In the context of a public health emergency it is imperative to conduct research studies that will produce evidence rapidly while upholding ethical standards. The Ebola and Zika outbreaks highlighted the importance of devising agile processes for ethics review in emergencies, and international research ethics guidelines stress the duty to depart from standard processes for ethics review in emergency circumstances. However, before the COVID-19 pandemic it was not entirely clear what emergency procedures should look like. An additional challenge is that (...) while the same substantive ethical standards apply in emergency and non-emergency settings, deciding what these standards entail in the specific circumstances of a pandemic may be difficult. During the COVID-19 pandemic, challenges included identifying thresholds of social and scientific value, along with duties towards research participants, given the absence of therapeutic options; assessing continually changing risk–benefit profiles of studies, given rapidly emerging new evidence; developing appropriate informed consent processes, given lockdown scenarios; and even addressing the ethics of offering unproven interventions outside research settings. Additional issues raised during epidemics include devising feasible and meaningful community engagement strategies, mechanisms to ensure fairness in the distribution of the benefits that may result from research, and equitable and effective data-sharing plans that will inform pandemic response. Learning from these procedural and substantive challenges encountered in the ethics review of COVID-19 research is important for enhancing ethics preparedness for future emergencies. It can also potentially contribute to improving the ethics review of research in non-emergency circumstances. The seven cases in this chapter highlight ethical issues associated with ethics approval of multi-centre studies in pandemics, the need for careful consideration of the social and scientific value of research and challenges encountered when interventions are being transitioned from research to rollout, and issues that can arise when existing regulations and policies may limit capacities to appropriately adapt research to pandemic contexts. (shrink)

BackgroundResearch has been an essential part of the COVID-19 pandemic response, including in Latin American (LA) countries. However, implementing research in emergency settings poses the challenge of producing valuable knowledge rapidly while upholding research ethical standards. Research ethics committees (RECs) therefore must conduct timely and rigorous ethics reviews and oversight of COVID-19 research. In the LA region, there is limited knowledge on how countries have responded to this need. To address this gap, the objective of our project is to explore (...) if LA countries developed policies to streamline ethics review and oversight of research in response to the pandemic while ensuring its adherence to ethical standards, and to analyze to what extent these governance frameworks are in accordance with international guidance.MethodsWe conducted a descriptive and exploratory study assessing the COVID-19 research ethics governance frameworks of 19 LA countries, considering 4 dimensions based on international COVID-19 ethics guidance documents: (i) ethics review organizational model adopted, (ii) measures to coordinate between RECs and other research stakeholders, (iii) operational guidance for RECs, and (iv) key ethical issues for review and oversight of COVID-19 research.Results10 out of 19 LA countries have some policy to streamline ethics review of COVID-19 research. Of these countries only 6 issued comprehensive documents following international guidance that contemplate strategies with recommendations for concrete actions for a timely and rigorous review.ConclusionLA countries adopted partial strategies and operational guidance that may demonstrate a lack of a comprehensive view of research ethics for the review and oversight of COVID-19 research. Continuing efforts should be directed to strengthen LA countries' research capacity to respond timely and ethically to future health emergencies. Past lessons and the ones from this pandemic should be the basis to develop international standards and operational guidelines for ethics review and oversight of any research for public health emergencies. (shrink)

Over recent years, the research community has been increasingly using preprint servers to share manuscripts that are not yet peer-reviewed. Even if it enables quick dissemination of research findings, this practice raises several challenges in publication ethics and integrity. In particular, preprints have become an important source of information for stakeholders interested in COVID19 research developments, including traditional media, social media, and policy makers. Despite caveats about their nature, many users can still confuse pre-prints with peer-reviewed manuscripts. If unconfirmed but (...) already widely shared first-draft results later prove wrong or misinterpreted, it can be very difficult to “unlearn” what we thought was true. Complexity further increases if unconfirmed findings have been used to inform guidelines. To help achieve a balance between early access to research findings and its negative consequences, we formulated five recommendations: (a) consensus should be sought on a term clearer than ‘pre-print’, such as ‘Unrefereed manuscript’, “Manuscript awaiting peer review” or ‘’Non-reviewed manuscript”; (b) Caveats about unrefereed manuscripts should be prominent on their first page, and each page should include a red watermark stating ‘Caution—Not Peer Reviewed’; (c) pre-print authors should certify that their manuscript will be submitted to a peer-review journal, and should regularly update the manuscript status; (d) high level consultations should be convened, to formulate clear principles and policies for the publication and dissemination of non-peer reviewed research results; (e) in the longer term, an international initiative to certify servers that comply with good practices could be envisaged. (shrink)

My aim in this tentative text is framing political philosophy in the planetary context of Anthropocene. I will explore the political meaning of three non-excluding scenarios (emergencies, transitions and collapse) in order to demand the adequate doses of realism and utopianism to survive as an eco-dependent humanity. The climate emergency implies the acceptance of resilience as a political objective from the starting point of our radical vulnerability. We need a practical political philosophy that makes room for hope.

Biobased production has been promoted as a sustainable alternative to fossil resources. However, controversies over its impact on sustainability highlight societal concerns, value tensions and uncertainties that have not been taken into account during its development. In this work, the consideration of stakeholders’ values in a biorefinery design project is investigated. Value sensitive design is a promising approach to the design of technologies with consideration of stakeholders’ values, however, it is not directly applicable for complex systems like biorefineries. Therefore, some (...) elements of VSD, such as the identification of relevant values and their connection to a technology’s features, are brought into biorefinery design practice. Midstream modulation, an approach to promoting the consideration of societal aspects during research and development activities, is applied to promote reflection and value considerations during the design decision making. As result, it is shown that MM interventions during the design process led to new design alternatives in support of stakeholders' values, and allowed to recognize and respond to emerging value tensions within the scope of the project. In this way, the present work shows a novel approach for the technical investigation of VSD, especially for biorefineries. Also, based on this work it is argued that not only reflection, but also flexibility and openness are important for the application of VSD in the context of biorefinery design. (shrink)

Este artículo analiza algunos interesantes momentos en la recepción feminista del pensamiento de Hannah Arendt. Al igual que respecto a otros clásicos y clásicas del pensamiento contemporáneo —Beauvoir, Foucault o Habermas, por poner sólo tres ejemplos— nos hemos encontrado con una nutrida historia de encuentros y desencuentros. Tras una primera valoración negativa del pensamiento arendtiano, por parte de las teóricas feministas de la segunda ola, el juicio, posteriormente, se matizará y el estudio de la riqueza conceptual de la autora y (...) de su potencia filosófica —su novedosa concepción de la política, su apuesta por la narratividad y el juicio, su definición de la libertad en conexión con la noción de natalidad, …— harán que se desate un interesante juego de apropiaciones y reapropiaciones, de lecturas e interpretaciones, que, incluso, en el caso de Linda Zerilli, propondrá la posibilidad de pensar un feminismo adjetivado como arendtiano. Al hilo de esta reconstrucción histórico-crítica, hemos enhebrado nuestra propia estimación de la recepción feminista de la obra de Arendt en el contexto de los debates políticos feministas de las últimas décadas. La controvertida filósofa política se ha convertido, en suma, en un referente insoslayable en el decurso de la teoría feminista contemporánea. (shrink)

El fenómeno migratorio es creador de transnacionalidad. En este contexto se replantea el carácter restrictivo de la ciudadanía ligada a la mera garantía de los derechos de los individuos pertenecientes al Estado-Nación. La discusión sobre la desterritorialización de la ciudadanía está abierta y no puede desligarse de los cambios propiciados por la globalización. Sin embargo, la perspectiva de género a la que obliga el fenómeno de la feminización de las migraciones, tanto en el plano normativo como en los estudios empíricos, (...) es, hoy por hoy, marginal. Visibilizar las injusticias estructurales ligadas al género tanto en las sociedades emisoras como receptoras de inmigración es una clave para reproponer un nuevo modelo de ciudadanía, con especial incidencia en la igualdad y en los derechos sociales y económicos, coherente con el marco normativo de los derechos humanos. (shrink)

RESUMENEste artículo reconstruye el espectro de críticas feministas a la idea habermasiana de espacio público por su ceguera frente al género. joan Landes, iris Young, Seyla Benhabib y Nancy Fraser lo objetarán con distinto grado de racionalidad. El motivo de este alud de objeciones lo provocó la trudicción al inglés de la historia y critica de la opinión pública, una obra en la que se idealizaba la esera pública burguesa deudora de las ideas de igualdad y universidad. No obstante, las (...) mujeres al ser consideradas seres báicamente privados, simplemente no tenían, por definición, cabida en ella. La tesis de la que partimos es que sin acceso al reconocimiento en el ámbito público no hay posibilidad de acceso a la identidad: ser, como apunta Hannah Ardent, es aparecer públicamente. El reto consiste en incluir a las mujeres como miembros de pleno derecho de la esfera pública dejando de lado los sobreentendidos que las sitúan en los márgenes de la políticaPALABRAS CLAVEESFERA PÚBLICA- FEMINISMO-IDENTIDAD-RECONOCIMIENTOABSTRACTThis paper reviews the spectrum of feminist critiques tothe Habermasian idea of the public space, because of his negligence towards gender issues. Joan Landes, iris young, Seyla Benhabib and Nancy Fraser reject it with different degrees of radicality. At the centr of this critical interest in Habermas lies the publication in English of his The structural Transformation of the public sphere, a book where the bourgeois public sphere, heir to the ideas of equality and universitality, got idealized. Women, deemed to be private individuals, did not enter the public sphere. The paper argues that without recognition in the public sphere there is no acces to having an identity: being, as claimed by Hannah Ardent, is to be public. The rest entails the inclusion of women as equal patners in the public shere, in sprite of the claims that put them in the margins of politicsKEYWORDSPUBLIC SPHERE-FEMINISM-IDENTITY-RECOGNITION. (shrink)

todas las esferas de la sociedad cubana, en tal sentido, la presente investigación ofrece una metodología para promover un accionar más activo y transformador de las instituciones sociales en la Educación Comunitaria desde el trabajo comunitario integrado que vincula los intereses y necesidades de la población en las tareas del desarrollo social. The existence of indifference behaviors to principles reveals the need for strengthening the educative work in all spheres of the Cuban society. In that sense, the present research provides (...) a methodology in order to promote a more active and transforming work of social institutions in the community education from the integrated community work connecting the interests and needs of the people on duties of social development. (shrink)

Online education has become an essential component of education. Thus, several factors, such as the student’s learning strategy and motivation, generally contribute to their academic success. This study investigates the relationship between learning strategies, motivation, and online learning environment among 150 first-year college students. Employing correlational design, the statistical findings of the study reveal that the r coefficient of 0.59 indicates a moderate positive correlation between the variables. The p-value of 0.00, which is less than 0.05, leads to the decision (...) to reject the null hypothesis. Hence, a significant relationship exists between learning strategies, motivation, and the online learning environment. (shrink)

Lack of vaccine confidence can contribute to drops in vaccination coverage and subsequent outbreaks of diseases like measles and polio. Low trust in vaccines is attributed to a combination of factors, including lack of understanding, vaccine scares, flawed policies, social media and mistrust of vaccine manufacturers, scientists and decision-makers. The COVID-19 crisis has laid bare societies’ vulnerability to new pathogens and the critical role of vaccines in containing this and future pandemics. It has also put science at the forefront of (...) the response, with several governments relying on academics to help shape policy and communicate with the public. Against this backdrop, protecting public trust in scientists and scientific output is arguably more important than ever. Yet, conflicts of interest in biomedical research remain ubiquitous and harmful, and measures to curb them have had limited success. There is also evidence of bias in industry-sponsored vaccine studies and academics are voicing concerns about the risks of working in a CoI prevalent research area. Here, we set out to challenge established thinking with regard to vaccine confidence, by shifting the gaze from a deficit in public understanding towards probity in research relationships and suggesting an alternative and perhaps complementary strategy for addressing vaccine mistrust. We argue that a concerted effort needs to be made to revisit the norms that undergird contemporary vaccine research, coupled with a willingness of all stakeholders to reimagine those relationships with an emphasis on demonstrating trustworthiness and probity. (shrink)

Fencing for the blind and visually impaired is an emerging sub-discipline of fencing that creates unusual conditions for meaning-making through interaction between embodied endowments and worldly affordances. With the rules of fencing slightly adjusted to the needs of the blindfolded participants – regardless of their sightedness – the discipline requires the fencers to engage in a duel by relying on other than visual cues. This article explores what an autoethnographic account of experiences of participation in fencing for the blind and (...) visually impaired brings to debates on the embodied, and specifically sensory difference. The discussion of these experiences intersects with debates on affect, affordance, and habit, with all three having important roles in related semiotic processes. Presented vignettes draw upon the author’s lived experiences of participation in fencing for the blind and visually impaired and are analyzed as part of a mixed-method autoethnographic study, accompanied by sensory methodologies, with a focus on an inquiry beyond the visual. The vignettes elucidate how we make sense of our surroundings through a complex engagement with the ecology of sensory and affective processes. In addition to exploring the role of affective and pre-conceptual aspects of our experiences, the article seeks to understand how semiosis occurs through both exposure to as well as the active pursuit of specific environmental signs available to us. The article also derives from biosemiotics to examine the complex relationship between meaning-making processes and habits. Finally, the autoethnographic account provides an insight into how we habituate the world and our embodied differences and thus enable meaning-making processes. (shrink)

The purpose of this article is to investigate human spatiality and perception in general, with the experience of adventure sports as its background. These activities highlight especially our strong relationship with the world when we consider the specific way in which the environment participates in the development of human potential. We first analyse the notions of risk and instability as important elements in adventure sports. Then we explore the notion of experience and spatiality, considering the way in which we establish (...) our relationship with the world. The theoretical background is found in the phenomenology of Merleau-Ponty and Bachelard’s phenomenology of imagination to investigate perspectives of space among adventurers. We hold that more than a different range of corporeal techniques, adventure sports can teach us a way of interrogating and looking at the world. They require a peculiar sensibility that allows our body to experience the environment in favour of a corporeal wisdom. Alternative sports indicate the possibility that we have to build up different ways of inhabiting the world and comprehending it. (shrink)

Flexibility in conceptual projection constitutes one of the most challenging issues in the embodiment and conceptual metaphor literatures. We sketch a theoretical proposal that places the burden of the explanation on attentional dynamics in interaction with mental models in working memory that are constrained to be maximally coherent. A test of this theory is provided in the context of the conceptual projection of time onto the domain of space. Participants categorized words presented at different spatial locations (back–front, left–right) as referring (...) to the past or to the future. Responses were faster when the irrelevant word location was congruent with the back–past, front–future metaphoric mapping. Moreover, when a new highly task-relevant spatial frame of reference was introduced, it changed the projection of past and future onto space in a way that was congruent with the new frame (past was now projected to left space and future to right space), as predicted by the theory. This study shows that there is substantial flexibility in conceptual projection and opens a venue to study metaphoric variation across tasks, individuals, and cultures as the result of attentional dynamics. (shrink)

Body ecology by cosmosis refers to the experience of immersion, or the incorporation of the elements of nature through a body practice, leisure or sport. In this article, we propose comprehensive u...

Despite its potential implications for the objectivity of scientific knowledge, the claim that “scientific instruments are perspectival” has received little critical attention. I show that this claim is best understood as highlighting the dependence of instruments on different perspectives. When closely analyzed, instead of constituting a novel epistemic challenge, this dependence can be exploited to mount novel strategies for resolving two old epistemic problems: conceptual relativism and theory-ladeness. The novel content of this article consists in articulating and developing these strategies (...) by introducing two fine-grained notions of perspectives as the key units of analysis: “broad perspectives” and “narrow perspectives.”. (shrink)

Croatia is a transitional society in that it is a country emerging from a socialist command economy toward a market-based economy with ensuing structural changes of a social and political nature—some extending into the healthcare system. A legacy from our past is that, until now, Croatian healthcare institutions have had no real experience with clinical ethics support services. When clinical cases arise presenting complex ethical dilemmas in treatment options, the challenges presented to the medical team are substantial. The case described (...) below recently occurred on a ward in a university hospital in Croatia. An unexpected request from the patient’s parents created a number of issues that needed to be addressed by the medical team, which was made more difficult by the lack of clinical ethics support services. Such cases press the question currently being debated as to what type of ethics support services would be suitable for Croatia and why. (shrink)

In this essay I present some of my thoughts on the issue of boundaries in the professional relationship between service users and social workers. As a graduate student of social work, I had an opportunity to discuss ethical dilemmas in an international perspective in one of my courses. A guest professor, who provided international perspectives, was Prof. Kim Strom from UNC at Chapel Hill in North Carolina, USA. The lectures offered a fresh perspective that raised many questions about thick and (...) thin boundaries in social work – especially when approaching social work by following prevailing guidelines for social work in Slovenia requiring us to co-create solutions through dialogue with service users, keeping in mind that service users are actually the ones who are the experts from experience. In this way, the working relationship seeks to foster a sense of partnership between social workers and service users. In this essay I would like to challenge the idea of rigid boundaries in social work and explore the possibility of fluid boundaries, keeping in mind that boundaries should reflect their main purpose, which I believe is to protect human dignity. (shrink)

Citizenship is no longer an exclusive relationship. Many people today are citizens of multiple countries, whether by birth, naturalization, or even through monetary means, with schemes fast-tracking citizenship applications from foreigners making large investments in the state. Moral problems surround each of those ways of acquiring a second citizenship, while retaining one's original citizenship. Multiple citizenship can also have morally problematic consequences for the coherence of collective decisions, for the constitution of the demos, and for global inequality. The phenomenon of (...) multiple citizenship and its ramifications remains understudied, despite its magnitude and political importance. In this innovative book, Ana Tanasoca explores these issues and shows how they could be avoided by unbundling the rights that currently come with citizenship and allocating them separately. It will appeal to scholars and students of normative political theory, citizenship, global justice, and migration in political science, law, and sociology. (shrink)

Analytic study of ethical conviction and beliefs with reference to the Advaitavada of Śaṅkarācārya and Śuddhādvaitavāda of Vallabhachars.

Authentic leadership has become increasingly important in the literature, attracting the attention of many scholars in the last decade. This study adopted an employee-centered perspective to guide its examination of the relationship between authentic leadership and individual performance and investigation of the sequential mediation of employees’ affective commitment and individual creativity. An analysis was conducted of data collected from 214 employees working in different business sectors. The results reveal a statistically significant positive relationship between authentic leadership and employees’ workplace performance, (...) which are both directly connected and indirectly linked through the two proposed psychosocial mechanisms. The findings thus indicate that authentic leadership reinforces workers’ emotional connection with their organizations, thereby increasing their individual creativity and, subsequently, promoting better on-the-job performance. This study presents new and significant results since, on the one hand, it relied on a sequential mediation analysis of variables and, on the other hand, integrated the four main constructs into a single model. The proposed model displays the chain of effects between authentic leadership, affective commitment, individual creativity, and employee workplace performance. Implications for organizational management are discussed. (shrink)

Reseña crítica del libro de Alicia H. Puleo titulado Ecofeminismo para otro mundo posible . Madrid, Cátedra, 2011.

The language of ethics expertise has become particularly important in bioethics in light of efforts to establish the value of the clinical ethics consultation, to specify who is qualified to function as a clinical ethics consultant, and to characterize how one should evaluate whether or not a person is so qualified. Supporters and skeptics about the possibility of ethics expertise use the language of ethics expertise in ways that reflect competing views about what ethics expertise entails. We argue for clarity (...) in understanding the nature of expertise and ethics expertise. To be an ethics expert, we argue, is to be an expert in knowing what ought to be done. Any attempt to articulate expertise with respect to knowing what ought to be done must include an account of ethics that specifies the nature of moral truth and the means by which we access this truth or a theoretical account of ethics such that expertise in another domain is linked to knowing or being better at judging what ought to be done and the standards by which this “knowing” or “being better at judging” is determined. We conclude with a discussion of the implications of our analysis for the literature on ethics expertise in CEC. We do think that there are clear domains in which a clinical ethics consultant might be expert but we are skeptical about the possibility that this includes ethics expertise. Clinical ethics consultants should not be referred to as ethics experts. (shrink)

Prominent tuberculosis (TB) actors are invoking solidarity to motivate and justify collective action to address TB, including through intensified development and implementation (D&I) of technologies such as drugs and diagnostics. We characterize the ethical challenges associated with D&I of new TB technologies by drawing on stakeholder perspectives from 23 key informant interviews and we articulate the ethical implications of solidarity for TB technology D&I. The fundamental ethical issue facing TB technological D&I is a failure within and beyond the TB community (...) to stand in solidarity with persons with TB in addressing the complex sociopolitical contexts of technological D&I. The failure in solidarity relates to two further ethical challenges raised by respondents: skewed power dynamics that hinder D&I and uncertainties around weighing risks and benefits associated with new technologies. Respondents identified advocacy and participatory research practices as necessary to address such challenges and to motivate sustained collective action to accelerate toward TB elimination. We present the first empirical examination of bioethical accounts of solidarity in public and global health. Our study suggests that solidarity allows us better to understand and address the ethical challenges that arrest the D&I of new TB technologies. Solidarity lends credence to policies and practices that address the relational nature of illness and health through collective action. (shrink)

The theory of mental models postulates that meaning and knowledge can modulate the interpretation of conditionals. The theory's computer implementation implied that certain conditionals should be true or false without the need for evidence. Three experiments corroborated this prediction. In Experiment 1, nearly 500 participants evaluated 24 conditionals as true or false, and they justified their judgments by completing sentences of the form, It is impossible that A and ___ appropriately. In Experiment 2, participants evaluated 16 conditionals and provided their (...) own justifications, which tended to be explanations rather than logical justifications. In Experiment 3, the participants also evaluated as possible or impossible each of the four cases in the partitions of 16 conditionals: A and C, A and not-C, not-A and C, not-A and not-C. These evaluations corroborated the model theory. We consider the implications of these results for theories of reasoning based on logic, probabilistic logic, and suppositions. (shrink)

ResumenLa descortesía de Donald Trump ha causado preocupación en su país y en casi todo el planeta por los efectos geopolíticos que su discurso racista, xenofóbico y misógino podría tener en la política mundial (Wodak y Krzyżanowski, 2017). En América Latina, México ha sido blanco de su discurso ofensivo y esto ha generado respuestas de diferentes sectores de la sociedad. En este trabajo, nos concentramos en la respuesta que el diario La Jornada ha dado a los insultos y amenazas contra (...) los migrantes mexicanos y de otras nacionalidades desde su campaña electoral para presidente cuando amenazó con construir un muro entre Estados Unidos y México. Planteamos que aquí la descortesía es una práctica política de (auto)legitimación ideológica que amerita un estudio más allá de la construcción de la imagen social de los interlocutores individualmente porque, en este caso, se trata de una descortesía con implicaciones sociales, económicas y políticas para el diálogo internacional. Desde una perspectiva lingüística, interaccional y crítica (Bolívar, 2018, 2019) analizamos la situación, analizamos la situación entre México y EUA a través de los editoriales de La Jornada, concebidos como un espacio para el diálogo mediado por la prensa. Analizamos un corpus de editoriales que comprende de 2016 a 2020. El estudio revela cómo funciona la descortesía en la práctica política de Trump y la forma en que La Jornada responde en su rol de actor social. (shrink)

International criminal law (ICL) has traditionally overlooked sexual and gender-based violence (SGBV) and struggles to understand it. Prosecutions have been largely inefficient and not reflective of gender harms. The Rome Statute requires interpreting SGBV as a social construction (article 7(3)), in consistency with international human rights law (IHRL) and without discrimination (article 21(3)). There is, however, little guidance to implement these approaches. This article argues that intersectionality, an IHRL-based approach that reveals compounded discrimination, is an efficient tool to interpret SGBV (...) and, therefore, should be integrated in ICL. The article traces the origins of intersectionality in feminism and its recognition by IHRL dealing with violence against women. It establishes the applicability of intersectionality in ICL that it demonstrates with a comparative analysis of the Lubanga and Ntaganda cases. The findings show that intersectionality suits ICL’s specific needs which allows labelling and explaining some of those contributions throughout the judicial process. (shrink)

Codes of medical ethics (codes) are part of a longstanding tradition in which physicians publicly state their core values and commitments to patients, peers, and the public. However, codes are not static. Using the historical evolution of the Canadian Medical Association's Code of Ethics as an illustrative case, we argue that codes are living, socio-historically situated documents that comprise a mix of prescriptive and aspirational content. Reflecting their socio-historical situation, we can expect the upheaval of the COVID-19 pandemic to prompt (...) calls to revise codes. Indeed, Alex John London has argued in favour of specific modifications to the World Medical Association's International Code of Medical Ethics (which has since been revised) in light of moral and scientific failures that occurred during the COVID-19 pandemic. Responding to London, we address the more general question: should codes be modified to reflect lessons drawn from the COVID-19 pandemic or future such upheavals? We caution that codes face limitations as instruments of policy change because they are inherently interpretive and ‘multivocal’, that is, they usually underdetermine or provide more than one answer to the question, ‘What should I do now?’ Nonetheless, as both prescriptive and aspirational documents, codes also serve as tools for reflection and deliberation—collective practices that are necessary to engaging with and addressing the moral and scientific uncertainties inherent to medicine. (shrink)