Well before patient-centered or patient-controlled research became trendy, and earlier than calls to preferentially refer to research subjects as participants, Bob Veatch wrote “The Patient as Partner” Veatch presciently argued that research patients should not be thought of as passive subjects nor material from which to obtain data, but rather as partners in discovery. In this manuscript, I will explore Veatch’s conception of patient as partner in research and how that idea has evolved and been implemented over time and consider (...) some of the remaining challenges. Complexities of patient partnership include: clarifying the types of research in which patient partnership is most appropriate, recognizing the various possible levels of patient engagement in each case, avoiding tokenism and striving for respectful partnership, and keeping in mind the appropriate implementation of protections and safeguards. Bob Veatch would be pleased with the progress that has been made in creating research partnerships with patients, while also undoubtedly pushing us to continue to do better. (shrink)

In this essay, I offer some reflections on how the topics were identified and approached by the Presidential Commission for the Study of Bioethical Issues, on which I had the honor to serve, in the hope that the reflections may be useful to future national bioethics commissions. In the executive order that established the bioethics commission, President Obama explicitly recognized the ethical imperative to responsibly pursue science, innovation, and advances in biomedical research and health care, and the importance of national (...) attention to these issues. The bioethics commission prioritized practicable, actionable, targeted recommendations. Like most earlier U.S. national bioethics commissions, President Obama's commission did not undertake projects on significant and troublesome issues related to health and health care that were not associated with new science or technology. Issues such as health care access, health care delivery, opioid addiction, end‐of‐life care, and physician‐aid‐in‐dying are topical and ethically complex areas of significance to bioethics, and they are also being discussed and debated by the public, the media, and policy‐makers. In my view, there are good reasons to select and prioritize projects as well as a justification for confining commission efforts to issues related to novel science and emerging technologies, when there is only one national‐level bioethics commission that has been established by the Office of the President. (shrink)

Several studies conducted in the 1970's by western analysts concluded that Buddhism is the main obstacle to economic development in Thailand. This view typifies the reasoning of mainstream modernization and development practices in Third World countries. Yet in recent years, Post World War II policies based upon the goal of modernization have been under attack for the environmental disasters they have generated, for their failure to improve human conditions where they have been implemented, and for their assumption that the western (...) world's high levels of production and consumption are superior to all other socio-economic possibilities. This dissertation focuses on Buddhist community and environmental action as a response to the hardships generated by modernization, and the ethical and spiritual system on which this action is based, especially as demonstrated by Thailand's forest monks. ;Chapter 1 examines traditionally accepted views of Buddhist ethics, the background against which new environmental interpretations emerge. Chapter 2 surveys the present trend of Buddhist social action, the application of Buddhist philosophy to contemporary social issues. Socially-engaged Buddhism is also considered with a view to its scriptural justification. Chapter 3 explores both the ethics and social action of Buddhism with specific reference to the conservation of nature. ;At this point in the modernization of Thailand, poverty is growing in rural areas, compounded by increasing drought and environmental adversity. At the same time, expanded corporate and governmental control over arable land and forests assumes command of the nation's remaining natural resources. Chapter 4 discusses this recent history. Chapter 5 concentrates on Thailand's conservationist forest monks, their ethical philosophy, the social and natural environments they are endeavoring to preserve or recover, and their work with villagers whose well-being is at stake. ;The concluding chapter investigates the western model of economic development, criticizing its universalizability, its underlying values, and its outcomes. I argue that the challenge to contemporary economic practices and lifestyles represented by the conservationist forest monks' revitalization of Buddhist tradition offers Thailand's rural poor the potential for a more satisfying and beneficial way of life. (shrink)

Giving advice to Henry Bolingbroke was a pastime that could be very rewarding or very dangerous. Consider the following two cases. In May 1401, a little over nineteen months after Henry had deposed his cousin Richard and ascended the throne, his friend and confessor Philip Repyngdon, at that time the abbot of St. Mary de Prè in Leicester and chancellor of Oxford, sent Henry a long letter about the condition of the realm. Henry had personally requested such a report, according (...) to the version of the letter preserved in Adam of Usk's Chronicle: “Whereas your singular serenity did require of me, the least of your servants, when last I went out from before you with heavy heart, that, if I should hear aught adverse, I should make it known unto your excellency without delay, now, as your most obedient servant, do I take my pen in hand to show what I have heard and seen.” And Repyngdon had apparently heard and seen a lot, as he claimed that “law and justice are banished from the realm; thefts, murders, adulteries, fornications, extortions, oppressions of the poor, hurts, wrongs, and much reproach, are rife; and one tyrant will doth serve for law.”. (shrink)

There is a general presumption that epistemology does not have anything to do with wellbeing. In this paper I challenge these assumption, by examining the aftermath of the Gettier examples, the debate between internalism and externalism and the rise of virtue epistemology. In focusing on the epistemic agent as the locus of normativity, virtue epistemology allows one to ask questions about epistemic goods and their relationship to other kinds of good, including the good of the agent. Specifically it is argued (...) that emotion has a positive role to play in epistemology, an example from Aquinas is used to illustrate this and to illustrate the different kinds of good involved in cognition. (shrink)

In this paper, I examine the debate about existence between deflationist analytic accounts and the ‘thicker’ conception used by Aquinas when speaking of esse. I argue that the way one evaluates the debate will depend on background philosophical assumptions and that reflection on those assumptions could constitute an account of theoretical wisdom.

Aquinas’s actual response to a naturalistic challenge at ST I.2.3 is one which most naturalists would find unimpressive. However, I shall argue that there is a stronger response latent in his philosophical system. I take Quine as an example of a methodological naturalist, examine the roots of his position and look at two critical responses to his views (those of BonJour and Boghossian). If one adjusts some of the problematical aspects of their responses and establishes a hybrid position on the (...) epistemology and metaphysics of an antinaturalistic stance, it turns out to be the position Aquinas himself takes on meaning and knowledge. (shrink)

"...there is nothing elementary about O'Grady's primer. She pulls off the feat of writing a reliable and accessible introduction to modern philosophy that is also a meaningful contribution to the subject." - London Times Literary Supplement From Descartes' famous line 'I think therefore I am' to Kant's fascinating discussions of morality, the thinkers of the Enlightenment have helped to shape the modern world. Addressing such important subjects as the foundations of knowledge and the role of ethics, the theories of (...) these philosophers continue to have great relevance to our lives. Ranging across Enlightenment thinking from Berkeley to Rousseau, Enlightenment Philosophy in a Nutshell explains important ideas such as Locke's ideas of primary and secondary qualities, Kant's moral rationalism, and Hume's inductive reasoning. Filled with helpful diagrams and simple summaries of complex theories, this essential introduction brings the great ideas of the past to everyone. (shrink)

I focus on two challenges that processing-based theories of language must confront: the need to explain why language has the particular properties that it does, and the need to explain why processing pressures are manifested in the particular way that they are. I discuss these matters with reference to two illustrative phenomena: proximity effects in word order and a constraint on contraction.

Wisdom has not been widely discussed in analytical epistemology. An interesting recent analysis comes from Stephen Grimm who argues that wisdom requires knowledge and that the traditional dichotomy between theoretical and practical wisdom doesn’t hold. I note a tension between these aspects of his work. He wishes to maintain that traditional exemplars of wisdom may still be termed ‘wise’ by his theory. But his knowledge condition seems to require that only a subset of those who hold conflicting views are really (...) wise. I consider a number of possible responses to this and endorse a non-indexical contextualist approach which will allow the knowledge condition and also allow the traditional exemplars to be termed ‘wise’. (shrink)

Emergentist approaches to language are burdened with two responsibilities in contemporary cognitive science. On the one hand, they must offer a different and better understanding of the well-known phenomena that appear to support traditional formal approaches to language. On the other hand, they must extend the search for alternative explanations beyond the familiar languages of Europe and East Asia. I pursue this joint endeavor here by outlining an emergentist account for constraints on local anaphora in English and Balinese, with a (...) view to showing that, despite numerous proposals to the contrary, the two languages manifest essentially the same system of coreference and that the system in question is shaped by processing pressures rather than grammatical principles. (shrink)

Paul Gregory's careful and insightful response to “Carnap and Two Dogmas of Empiricism” highlights a number of points which were underdeveloped in that paper. I think that he has brought into relief a central issue between Camap and Quine by supplying a crucial distinction. However I still maintain that Quine's assault is less than successful and that Gregory's further analysis of the debate sheds light on why this is so.

The critical commentaries that take up the work of Julia Kristeva all too often disregard the 'religious content' that is central to her oeuvre from the 1980s to the present. Topics such as maternity, abjection, love and melancholia have been covered extensively by readers of Kristeva, yet most neglect to forge a connection between Kristevan theory and her religious, primarily Catholic, forays and examples, choosing to view these theologically inspired illustrations as merely incidental to her theory. And those readers who (...) have addressed the religious component of Kristeva's work, most notably feminist commentators, have dismissed it, labelling it with such terms as 'regressive', 'sentimental' and 'nostalgic' or 'troubling'. This paper argues that much of the confusion concerning Kristeva's relationship to feminism and the all too common attacks of essentialism, sexism and conservatism that are made against her, arise directly from the exclusion of her writings on theology and religion. What has ensued in the secondary source material has been a proliferation of false information concerning both Kristeva herself and her theoretical work, and a number of misplaced criticisms have followed. By truncating the religious dimen sion of Kristeva's philosophy, feminist readers have risked misunderstanding the import and scope of her entire project. Through a detailed examination of Kristeva's use of the image of 'Saint Barbara' in her theoretical, fictive and autobiographical works, this essay establishes that there is a direct connection between her core theoretical assertions and her views on religion. 'But we are, I know not how, double within ourselves'. 1. (shrink)

The objective of this study—a substudy to a phase I bioequivalence study—was to compare the effect of standard and concise consent forms on research volunteers’ comprehension of and satisfaction with consent forms, as well as to assess the effect of select volunteer characteristics, such as financial motivations to participate in research, on their comprehension. A 36-item questionnaire measured volunteers’ comprehension, satisfaction, and motivations for participation. Volunteers were randomized to the standard Pfizer consent form or a concise, easier-to-read form. We approached (...) 139 volunteers to participate, and 138 completed the questionnaire . The cohorts did not differ in sociodemographic characteristics. We found that the average comprehension scores for the standard consent form cohort and the concise consent cohort were about the same, and that satisfaction with the consent form was high in both cohorts. Surprisingly, volunteers with a financial motivation had significantly greater comprehension of the study. (shrink)

We reviewed 272 phase I oncology trial consent forms and then created an improved informed consent template in both English and Spanish by redesigning and rewording the consent form to be specific to phase I trials, to avoid repetition, and to use simplified language, identifiable sections framed by first-person questions, and tables to present information. The resulting consent form template is shorter than average and considerably easier to read . The template also meets the recommended eighth-grade maximum reading level for (...) consent forms. Use of this template should help improve the informed consent process. (shrink)

Importance Informed consent is essential to ethical, rigorous research and is important to recruitment and retention in cancer trials.Objective To examine cancer clinical trial (CCT) participants’ perceptions of informed consent processes and variations in perceptions by cancer type.Design and Setting and Participants Cross-sectional survey from mixed-methods study at National Cancer Institute–designated Northeast comprehensive cancer center. Open-ended and forced-choice items addressed: (1) enrollment and informed consent experiences and (2) decision-making processes, including risk-benefit assessment. Eligibility: CCT participant with gastro-intestinal or genitourinary, hematologic-lymphatic (...) malignancies, lung cancer, and breast or gynecological cancer (N = 334).Main Outcome Measures Percentages satisfied with consent process and information provided; and assessing participation’s perceptions of risks/benefits. Multivariable logistic or ordinal regression examined differences by cancer type.Results Most patient-participants felt well informed by the consent process (more than 90% overall and by cancer type) and. most (87.4%) reported that the consent form provided all the information they wanted, although nearly half (44.8%) reported that they read the form somewhat carefully or less. More than half (57.9%) said that talking to research staff (i.e., the consent process) had a greater impact on participation decisions than reading the consent form (2.1%). A third (31.1%) were very sure of joining in research studies before the informed consent process (almost half of lung cancer patients did—47.1%). Most patients personally assessed the risks and benefits before consenting. However, trust in physicians played an important role in the decision to enroll in CCT.Conclusions and Relevance Cancer patients rely less on written features of the informed consent process than on information obtained from the research staff and their own physicians. Research should focus on information and communication strategies that support informed consent from referring physicians, researchers, and others to improve patient risk-benefit assessment and decision-making. (shrink)

Van Fraassen begins with a swingeing attack on metaphysics in general and analytical metaphysics in particular. This is reasonably familiar territory, as he is best known for his antimetaphysical understanding of science. His chief complaint is that metaphysics purports to be a factual enterprise, but under examination it turns out to be mere word play. Analytic metaphysics offers a formal parallel with scientific inquiry—it offers “explanations” which mimic scientific explanations but which have no real purchase on us. No one offers (...) genuine probabilities, specificities, or achievable goals; it is idle word play. However, such word play exerts a deep pull on philosophers: “Even analytic metaphysicians uninterested in religion succumb to this fascination with the logical problem of theodicy. But I point to it only as an instructive parallel. The constructed God is not so different from the constructed world. Both are abstract simulacra of something real and important whose appeal lies mainly in the logical problems they engender and the virtuoso displays of ingenuity we can enjoy”. (shrink)

No detailed description available for "I gradi dell'organico e l'uomo".

Stories express hypotheses, interpretations of the world that have a certain degree of probability. To demonstrate this thesis I have adopted the notion of hypothesis, in a sense very close to the Meinongian concept of assumption, and a ‘metric’ conception of the values of the truth or falsity of a proposition – as that has been proposed in several ways by Peirce, Vasil’ev and Meinong. To show the the cognitive value of literary texts, and therefore their truth value, I take (...) my move from chapter 9 of Aristotle’s Poetics, where he holds that poetry is imitative of reality, not in the sense of history – which relates what has happened – but rather, in so far as it expresses “the kinds of things that might happen, that is, that could happen because they are either probable or necessary.” The probable admits variations of degree. By means of an examination of the Meinongian concepts of assumption and objective (i.e. state of affairs), which also allow different modes of gradation, I introduce, with examples drawn from Dante’s Divine Comedy and The Description (Tradimento) by Machiavelli, a theory of degrees of truth that makes it possible to apply the concept of probability to literary as well as to historical texts. Finally, I connect the universal character of the literary text with the ontological notion of incomplete object and argue that a fictional object, as it is incomplete, is not an individual but a type. (shrink)

Introduction Grady Hendrix is an American author and journalist who is also one of the founders of the New York Asian Film Festival. Horrostör: A Novel was published in 2014 by Quirk Books, a publisher based in Philadelphia and distributed by Penguin Random House. According to its website, Quirk Books was founded in 2002 and publishes ‘a highly curated list of entertaining, enlightening, and strikingly unconventional books for adults and children in a number of genres and categories,’ which i...

This book offers eleven different philosophical approaches to issues concerning the basis of value, the nature of the good life, and human destiny; important matters in this recession. The essayists featured are professors at Trinity College Dublin.

The Language Dynamic identifies a number of mechanisms that enable the meaning potential of language from the phoneme through grammar and discourse and onto ideological systems. This book, which underpins functional theories of language with concepts from biological and cultural evolution, social semiotics and systems theory, is relevant to all who are interested in how and why we can mean and what it means for us as humans to be semiotic agents.

The late twentieth century has provided both reasons and occasions for reassessing just war theory as an organizing framework for the moral analysis of war. Books by G. Scott Davis, James T. Johnson, and John Kelsay, together with essays by Jeffrey Stout, Charles Butterworth, David Little, Bruce Lawrence, Courtney Campbell, and Tamara Sonn, signal a remarkable shift in war studies as they enlarge the cultural lens through which the interests and forces at play in political violence are identified and evaluated. (...) In his review of the contribution made by these texts, the author focuses on the cohesion of just war theory, the asymmetry between Christian and Islamic attitudes toward holy war, and the need to develop just war theory into a tool adequate to assist in the moral evaluation of violent conflicts within, not just between, nation-states. (shrink)

The late twentieth century has provided both reasons and occasions for reassessing just war theory as an organizing framework for the moral analysis of war. Books by G. Scott Davis, James T. Johnson, and John Kelsay, together with essays by Jeffrey Stout, Charles Butterworth, David Little, Bruce Lawrence, Courtney Campbell, and Tamara Sonn, signal a remarkable shift in war studies as they enlarge the cultural lens through which the interests and forces at play in political violence are identified and evaluated. (...) In his review of the contribution made by these texts, the author focuses on the cohesion of just war theory, the asymmetry between Christian and Islamic attitudes toward holy war, and the need to develop just war theory into a tool adequate to assist in the moral evaluation of violent conflicts within, not just between, nation-states. (shrink)

Research participants' views about investigator financial interests were explored. Reactions ranged from concern to acceptance, indifference, and even encouragement. Although most wanted such information, some said it did not matter, was private, or was burdensome, and other factors were more important to research decisions. Very few said it would affect their research decisions, and many assumed that institutions managed potential conflicts of interest. Although disclosure of investigator financial interest information to research participants is often recommended, its usefulness is limited, especially (...) when participation is desired because of illness. (shrink)

Wittgenstein is often associated with different forms of relativism. However, there is ambiguity and controversy about whether he defended relativistic views or not. This paper seeks to clarify this issue by disambiguating the notion of relativism and examining Wittgenstein's relevant texts in that light.

An accessible guide to philosophy, presenting a collection of 70 essays covering the major themes, theories and arguments of the most prominent thinkers of ancient Greece.

Concerns about exploiting the poor or economically disadvantaged in clinical research are widespread in the bioethics community. For some, any research that involves economically disadvantaged individuals is de facto ethically problematic. The economically disadvantaged are thought of as “venerable” to exploitation, impaired decision making, or both, thus requiring either special protections or complete exclusion from research. A closer examination of the worries about vulnerabilities among the economically disadvantaged reveals that some of these worries are empirically or logically untenable, while others (...) can be better resolved by improved study designs than by blanket exclusion of poorer individuals from research participation. The scientific objective to generate generalisable results and the ethical objective to fairly distribute both the risks and benefits of research oblige researchers not to unnecessarily bar economically disadvantaged subjects from clinical research participation. (shrink)

The dictionary shows philosophers at their best (and their worst), at their most perverse and their most elegant. Organised by philosopher, and indexed by thought, concept and phrase, it enables readers to discover who said what, and what was said by whom. Over 300 philosophers are represented, from Aristotle to Zeno, including Einstein, Aquinas, Sartre and De Beauvoir, and the quotations range from short cryptic phrases to longer statements. This Dictionary of Philosophical Quotations d will not change your life. It (...) will change your mind. (shrink)

BackgroundReports suggest that some health care personnel fear retaliation from seeking ethics consultation. We therefore examined the prevalence and determinants of fear of retaliation and determined whether this fear is associated with diminished likelihood of consulting an ethics committee.MethodsWe surveyed registered nurses (RNs) and social workers (SWs) in four US states to identify ethical problems they encounter. We developed a retaliation index (1–7 point range) with higher scores indicating a higher perceived likelihood of retaliation. Linear regression analysis was performed to (...) identify socio-demographic and job characteristics associated with fear of retaliation. Logistic regression analysis was performed to determine whether fear of retaliation was associated with less likelihood of seeking consultation. Results Our sample (N = 1215) was primarily female (85%) and Caucasian (83%) with a mean age of 46 years and 17 years of practice. Among the sample, 293 (48.7%) RNs and 309 (51.3%) SWs reported access to an ethics consultation service. Amongst those with access, 2.8% (n = 17) personally experienced retaliation, 9.1% (n = 55) observed colleagues experience retaliation, 30.2% (n = 182) reported no experience with retaliation but considered it a realistic fear, and 50.8% (n = 305) did not perceive retaliation to be a problem. In logistic regression modeling, fear of retaliation was not associated with the likelihood (OR = 0.64; 95% CI = 0.22–1.89) or frequency of requesting ethics consultation (OR = 0.81; 95% CI = 0.27–2.38). Conclusion Fear of retaliation from seeking ethics consultation is common among nurses and social workers, nonetheless this fear is not associated with reduced requests for ethics consultation. (shrink)

Ethically challenging situations routinely arise in the course of illness and healthcare. However, very few studies have surveyed patients and family members about their experiences with ethically challenging situations. To address this gap in the literature, we surveyed patients and family members at three hospitals. We conducted a content analysis of their responses to open-ended questions about their most memorable experience with an ethical concern for them or their family member. Participants described 219 unique ethical experiences that spanned many of (...) the prevailing themes of bioethics, including the patient-physician relationship, end-of-life care, decision-making capacity, healthcare costs, and genetic testing. Participants focused on relational issues in the course of experiencing illness and receiving medical care and concerns regarding the patient-physician encounters. Many concerns arose outside of a healthcare setting. These data indicate areas for improvement for healthcare providers but some concerns may be better addressed outside of the traditional healthcare setting. (shrink)

New fetal therapies offer important prospects for improving health. However, having to consider both the fetus and the pregnant woman makes the risk–benefit analysis of fetal therapy trials challenging. Regulatory guidance is limited, and proposed ethical frameworks are overly restrictive or permissive. We propose a new ethical framework for fetal therapy research. First, we argue that considering only biomedical benefits fails to capture all relevant interests. Thus, we endorse expanding the considered benefits to include evidence-based psychosocial effects of fetal therapies. (...) Second, we reject the commonly proposed categorical risk and/or benefit thresholds for assessing fetal therapy research. Instead, we propose that the individual risks for the pregnant woman and the fetus should be justified by the benefits for them and the study’s social value. Studies that meet this overall proportionality criterion but have mildly unfavorable risk–benefit ratios for pregnant women and/or fetuses may be acceptable. (shrink)

Research ethics consultation is increasingly recognized as a potentially valuable mechanism for addressing the depth and breadth of ethical issues that arise in research related to human health and well-being. However, fundamental questions remain, including: What is “research ethics consultation”? And what is its justification beyond the purposes already served by existing entities? We examine how a research ethics consultation service may differ from or complement the role of an institutional review board by offering a definition of research ethics consultation (...) and by exploring the potential scope of a consultation service in terms of types of clients served, questions addressed, and advice provided at various stages of the research process. We then consider the relationship between research ethics consultation services and IRBs, as well as the issues that may arise between them, including possible conflicts of interest. (shrink)

Vulnerability is one of the least examined concepts in research ethics. Vulnerability was linked in the Belmont Report to questions of justice in the selection of subjects. Regulations and policy documents regarding the ethical conduct of research have focused on vulnerability in terms of limitations of the capacity to provide informed consent. Other interpretations of vulnerability have emphasized unequal power relationships between politically and economically disadvantaged groups and investigators or sponsors. So many groups are now considered to be vulnerable in (...) the context of research, particularly international research, that the concept has lost force. In addition, classifying groups as vulnerable not only stereotypes them, but also may not reliably protect many individuals from harm. Certain individuals require ongoing protections of the kind already established in law and regulation, but attention must also be focused on characteristics of the research protocol and environment that present ethical challenges. (shrink)

Technology has played a central role in development programming since the inception of development assistance. Recent development organizations, like the Bill and Melinda Gates Foundation, believe technological innovation can improve development outcomes. Development ethics, a field of study focused on the ethical questions posed by development policies and practices, has yet to fully appreciate the ethical dimensions of the science and technology. Addressing this important research and policy gap, we contend that science and technology studies (STS) offers important insights that (...) can be used in combination with development ethics to influence development policies and practices. Utilizing a case study of a private development program in Uganda, we illustrate how STS offers important insights for understanding how a sociotechnical ensemble placed pressure on already scarce water resources. Two dimensions of STS scholarship, the power asymmetries of technological development and the incomplete or partial nature of technoscientific knowledge, are examined and help us to understand how sociotechnical ensembles in development increase the likelihood of the emergence of publics who are negatively impacted by sociotechnical ensembles in development programs. Leveraging STS insights, we argue for the importance of situated ethics—a pragmatic approach to ensuring responsiveness to the emergence of these publics. (shrink)

Different types of consent are used to obtain human biospecimens for future research. This variation has resulted in confusion regarding what research is permitted, inadvertent constraints on future research, and research proceeding without consent. The National Institutes of Health Clinical Center's Department of Bioethics held a workshop to consider the ethical acceptability of addressing these concerns by using broad consent for future research on stored biospecimens. Multiple bioethics scholars, who have written on these issues, discussed the reasons for consent, the (...) range of consent strategies, and gaps in our understanding, and concluded with a proposal for broad initial consent coupled with oversight and, when feasible, ongoing provision of information to donors. This article describes areas of agreement and areas that need more research and dialogue. Given recent proposed changes to the Common Rule, and new guidance regarding storing and sharing data and samples, this is an important and tim.. (shrink)

The Covid‐19 pandemic has highlighted many of the difficult ethical issues that health care professionals confront in caring for patients and families. The decisions such workers face on the front lines are fraught with uncertainty for all stakeholders. Our focus is on the implications for nurses, who are the largest global health care workforce but whose perspectives are not always fully considered. This essay discusses three overarching ethical issues that create a myriad of concerns and will likely affect nurses globally (...) in unique ways: the safety of nurses, patients, colleagues, and families; the allocation of scarce resources; and the changing nature of nurses’ relationships with patients and families. We urge policy‐makers to ensure that nurses’ voices and perspectives are integrated into both local and global decision‐making so as to minimize the structural injustices many nurses have faced to date. Finally, we urge nurses to seek sources of support throughout this pandemic. (shrink)

Using payment to recruit research subjects is a common practice, but it raises ethical concerns that coercion or undue inducement could potentially compromise participants’ informed consent. This is the first national study to explore the attitudes of IRB members and other human subjects protection professionals concerning whether payment of research participants constitutes coercion or undue influence, and if so, why. The majority of respondents expressed concern that payment of any amount might influence a participant’s decisions or behaviors regarding research participation. (...) Respondents expressed greater acceptance of payment as reimbursement or compensation than as an incentive to participate in research, and most agreed that subjects are coerced if the offer of payment makes them participate when they otherwise would not or when the offer of payment causes them to feel that they have no reasonable alternative but to participate . Views about undue influence were similar. We conclude that human subjects protection professionals hold expansive and inconsistent views about coercion and undue influence that may interfere with the recruitment of research participants and impede valuable research. (shrink)

Payment to recruit research subjects is a common practice but raises ethical concerns relating to the potential for coercion or undue influence. We conducted the first national study of IRB members and human subjects protection professionals to explore attitudes as to whether and why payment of research participants constitutes coercion or undue influence. Upon critical evaluation of the cogency of ethical concerns regarding payment, as reflected in our survey results, we found expansive or inconsistent views about coercion and undue influence (...) that may interfere with valuable research. In particular, respondents appear to believe that coercion and undue influence lie on a continuum; by contrast, we argue that they are wholly distinct: whereas undue influence is a cognitive distortion relating to assessment of risks and benefits, coercion is a threat of harm. Because payment is an offer, rather than a threat, payment is never coercive. (shrink)