Human Embryonic Stem Cell Research, Abortion, and Publication Bias in the New England Journal of Medicine

Current Challenges for Conscientious Objection by Physicians in Spain

The College of Physicians of Madrid organized an open debate on conscientious objection (CO) in the medical profession on September 14, 2022. We summarize here the main arguments discussed. CO is defined as the right to raise exceptions to the performance of legal duties when they involve a contravention of personal convictions, whether religious, moral, or philosophical. It is not insubordination. Some authors contend that any decision by elected authorities should be uniformly followed by all citizens, physicians not being an exception. However, suppressing the ethical dimension of medical care may have an unacceptable cost with harm to physicians, their patients, and ultimately society. Health professionals are not blind instruments or mere "executors." The practice of medicine must follow the aim of the profession, namely the pursuit of the patient's good. Medical care must conform to medical ethics, which was first defined twenty-five centuries ago in the Hippocratic oath, and summarized with the triad of precepts "cure, relief, accompaniment." Since then and particularly in light of the Nuremberg trials, most medical declarations have highlighted the duty of defending human life and the importance of CO. In modern societies, there may be medical services that are not health care, even if they are legal. Then, which comes first law or ethics? Ultimately, CO is the tool that protects the freedom of the physician to refuse to perform actions that go against the values of medical ethics. With respect to the recent Spanish laws on abortion, euthanasia, and sex re-assignment of minors, if administrators want to know who is available for a health service that raises issues of conformity to medical ethics, requesting a list of volunteers is preferable to producing an objector list. Asking for registration of conscientious objectors goes against the right to privacy and is coercive, intrusive, and abusive.

Difficulties With Methodology in Social Science Research With Controversial Issues Regarding Human Sexuality

Social science is commonly used in debates about controversial issues, especially for those concerning human sexuality. However, caution must be exercised in interpreting such social science literature, because of a variety of methodological and theoretical weaknesses that are not uncommon. Families are complex structurally and over time; such data are not easily analyzed. Merely determining the number of, for example, sexual minority families has been a difficult task. While some new theories are popular with social scientists, for example, sexual minority theory, they are often used to the exclusion of other, equally valid theories and often are not well tested empirically. Some types of families remain relatively unexamined. Social scientists can be biased by their own values, which are reflected in weak use of theory and in a variety of methodological problems. Eight studies are presented as examples of probable confirmation bias, in which methods and theory were modified in unusual ways that may have affected the outcomes and conclusions. Suggestions for improving social science include greater attention to effect sizes rather than statistical significance per se, deliberately minimizing the politicization of science, developing a culture of humility with respect to social science, deliberately reducing common biases, and maintaining a deeper curiosity about social science than is often seen. Scientists must be open to seeing their best "sacred cow" ideas or theories disproven or modified with increases in research on such issues.

Summary

In controversial areas of social science, there can be numerous threats to the validity of science. Here, some of the more common risks for social science research and theory are examined, with several specific illustrations of how bias appears to have crept into social science, often as confirmation bias. Recommendations are made for reducing bias in future research.