Looking for Trouble: Preventive Genomic Sequencing in the General Population and the Role of Patient Choice

Advances in genomics have led to calls for developing population-based preventive genomic sequencing (PGS) programs with the goal of identifying genetic health risks in adults without known risk factors. One critical issue for minimizing the harms and maximizing the benefits of PGS is determining the kind and degree of control individuals should have over the generation, use, and handling of their genomic information. In this article we examine whether PGS programs should offer individuals the opportunity to selectively opt out of the sequencing or analysis of specific genomic conditions (the menu approach) or whether PGS should be implemented using an all-or-nothing panel approach. We conclude that any responsible scale-up of PGS will require a menu approach that may seem impractical to some, but that draws its justification from a rich mix of normative, legal, and practical considerations.     

不同博弈情境下社会排斥对社会决策的影响作用

本研究借助经典的最后通牒博弈范式(UG)和独裁者博弈范式(DG),将回应者/接受者作为研究对象,考察了不同公平条件、平等条件下社会排斥对社会决策的影响作用。实验结果发现:(1)在面对高不公平性的分配方案时,被排斥组比被接纳组更倾向于拒绝接受该分配方案;(2)被排斥组对高不公平性分配方案的满意度要显著低于被接纳组;(3)被排斥组在不平等的博弈(DG)条件下对分配方案的满意度显著低于平等博弈(UG)条件下对分配方案的满意度。本研究结果说明,社会排斥情境下的被试对公平与平等因素更加敏感:在高不公平条件下,被排斥的个体表现出更少的合作互惠行为,甚至不惜放弃自身经济利益,也要惩罚博弈对方的不公平行为;此外,在不平等的博弈条件下,被排斥的个体产生了更多的消极情绪体验。本文的研究结果提高了社会决策研究的生态效度和传统决策模型的预测效度,有利于更加完整透彻地了解社会决策的影响因素。     

主动性人格、自我监控与大学毕业生职业决策自我效能感的关系

为探讨主动性人格、自我监控与大学毕业生职业决策自我效能感的关系,采用主动性人格量表、职业决策自我效能感量表和自我监控量表对339名大学毕业生进行了测查。结果表明:大学毕业生在自我监控上的得分与主动性人格得分呈显著正相关;主动性人格与自我监控与职业决策自我效能感部分及五个维度均显著正相关;主动性人格和自我监控能显著预测职业决策自我效能感,其中主动性人格能够单独预测职业决策自我效能感的34%变异,自我监控对职业决策自我效能感及其4个分量表有显著预测作用,能解释2%左右的增益方差。     

Military Ethical Decision Making: The Effects of Option Choice and Perspective Taking on Moral Decision-Making Processes and Intentions

We investigated the ethical decision-making processes and intentions of 151 military personnel responding to 1 of 2 ethical scenarios drawn from the deployment experiences of military commanders. For each scenario, option choice and perspective affected decision-making processes. Differences were also found between the 2 scenarios. Results add to the emerging literature concerning operational ethical conflicts and highlight the complexity and challenge that often accompanies operational ethics.     

If You Are Going to Pay Within the Next 24 Hours,Press 1: Automatic Planning Prompt Reduces Credit Card Delinquency

People often form intentions but fail to follow through on them. Mounting evidence suggests that such intention‐action gaps can be narrowed with prompts to make concrete plans about when, where, and how to act to achieve the intention. In this paper, we pushed the notion of plan‐concreteness to test the efficacy of a prompt under a minimalist automated calling setting, where respondents were only prompted to indicate a narrower duration within which they intent to act. In a field experiment, this planning prompt significantly helped people to pay their past dues and get out of debt delinquency. These results suggest that minimalist automatic planning prompts are a scalable, cost‐effective intervention.     

The Influence of Physical Elevation in Buildings on Risk Preferences: Evidence from a Pilot and Four Field Studies

Little empirical research has been reported on the role of spatial positioning inside buildings on consumer behavior. Based on embodied cognition literature, we propose that elevation from street level influences risk preferences. In a pilot study and four field studies involving financial decisions with both hypothetical and real payoffs, we find evidence that high physical elevation increases risk‐seeking tendencies. Furthermore, we demonstrate that elevation leads to riskier behavior by increasing sensitivity to power. Finally, we establish a boundary condition for the impact of elevation on risk preferences by demonstrating that the effect attenuates when accessibility of physical elevation is low. These findings show that a subtle environmental parameter—physical elevation from street level—can influence human psychological states and consequently affect decisions.     

The Harm Principle Cannot Replace the Best Interest Standard: Problems With Using the Harm Principle for Medical Decision Making for Children

For many years the prevailing paradigm for medical decision making for children has been the best interest standard. Recently, some authors have proposed that Mill’s “harm principle” should be used to mediate or to replace the best interest standard. This article critically examines the harm principle movement and identifies serious defects within the project of using Mill’s harm principle for medical decision making for children. While the harm principle proponents successfully highlight some difficulties in present-day use of the best interest standard, the use of the harm principle suffers substantial normative and conceptual problems. A medical decision-making framework for children is suggested, grounded in the four principles. It draws on the best interest standard, incorporates concepts of harm, and provides two questions that can act as guide and limit in medical decision making for children.     

When Parents Refuse: Resolving Entrenched Disagreements Between Parents and Clinicians in Situations of Uncertainty and Complexity

When shared decision making breaks down and parents and medical providers have developed entrenched and conflicting views, ethical frameworks are needed to find a way forward. This article reviews the evolution of thought about the best interest standard and then discusses the advantages of the harm principle (HP) and the zone of parental discretion (ZPD). Applying these frameworks to parental refusals in situations of complexity and uncertainty presents challenges that necessitate concrete substeps to analyze the big picture and identify key questions. I outline and defend a new decision-making tool that includes three parts: identifying the nature of the disagreement, checklists for key elements of the HP and ZPD, and a “think list” of specific questions designed to enhance use of the HP and ZPD in clinical decision making. These tools together will assist those embroiled in complex disagreements to disentangle the issues to find a path to resolution.