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Background: The banking of biological samples raises a number of ethical issues in relation to the storage,export and re-use of samples. Whilst there is a growing body of literature exploringparticipant perspectives in North America and Europe, hardly any studies have been reportedin Africa. This is problematic in particular in light of the growing amount of research takingplace in Africa, and with the rise of biobanking practices also on the African continent. Inorder to investigate the perspectives of African research participants, we (...) conducted a studywith research participants in a TB study in the Western Cape, South Africa. Methods: Semi-structured interviews were conducted using an interview guide which drew on the mostprominent themes expressed in current literature on sample storage, re-use and exportation.Interviews were conducted in Afrikaans and subsequently translated into English by the sameinterviewer. Interviews were transcribed verbatim and analysed qualitatively. Results: The results of our study indicate that the majority of participants were supportive of givingone-time consent to the storage and re-use of their samples. The concept of research being fora "good cause" was a central prerequisite. Additionally, a significant minority requested thatthey be re-contacted if a future use was not stipulated on the original consent. There was alsoconsiderable variation in how participants understood the concept of a 'good cause', withparticipants describing three distinct categories of research, of which two were generallythought to constitute 'good cause' research. Research that was for-profit was considered tofall outside the spectrum of 'good cause' research. Participants displayed confidence in theabilities of the researchers to make future decisions regarding sample use, but seemedunaware of the role of ethics committees in either this process or more generally. Conclusions: Participants expressed a wide and complex range of views about issues of sample storage andre-use, and they showed a great deal of trust in researchers. Participants' willingness to havetheir samples stored and re-used is consistent with findings from existing studies. However,in contrast to existing literature, participants were generally not in favour of for-profitresearch. Further research needs to be done to explore these ideas in other communities, bothin South Africa and other countries. (shrink)

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This study investigates whether the conscious awareness of action is based on predictive motor control processes, or on inferential “sense-making” process that occur after the action itself. We investigated whether the temporal binding between perceptual estimates of operant actions and their effects depends on the occurrence of the effect (inferential processes) or on the prediction that the effect will occur (predictive processes). By varying the probability with which a simple manual action produced an auditory effect, we showed that both the (...) actual and the predicted occurrence of the effect played a role. When predictability of the effect of action was low, temporal binding was found only on those trials where the auditory effect occurred. In contrast, when predictability of the effect of action was high, temporal binding occurred even on trials where the action produced no effect. Further analysis showed that the predictive process is modulated by recent experience of the action-effect relation. We conclude that the experience of action depends on a dynamic combination of predictive and inferential processes. (shrink)

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Clinical ethicists tend to see themselves as moral experts to be called in when clinicians encounter a particularly difficult moral problem. Drawing on a naturalized moral epistemology, we argue that clinicians already have the moral knowledge they need—the norms and values that guide clinical practice are built right into the various health care professions. To reflect on their practice, clinicians need to (a) be aware of their own professional norms and values; (b) be able to express them to their colleagues, (...) their patients, and the patients' families; and (c) work together with these other actors to provide ethically responsible care. The ethicist's job is to use her own training in three kinds of philosophical reflection as the basis for teaching clinicians how to think about what they do. (shrink)

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The sense of agency is the experience of being the origin of a sensory consequence. This study investigates whether contextual beliefs modulate low-level sensorimotor processes which contribute to the emergence of the sense of agency. We looked at the influence of causal beliefs on ‘intentional binding’, a phenomenon which accompanies self-agency. Participants judged the onset-time of either an action or a sound which followed the action. They were induced to believe that the tone was either triggered by themselves or by (...) somebody else, although, in reality, the sound was always triggered by the participants. We found that intentional binding was stronger when participants believed that they triggered the tone, compared to when they believed that another person triggered the tone. These results suggest that high-level contextual information influences sensorimotor processes responsible for generating intentional binding. (shrink)

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The “default system” of the brain has been described as a set of regions which are ‘activated’ during rest and ‘deactivated’ during cognitively effortful tasks. To investigate the reliability of task-related deactivations, we performed a meta-analysis across 12 fMRI studies. Our results replicate previous findings by implicating medial frontal and parietal brain regions as part of the “default system”.However, the cognitive correlates of these deactivations remain unclear. In light of the importance of social cognitive abilities for human beings and their (...) propensity to engage in such activities, we relate our results to findings from neuroimaging studies of social cognition. This demonstrates a remarkable overlap between the brain regions typically involved in social cognitive processes and the “default system”.We, henceforth, suggest that the physiological ‘baseline’ of the brain is intimately linked to a psychological ‘baseline’: human beings have a predisposition for social cognition as the default mode of cognizing which is implemented in the robust pattern of intrinsic brain activity known as the “default system”. (shrink)

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In lieu of an abstract, here is a brief excerpt of the content:American Journal of Philology 123.1 (2002) 95-110 [Access article in PDF] Dead Parrots Society Jessica S. Dietrich Statius' Silvae 2.4 is ostensibly written as a consolation poem to the poet's friend and benefactor Atedius Melior on the death of his pet parrot. But Statius also uses the opportunity provided by the poem's subject matter to engage in a dialogue with his literary predecessors. I will argue here that Statius (...) both inserts himself into and distinguishes himself from the Latin literary tradition through the use of two catalogues of birds, the first at 2.4.16-23 and the second at 2.4.26-28. Statius plays these catalogues off several stories in Ovid's Metamorphoses that also feature birds in order to comment on his own work, to locate it within the Latin tradition (particularly the poetry of Ovid), and to comment on the changing role of the poet under the emperors.Statius uses the form of, or at least certain elements of, the consolatio or epicedion 1 for many of the Silvae (1.4, 2.1, 2.4, 2.5, 2.6, 2.7, 3.3, 5.1, 5.3, 5.5), but these poems are concentrated in the second book whose overarching theme is death. 2 Two of the poems in book 2 are explicitly marked by Statius as consolationes: Silvae 2.1 (on the death of Melior's slave boy Glaucias) and 2.6 (on the death of Ursus' slave boy Philetus) are strikingly similar in form and content. 3 Although Silvae 2.4 is not specifically called a consolatio or epicedion by Statius in the preface, many scholars classify it as a consolatio because of its similarity to 2.1 and 2.6. 4 The poem begins with the poet's address to the parrot and a [End Page 95] statement about its death (2.4.1-3). There is no account of the death, but there is a description of the bird as he was in life when at a dinner party, hopping around the table and picking at the food (2.4.4-7). Statius also comments on the parrot's ability to exchange words and greetings (2.4.7-8). There follows a second declaration of its death (2.4.8-10), and then Statius begins to praise the bird by commenting on its cage (2.4.11-15). This is followed by an exhortation to mourn (2.4.16-23) in which the speaker of the poem (Statius) calls on a catalogue of birds to perform the parrot's funeral and he teaches them his lament for the parrot. The lament (2.4.24-28) sung to the birds returns to the beginning of the poem and almost repeats the address to the parrot (psittacus [2.4.25]); this lament includes a second catalogue of birds (2.4.26-28) to whom the parrot is compared. At the end of the poem, in order to bring comfort to the living, the poet focuses again on how the bird was in life and on its ability to speak (2.4.29-32). The poem ends with a description of the funeral and the pyre and hope for the afterlife (2.4.32-37).The similarity in the forms of Silvae 2.1, 2.4, and 2.6 creates a problem for the interpretation of the poems. As noted earlier, Silvae 2.1 is addressed to Atedius Melior on the death of his slave boy Glaucias, while Silvae 2.6 mirrors the opening poem by addressing Ursus on the death of his slave boy Philetus. While Statius' relationship with the addressees of 2.1 and 2.6 may be different, the relationship between Melior and Ursus and their objects of lament is similar--both Glaucias and Philetus are slaves. 5 By placing the parrot poem between the poems on dead slave boys, Statius seems to be drawing an uncomfortable parallel between the pet parrot and the human slave children. Perhaps in antiquity the equation of pets and slaves would not have been so striking, 6 but modern... (shrink)

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The Therapeutic Misconception (TM) is a cognitive error with similarities to another cognitive error -- the Gambler's Fallacy (GF). This paper examines the similarities between TM and GF in an attempt to further illuminate the nature of TM, and to distinguish it from another cognitive error, Unrealistic Optimism (UO). Many cases of UO and mis-classified as TM.

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Payment for research participation has raised ethical concerns, especially with respect to its potential for coercion. We argue that characterising payment for research participation as coercive is misguided, because offers of benefit cannot constitute coercion. In this article we analyse the concept of coercion, refute mistaken conceptions of coercion and explain why the offer of payment for research participation is never coercive but in some cases may produce undue inducement.

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What makes individuals, groups, or even entire countries vulnerable? And why is vulnerability a concern in bioethics? A simple answer to both questions is that vulnerable individuals and groups are subject to exploitation, and exploitation is morally wrong. This analysis is limited to two areas. First is the context of multinational research, in which vulnerable people can be exploited even if they are not harmed, and harmed even if they are not exploited. Second is the situation of women, who are (...) made vulnerable in cultural settings or in entire countries in which they are oppressed and powerless. (edited). (shrink)

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In response to the article by Baum-Baicker and Sisti, I will consider the kind of wisdom involved in therapeutic listening; the role of life wisdom; and the challenge of imparting clinical wisdom to young health professionals’ education.

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Empathy is a lay term that is becoming increasingly viewed as a unitary function within the field of cognitive neuroscience. In this paper, a selective review of the empathy literature is provided. It is argued from this literature that empathy is not a unitary system but rather a loose collection of partially dissociable neurocognitive systems. In particular, three main divisions can be made: cognitive empathy , motor empathy, and emotional empathy. The two main psychiatric disorders associated with empathic dysfunction are (...) considered: autism and psychopathy. It is argued that individuals with autism show difficulties with cognitive and motor empathy but less clear difficulties with respect to emotional empathy. In contrast, individuals with psychopathy show clear difficulties with a specific form of emotional empathy but no indications of impairment with cognitive and motor empathy. (shrink)

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Thought-intrusions, automatic inferences, and other unintended thought are beginning to play an important role in the study of psychiatric disease as well as normal thought processes. We examine one method for study of task-unrelated imagery and thought . TUIT likelihood was shown to be reliably measured over a wide range of vigilance tasks, to have high short-term and long-term test-retest reliability, and to be sensitive to information processing demands. Likelihood of TUITs was shown to be different as a function of (...) aging, hyperactivity, time of day, and level of depression. Thus, we now can reliably measure the influence of endogenous and exogenous influences on TUITs. In addition, TUIT measurement was proposed as a minimally interfering and natural second task for determining resource utilization in a primary task. Finally, this method was offered as a reliable approach to quantification of such mental states as obsessions and drug craving and addiction. (shrink)

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In research involving pregnant women and fetuses, a number of questions arise concerning the balancing of risks and benefits. In research that holds out a prospect of direct benefit for the woman, how much risk to the fetus is permissible? How should the principle of minimizing risks be applied when there are two subjects—pregnant woman and fetus? Should risks for each of them be minimized? What if minimizing risks for one increases risks for the other? These and other questions are (...) not addressed in the current federal regulations for the protection of human subjects. This paper reviews the current regulations, attempts to identify issues that need to be addressed, considers alternative viewpoints concerning those issues, and argues for particular views. It concludes with a set of proposed guidelines for balancing risks and benefits in research involving pregnant women and fetuses. (shrink)

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Patients with delusions of control are abnormally aware of the sensory consequences of their actions and have difficulty with on-line corrections of movement. As a result they do not feel in control of their movements. At the same time they are strongly aware of the action being intentional. This leads them to believe that their actions are being controlled by an external agent. In contrast, the normal mark of the self in action is that we have very little experience of (...) it. Most of the time we are not aware of the sensory consequences of our actions or of the various subtle corrections that we make during the course of goal-directed actions. We know that we are agents and that we are successfully causing the world to change. But as actors we move through the world like shadows glimpsed only occasional from the corner of an eye. (shrink)

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Recent work has demonstrated that the sense of agency is not only determined by efference-copy-based internal predictions and internal comparator mechanisms, but by a large variety of different internal and external cues. The study by Moore and colleagues [Moore, J. W., Wegner, D. M., & Haggard, P. . Modulating the sense of agency with external cues. Conscious and Cognition] aimed to provide further evidence for this view by demonstrating that external agency cues might outweigh or even substitute efferent signals to (...) install a basic registration of self-agency. Although the study contains some critical points that, so we argue, are central to a proper interpretation of the data, it hints at a new perspective on agency: optimal cue integration seems to be the key to a robust sense of agency. We here argue that this framework could allow integrating the findings of Moore and colleagues and other recent agency studies into a comprehensive picture of the sense of agency and its pathological disruptions. (shrink)

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Eugenics can be defined as the use of science applied to the qualitative and quantitative improvement of the human genome. The subject was initiated by Francis Galton with considerable support from Charles Darwin in the latter half of the 19th century. Its scope has increased enormously since the recent revolution in molecular genetics. Genetic files can be easily obtained for individuals either antenatally or at birth; somatic gene therapy has been introduced for some rare inborn errors of metabolism; and gene (...) manipulation of human germ-line cells will no doubt occur in the near future to generate organs for transplantation. The past history of eugenics has been appalling, with gross abuses in the USA between 1931 and 1945 when compulsory sterilization was practised; and in Germany between 1933 and 1945 when mass extermination and compulsory sterilization were performed. To prevent such abuses in the future statutory bodies, such as a genetics commission, should be established to provide guidance and rules of conduct for use of the new information and technologies as applied to the human genome. (shrink)

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The efforts of some institutional review boards (IRBs) to exercise what is viewed as appropriate oversight may contribute to deceit on the part of investigators who feel unjustly treated. An organizational justice paradigm provides a useful context for exploring why certain IRB behaviors may lead investigators to believe that they have not received fair treatment. These feelings may, in turn, lead to intentional deception by investigators that IRBs will rarely detect. Paradoxically, excessive protective zeal by IRBs may actually encourage misconduct (...) by some investigators. The authors contend that, by fostering a climate in which investigators perceive that they receive fair and unbiased treatment, IRBs optimize the likelihood of collegial compliance with appropriate participant protections. (shrink)

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In this paper we consider two major issues: conceptual–experimental approaches to the self, and the neuroanatomical substrate of the self. We distinguish content- and processed-based concepts of the self that entail different experimental strategies, and anatomically, we investigate the concept of midline structures in further detail and present a novel view on the anatomy of an integrated subcortical–cortical midline system. Presenting meta-analytic evidence, we show that the anterior paralimbic, e.g. midline, regions do indeed seem to be specific for self-specific stimuli. (...) We conclude that future investigation of the self need to develop novel concepts that are more empirically plausible than those currently in use. Different concepts of self will require novel experimental designs that include, for example, the brain’s resting state activity as an independent variable. Modifications of both conceptual and anatomical dimensions will allow an empirically more plausible account of the relationship between brain and self. (shrink)

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Unlike bioethics mediators who are employed by healthcare organizations as outside consultants, mediators who are embedded in an institution must be authorized to chronicle a clinical ethics consultation (CEC) or a mediation in a patient’s medical chart. This is an important privilege, as the chart is a legal document. In this article I discuss this important part of a bioethics mediator’s tool kit in my presentation of a case illustrating how bioethics mediation may proceed, and what this approach using both (...) bioethics and mediation may add. (shrink)

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Mental-content verbs such as think, believe, imagine and hope seem to pose special problems for the young language learner. One possible explanation for these diYculties is that the concepts that these verbs express are hard to grasp and therefore their acquisition must await relevant conceptual development. According to a diVerent, perhaps complementary, proposal, a major contributor to the diYculty of these items lies with the informational requirements for identifying them from the contexts in which they appear. The experiments reported here (...) explore the implications of these proposals by investigating the contribution of observational and linguistic cues to the acquisition of mental predicate vocabulary. We Wrst demonstrate that particular observed situations can be helpful in prompting reference to mental contents, speciWcally, contexts that include a salient and/or unusual mental state such as a false belief. We then compare the potency of such observational support to the reliability of alternate or concomitant syntactic information (e.g., sentential complementation) in tasks where both children and adults are asked to hypothesize the meaning of novel verbs. The Wndings support the eYcacy of false belief situations for increasing the saliency of mental state descriptions, but also show that.. (shrink)

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The author describes an alternative approach that careproviders may want to consider when caring for patients who request interventions that careproviders see as futile. This approach is based, in part, on findings of recent neuroimaging research. The author also provides several examples of seemingly justifiable “paternalistic omissions,” taken from articles in this issue of The Journal of Clinical Ethics (JCE). The author suggests that while careproviders should always give patients and their loved ones all potentially relevant information regarding “futile” decisions, (...) careproviders may wish to consider, paradoxically, not giving advice in these situations, when the advice is based mostly or wholly on their own moral views, based on this same, ethical rationale. (shrink)

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