Researching stigma as an outsider: considerations for qualitative outsider research

In this article, we discuss a number of important considerations that we have encountered in the process of researching health stigma topics as “outsiders”: researchers (personally) unfamiliar with the experience or topic under study. In particular, we discuss the importance of the following: a reflective stance, challenging negative representations, flexible and sensitive recruitment strategies, validating experiences of stigma, and participant control and power. We see these points as particularly important in the context of researching stigma as outsiders, where our privilege may contribute to unhelpful, narrow, de-politicized or overly simplistic representations of particular “groups” or experiences. We share these considerations in hope of assisting other researchers to reflect on, and articulate, how they negotiate their positionings within their research and the ways in which they shape and construct the research agenda and, by implication, the people or topics under examination.     

A Pilot Evaluation of Portfolios for Quality Attestation of Clinical Ethics Consultants

Although clinical ethics consultation is a high-stakes endeavor with an increasing prominence in health care systems, progress in developing standards for quality is challenging. In this article, we describe the results of a pilot project utilizing portfolios as an evaluation tool. We found that this approach is feasible and resulted in a reasonably wide distribution of scores among the 23 submitted portfolios that we evaluated. We discuss limitations and implications of these results, and suggest that this is a significant step on the pathway to an eventual certification process for clinical ethics consultants.     

An Ethical Exploration of Barriers to Research on Controlled Drugs

We examine the ethical, social, and regulatory barriers that may hinder research on therapeutic potential of certain controversial controlled substances like marijuana, heroin, or ketamine. Hazards for individuals and society and potential adverse effects on communities may be good reasons for limiting access and justify careful monitoring of these substances. Overly strict regulations, fear of legal consequences, stigma associated with abuse and populations using illicit drugs, and lack of funding may, however, limit research on their considerable therapeutic potential. We review the surprisingly sparse literature and address the particular ethical concerns pertinent to research with illicit and addictive substances, such as undue inducement, informed consent, therapeutic misconception, and risk to participants, researchers, and institutions. We consider the perspectives of key research stakeholders and explore whether they may be infected with bias. We conclude by proposing an empirical research agenda to provide an evidentiary basis for ethical reasoning.     

Ethics Consultation Quality Assessment Tool: A Novel Method for Assessing the Quality of Ethics Case Consultations Based on Written Records

Although ethics consultation is offered as a clinical service in most hospitals in the United States, few valid and practical tools are available to evaluate, ensure, and improve ethics consultation quality. The quality of ethics consultation is important because poor quality ethics consultation can result in ethically inappropriate outcomes for patients, other stakeholders, or the health care system. To promote accountability for the quality of ethics consultation, we developed the Ethics Consultation Quality Assessment Tool (ECQAT). ECQAT enables raters to assess the quality of ethics consultations based on the written record. Through rigorous development and preliminary testing, we identified key elements of a quality ethics consultation (ethics question, consultation-specific information, ethical analysis, and conclusions and/or recommendations), established scoring criteria, developed training guidelines, and designed a holistic assessment process. This article describes the development of the ECQAT, the resulting product, and recommended future testing and potential uses for the tool.     

Divergent thinking in the grasslands: thinking about object function in the context of a grassland survival scenario elicits more alternate uses than control scenarios

The survival processing effect is a recall advantage for information processed in the context of a grassland survival scenario. The current studies build upon previous research suggesting the effect is due to elaborative encoding and functional thinking. In two experiments, participants completed the “alternate uses test” under five conditions: baseline, grassland survival, Ebola survival, moving to a new home and planning a bank heist. Experiment 1 stimuli were everyday objects. Experiment 2 stimuli were functionally ambiguous “mystery” objects. Number of generated uses was highest in the baseline, but the grassland scenario was consistently highest of the schematic conditions. Recall data lend support to the mnemonic superiority of the grassland condition. Results suggest that grassland scenarios place fewer attenuating constraints on divergent thinking. It is suggested that the survival processing effect might be usefully conceptualised as an effect of creatively thinking about object function in response to broadly defined problems.     

A Postcolonial Framework for Justification and Eco‐Justice

This work proposes a relationship between eco‐justice and justification by grace rooted in a phenomenological approach. The reality of structural sin experienced by persons living in economic poverty on the African continent is interpreted through the lens of Lutheran catechetical ethics. Lives of repentance will lead to incarnational interventions striving for concrete social transformation.     

The refugee’s flight: homelessness,hospitality, and care of the self

This paper argues that the contemporary international refugee regime is grounded in a paradigm of ‘homesickness’, which puts the refugee in an inferior position of the supplicant, whose subjectivity is framed by the regime of fixed belonging. In order to address this situation, we need to challenge the ontological primacy of homesickness and embrace ‘homelessness’, which offers the possibility of rethinking the positions of both refugees and non-refugees in ethical terms. While the responsibility of the non-refugees lies in cultivating an ethos of hospitality, the refugee can take hold of her subjectivity through the practice of care of the self. This paper first examines Nietzsche’s thought on homelessness and compares it with Foucault’s reading of the role of anakhōrēsis in the Hellenistic practice of care of the self. It then suggests how, by building on the project of universal hospitality, we can interpret the figure of the refugee through the prism of an ethic of freedom, anchored in a positive break with the city. From this perspective, the refugee regains her ethico-political agency by cultivating the relationship with her own living self, which offers new avenues for resistance against the dominant paradigm of ‘homesickness’ that governs her subjectivity today.     

The Aha! moment: Is insight a different form of problem solving?

In everyday life, we mainly solve problems with a conscious solution search (non-insight). However, sometimes a perplexing problem is resolved by a quantum leap in understanding. This phenomenon is known as the Aha! experience (insight). Although insight has a distinct phenomenological and behavioral signature, its driving mechanism remains debated. Weisberg (2015) proposed an integrated theory of insight arguing that insight, like non-insight, mainly depends on conscious, cognitive operations with restructuring as a distinguishing feature of insight. However, only if those operations lead to an impasse, insight is achieved through unconscious processes. We assessed some of the premises of this theory by asking participants (N = 42) to solve 70 word puzzles (CRAT) that can either be solved with insight or non-insight. For each puzzle, participants indicated word puzzle difficulty, solution confidence, solution suddenness, and the experiences of impasse and restructuring. As expected, participants reported higher suddenness of and confidence in insight solutions than non-insightful ones. Surprisingly, we could not corroborate the otherwise consistently reported higher solution accuracy and faster solution speed for insight. Crucially, as suggested by the integrated theory of insight, impasse was not a prerequisite for insight to occur. Although restructuring, indeed, preceded insight solutions more often, it seemed a more general problem-solving skill also applied for non-insight solutions. Moreover, early on, participants reported an increased experience of problem difficulty for puzzles later solved with insight. This ability to report on the solution search of insight demonstrates that, as proposed by the theory, insight involves conscious, cognitive operations.     

Accidentally True Beliefs and the Williamsonian Mental State of Knowing

In this paper, I will explore some philosophical implications of Williamson’s thesis that knowing is a state of mind (KSM). Using the fake barn case, I will introduce a way to evaluate Williamson’s KSM thesis and determine whether the Williamsonian mental state of knowing can be plausibly distinguished from certain other similar but epistemologically distinctive states of mind (i.e., accidentally true beliefs). Then, some tentative externalist accounts of the supposed differences between the Williamsonian mental state of knowing and accidentally true beliefs will be critically assessed, implying that the evaluated traditional versions of externalism in semantics and epistemology do not fit well with Williamson’s KSM thesis. Ultimately, I suggest that the extended-mind or extended-knower approach may be more promising, which indicates that active externalism would be called for by Williamson’s KSM thesis.     

The ethical dimension of analytical psychology

The centrality of the ethical dimension in Carl Gustav Jung's analytical psychology is demonstrated through careful reference to fundamental moments in the Jungian text. Tracking Jung's statements about the primacy of the ‘moral function’ (or ‘moral factor’) in the cure of neurosis as well as in the process of individuation, the ethical nature of the psychotherapeutic praxis proposed by Jung is highlighted. This allows us to see the ethical aspect of psychological conflicts, and thus to understand better why individuation can be seen as a ‘moral achievement’. Finally, the intelligible ethical structure of Jungian psychotherapeutic praxis is exposed.