Publics are key stakeholders in population genomic screening and their perspectives on ethical considerations are relevant to programme design and policy making. Using semi-structured interviews, we explored social views and attitudes towards possible future provision of personalised genomic risk information to populations to inform prevention and/or early detection of relevant conditions. Participants were members of the public who had received information on their personal genomic risk of melanoma as part of a research project. The focus of the analysis presented here (...) is participants’ views regarding ethical considerations relevant to population genomic screening more generally. Data were analysed thematically and four key themes related to ethical considerations were identified: personal responsibility for health: ‘forewarned is forearmed’; perceptions of, and responses to, genetic fatalism; implications for parenting and reproduction; divided views on choosing to receive genomic risk information. Ethical considerations underlying these themes include the valorisation of information and choice, paternalism, non-directiveness and increasing responsibilisation of individuals in health and healthcare. These findings arguably indicate a thin public conceptualisation of population genomic testing, which draws heavily on how these themes tend to be described in existing social discourses. Findings suggest that further public engagement is required to increase complexity of debate, to consider the appropriate place of individual and social interests in population genomic testing. Further discernment of relevant ethical approaches, drawing on ethical frameworks from both public health and clinical settings, will also assist in determining the appropriate implementation of population genomic screening for complex conditions. (shrink)

This volume explores questions that emerge from considering the relationship between nature and ethics through philosophical, theological, ethical, and environmental lenses.

During the debates about the legalization of Voluntary Assisted Dying in Victoria, Australia, the presence of anti-VAD health professionals in the medical community and reported high rates of conscientious objection to VAD suggested access may be limited. Most empirical research on CO has been conducted in the sexual and reproductive health context. However, given the fundamental differences in the nature of such procedures and the legislation governing it, these findings may not be directly transferable to VAD. Accordingly, we sought to (...) understand how CO operates in the context of VAD. Prior to the implementation of the VAD legislation in June 2019, we conducted semi-structured interviews with seventeen health professionals with a self-declared CO to VAD, to explore what motivated their CO. Participants identified multiple motivations, which can be broadly categorized as: concerns for oneself; concerns for patients; concerns about the current Victorian legislation; and concerns for the medical profession. Participants’ moral commitments included personal, professional, and political commitments. In some cases, one’s CO was specific to Victoria’s current legislation rather than VAD more broadly. Our findings suggest CO motivations extend beyond those traditionally cited and suggest a need to better understand and manage CO in the healthcare context. (shrink)

In Victoria, Australia, the law regulating abortion was reformed in 2008, and a clause was introduced requiring doctors with a conscientious objection to abortion to refer women to another provid...

Background Victoria was the first Australian state to legalize voluntary assisted dying (elsewhere known as physician-assisted suicide and euthanasia). Some institutions indicated they would not participate in voluntary assisted dying. The Victorian government issued policy approaches for institutions to consider Objective To describe and analyse publicly available policy documents articulating an institutional objection to voluntary assisted dying in Victoria. Methods Policies were identified using a range of strategies, and those disclosing and discussing the nature of an institutional objection were thematically (...) analysed using the framework method. Results The study identified fifteen policies from nine policymakers and developed four themes: (1) extent of refusal to participate in VAD, (2) justification for refusal to provide VAD, (3) responding to requests for VAD, and (4) appeals to state-sanctioned regulatory mechanisms. While institutional objections were stated clearly, there was very little practical detail in most documents to enable patients to effectively navigate objections in practice. Conclusion This study demonstrates that despite having clear governance pathways developed by centralized bodies (namely, the Victorian government and Catholic Health Australia), many institutions’ public-facing policies do not reflect this guidance. Since VAD is contentious, laws governing institutional objection could provide greater clarity and regulatory force than policies alone to better balance the interests of patients and non-participating institutions. (shrink)

BackgroundDealing with end of life is challenging for patients and health professionals alike. The situation becomes even more challenging when a patient requests a legally permitted medical service that a health professional is unable to provide due to a conflict of conscience. Such a scenario arises when Victorian health professionals, with a conscientious objection (CO) to voluntary assisted dying (VAD), are presented with patients who request VAD or merely ask about VAD. The Voluntary Assisted Dying Act 2017 (Vic) recognizes the (...) inherent conflict of conscience that may arise for some health professionals when asked to provide VAD and responds by affording broad protection to conscientious objectors who wish to refuse to take part in the VAD process.MethodsSeventeen semi-structured qualitative interviews were conducted with Victorian health professionals with a self-identified CO to VAD in the lead-up to the implementation of VAD in Victoria. Interviews explored how participants anticipated they would manage their CO in practice. Interviews were transcribed verbatim and analyzed thematically.ResultsOur results reveal that the way in which health professionals claimed they would approach CO conversations is variable and was dependant on the strength of their opposition to VAD. We categorized conscientious objectors according to their approach as either dissuasive non-referrers, passive non-referrers, facilitators or negotiators. Our study also explores the perceived difficulties of exercising one’s CO as identified by our participants.ConclusionThe broad protection offered by the Voluntary Assisted Dying Act 2017 (Vic) encourages a range of behaviors from conscientious objectors, due to the minimal obligations imposed. In order to assist conscientious objectors, more policy, institutional guidance, and education needs to be available to conscientious objectors explicitly addressing how to effectively manage one’s CO. Such guidance is imperative to ensuring that their moral integrity is preserved and that they are exercising their CO appropriately. (shrink)

BackgroundThe use of genetic test results in risk-rated insurance is a significant concern internationally, with many countries banning or restricting the use of genetic test results in underwriting. In Australia, life insurers’ use of genetic test results is legal and self-regulated by the insurance industry (Financial Services Council (FSC)). In 2018, an Australian Parliamentary Inquiry recommended that insurers’ use of genetic test results in underwriting should be prohibited. In 2019, the FSC introduced an industry self-regulated moratorium on the use of (...) genetic test results. In the absence of government oversight, it is critical that the impact, effectiveness and appropriateness of the moratorium is monitored. Here we describe the protocol of our government-funded research project, which will serve that critical function between 2020 and 2023.MethodsA realist evaluation framework was developed for the project, using a context-mechanism-outcome (CMO) approach, to systematically assess the impact of the moratorium for a range of stakeholders. Outcomes which need to be achieved for the moratorium to accomplish its intended aims were identified, and specific data collection measures methods were developed to gather the evidence from relevant stakeholder groups (consumers, health professionals, financial industry and genetic research community) to determine if aims are achieved. Results from each arm of the study will be analysed and published in peer-reviewed journals as they become available.DiscussionThe A-GLIMMER project will provide essential monitoring of the impact and effectiveness of the self-regulated insurance moratorium. On completion of the study (3 years) a Stakeholder Report will be compiled. The Stakeholder Report will synthesise the evidence gathered in each arm of the study and use the CMO framework to evaluate the extent to which each of the outcomes have been achieved, and make evidence-based recommendations to the Australian federal government, life insurance industry and other stakeholders. (shrink)

Weiss, Propen, and Reid gather a diverse group of scholars to analyze the growing obsolescence of the human-object dichotomy in today's world. In doing so, Design, Mediation, and the Posthuman brings together diverse disciplines to foster a dialog on significant technological issues pertinent to philosophy, rhetoric, aesthetics, and science.

General principles of human cognition can help to explain why languages are more likely to have certain characteristics than others: structures that are difficult to process or produce will tend to be lost over time. One aspect of cognition that is implicated in language use is working memory—the component of short‐term memory used for temporary storage and manipulation of information. In this study, we consider the relationship between working memory and regularization of linguistic variation. Regularization is a well‐documented process whereby (...) languages become less variable (on some dimension) over time. This process has been argued to be driven by the behavior of individual language users, but the specific mechanism is not agreed upon. Here, we use an artificial language learning experiment to investigate whether limitations in working memory during either language learning or language production drive regularization behavior. We find that taxing working memory during production results in the loss of all types of variation, but the process by which random variation becomes more predictable is better explained by learning biases. A computational model offers a potential explanation for the production effect using a simple self‐priming mechanism. (shrink)

A Pedagogy of Purpose offers a completely fresh take on key problems in the education system. Gary Keogh argues that the education system has lost its way; it has become mechanistic, vapid, driven by an obsession with dubious measurements and led by a very narrow understanding of what it means to succeed. It has lost its sense of purpose. Using many real classroom examples, Keogh provides a new way forward, demonstrating how insights from classical philosophy can have a (...) positive influence on crucial issues in education like student behaviour, assessment, attendance, the quality of teaching and learning, and perhaps most importantly, the mental health of students and teachers. (shrink)

Theological reactions to the rise of the new atheist movement have largely been critically hostile or defensively deployed apologetics to shore up the faith against attack. Gary Keogh contends that focusing on scholarly material that is inherently agreeable to theology will not suffice in the context of modern academia. Theology needs to test its boundaries and venture into dialogue with those with antithetical positions. Engaging Richard Dawkins, as the embodiment of such a position, illustrates how such dialogue may offer (...) new perspectives on classical theological problems, such as the relationship of science and religion, the existence of God, creation, natural suffering and theodicy. Keogh demonstrates how a dialogical paradigm may take shape, rather than merely discussing it as a theoretical framework. A dialogue between such opposing hermeneutics may provide a new paradigm of theological scholarship - one which is up to the task of facing its critics in the public and pluralistic context of modern academia. (shrink)

Across worlds and bodies -- Touching the looking glass -- With thumbs in mind -- To touch sights and sounds -- Repetition, failure, and permanence -- From hackers to cyborgs.

The dorsal anterior cingulate cortex is a key node in the human salience network. It has been ascribed motor, pain-processing and affective functions. However, the dynamics of information flow in this complex region and how it responds to inputs remain unclear and are difficult to study using non-invasive electrophysiology. The area is targeted by neurosurgery to treat neuropathic pain. During deep brain stimulation surgery, we recorded local field potentials from this region in humans during a decision-making task requiring motor output. (...) We investigated the spatial and temporal distribution of information flow within the dACC. We demonstrate the existence of a distributed network within the anterior cingulate cortex where discrete nodes demonstrate directed communication following inputs. We show that this network anticipates and responds to the valence of feedback to actions. We further show that these network dynamics adapt following learning. Our results provide evidence for the integration of learning and the response to feedback in a key cognitive region. (shrink)

Women typically report more pain than men, as well as exhibit specific sex differences in the perception and emotional expression of pain. We present evidence that sex is a significant variable in the evolution of facial expression of pain.

This book is situated within the realm of theological engagement with the sciences with a particular focus on how the nature of ethics is understood through this dialogue. Its purpose is to provide a theological appreciation of the nature of ethics which also takes seriously evolutionary accounts of how ethics came to be. It argues that such a theological metaethic can be interpreted as hopeful and optimistic given the apparent evolution of the moral from the amoral. This work hinges on (...) two different but intertwined levels. One is the level of ethical systems: a particular understanding of Western Christian ethics. This level is framed by another, broader level of metaethics: an overarching understanding of the character of ethics that emerges from reflections on evolutionary theory and its naturalistic context. (shrink)

Assessing the current situation of the religion–science dialogue, it seems that a consensus of nonconsensus has been reached. This nonconsensus provides a pluralistic context for the religion and science dialogue, and one area where this plurality is clear is the discourse on relational models of God and creation. A number of interesting models have gained attention in contemporary theological dialogue with science, yet there is an overriding theme: an emphasis on God's involvement with the world. In this article, I argue (...) that theology has been preoccupied with this emphasis. It is suggested that the theme of the freedom of nature has been underrepresented. This theme of the freedom of nature I argue carries important theological implications. It is suggested that acts or events gain their significance largely by way of being contextualized by the fact that such acts or events could have been otherwise, a realization that might provide the various relational models of God and the world food for thought. (shrink)

This paper examines features of the talk in a number of teacher-parent interviews recently audio-recorded in a secondary school in Brisbane, Australia. The central topic of the talk is the academic achievement of the student. In offering accounts of the student's achievement, participants offer moral versions of themselves as parents and teachers. These institutional identities are oriented to and elaborated in the course and in the organisation of this talk. The student about whom the talk is done is present but (...) largely silent, an overhearing audience to this talk. The analysis shows how parents and teachers talk two institutions, and the relation between them, into being. (shrink)

In jurisdictions where voluntary assisted dying is legal, eligibility assessments, prescription and administration of a VAD substance are commonly performed by senior doctors. Junior doctors’ involvement is limited to a range of more peripheral aspects of patient care relating to VAD. In the Australian state of Victoria, where VAD has been legal since June 2019, all health professionals have a right under the legislation to conscientiously object to involvement in the VAD process, including provision of information about VAD. While this (...) protection appears categorical and straightforward, conscientious objection to VAD-related care is ethically complex for junior doctors for reasons that are specific to this group of clinicians. For junior doctors wishing to exercise a conscientious objection to VAD, their dependence on their senior colleagues for career progression creates unique risks and burdens. In a context where senior colleagues are supportive of VAD, the junior doctor’s subordinate position in the medical hierarchy exposes them to potential significant harms: compromising their moral integrity by participating, or compromising their career progression by objecting. In jurisdictions intending to provide all health professionals with meaningful conscientious objection protection in relation to VAD, strong specific support for junior doctors is needed through local institutional policies and culture. There are no data in this work. (shrink)

We have identified a sample of 53 societies outside of the classical Himalayan and Marquesean area that permit polyandrous unions. Our goal is to broadly describe the demographic, social, marital, and economic characteristics of these societies and to evaluate some hypotheses of the causes of polyandry. We demonstrate that although polyandry is rare it is not as rare as commonly believed, is found worldwide, and is most common in egalitarian societies. We also argue that polyandry likely existed during early human (...) history and should be examined from an evolutionary perspective. Our analysis reveals that it may be a predictable response to a high operational sex ratio favoring males and may also be a response to high rates of male mortality and, possibly, male absenteeism. Other factors may contribute, but our within-polyandry sample limits analysis. (shrink)

Big Ideas for Little Kids includes everything a teacher, a parent, or a college student needs to teach philosophy to elementary school children from picture books. Written in a clear and accessible style, the book explains why it is important to allow young children access to philosophy during primary-school education. Wartenberg also gives advice on how to construct a "learner-centered" classroom, in which children discuss philosophical issues with one another as they respond to open-ended questions by saying whether they agree (...) or disagree with what others have said. (shrink)

Ethics is a foundational competency in healthcare inherent in everyday nursing practice. Therefore, the promotion of qualified nurses’ and nursing students’ moral competence is essential to ensure ethically high-quality and sustainable healthcare. The aim of this integrative literature review is to identify the factors contributing to the promotion of qualified nurses’ and nursing students’ moral competence. The review has been registered in PROSPERO (CRD42023386947) and reported according to the PRISMA guideline. Focusing on qualified nurses’ and nursing students’ moral competence, a (...) literature search was undertaken in January 2023 in six scientific databases: CINAHL, Cochrane Library, PsycINFO, PubMed Medline, Scopus and Web of Science. Empirical studies written in English without time limitation were eligible for inclusion. A total of 29 full texts were retrieved and included out of 5233 citations. Quality appraisal was employed using Joanna Briggs Institute checklists and the Mixed Method Appraisal Tool. Data were analysed using inductive content analysis. Research about the factors contributing to the promotion of qualified nurses’ and nursing students’ moral competence is limited and mainly explored using descriptive research designs. The contributing factors were identified as comprising two main categories: (1) human factors, consisting of four categories: individual, social, managerial and professional factors, and ten sub-categories; and (2) structural factors, consisting of four categories: educational, environmental, organisational and societal factors, and eight sub-categories. This review provides knowledge about the factors contributing to the promotion of qualified nurses’ and nursing students’ moral competence for the use of researchers, nurse educators, managers, organisations and policymakers. More research about the contributing factors is needed using complex intervention, implementation and multiple methods designs to ensure ethically sustainable healthcare. (shrink)

The aim of this study is to explore how nurses perceive patient participations of patients over 75 years old undergoing hemodialysis treatment in dialysis units, and of their next of kin. Ten nurses told stories about what happened in the dialysis units. These stories were analyzed with critical discourse analysis. Three discursive practices are found: (1) the nurses’ power and control; (2) sharing power with the patient; and (3) transferring power to the next of kin. The first and the predominant (...) discursive practice can be explained with an ideology of paternalism, in which the nurses used biomedical explanations and the ethical principle of benefice to justify their actions. The second can be explained with an ideology of participation, in which the nurses used ethical narratives as a way to let the patients participate in the treatment. The third seemed to involve autonomous decision-making and the ethical principle of autonomy for the next of kin in the difficult end-of-life decisions. (shrink)

A dialogue between a foreign philosopher and a powerful statesman outline Plato's reflections on the family, the status of women, property rights, and criminal law.

В статье философия характеризуется на основе дискурсной парадигмы анализа: как текст, интеллектуальная деятельность и коммуникация. Характеризуются два равнозначных аспекта философского дискурса - когнитивный и коммуникативный. Обсуждается феномен философских контроверз, специфика философского спора, выразительные (знаковые) средства философского дискурса, роль мировоззренческого дискурса в современной общественно-политической ситуации в стране.

Background: Despite an increase in health research conducted in Africa, there are still inadequate human resources with research ethics training and lack of local long-term training opportunities in research ethics. A research ethics training program named United States-Mali Research Ethics Training Program (US-Mali RETP) was established through a partnership between the George Washington University Milken Institute School of Public Health (GWSPH), USA and University of Sciences, Techniques & Technologies of Bamako (USTTB), to address the critical need for improved bioethics training, (...) leadership, and policy in Mali. Methods: The aims of the capacity building programme are achieved by leveraging US and Africa-based expertise to strengthen research ethics education and capacity through: (1) intensive faculty development to design ethics training curricula; (2) development of a research ethics specialization within the existing Masters of Public Health program (MPH); and (3) establishing professional development courses through short-term training workshops and webinars to address research and professional needs in ethics. Results: The program will strengthen USTTB’s capacity of research ethics by training at least 15 MPH students over 5 years to prepare the next generation of ethics researchers. During the first two years of the program, a new ethics training curricula was developed, two cohorts of Master’s students were enrolled, and a series of webinars and workshops were conducted with participation of Malian and international researchers. Conclusions: US-Mali RETP will promote a sustainable bioethics enterprise at USTTB, and enable dissemination of research ethics training to increase health research capacity in Mali. (shrink)

Many writers in various fields--philosophy, religion, literature, and psychology--believe that the question of the meaning of life is one of the most significant problems that an individual faces. In The Meaning of Life, Second Edition, E.D. Klemke collects some of the best writings on this topic, primarily works by philosophers but also selections from literary figures and religious thinkers. The twenty-seven cogent, readable essays are organized around three different perspectives on the meaning of life. In Part I, the readings assert (...) and defend the theistic view that without the existence of God--or faith in God--life has no significance or purpose. In Part II the selections deny this thesis, defending instead the humanistic alternative--that life has or can have meaning and worth without any theistic beliefs or commitment. In the final group of readings, contributors ask if the question of the meaning of life is in itself legitimate and significant. The volume also includes an introduction by the editor and a selected bibliography. This new edition adds essays by A. J. Ayer, Hazel Barnes, William Lane Craig, Owen Flanagan, Antony Flew, Thomas Nagel, Kai Nielsen, Philip L. Quinn, Arthur Schopenhauer, and Walter T. Stace. The only anthology of its kind, The Meaning of Life, Second Edition, is ideal for courses in introduction to philosophy and human nature. It also provides an accessible and stimulating introduction to the subject for general readers. (shrink)

Although the equally pervasive and abstract concept of space has generated a vast body of disciplines, time, and the related idea of "becoming" (transforming, ...