Shaping Medical Students' Attitudes Toward Ethically Important Aspects of Clinical Research: Results of a Randomized,Controlled Educational Intervention

The effects of research ethics training on medical students' attitudes about clinical research are examined. A preliminary randomized controlled trial evaluated 2 didactic approaches to ethics training compared to a no-intervention control. The participant-oriented intervention emphasized subjective experiences of research participants (empathy focused). The criteria-oriented intervention emphasized specific ethical criteria for analyzing protocols (analytic focused). Compared to controls, those in the participant-oriented intervention group exhibited greater attunement to research participants' attitudes related to altruism, trust, quality of relationships with researchers, desire for information, hopes about participation and possible therapeutic misconception, importance of consent forms, and deciding quickly about participation. The participant-oriented group also agreed more strongly that seriously ill people are capable of making their own research participation decisions. The criteria-oriented intervention did not affect learners' attitudes about clinical research, ethical duties of investigators, or research participants' decision making. An empathy-focused approach affected medical students' attunement to research volunteer perspectives, preferences, and attributes, but an analytically oriented approach had no influence. These findings underscore the need to further examine the differential effects of empathy-versus analytic-focused approaches to the teaching of ethics.     

Action Perception and Outcome Valence: Effects on Children's Inferences of Intentionality and Moral and Liking Judgments

The influences of different action-outcome scenarios on children's evaluative judgments and inferences of outcome intentionality were assessed. One hundred forty-five kindergartners, 2nd graders, and 4th graders heard 4 stories about child actors who engaged in 1 action or 3 equifinal actions and caused a positive or negative outcome. The stories made no mention of the actors' anticipated outcome so that we could assess the children's inferences of whether the actors wanted and had tried to cause the outcome. Children also rated their liking for the actors and the actors' morality. Children's moral and liking judgments were not significantly differentiated by action condition. However, actors who caused positive outcomes received favorable liking and moral judgments, and actors who caused negative outcomes received neutral liking and moral judgments. Children's intentionality inferences varied by the actors' actions and were moderated by outcome valence. The authors discuss children's apparent use of the valence rule when inferring intentionality and their reluctance to judge harshly actors who cause negative outcomes when not privy to the actors' intentions.     

Error Theory and the Concept of Morality

Error theories about morality often take as their starting point the supposed queerness of morality, and those resisting these arguments often try to argue by analogy that morality is no more queer than other unproblematic subject matters. Here, error theory (as exemplified primarily by the work of Richard Joyce) is resisted first by arguing that it assumes a common, modern, and peculiarly social conception of morality. Then error theorists point out that the social nature of morality requires one to act against one's self‐interest while insisting on the categorical, inescapable, or overriding status of moral considerations: they argue that morality requires magic, then (rightly) claim that there is no such thing as magic. An alternate eudaimonist conception of morality is introduced which itself has an older provenance than the social point of view, dating to the ancient Greeks. Eudaimonism answers to the normative requirements of morality, yet does not require magic. Thus, the initial motivation for error theory is removed.     

Review of "The Cultural Context of Sexual Pleasure and Problems: Psychotherapy With Diverse Clients," edited by Kathryn S. K. Hall and Cynthia A. Graham

A content and thematic analysis was conducted using forum messages from websites developed for wives of online gamers who play World of Warcraft. Blog posts from 50 women describing conflict in their marital relationship involving their husband's online game play were analyzed. Four overarching themes were identified and discussed in terms of the impact of online gaming on family functioning and relationships, emotional outcomes, and coping mechanisms. Results of ensuing issues arising from excessive gaming as perceived by the non-gaming spouse and ways in which they cope with these issues are shared.     

APP conference summary

This is an account of the extended assessment of a 22-year-old man who was initially sent for a court report, having been accused of setting fires. He had a history both of delinquency and, importantly, of childhood asthma. Although he proved unable to engage in psychotherapy, some management was provided, such as Winnicott advocates in cases of delinquency. This paper explores the symbolic meanings and functions of the patient's delinquent acts, drawing upon theoretical concepts from Freud, Aichhorn, and Deutsch. Of particular importance is the link between this patient's delinquency, his asthma, and the unresolved mourning for his dead mother which he carried not simply for himself but for his whole family.     

A Behavioral Analysis of Morality and Value

Morality has long been conceived as divinely instituted, so otherworldly, rules meant not to describe or explain behavior but to guide it towards an absolute good. The philosophical formulation of this theory by Plato was later grafted onto Christian thought by Augustine and Aquinas. The equally ancient theory of the Greek sophist Protagoras (that the good is relative to personal preferences and morality to man-made social customs) was forgotten until revived in the 18th and 19th centuries by such empiricists as David Hume and J. S. Mill. Then it was dismissed again in the 20th century by G. E. Moore and W. D. Ross as naturalistic fallacy, that is, conflation of what is with what ought to be. However, those who took this dismissive attitude themselves made the reverse mistake of conflating what ideally ought to be with what actually is. In other words, they mistook ideals for actualities. As B. F. Skinner (1971) said in Beyond Freedom and Dignity, sorting things out requires behaviorist parsing of the good (the personally reinforcing) and duty (the socially reinforced).     

Compassion and purity: the ethics and boundary-making of Christian evangelicals

The paper explores the ethical attitude of Christian evangelicals in a church in Britain and how it affects boundary-making of their community. Evangelicals in the case study seek to be accepting of the person and to refrain from being judgemental. The paper distinguishes between the person-centred ‘ethic of compassion’ and the norm-centred ‘ethic of purity’. The ethic of compassion consists in accepting another and recognising the dignity of another based on shared humanity. It is a frame of mind that combines moral intention with the emotions of empathy and sympathy. In contrast, the ethic of purity privileges adherence to the moral order of the group over considerations for the person. The ‘compassionate’ frame of mind weakens boundaries, while the ‘pure’ frame of mind reinforces them. The boundaries of a community result from the interplay of the two ethics.     

道德概念的垂直空间隐喻及其对认知的影响

采用不同的研究方法考察道德概念的垂直空间隐喻表征, 及其对于人的认知的影响。实验1采用迫选法, 在明确要求被试把道德词放在垂直空间位置的上方或下方时, 发现在意识层面, 被试倾向于把道德词放在垂直空间的上部, 把不道德词放在垂直空间的下部。实验2采用无关任务法, 对实验词语作褒贬义判断, 实验结果发现, 道德词出现在空间的上方(相对于下方)时, 被试对道德词作褒贬义判断的时间短; 不道德词出现在空间的下方(相对于上方)时, 被试作褒贬义判断的时间则短。实验3通过记忆任务发现, 道德概念的启动使得个体高估了相继出现的客体的高度和长度, 不道德概念的启动使得个体低估了其高度和长度。三个实验的结果表明, 汉语道德概念的垂直空间隐喻具有心理现实性; 汉语道德概念的垂直空间隐喻既存在于无意识层面又可以在意识的层面显现; 汉语道德概念的垂直空间隐喻表征会影响对物体的高度和长度的估计, 表现为汉语道德概念隐喻表征的“认知偏移效应”。     

THE INTERPLAY BETWEEN RELIGIOUS LEADERS AND ORGAN DONATION AMONG MUSLIMS

Bioethics and health researchers often turn to Islamic jurisconsults (fuqahā’) and their verdicts (fatāwā) to understand how Islam and health intersect. Yet when using fatwā to promote health behavior change, researchers have often found less than ideal results. In this article we examine several health behavior change interventions that partnered with Muslim religious leaders aiming at promoting organ donation. As these efforts have generally met with limited success, we reanalyze these efforts through the lens of the theory of planned behavior, and in light of two distinct scholarly imperatives of Muslim religious leaders, the ?ilmī and the islāhī. We argue for a new approach to health behavior change interventions within the Muslim community that are grounded in theoretical frameworks from the science of behavior change, as well the religious leadership paradigms innate to the Islamic tradition. We conclude by exploring the implications of our proposed model for applied Islamic bioethics and health research.