Objective The study evaluated patient informed consent (IC) for the Quad screen and examined differences in IC between test acceptors and test refusers. A multidimensional model of IC was used. Methods Women seeking prenatal care at nine obstetrics clinics in a large Midwestern city completed surveys between February and December 2006. Surveys contained measures for three dimensions of IC: intention, understanding and controlling influence. Results 56.2% of women did not meet criteria for all three of our dimensions of IC and (...) therefore failed to give it. The failure rate was higher among women who choose to screen (72.6%) than women who choose not screen (50%) (p < 0.001). Women who met all criteria for IC were over three times less likley to choose to screen (or = 0.32, CI 0.17–0.62 ( p < 0.01)) than women who did not meet criteria for IC. Conclusion The decision to screen for fetal anomalies is less of a deliberated action than the decision not to screen. Women who lack a fundamental understanding of the purpose and nature of the screen may be operating on the belief that the screen is part of standard care and presents no need to deliberate. (shrink)

Autism-related concepts shape psychiatric classification, research agendas, clinical communication, policy decisions, and forms of autistic self-understanding. Yet these concepts are often adopted, contested, or revised without sustained reflection on the roles they are meant to serve across different settings. This article examines two widely discussed terms, “neurodivergent” and “profound autism,” and argues that disputes surrounding them often reflect mismatches in conceptual function rather than disagreement about descriptive accuracy alone. Building on conceptual work in philosophy of psychiatry, conceptual ethics, and interdisciplinary (...) autism research, the article develops a four-dimensional framework for evaluating autism-related concepts in terms of internal structure, degree of intentional design, ethical orientation, and empirical grounding. Historical and comparative analysis shows that “neurodivergent” emerged from autistic-led and cross-disability activism as a minimally structured identity concept, whereas “profound autism” was introduced in clinical and administrative contexts as a more structured category tied to research visibility, service coordination, and clinical proxies. The contrast clarifies why tensions arise when concepts designed for different tasks are assessed by the same standards. Rather than proposing conceptual uniformity, the article advances conceptual responsibility as a requirement to make explicit what concepts are being asked to do, which evidential infrastructures sustain them, whose perspectives shape them, and what trade-offs their use entails. (shrink)

Review of: Capitalism and the Camera: Essays on Photography and Extraction, Kevin Coleman and Daniel James (eds) (2021) London and New York: Verso, 320 pp., ISBN 978-1-83976-080-8, p/bk, GBP 19.99.

Race scholars have discussed how the pandemic has disproportionately burdened marginalized communities and exacerbated pre-existing inequities, particularly for Black Indigenous People of Color (BIPOC) in the United States (U.S.). One glaring social determinant during the time of the COVID-19 is racial discrimination. This chapter will discuss lessons learned regarding the negative impact of discrimination on BIPOC, especially as it pertains to their experiences of trauma. Some of these lessons include (1) the need for clinical psychologist to improve access to treatment (...) through increased research on culturally adaptive interventions, (2) increased research on the effects of race-based trauma on mental health symptomatology, (3) policy and institutional changes that reduce disparities in access to care, and (4) increased education for psychologists around billing procedures for individuals with race-based stress. (shrink)

The American Journal of Bioethics, Volume 12, Issue 4, Page 17-19, April 2012.