Research ethicists have recently declared a new ethical imperative: that researchers should communicate the results of research to participants. For some analysts, the obligation is restricted to the communication of the general findings or conclusions of the study. However, other analysts extend the obligation to the disclosure of individual research results, especially where these results are perceived to have clinical relevance. Several scholars have advanced cogent critiques of the putative obligation to disclose individual research results. They question whether ethical goals (...) are served by disclosure or violated by non-disclosure, and whether the communication of research results respects ethically salient differences between research practices and clinical care. Empirical data on these questions are limited. Available evidence suggests, on the one hand, growing support for disclosure, and on the other, the potential for significant harm. (shrink)

Hastings Center Report, Volume 52, Issue 2, Page 49-57, March‐April 2022.

While every health care system stakeholder would seem to be concerned with obtaining the greatest value from a given technology, there is often a disconnect in the perception of value between a technology’s promoters and those responsible for the ultimate decision as to whether or not to pay for it. Adopting an empirical ethics approach, this paper examines how five Canadian medical device manufacturers, via their websites, frame the corporate “value proposition” of their innovation and seek to respond to what (...) they consider the key expectations of their customers. Our analysis shows that the manufacturers’ framing strategies combine claims that relate to valuable socio-technical goals and features such as prevention, efficiency, sense of security, real-time feedback, ease of use and flexibility, all elements that likely resonate with a large spectrum of health care system stakeholders. The websites do not describe, however, how the innovations may impact health care delivery and tend to obfuscate the decisional trade-offs these innovations represent from a health care system perspective. Such framing strategies, we argue, tend to bolster physicians’ and patients’ expectations and provide a large set of stakeholders with powerful rhetorical tools that may influence the health policy arena. Because these strategies are difficult to counter given the paucity of evidence and its limited use in policymaking, establishing sound collective health care priorities will require solid critiques of how certain kinds of medical devices may provide a better (i.e., more valuable) response to health care needs when compared to others. (shrink)

In the late 1940s, a microanatomist from London Ontario, Murray Barr, discovered a mark of sex chromosome status in bodily tissues, what came to be known as the ‘Barr body’. This discovery offered an important diagnostic technology to the burgeoning clinical science community engaged with the medical interpretation and management of sexual anomalies. It seemed to offer a way to identify the true, underlying sex in those whose bodies or lives were sexually anomalous . The hypothesis that allowed the Barr (...) body to stand in for ‘chromosomal’ or ‘genetic’ sex was provisional, but it supported the expectation that genetic information established one’s primary identity, and the conviction that the animal world could be neatly divided into two, and only two, sexes. Ultimately, this provisional hypothesis, and its status as an unambiguous arbiter of true sex, was overturned. But during much of the 1950s, Barr’s thesis about the identity of the Barr body was consistent with a coherent set of theories and evidence explaining sexual development and sexual pathology. Though provisional, the scientific status of the sex chromatin within this system of knowledge was good enough to support a flourishing research enterprise in the clinical sciences. (shrink)

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.

UK-based research conducted within a healthcare setting generally requires approval from the National Research Ethics Service. Research ethics committees are required to assess a vast range of proposals, differing in both their topic and methodology. We argue the methodological benchmarks with which research ethics committees are generally familiar and which form the basis of assessments of quality do not fit with the aims and objectives of many forms of qualitative inquiry and their more iterative goals of describing social processes/mechanisms and (...) making visible the complexities of social practices. We review current debates in the literature related to ethical review and social research, and illustrate the importance of re-visiting the notion of ethics in healthcare research. (shrink)

A July, 1990, controversy in British Columbia, Canada, involved a set of audiotapes detailing an apparent abuse of power by the province's attorney general and a relationship between the attorney general and a member of the press. The controversy was covered extensively in local media. A discussion of relevant ethical issues is followed by an analysis of their coverage in the press. Recommendations are made for more effective handling of ethical issues by media organizations and more meaningful reporting of such (...) issues. (shrink)

John McMillan's article raises numerous important points about the ethics of surgical castration of sex offenders.1 In this commentary, we focus solely on and argue against the claim that the offer of release from detention conditional upon surgical castration is a coercive offer that compromises the validity of the offender's consent. We take no view on the question as to whether castration for sex offenders is ethically permissible. But, we reject the claim that it is ethically permissible only if competing (...) ethical considerations outweigh worries about coercion. For in the situation described, the proposal is not coercive at all.McMillan states that if offenders agree to castration because they fear long-term detention, then ‘it seems, intuitively, as if agreeing to be castrated under these conditions makes the decision coerced in some way.’1 He adds that if castration is ‘the only way that they will be released back into the community, the status of this decision as a genuine expression of their autonomy is questionable.’1 In defence of his claim, he uses two analogies that he borrows from Joel Feinberg. First, if a governor offers to commute a death sentence if the prisoner agrees to participate in a medical experiment, then ‘it's clear that the governor is coercing the prisoner.’1 Second, if a millionaire offers to give a woman $1 000 000 …. (shrink)

Cesario misrepresents experimental social psychology. The discipline encompasses significantly more than implicit bias research, including controlled decision making and real-world behavioral observations. Paradoxically, while critiquing popular implicit bias tasks, Cesario also describes task refinements that have significantly advanced their external validity and our contextual understanding of bias. Thus rather than abandonment, a call for “continued improvement” is a far more sensible proposition.

The idea that our conscious decisions determine our actions has been challenged by a report suggesting that the brain starts to prepare for a movement before the person concerned has consciously decided to move . Libet et al. claimed that their results show that our actions are not consciously initiated. The current article describes two experiments in which we attempted to replicate Libet et al.'s comparison of participants' movement-related brain activity with the reported times of their decisions to move and (...) also the reported times of their decisions of which hand to move. We also looked at the distribution of participants' reports over time to evaluate an alternative explanation of Libet et al.'s results. Although the Readiness Potential was usually present before all of the decisions to move, consistent with the findings of Keller and Heckhausen and Libet et al. , we found that many reported decision times were before the onset of the Lateralized Readiness Potential, which measures hand-specific movement preparation. The latter finding is consistent with the conclusion that the LRP always started after the conscious decision to move. We conclude that even though activity related to movement anticipation may be present before a conscious decision to move, the cortical preparation necessary for the movement to happen immediately may not start until after the conscious decision to move. (shrink)

We argued last year in this journal that extensive integration of research and care is a worthy goal of health system design, and we second the call from Ruth Faden and colleagues to move toward learning health care systems. As they recognize, learning health care systems demand the coordination of research and medical ethics—two sets of normative commitments that have long been considered distinct. In offering a novel ethics framework for such systems, Faden et al. advance the scholarly debate about (...) how best to do this and challenge us to think more deeply about its practical implications. However, we believe that at least three issues they raise require additional attention. First, the research‐care distinction has more normative bite than they are willing to concede. Second, the role for independent oversight requires clarification. Finally, they neglect the concept of stewardship as a guiding obligation of learning health care systems. (shrink)

We argued last year in this journal that extensive integration of research and care is a worthy goal of health system design, and we second the call from Ruth Faden and colleagues to move toward learning health care systems. As they recognize, learning health care systems demand the coordination of research and medical ethics—two sets of normative commitments that have long been considered distinct. In offering a novel ethics framework for such systems, Faden et al. advance the scholarly debate about (...) how best to do this and challenge us to think more deeply about its practical implications. However, we believe that at least three issues they raise require additional attention. First, the research‐care distinction has more normative bite than they are willing to concede. Second, the role for independent oversight requires clarification. Finally, they neglect the concept of stewardship as a guiding obligation of learning health care systems. (shrink)

Business and Society Review, Volume 127, Issue S1, Page 193-222, Spring 2022.

In the ancient world, precious stones (valuable stones and hard substances excluding gold, silver and copper) were distinguished in terms of appearance (beauty, colour), function (durability) and cost (rarity). As a result, there is considerable difficulty in determining how to correlate the inventory of lexical terms referring to precious stones in the ancient Near East with modern mineralogical identifications. In this article, the etymology and identification of precious stones in the Bible are revisited using editorial theory and complexity thinking. The (...) starting point for lexicographical identification is the breastpiece of the high priest (Ex 28:17–20; 39:10–14) with its 12 precious stones and the translation of the Hebrew terms in the Septuagint. In the light of the considerable writings in the Hellenistic world on precious stones, especially Pliny’s Naturalis Historia and Theophrastus’ On Stones, the Septuagint provides the key for the etymology and identification of the precious stones in both the Old Testament and the New Testament. Contribution: The Septuagint translation of the precious stones in the high priest’s breastpiece is the Rosetta Stone for the identification all of the precious stones in the Hebrew Bible and New Testament. The subsequent translations of the terms indicate changes or substitutions of referents and their meanings. (shrink)

We seek to add to the Corporate Social Responsibility (CSR) and Sustainable Development (SD) literature through the empirical study of Latin American firm membership in the United Nations Global Compact (GC) and Global Report Initiative (GRI). Within an institutional-based framework, we explore through three filters – commercial, state-signaling, and distinguished peers – the impact of normative and mimetic pressures associated with GC/gri membership. Our sample includes 207 public firms from six Latin American countries (Argentina, Brazil, Chile, Colombia, Mexico, and Peru). (...) Our results suggest Latin American firms from countries with a greater European influence (normative pressure) are twice as likely to be enrolled in the GC/gri. Additionally, we find that Latin American firms listed on the NYSE (mimetic pressure) are also twice as likely to sign up under the GC/gri. Hence, the normative and mimetic pillars of institutional theory are found to be significant factors for Latin American firms adopting sustainability initiatives. (shrink)

Purpose Prescription stimulant use as “cognitive enhancers” has been described among undergraduate college students. However, the use of prescription stimulants among future health care professionals is not well characterized. This study was designed to determine the prevalence of prescription stimulant misuse among students at an academic health sciences center. -/- Method Electronic surveys were e-mailed to 621 medical, pharmacy, and respiratory therapy students at East Tennessee State University for four consecutive weeks in fall 2011. Completing the survey was voluntary and (...) anonymous. Surveys asked about reasons for, frequency of, and side effects of nonprescription misuse of prescription stimulants. Given the sensitive material, an opportunity to win one of ten $50 gift cards was used as an incentive. -/- Results Three hundred seventy-two (59.9%) students completed the survey from three disciplines (47.6% medical, 70.5% pharmacy, and 57.6% respiratory therapy). Overall, 11.3% of responders admitted to misusing prescription stimulants. There was more misuse by respiratory therapy students, although this was not statistically significant (10.9% medicine, 9.7% pharmacy, 26.3% respiratory therapy; P = .087). Reasons for prescription stimulant misuse included to enhance alertness/ energy (65.9%), to improve academic performance (56.7%), to experiment (18.2%), and to use recreationally/get high (4.5%). -/- Conclusions Prescription stimulant misuse was prevalent among participating students, but further research is needed to describe prevalence among future health care workers more generally. The implications and consequences of such misuse require further study across professions with emphasis on investigating issues of academic dishonesty (e.g., “cognitive enhancement”), educational quality, and patient safety or health care quality. (shrink)

Background Clinical ethics consultants are expected to “reduce disparities, discrimination, and inequities when providing consultations,” but few studies about inequities in ethics consultation exist.1 The objectives of this study were (1) to determine if there were racial or gender differences in the timing of requests for ethics consultations related to limiting treatment, and (2) if such differences were found, to identify factors associated with that difference and the role, if any, of ethics consultants in mitigating them. Methods The study was (...) a mixed methods retrospective study of consultation summaries and hospital and ethics center data on 56 age-and gender-matched Caucasian and African American Medicare patients who received ethics consultations related to issues around limiting medical treatment in the period 2011 to 2014. The average age of patients was 70.9. Results Consultation requests for females were made significantly earlier in their stays in the hospital (6.57 days) than were consultation requests made for males (16.07 days). For African American patients, the differences in admission-to-request intervals for female patients (5.93 days) and male patients (18.64 days) were greater than for Caucasian male and female patients. Differences in the timing of a consultation were not significantly correlated with the presence of an advance directive, the specialty of the attending physician, or the reasons for the consult request. Ethics consultants may have mitigated problems that developed during the lag in request times for African American males by spending more time, on average, on those consultations (316 minutes), especially more time, on average, than on consultations with Caucasian females (195 minutes). Most consultations (40 of 56) did result in movement toward limiting treatment, but no statistically significant differences were found among the groups studied in the movement toward limiting treatment. The average number of days from consult to discharge or death were strongly correlated with the intervals between admission to the hospital and request for an ethics consultation. Conclusion Our findings suggest race and gender disparities in the timing of ethics consultations that consultants may have partially mitigated. (shrink)

In this article we examine how Qumran Hebrew can contribute to our knowledge of historical Hebrew linguistics. The premise of this paper is that Qumran Hebrew reflects a distinct stage in the development of Hebrew which sets it apart from Biblical Hebrew. It is further assumed that these unique features are able to assist us to understand the nature of the development of Biblical Hebrew in a more precise way. Evidence from the syntax of participial negation at Qumran as opposed (...) to Biblical Hebrew provides evidence for this claim. (shrink)

In this essay, we demonstrate that in addition to the Revised Standard Version and its revisions as part of the linear emergence of the Tyndale–King James Version tradition in the 20th and 21st centuries, there are also alternative revisions and retranslations of the King James Version (KJV) of 1611 as literal or word-for-word translations, which emerge as divergent branches. The revisions of the American Standard Version (ASV) (1901) emerged in the following branches, namely the New American Standard Bible (NASB) and (...) its revisions, The Amplified Bible (AB) and its revisions, as well as The Living Bible, Paraphrased and its retranslation, the New Living Translation (NLT). Then there are revisions that emerged as alternatives to the Revised Standard Version (1946–1952/1971) by reverting to the King James Revised (Blayney) Edition (1769) as their incipient text rather than the ASV, namely The Modern King James Version (MKJV) (and similar revisions), The New King James Version (NKJV) and the New Cambridge Paragraph Bible. Finally, there are retranslations within the Tyndale–King James Version tradition, namely the Contemporary English Version (CEV), and the Common English Bible (CEB). The diversity reflects the search for individual identity to satisfy particular reader expectations in an age of digital-media interpretive culture featuring broad universal values.Contribution: Instead of viewing the revisions and retranslations within the Tyndale–King James Version tradition since the second half of the 20th century as new and independent, it is demonstrated that the various branches and their versions rather continue the emergence of the pre-20th century translation complex within this tradition to satisfy particular reader expectations. (shrink)

This study investigated the consistency of the finding that family cohesion and adaptability are significant predictors of adolescent moral thought. To test this, 175 adolescents from a metropolitan population and 146 from an urban fringe population were administered White's revised Moral Authority Scale, Olson et al.'s Family Adaptability and Cohesion Evaluation Scale, and a family demographic questionnaire. A linear relation between family cohesion and family and equality sources of moral authority was found in both samples. However, the significant linear relation (...) between family adaptability and total source influence score found in Sample 1 was not found in Sample 2. This finding might result from the heterogeneity of sociocultural factors across the samples; post hoc analyses suggested that sociocultural factors might play an important moderating role in the relation between family adaptability and adolescent moral thought. (shrink)

The lysine demethylase KDM5A collaborates with PARP1 and the histone variant macroH2A1.2 to modulate chromatin to promote DNA repair. Indeed, KDM5A engages poly(ADP‐ribose) (PAR) chains at damage sites through a previously uncharacterized coiled‐coil domain, a novel binding mode for PAR interactions. While KDM5A is a well‐known transcriptional regulator, its function in DNA repair is only now emerging. Here we review the molecular mechanisms that regulate this PARP1‐macroH2A1.2‐KDM5A axis in DNA damage and consider the potential involvement of this pathway in transcription (...) regulation and cancer. Using KDM5A as an example, we discuss how multifunctional chromatin proteins transition between several DNA‐based processes, which must be coordinated to protect the integrity of the genome and epigenome. The dysregulation of chromatin and loss of genome integrity that is prevalent in human diseases including cancer may be related and could provide opportunities to target multitasking proteins with these pathways as therapeutic strategies. (shrink)

Background: In 2014, companies began covering the costs of egg freezing for their employees. The adoption of this benefit was highly contentious. Some argued that it offered women more reproductive...

Responding to volatile criticisms frequently leveled at Leo Strauss and those he influenced, the prominent contributors to this volume demonstrate the profound influence that Strauss and his students have exerted on American liberal democracy and contemporary political thought. By stressing the enduring vitality of classic books and by articulating the theoretical and practical flaws of relativism and historicism, the contributors argue that Strauss and the Straussians have identified fundamental crises of modernity and liberal democracy.

DBS Think Tank IX was held on August 25–27, 2021 in Orlando FL with US based participants largely in person and overseas participants joining by video conferencing technology. The DBS Think Tank was founded in 2012 and provides an open platform where clinicians, engineers and researchers can freely discuss current and emerging deep brain stimulation technologies as well as the logistical and ethical issues facing the field. The consensus among the DBS Think Tank IX speakers was that DBS expanded in (...) its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. After collectively sharing our experiences, it was estimated that globally more than 230,000 DBS devices have been implanted for neurological and neuropsychiatric disorders. As such, this year’s meeting was focused on advances in the following areas: neuromodulation in Europe, Asia and Australia; cutting-edge technologies, neuroethics, interventional psychiatry, adaptive DBS, neuromodulation for pain, network neuromodulation for epilepsy and neuromodulation for traumatic brain injury. (shrink)

Denton and Hockx present thirteen essays treating a variety of literary organizations from China's Republican era . Interdisciplinary in approach, the essays are primarily concerned with describing and analyzing the social and cultural complexity of literary groupings and the role of these social formations in literary production of the period.

T he O bject of this paper is the development of a view of punishment which incorporates what is of importance in retributive and utilitarian justifications of the practice of punishment. This proposed theory was noted and referred to as the plene esse , but not fully worked out, in the course of a discussion paper in which my concern was to offer an alternative view, to that of Mr Anthony Quinton, by construing ‘the right to punishment’ as meaning that (...) ‘the offender has the right to be regarded as responsible for his actions’. (shrink)

Analysis of a diverse cross‐sample of plant‐insect interactions suggests that the abundance of vitamin C (L‐ascorbic acid, ascorbate or AsA) in plants influences their susceptibility to insect feeding. These effects may be mediated by AsAs roles as an essential dietary nutrient, as an antioxidant in the insect midgut, or as a substrate for plant‐derived ascorbate oxidase, which can lead to generation of toxic reactive oxygen species. Ascorbate can also influence the efficacy of plant defenses such as myrosinases and tannins, and (...) alter insects' susceptibility to natural enemies. Conversely, herbivores appear to influence both de novo synthesis and redox cycling of AsA in their host plants, thereby potentially altering the nutritional value of crops and their susceptibility to pests. The recent development of genetically modified crops with enhanced AsA content provides both an impetus and a tool set for further studies on the role of AsA in plant‐insect interactions. (shrink)

Many research ethics guidelines now oblige researchers to offer research participants the results of research in which they participated. This practice is intended to uphold respect for persons and ensure that participants are not treated as mere means to an end. Yet some scholars have begun to question a generalised duty to disclose research results, highlighting the potential harms arising from disclosure and questioning the ethical justification for a duty to disclose, especially with respect to individual results. In support of (...) this view, we argue that current rationales for a duty of disclosure do not form an adequate basis for an ethical imperative. We review policy guidance and scholarly commentary regarding the duty to communicate the results of biomedical, epidemiological and genetic research to research participants and show that there is wide variation in opinion regarding what should be disclosed and under what circumstance. Moreover, we argue that there is fundamental confusion about the notion of “research results,” specifically regarding three core concepts: the distinction between aggregate and individual results, amongst different types of research, and across different degrees of result veracity. Even where policy guidance and scholarly commentary have been most forceful in support of an ethical imperative to disclose research results, ambiguity regarding what is to be disclosed confounds ethical action. (shrink)

After U.S. welfare was reformed in 1996, many states reduced their support of postsecondary education and instead emphasized work-first programs. This study uses in-depth interviews and participant observation to examine how case managers implement work-first policies when dealing with students desiring a college education. Case managers are expected to reconcile the goals of their clients with those of the Temporary Assistance for Needy Families program, while negotiating cultural definitions of “work” that frequently serve to reproduce gender, race, and class inequalities. (...) In this context, overburdened case managers, many of whom support proffering educational solutions, nonetheless find themselves promoting work over education. As a result, many economically poor women are dissuaded from pursuing postsecondary degrees that have the potential of increasing their chances of achieving financial self-sufficiency. (shrink)

BackgroundConcerns about decision making related to resuscitation have led to two important challenges in the courts resulting in new legal precedents for decision-making practice. Systematic research investigating the experiences of doctors involved in decisions about resuscitation in light of the recent changes in law remains lacking.AimTo analyse the practice of resuscitation decision making on hospital wards from the perspectives of doctors.DesignThe data presented in this paper were collected as part of a wider research study of end-of-life care in an acute (...) hospital setting. Data collection comprised ethnographic non-participant observation on two acute hospital wards and individual interviews with patients, relatives and healthcare professionals caring for patients thought to be approaching the end of life. Data were analysed using a constructivist grounded theory approach.ResultsDiscussions and decision making about resuscitation present many challenges for those involved on acute medical wards. The data highlight the potential for multiple interpretations of legal precedents, creating misunderstandings that may impact patient care in less positive ways.ConclusionsThis paper provides unique insights into how doctors respond to the changing medico-legal culture and the subsequent effects on patient care. It demonstrates how the juridification of medical practice can occur. It highlights the potential benefit of a structure to support clinicians, patients and relatives in discussing and navigating decisions around care at the end of life in line with the patient’s wishes and preferences. Recommendations for future research are made and legal ramifications are discussed. (shrink)