From Therapy and Enhancement to Assistive Technologies: An Attempt to Clarify the Role of the Sports Physician

Sports physicians are continuously confronted with new biotechnological innovations. This applies not only to doping in sports, but to all kinds of so-called enhancement methods. One fundamental problem regarding the sports physician's self-image consists in a blurred distinction between therapeutic treatment and non-therapeutic performance enhancement. After a brief inventory of the sports physician's work environment I reject as insufficient the attempts to resolve the conflict of the sports physician by making it a classificatory problem. Followed by a critical assessment of some ideas from the US President's Council on Bioethics, the formulation of ethical codes and attempts regarding a moral topography, it is argued that the sports physician's conflict cannot be resolved by the distinction between therapy and enhancement. Instead, we also have to consider the possibility that the therapy-based paradigm of medicine cannot do justice to the challenges of the continuously increasing technical manipulability of the human body and even our cognitive functions as well. At the same time we should not adhere to transhumanist ideas, because non-therapeutic interventions require clear criteria. Based on assistive technologies an alternative framework can be sketched that allows for the integration of therapeutic and non-therapeutic purposes. After a thorough definition of standards and criteria, the role of the sports physician might be defined as that of an assistant for enhancement. Yet the process of defining such an alternative framework is a societal and political task that cannot be accomplished by the sports physicians themselves. Until these questions are answered sports physicians continue to find themselves in a structural dilemma that they partially can come to terms with through personal integrity.     

THE LIMITS TO PARTICIPATION IN DIS‐EQUILIBRIUM ECOLOGY: Maori involvement in habitat restoration within Te Urewera National Park

In this paper, we explore conceptualizations of ‘ordinary’ citizens common in public engagement forums on emerging technologies and assumptions from deliberative theory that ordinary people are more likely to be appropriately ‘changed’ through deliberative processes facilitated by experts. Looking at a large US public forum event [the National Citizens Technology Forum (NCTF)], we asked: What were the goals for this exercise and how did they shape conceptualizations of ordinariness and representativeness? Whose goals and conceptualizations were they? Were the engaged citizens ordinary and representative—and were they changed by the exercise? Our exploration revealed that exercise organizers conceived of ordinary citizens as people lacking science and technology backgrounds, without advocacy or business connections to the technologies at hand, and demographically reflecting the US population. Exercise materials also implied that ideal ordinary participants would lack strong opinions and emotions about these technologies. Actual NCTF participants, however, tended to be more educated, have higher incomes, and to be more liberal than the US public, and participants from all backgrounds had a range of relevant knowledge, experiences and opinions about science and technology. They were changed by the exercise in complex and conflicting ways—based as much on their own knowledge and reflections on relational dynamics as on exercise processes, interactions with experts, and information provided in the exercise. We argue that inadequately explored ideas about ordinary citizens are highly problematic. Further, invisible assumptions about what is ‘normal’ among experts and status quo institutions serve to reify the lay–expert divide that engagement exercises are intended to counteract.     

Category-specific enhancement of retrieval due to field perspective

Two memory perspectives have been distinguished: A field perspective where events are re-experienced in the first person, and an observer perspective where events are witnessed in the third person. Two experiments examined the influence of memory perspective on objective memory performance. In both experiments participants were presented with a series of verbal passages, each of which contained several different categories of information. For four of these categories (pertaining to affective reactions, physical sensations, psychological states, and associated ideas), recall was significantly higher when a field perspective was adopted than when an observer perspective was adopted, but for the five other categories (pertaining to physical actions, personal appearance, fine details, spatial relations, and peripheral details) there was no significant effect of perspective upon recall. The study is examined in the context of mental models and imagined episodic events.     

Inconsistent handedness and saccade execution benefit face memory without affecting interhemispheric interaction

Individuals who consistently use their dominant hand for most tasks exhibit poorer memory than individuals whose handedness is relatively inconsistent, but consistent-handers’ memory can be enhanced by making repetitive saccadic eye movements before attempting retrieval. One account of these effects is that inconsistent handedness and saccade execution are associated with increased interhemispheric interaction, which putatively facilitates retrieval. We tested this account by having participants classify faces as famous or novel. Faces were presented in the left and right visual fields simultaneously (bilaterally) or in one field only (unilaterally). As in prior studies, famous faces were classified more quickly and more accurately given bilateral presentation, but novel faces were not. These bilateral gain effects indicate that interhemispheric interaction specifically facilitates famous-face recognition, and therefore larger gains may reflect greater interhemispheric interaction. However, neither inconsistent handedness nor saccade execution increased the size of bilateral gain. Inconsistent handedness and saccade execution (the latter for consistent-handers only) did increase face-classification accuracy, but the increases were not specific to famous-face recognition, and, in fact, were somewhat stronger for novel-face identification. These results extend the beneficial mnemonic effects of inconsistent handedness and saccade execution to faces, but indicate that these benefits are not caused by increased interhemispheric interaction.     

Is saccade-induced retrieval enhancement a potential means of improving eyewitness evidence?

Saccade-induced retrieval enhancement (SIRE) is the effect whereby making bilateral saccades enhances the subsequent retrieval of memories. Two experiments explored SIRE's potential to improve eyewitness evidence. Participants viewed slideshows depicting crimes, and received contradictory and additive misinformation about event details either once (Experiment 1) or three times (Experiment 2). Participants then performed saccades or a fixation control task before being tested on their memory for the slideshows and making confidence judgements. Saccades increased discrimination between seen and unseen event details regardless of whether or what type of misinformation was presented. Because prior studies indicated that SIRE might be more robust for individuals who are strongly right-handed versus not, we examined SIRE as a function of handedness and found that saccades improved memory for event details regardless of participants' handedness. However, participants who were not strongly right-handed had fewer false memories than participants who were strongly right-handed, extending previous findings of superior memory among individuals who are not strongly right-handed. Saccades also increased confidence in true memories (Experiment 1) and decreased confidence in false memories (Experiment 2). The results support SIRE's potential to improve eyewitness evidence.     

The Constituent Structure of Subjective Memory Questionnaires: Evidence from Multiple Sclerosis

Making repetitive saccadic eye movements has been found to increase subsequent episodic memory retrieval and also to increase subsequent top-down attentional control. We theorise that these effects are related such that saccade-induced changes in attentional processing facilitate memory retrieval. We tested this idea by examining the effect of saccade execution on retrieval conditions that differed in relative ease of consciously accessing episodic memories. Based on recent theories of episodic retrieval, we reasoned that there is a larger role for top-down attention when memories are more difficult to access. Consequently, we expected saccade execution to have a greater facilitative effect on retrieval when memories were more difficult to access. We obtained the expected result in a recall procedure in Experiment 1 and in a recognition procedure in Experiment 2. We also examined an individual difference factor—consistency of handedness—as a possible moderator of saccade execution effects on retrieval. We discuss how our top-down attentional control hypothesis can be extended to explain beneficial effects of saccade execution on other types of cognition, as well as negative effects on retrieval in some cases.     

Conditioned Reflex and Perception: The Concept of Syncretism

Delay discounting occurs when the subjective value of an outcome decreases because its delivery is delayed. Past research has shown that how steeply participants discount an outcome varies inversely with the value of previously discounted outcomes. In the present study, participants discounted the same hypothetical monetary outcome ($1,000) after their hypothetical annual income was halved (Experiment 1) or doubled (Experiment 2). Rates of discounting decreased and increased, respectively, after these manipulations (although a similar change in discounting was observed for the control and treatment groups in Experiment 2). These results suggest that altering the context in which the discounting task is framed alters the subjective value of the outcome itself, in this case money. This result has implications for understanding contrast effects that are observed in rates of discounting, as well as for researchers and practitioners who are interested in determining methods for altering how individuals discount delayed outcomes.     

Visual enhancement of touch and the bodily self

We experience our own body through both touch and vision. We further see that others’ bodies are similar to our own body, but we have no direct experience of touch on others’ bodies. Therefore, relations between vision and touch are important for the sense of self and for mental representation of one’s own body. For example, seeing the hand improves tactile acuity on the hand, compared to seeing a non-hand object. While several studies have demonstrated this visual enhancement of touch (VET) effect, its relation to the ‘bodily self’, or mental representation of one’s own body remains unclear. We examined whether VET is an effect of seeing a hand, or of seeing my hand, using the rubber hand illusion. In this illusion, a prosthetic hand which is brushed synchronously—but not asynchronously—with one’s own hand is felt to actually be one’s hand. Thus, we manipulated whether or not participants felt like they were looking directly at their hand, while holding the actual stimulus they viewed constant. Tactile acuity was measured by having participants judge the orientation of square-wave gratings. Two characteristic effects of VET were observed: (1) cross-modal enhancement from seeing the hand was inversely related to overall tactile acuity, and (2) participants near sensory threshold showed significant improvement following synchronous stroking, compared to asynchronous stroking or no stroking at all. These results demonstrate a clear functional relation between the bodily self and basic tactile perception.