Abstract:
:Several studies suggest that clinical researchers are prone to overestimating the chance that scientific protocols will succeed, say, by confirming a treatment hypothesis or reaching recruitment targets. In this essay, we address the normative question of whether such "unrealistic optimism" is harmful in clinical research. We entertain five plausible defenses of unrealistic optimism: agnosticism (optimism cannot be objectively assessed), skepticism (expressions of unrealistic optimism are difficult to interpret, since researchers are not accustomed to thinking in terms of probability), contrarianism (unrealistic optimism is salutary), denialism (any effects of unrealistic optimism are neutralized by oversight mechanisms), and fatalism (nothing can be done to alter unrealistic optimism or its effects). Though each argument has force, we find each insufficient to dispel moral concerns about community-wide unrealistic optimism in research. We close by describing how each argument might inform the study and moral evaluation of unrealistic optimism in research.
journal_name
Perspect Biol Medjournal_title
Perspectives in biology and medicineauthors
Benjamin D,Kimmelman Jdoi
10.1353/pbm.2016.0043subject
Has Abstractpub_date
2016-01-01 00:00:00pages
491-506issue
4eissn
0031-5982issn
1529-8795pii
S1529879516400049journal_volume
59pub_type
杂志文章abstract::Milton Winternitz led Yale Medical School as its Dean from 1920 to 1935. An innovative, even maverick leader, he not only kept the school from going under, but turned it into a first-class research institution. Dedicated to the new scientific medicine established in Germany, he was equally fervent about "social medici...
journal_title:Perspectives in biology and medicine
pub_type: 传,历史文章,杂志文章
doi:10.1353/pbm.2003.0046
更新日期:2003-07-01 00:00:00
abstract::Ensuring experimental outcomes are of the highest clinical caliber is crucial prior to the introduction of germline genome editing. However, if we are to police scientific progress using probability or the potential to go wrong, then we must account for the specious standards of human reproduction. With 15% of clinica...
journal_title:Perspectives in biology and medicine
pub_type: 杂志文章
doi:10.1353/pbm.2020.0008
更新日期:2020-01-01 00:00:00
abstract::The idea of being "haunted" appears often in accounts of the experience of health-care professionals and trainees who suffer from unresolved sorrow or regret about past clinical events, in particular the deaths of patients. The trope of haunting draws a direct line between past professional trauma and the dread of fut...
journal_title:Perspectives in biology and medicine
pub_type: 杂志文章
doi:10.1353/pbm.2020.0034
更新日期:2020-01-01 00:00:00
abstract::Randomized, controlled clinical trials (RCTs) may be possible, permissible, and practical in certain circumstances, but ethical or practical considerations often preclude their utilization. In many such cases, ethical objections will not apply to a similarly oriented, prospective, matched-pair observational study. Add...
journal_title:Perspectives in biology and medicine
pub_type: 杂志文章
doi:10.1353/pbm.2013.0014
更新日期:2013-04-01 00:00:00
abstract::The linguistic metaphor in biology adheres to a representational theory that seeks similarities between pre-given domains. The point of departure of this paper is the generative and nonrepresentational conception of metaphor. This paper argues that by adopting the nonrepresentational conception of metaphor, meaning-ma...
journal_title:Perspectives in biology and medicine
pub_type: 杂志文章,评审
doi:10.1353/pbm.2005.0076
更新日期:2005-07-01 00:00:00
abstract::Human beings rely on metaphor as a primary cognitive device for interpreting the world around them. Metaphors figure especially strongly in discourse around health, illness, and medicine. It is not just that patients use metaphors to describe their personal experience of being unwell, or that medical professionals emp...
journal_title:Perspectives in biology and medicine
pub_type: 杂志文章
doi:10.1353/pbm.2015.0010
更新日期:2015-01-01 00:00:00
abstract::This is a daunting time, not only in terms of our public health and our economic health but also in terms of the health of the republic. It is an old theme that any form of popular government needs virtuous citizens if it is to survive. It also needs citizens to agree on what counts as a virtue. I fear that the pandem...
journal_title:Perspectives in biology and medicine
pub_type: 杂志文章
doi:10.1353/pbm.2020.0050
更新日期:2020-01-01 00:00:00
abstract::Fifty years after Beecher's landmark article, an old question is being debated anew: is it ethical to conduct clinical research without consent? This paper provides a systematic analysis of this question. First, it describes five clinical trials that have either been conducted (or proposed) without the subjects provid...
journal_title:Perspectives in biology and medicine
pub_type: 杂志文章
doi:10.1353/pbm.2016.0023
更新日期:2016-01-01 00:00:00
abstract::Scholars have shown that organ transplantation may transform ideas about one's body, with recipients feeling that they are receiving not just a body part but also a part of the donor's identity. This article focuses on a different way in which organ transplantation shapes recipient identity: the idea of becoming whole...
journal_title:Perspectives in biology and medicine
pub_type: 历史文章,杂志文章
doi:10.1353/pbm.2011.0036
更新日期:2011-07-01 00:00:00
abstract::Judgments of futility are always relative to some goal. In light of that proposition, continued treatment for those diagnosed as "brain dead" is not necessarily futile. ...
journal_title:Perspectives in biology and medicine
pub_type: 评论,杂志文章
doi:10.1353/pbm.2018.0014
更新日期:2018-01-01 00:00:00
abstract::This article examines five letters from the correspondence of American zoologist Edwin Grant Conklin that highlight his theories of genetic and social inheritance, in order to suggest that Conklin's eugenic beliefs--like those of many American authorities during this time--were complex and sometimes contradictory. The...
journal_title:Perspectives in biology and medicine
pub_type: 传,历史文章,杂志文章
doi:10.1353/pbm.2001.0058
更新日期:2001-07-01 00:00:00
abstract::The treatment of broken bones has long adhered to principles of tight juxtaposition of fracture ends and of strict rest. Splinting and casting with plaster of Paris helped considerably. Attempts at internal splinting with pegs, bolts, or stabilizing contraptions usually failed. Foreign materials were either not biocom...
journal_title:Perspectives in biology and medicine
pub_type: 传,历史文章,杂志文章
doi:10.1353/pbm.2014.0021
更新日期:2014-07-01 00:00:00
abstract::The health aspects and benefits of conception control as a justification for U.S. government support of family planning are reviewed. The Family Planning Services Act of 1970 set a goal of serving 5 million indigent women by 1975. It is predicted that the program will far surpass that goal. 340 million dollars were...
journal_title:Perspectives in biology and medicine
pub_type: 杂志文章
doi:10.1353/pbm.1973.0050
更新日期:1973-04-01 00:00:00
abstract::How we discovered that sea birds on the Great Barrier Reef are riddled with influenza viruses, and how one of these led to a new drug now being used in the battle against the flu. ...
journal_title:Perspectives in biology and medicine
pub_type: 历史文章,杂志文章
doi:10.1353/pbm.2004.0066
更新日期:2004-10-01 00:00:00
abstract::The pace of biomedical innovation is important because it determines the rate of progress in medicine and allied disciplines. A review of the history of medical advances reveals that the three decades from 1950 to 1980 were a particularly innovative time. Subsequent decades have seen fewer seminal advances, despite co...
journal_title:Perspectives in biology and medicine
pub_type: 杂志文章
doi:10.1353/pbm.2018.0067
更新日期:2018-01-01 00:00:00
abstract::Charles Dickens's adult life parallels the period when the movement for sanitary reform took root in England. Although he was not one of its leaders, he became in time one of its most outspoken advocates. This essay describes Dickens's growing involvement in the sanitary movement and looks at one of the most important...
journal_title:Perspectives in biology and medicine
pub_type: 传,历史文章,杂志文章
doi:10.1353/pbm.2003.0025
更新日期:2003-04-01 00:00:00
abstract::C. Wright Mills said that when done well, sociology illuminates the intersection of biography and history. This essay examines how the author's vocational choices and career path were shaped by historical circumstance, leading him to a degree in sociology and to participation in the odd and interesting interdiscipline...
journal_title:Perspectives in biology and medicine
pub_type: 杂志文章
doi:10.1353/pbm.2017.0020
更新日期:2017-01-01 00:00:00
abstract::Diverse and non-coherent sets of epistemological principles currently inform research in the general area of functional genomics. Here, from the personal point of view of a scientist with over half a century of immersion in hypothesis driven scientific discovery, I compare and deconstruct the ideological bases of prom...
journal_title:Perspectives in biology and medicine
pub_type: 杂志文章
doi:10.1353/pbm.2015.0025
更新日期:2015-04-01 00:00:00
abstract::Both leading scientific journals and the popular press now regularly report the convincing evidence of massive environmental degradation and decline. Yet despite the seriousness of the problems, despite their anthropogenic nature, and despite their profound implications for present and future population health, such t...
journal_title:Perspectives in biology and medicine
pub_type: 杂志文章
doi:10.1353/pbm.2007.0008
更新日期:2007-01-01 00:00:00
abstract::The reigning paradigm of rational drug discovery in translational medicine attempts to exploit biological theories and pathophysiological explanations to identify novel drug targets and therapeutic strategies. Yet because many theories in medicine are either incomplete (at best) or false (at worst), relying on theoret...
journal_title:Perspectives in biology and medicine
pub_type: 杂志文章
doi:10.1353/pbm.2019.0039
更新日期:2019-01-01 00:00:00
abstract::Shopping for genetic information has become popular, but consumers may not understand what exactly they are buying. The retail DNA industry is forcing laypersons, academics, and medical and legal professionals alike to face the crossroads of genetics, law, and society. How will we decipher the meanings of the tests, d...
journal_title:Perspectives in biology and medicine
pub_type: 杂志文章
doi:10.1353/pbm.0.0158
更新日期:2010-04-01 00:00:00
abstract::In retrospect, mortality from coronary heart disease (CHD) in the 20th century followed an epidemic pattern: mortality rates increased dramatically from 1920 until about 1960, remained roughly constant for almost a decade, and have been decreasing since the late 1960s. CHD has traditionally been conceived of as a sing...
journal_title:Perspectives in biology and medicine
pub_type: 历史文章,杂志文章
doi:10.1353/pbm.2007.0013
更新日期:2007-04-01 00:00:00
abstract::The concept and determination of death by neurological or cardio-circulatory criteria play a crucial role for medical practice, society, and the law. Academic debates on death determination have regained momentum, and recent cases involving the neurological determination of death ("brain death") in the United States h...
journal_title:Perspectives in biology and medicine
pub_type: 杂志文章
doi:10.1353/pbm.2015.0036
更新日期:2015-01-01 00:00:00
abstract::Over recent years there has been a gratifying decrease in the incidence of recorded deaths from coronary artery disease in the Western world. The common view is that coronary artery disease is a recent phenomenon, that we have been subject to an epidemic in the mid-20th century that is now tailing off, and that with a...
journal_title:Perspectives in biology and medicine
pub_type: 历史文章,杂志文章
doi:10.1353/pbm.2012.0015
更新日期:2012-01-01 00:00:00
abstract::Social media use in modern medicine is fraught with ethical dilemmas and risks of unprofessional behavior. This essay surveys the existing literature on the possibilities and pitfalls of social media use by health-care professionals and concludes that non-engagement with social media is not an option. A mindful approa...
journal_title:Perspectives in biology and medicine
pub_type: 杂志文章
doi:10.1353/pbm.2013.0039
更新日期:2013-10-01 00:00:00
abstract::This commentary considers two informing influences on Pope Francis's support of perinatal hospice care for families facing diagnoses of serious fetal anomalies. Reflecting on the morally formative scriptural narrative of Mary's pregnancy and Jesus's birth and drawing upon an often-repeated idea of Pope Francis's papac...
journal_title:Perspectives in biology and medicine
pub_type: 杂志文章
doi:10.1353/pbm.2020.0044
更新日期:2020-01-01 00:00:00
abstract::Since the beginning of the 21st century, the living conditions of undocumented migrant workers in Belgium have deteriorated drastically. In Brussels, after various social actions, undocumented people began squatting and occupying public buildings to make their struggle visible to society. Desperate, some seized the po...
journal_title:Perspectives in biology and medicine
pub_type: 杂志文章
doi:10.1353/pbm.2019.0006
更新日期:2019-01-01 00:00:00
abstract::How can we provide the best care for growing numbers of very frail, very sick, or very old people? The disciplines of geriatrics, palliative care, and clinical ethics each have a good deal to offer to improve care for elders, yet each field is saddled with heavy historical baggage. Using a case as a springboard, we ad...
journal_title:Perspectives in biology and medicine
pub_type: 杂志文章
doi:10.1353/pbm.2017.0039
更新日期:2017-01-01 00:00:00
abstract::The emerging field of synthetic biology is a novel biological discipline at the interface between traditional biology, chemistry, and engineering sciences. Synthetic biology aims at the rational design of complex synthetic biological devices and systems with desired properties by combining compatible, modular biologic...
journal_title:Perspectives in biology and medicine
pub_type: 杂志文章,评审
doi:10.1353/pbm.2012.0042
更新日期:2012-01-01 00:00:00
abstract::Iraqi detainees subjected to torture and mistreatment at Abu Ghraib prison may continue to suffer from significant physical and psychological consequences of their abuse. This article reports two cases of Iraqi individuals allegedly tortured at Abu Ghraib. Detailed forensic evaluations were conducted approximately one...
journal_title:Perspectives in biology and medicine
pub_type: 杂志文章
doi:10.1353/pbm.2006.0059
更新日期:2006-10-01 00:00:00