuroethics provides a pragmatic and constructive pathway to guide advancements in neuroscience in a manner that is culturally nuanced and relevant. Here we review a case study of one issue in culturally oriented neuroscience research where it is evident that traditional research ethics must be broadened and the values and needs of diverse populations considered for meaningful and relevant research practices. A global approach to neuroethics has the potential to furnish critical engagement with cultural considerations of advancements in neuroscience. 相似文献
973.
Bruno?FalissardEmail author Anne?Révah Suzanne?Yang Anne?Fagot-Largeault 《Philosophy, ethics, and humanities in medicine : PEHM》2013,8(1):18
In recent decades, there has been widespread debate in the human and social sciences regarding the compatibility and the relative merits of quantitative and qualitative approaches in research. In psychiatry, depending on disciplines and traditions, objects of study can be represented either in words or using two types of mathematization. In the latter case, the use of mathematics in psychiatry is most often only local, as opposed to global as in the case of classical mechanics. Relationships between these objects of study can in turn be explored in three different ways: 1/ by a hermeneutic process, 2/ using statistics, the most frequent method in psychiatric research today, 3/ using equations, i.e. using mathematical relationships that are formal and deterministic. The 3 ways of representing entities (with language, locally with mathematics or globally with mathematics) and the 3 ways of expressing the relationships between entities (using hermeneutics, statistics or equations) can be combined in a cross-tabulation, and nearly all nine combinations can be described using examples. A typology of this nature may be useful in assessing which epistemological perspectives are currently dominant in a constantly evolving field such as psychiatry, and which other perspectives still need to be developed. It also contributes to undermining the overly simplistic and counterproductive beliefs that accompany the assumption of a Manichean “quantitative/qualitative” dichotomy. Systematic examination of this set of typologies could be useful in indicating new directions for future research beyond the quantitative/qualitative divide. 相似文献
974.
Michael Bourne Simon J. Bennett Spencer J. Hayes Nicholas J. Smeeton A. Mark Williams 《Attention, perception & psychophysics》2013,75(7):1559-1569
We identified the information used to anticipate throw direction in handball. In two experiments, we examined how anticipation performance is affected when the information from one of five body areas (right arm, shoulders, hips, trunk, or total throw side) was either neutralized or decoupled from the motion of other body segments. In the first experiment, performance was significantly reduced when information from the throwing arm was neutralized, irrespective of skill levels. Skilled participants were negatively affected when the shoulders, hips, and trunk were neutralized, whereas less-skilled participants showed trends toward improvement under identical conditions. In the second experiment, partially disrupting relative motion via decoupling was not enough to reduce the anticipation performance among skilled participants to chance levels, whereas less-skilled participants lost their ability to anticipate in three conditions. Our findings suggest that skilled and less-skilled participants employ different information extraction strategies, yet information from the throwing arm is critical to anticipation for both groups. The two experiments suggest that relative motion mediated by both the absolute displacement trajectories of individual marker locations and their relative timings are important in informing anticipation, irrespective of skill level. 相似文献
975.
H F?rstl 《Brain and language》1991,40(1):145-150
John Abercrombie (1780-1844) was considered the most eminent Scottish physician of his time. In his Pathological and Practical Researches on the Diseases of the Brain and Spinal Cord (1836, Edinburgh: John Carfrae and Son, 3rd ed.) he described the cases of 140 patients with cerebral disorders, 48 of whom suffered from language disturbances. Despite the overwhelming clinical and neuropathological evidence of a close association between language disorder and right-sided hemiparesis or diseases of the left hemisphere, and in spite of his great interest in language disorders, he made no attempt to localize the aphasic syndrome to a specific brain area. 相似文献
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979.
Of the offensive yet non-pathological personalities in the literature, three are especially prominent: Machiavellianism, subclinical narcissism, and subclinical psychopathy. We evaluated the recent contention that, in normal samples, this ‘Dark Triad’ of constructs are one and the same. In a sample of 245 students, we measured the three constructs with standard measures and examined a variety of laboratory and self-report correlates. The measures were moderately inter-correlated, but certainly were not equivalent. Their only common Big Five correlate was disagreeableness. Subclinical psychopaths were distinguished by low neuroticism; Machiavellians, and psychopaths were low in conscientiousness; narcissism showed small positive associations with cognitive ability. Narcissists and, to a lesser extent, psychopaths exhibited self-enhancement on two objectively scored indexes. We conclude that the Dark Triad of personalities, as currently measured, are overlapping but distinct constructs. 相似文献
980.
Sara‐Jayne Williams Daniel B. Wright Norman H. Freeman 《Applied cognitive psychology》2002,16(6):651-664
Children are generally more susceptible than adults to suggestive interview techniques. Children's memories of an event can be altered and added to by presenting post‐event information (PEI). What is not known is whether embedding silence about a particular scene within the PEI makes that scene less likely to be reported. Children aged 5–6 years made cakes with an agent ‘Mrs Flour’. The following day they received PEI in which a target scene from the original event was omitted, resulting in children reporting the target scene significantly less often than did controls (control= 57% and omit= 23% correct responses). There was direct evidence from the children's language that the omission led to a detriment in memory for the original scene itself. Allowing children to draw during the interview did not reduce the effect. Implications are discussed in terms of child victims and witnesses particularly regarding child sexual abuse. Copyright © 2002 John Wiley & Sons, Ltd. 相似文献