Conscientious Refusal and Access to Abortion and Contraception

An overview of the philosophical and bioethics literature on conscientious refusals by health care professionals to provide abortion and contraceptive services

The evolution of moral intuitions and their feeling of rightness

Despite the widespread use of the notion of moral intuition, its psychological features remain a matter of debate and it is unclear why the capacity to experience moral intuitions evolved in humans. We first survey standard accounts of moral intuition, pointing out their interesting and problematic aspects. Drawing lessons from this analysis, we propose a novel account of moral intuitions which captures their phenomenological, mechanistic, and evolutionary features. Moral intuitions are composed of two elements: an evaluative mental state and a feeling of rightness (FOR). We illustrate the phenomenology of the FOR with examples of non-moral and moral cases, and provide a biological and mechanistic account: the emergence of human reasoning capacities created a need for the co-evolution of a psychological system producing the feeling of rightness (the FORs). This system is triggered when we experience conflicting evaluations. The FORs renders evaluations resulting from rational deliberation less compelling than the evaluations produced by simple evolved systems. It thus facilitates optimal decision-making, preventing excessive interference by rational deliberation. Our account sheds light on why moral intuitions are so frequently experienced and why they are so compelling and resistant to argument. In addition, the account fuels interesting speculations about common metaethical intuitions

Interventions designed to reduce implicit prejudices and implicit stereotypes in real world contexts: a systematic review

Background Implicit biases are present in the general population and among professionals in various domains, where they can lead to discrimination. Many interventions are used to reduce implicit bias. However, uncertainties remain as to their effectiveness. Methods We conducted a systematic review by searching ERIC, PUBMED and PSYCHINFO for peer-reviewed studies conducted on adults between May 2005 and April 2015, testing interventions designed to reduce implicit bias, with results measured using the Implicit Association Test (IAT) or sufficiently similar methods. Results 30 articles were identified as eligible. Some techniques, such as engaging with others’ perspective, appear unfruitful, at least in short term implicit bias reduction, while other techniques, such as exposure to counterstereotypical exemplars, are more promising. Robust data is lacking for many of these interventions. Conclusions Caution is thus advised when it comes to programs aiming at reducing biases. This does not weaken the case for implementing widespread structural and institutional changes that are multiply justified

Le réalisme métaéthique face à la science : un rapport conflictuel

Cet article traite d’un problème de métaéthique : la question de la possibilité du réalisme moral. Nous aborderons cette question à partir de ce que nous appellerons le point de vue du philosophe scientifique. L’objectif est de montrer l’incompatibilité de ce point de vue avec une position réaliste. La structure de l’article est la suivante. Nous commencerons par quelques éclaircissements terminologiques afin que le lecteur puisse se faire une idée précise de ce que nous entendons par réalisme moral (nous déclinerons notamment les différentes variantes possibles du réalisme au moyen d’un tableau) et point de vue scientifique sur la morale. Notre travail consistera ensuite à montrer de manière systématique qu’aucune des variantes du réalisme moral n’est acceptable pour un philosophe scientifique

How is physicians’ implicit prejudice against the obese and mentally ill moderated by specialty and experience ?

Background: Implicit prejudice can lead to disparities in treatment. The effects of specialty and experience on implicit obesity and mental illness prejudice had not been explored. The main objective was to examine how specializing in psychiatry/general medicine and years of experience moderated implicit obesity and mental illness prejudice among Swiss physicians. Secondary outcomes included examining the malleability of implicit bias via two video interventions and a condition of cognitive load, correlations of implicit bias with responses to a clinical vignette, and correlations with explicit prejudice. Methods: In stage 1, participants completed an online questionnaire including a clinical vignette. In stage 2, implicit prejudice pre- and post- intervention was tested using a 4 × 4 between-subject design including a control group. In stage 3, explicit prejudice was tested with feeling thermometers and participants were debriefed. Participants were 133 psychiatrists and internists working in Geneva, hospital-based and private practice. Implicit prejudice was assessed using a Weight IAT (Implicit Association Test) and a Mental Illness IAT. Explicit feelings towards the obese and the mentally ill were measured using Feeling Thermometers. A clinical vignette assessed the level of concern felt for a fictional patient under four conditions: control, obese, depression, obese and depression. Linear regression was conducted to test for association of gender, experience, and specialty with responses to vignettes, pre-intervention IATs and explicit attitudes, and to test for association of interventions (or control) with post-intervention IATs and explicit attitudes. Reported effect sizes were computed using Cohen’s d. Two-tailed p < 0.05 was selected as the significance threshold. Results: Compared to internists, psychiatrists showed significantly less implicit bias against mentally vs. physically ill people than internists and warmer explicit feelings towards the mentally ill. More experienced physicians displayed warmer explicit feelings towards the mentally ill and a greater level of concern for the fictional patients in the vignette than the less experienced, except when the patient was described as obese. Conclusions: Specialty moderates both implicit and explicit mental illness prejudice. Experience moderates explicit mental illness bias and concern for patients. The effect of specialty on implicit prejudice seems to be based principally on self-selection

Implicit bias in healthcare professionals: a systematic review

Implicit biases involve associations outside conscious awareness that lead to a negative evaluation of a person on the basis of irrelevant characteristics such as race or gender. This review examines the evidence that healthcare professionals display implicit biases towards patients