A report by the Nuffield Council on Bioethics, contrary to the Declaration of Helsinki, permits most important research initiatives in developing countries.The Ethics of Research Related to Health Care in Developing Countries by the Nuffield Council on Bioethics makes a number of innovative recommendations that depart from codes such as the Declaration of Helsinki. It recommends that standards of care might be relativised to the standard of that nation. It recommends that very good reasons need to be given for (...) not giving post-trial access to medications but recognises that there may be justifiable instances of this. It is the view of the authors that these and other recommendations of the report are sensible pieces of advice given the complexities of the developing world. (shrink)

NICE, the draft fertility guideline and dodging the big question: should fertility treatment be provided by the NHS?In August of this year the National Institute for Clinical Excellence made its draft guideline on fertility treatment available for consultation.1 As has been widely reported in the media the draft guideline recommends that the National Health Service should provide publicly funded fertility treatment in a consistent way across England and Wales. The guideline recommends that three cycles of IVF should be available when (...) “The woman is within the optimal range for in vitro fertilisation and there is an appropriately diagnosed cause of infertility of any duration, or unexplained infertility of at least three years’ duration .Those who need fertility treatment will celebrate the guideline, as will many fertility clinics. The guideline does not, however, address key questions that will be obvious to many. Is fertility treatment the kind of thing that ought to be available on the NHS? Will the inevitable increase in demand mean that resources are directed away from other services? Is fertility treatment really the same kind of intervention as heart or hip replacement surgery?My view is that there are good reasons for doing what we can to help people access fertility services. Most of us will start a family and for those of us who do it is probably the most important of all of our life projects. Given that social status and wealth can be significant obstacles to many of the things that people would like to do with their lives, the fact that most of us are able to pursue this important life project is good from an egalitarian …. (shrink)

A friend, correspondent and intellectual successor to David Ricardo, John Ramsay McCulloch forged his reputation in the emerging field of political economy by publishing deeply researched articles in Scottish periodicals and the Encyclopaedia Britannica. From 1828 he spent nearly a decade as professor of political economy at the newly founded University of London, thereafter becoming comptroller of the Stationery Office. Perhaps the first professional economist, McCulloch had become internationally renowned by the middle of the century, recognised for sharing his ideas (...) through lucid lecturing and writing. The present work, first published in 1845, has been hailed as 'the first systematic account of the theory and policy of public finance'. After a general introductory chapter, the book discusses direct and indirect taxation, before considering national debt and how to deal with it. Several other works written or edited by McCulloch are also reissued in the Cambridge Library Collection. (shrink)

The Norrington Table is scotched, but not killed. It still appears each year in a national daily, having been compiled by an enterprising graduate with more need for money than time. Some people argue that this shows the futility of trying to suppress the table. But that is not so. In a free society it is open to anyone to obtain information and publish his results. There are many things that people might like to know about colleges. Of greater interest (...) to many than schools results would be the average earnings of graduates of each college five years after going down: that would enable people to pick the best college for repaying student loans, and for enjoying the fruits of worldly success. An enterprising graduate with nothing better to do might go through the university telephone directory, and work out the Ms-ratio for each college and department: no doubt the Daily Telegraph would pay good money for a list of those parts of Oxford that were entirely Ms-free. What is important is not what other people say, but what we say, or seem to endorse its being said, about us. Once the Norrington table appeared to have our imprimatur, it suggested that we set too much score by schools results, and instead of regarding final examinations as a necessary evil, bad, but less bad than any available alternative, we reckoned that getting a good result in schools was the chief.. (shrink)

There are many challenges to be met when writing an introductory treatise on an academic topic. The subject matter must be presented in a simple but not oversimplified manner. Enough theory must be included to ground the discussion of specific issues but not so much as to overwhelm or bore the readers. The text should be long enough to do justice to the subject matter but short enough to be readily accessible, especially for readers such as healthcare professionals, whose primary (...) concerns lie elsewhere.There are additional challenges in a relatively novel interdisciplinary field such as bioethics. The scope and methodology of bioethics are matters of great controversy, as are its relations with related subjects such as professionalism and human rights. The field is so broad that a single author cannot claim expertise on all topics. Rivalries between law and ethics and among medicine, other health professions, and disciplines such as philosophy complicate efforts to produce a broadly acceptable text. Finally, national and cultural differences pose major challenges to anyone trying to write for a truly international readership.The difficulty of meeting all these challenges in producing the WMA Medical Ethics Manual provides ample opportunity for criticism, especially from bioethics experts. The three expert reviewers of the manual in this issue of the journal are remarkably restrained in pointing out its shortcomings.1–3 I am grateful for both their positive evaluations and their constructive criticism. In what follows, I will respond to each of them in turn, focusing in particular on their suggestions as to how the Manual could have been improved.Before addressing these suggestions, I wish to clarify a matter raised by Søren Holm, namely, to what degree the manual …. (shrink)

In November 2016, the Council for International Organizations of Medical Sciences published its revised International Ethical Guidelines for Health-related Research Involving Humans. In relation to earlier versions, the scope of the new guidelines has been expanded to include public-health research. While successful to some extent, the document does not take into sufficient account the differences between public-health research and other types of health research. It is silent on some issues of importance to public-health research, such as its definition, health inequities (...) and novel research methodologies. Its treatment of some other issues, including the need for researchethics committee approval, consent, community involvement and dissemination of research results, are deficient in some respects. The guidelines that are particularly applicable to and useful for public-health research deal with social value, the health needs of communities and populations, community engagement, disasters and disease outbreaks, cluster randomised trials and data sharing. Much further development of the foundations and applications of public-health research ethics is needed to inform future revisions of the guidelines and of other international and national research-ethics documents. (shrink)

Possible distributive justice frameworks for providing health care by general practitioners are discussed. The ethical considerations before and after the recent changes to the British National Health Service are contrasted, with particular emphasis on a possible ethical divide that has been produced between fund-holding and non-fund-holding general practitioners. It is argued that general practitioners in non-fund-holding practices can continue as ethical advocates for their patients and distribute health care within an egalitarian framework. However, those in fund-holding practices may now be (...) seen as interest advocates and may have to practise utilitarian distributive justice. Patient groups may be needed to ensure that these general practitioners are seen to act justly in the distribution of the health care resources for which they are now responsible. (shrink)

Sexual violence against women is an issue of urgency that arises in all cultures locally, nationally, globally and transnationally. This problem has broad dimensions in both the public and private domains, both cases that are reported or not reported to law enforcement. Factually, the trend of this problem has been identified as increasing every year in Maluku, Indonesia. Therefore, the church requires serious attention to prevention and systematic treatment to overcome it. This sensitivity and awareness are a manifestation of the (...) church’s sense of calling and responsibility for the restoration of human dignity. The pastoral sermon service model is the church’s strategic approach to handling this problem. This research aimed to develop a model of pastoral sermons for victims of sexual violence against women in Maluku. This research focused on identifying and exploring the tragic experiences and impacts of sexual violence against women. Furthermore, a cross-cultural pastoral model was created for victims of violence.Contribution: This article provided a new perspective from the post-modern homiletics to approach social issues. This new homiletical approach to dealing with the problem of women’s sexual violence is one of the main focuses of ‘Women’s Theological Studies’ in HTS. (shrink)

The least element 0 of a finite meet semi-distributive lattice is a meet of meet-prime elements. We investigate conditions under which the least element of an algebraic, meet semi-distributive lattice is a (complete) meet of meet-prime elements. For example, this is true if the lattice has only countably many compact elements, or if |L| < 2ℵ0, or if L is in the variety generated by a finite meet semi-distributive lattice. We give an example of an algebraic, meet semi-distributive lattice that (...) has no meet-prime element or join-prime element. This lattice L has |L| = |LC| = 2ℵ0 where Lc is the set of compact elements of L. (shrink)

The language of “participant-driven research,” “crowdsourcing” and “citizen science” is increasingly being used to encourage the public to become involved in research ventures as both subjects and scientists. Originally, these labels were invoked by volunteer research efforts propelled by amateurs outside of traditional research institutions and aimed at appealing to those looking for more “democratic,” “patient-centric,” or “lay” alternatives to the professional science establishment. As mainstream translational biomedical research requires increasingly larger participant pools, however, corporate, academic and governmental research programs (...) are embracing this populist rhetoric to encourage wider public participation. We examine the ethical and social implications of this recruitment strategy. We begin by surveying examples of “citizen science” outside of biomedicine, as paradigmatic of the aspirations this democratizing rhetoric was originally meant to embody. Next, we discuss the ways these aspirations become articulated in the biomedical context, with a view to drawing out the multiple and potentially conflicting meanings of “public engagement” when citizens are also the subjects of the science. We then illustrate two uses of public engagement rhetoric to gain public support for national biomedical research efforts: its post-hoc use in the “care.data” project of the National Health Service in England, and its proactive uses in the “Precision Medicine Initiative” of the United States White House. These examples will serve as the basis for a normative analysis, discussing the potential ethical and social ramifications of this rhetoric. We pay particular attention to the implications of government strategies that cultivate the idea that members of the public have a civic duty to participate in government-sponsored research initiatives. We argue that such initiatives should draw from policy frameworks that support normative analysis of the role of citizenry. And, we conclude it is imperative to make visible and clear the full spectrum of meanings of “citizen science,” the contexts in which it is used, and its demands with respect to participation, engagement, and governance. (shrink)

In this article, we propose the Fair Priority Model for COVID-19 vaccine distribution, and emphasize three fundamental values we believe should be considered when distributing a COVID-19 vaccine among countries: Benefiting people and limiting harm, prioritizing the disadvantaged, and equal moral concern for all individuals. The Priority Model addresses these values by focusing on mitigating three types of harms caused by COVID-19: death and permanent organ damage, indirect health consequences, such as health care system strain and stress, as well as (...) economic destruction. It proposes proceeding in three phases: the first addresses premature death, the second long-term health issues and economic harms, and the third aims to contain viral transmission fully and restore pre-pandemic activity. -/- To those who may deem an ethical framework irrelevant because of the belief that many countries will pursue "vaccine nationalism," we argue such a framework still has broad relevance. Reasonable national partiality would permit countries to focus on vaccine distribution within their borders up until the rate of transmission is below 1, at which point there would not be sufficient vaccine-preventable harm to justify retaining a vaccine. When a government reaches the limit of national partiality, it should release vaccines for other countries. -/- We also argue against two other recent proposals. Distributing a vaccine proportional to a country's population mistakenly assumes that equality requires treating differently situated countries identically. Prioritizing countries according to the number of front-line health care workers, the proportion of the population over 65, and the number of people with comorbidities within each country may exacerbate disadvantage and end up giving the vaccine in large part to wealthy nations. (shrink)

This study provides evidence regarding the level of ethical cognition of business students at the entry to college as compared to a national norm. It also provides comparative evidence on the effects of group versus individual ethical cognition upon completion of a business ethics course. The Principled Score (P-score) from the Defining Issues Test (DIT) was used to measure the ethical cognition of a total sample of 301 business students (273 entering students plus 28 students in a business ethics course). (...) The results indicate that (1) business students are not significantly different from the national norms at entry to college and (2) group reasoning helps male students improve their P-scores significantly in the business ethics course at a loss of P-score (albeit not statistically significant) for female students. (shrink)

Everywhere the 1990s have been characterized by an odd mixture of ideological triumphalism-Fukuyama's "end of history" being only the crassest example-and of ideological uncertainty-can there be, should there be, a "third way"? For all its pretensions to universality, the "New World Order" has never lost a fragility in appearance. Students of historiography can scarcely be surprised to learn that an uneasiness over the present and future has in turn frequently entailed uncertainty about the past and particularly about those parts of (...) the past which had seemed most able to give clear and significant "lessons."One evident example is the history of what in my Explaining Auschwitz and Hiroshima I called the "long" Second World War, that is, that crisis in confidence in the relationship between political and economic liberalism and the nation-state which, by the end of 1938, had left only Britain, France, the Low Countries, and Scandinavia as in any sense preserving those "liberal" freedoms which had spread across Europe since 1789. In this article, I briefly review the most recent difficulties World War II combatant societies have had in locating a usable past in the history of those times. However, my major focus is on the specific case of Italy, very much a border state in the Cold War system, and today the political home of an "Olive Tree" and a "Liberty Pole" whose historical antecedents and whose philosophical base for the future are less than limpid. 1990s Italian historians thus give very mixed messages about the Fascist past; these are the messages I describe and decode. (shrink)

Medical tourism is a practice, whereby individuals travel across national borders with the intention of receiving medical care. Medical tourists are motivated to travel abroad by a number of factors, including the affordability of care abroad, access to treatments not available at home, and wait times for care at home. In this article, we share the findings of interviews conducted with 32 Canadian medical tourists with the aim of developing a better understanding of medical tourism, the ethical issues it raises (...) for public health within Canada and other source countries for medical tourists, and to identify research gaps and policy responses to this practice. While patient and academic perspectives overlap in several regards, we suggest areas in which academic consideration of the ethical issues raised by medical tourism can be informed by patient perspectives. (shrink)

The language of “participant-driven research,” “crowdsourcing” and “citizen science” is increasingly being used to encourage the public to become involved in research ventures as both subjects and scientists....

In lieu of an abstract, here is a brief excerpt of the content:46. HUME AND THE FUTURE OF THE SOCIETY OF NATIONS In the section of Hume's Treatise of Human Nature entitled Of the laws of nations (Section XI of Book III) he says: Political writers tell us, that in every kind of intercourse, a body politic is to be consider 'd as one person; and indeed this assertion is so far just, that different nations, as well as private persons, (...) require mutual assistance; at the same time that their selfishness and ambition are perpetual sources of war and discord.But tho' nations in this particular resemble individuals, yet as they are very different in other respects, no wonder they regulate themselves by different maxims, and give rise to a new set of rules, which we call the laws of nations. 1 He goes on to give examples of such laws:the sacredness of the persons of ambassadors, the declaration of war, the abstaining from poison'd arms, with other duties of that kind, which are evidently calculated for the commerce, that is peculiar to different.societies. (T 567) Hume then tells us in the next paragraph that such laws of nations may be added to the three laws of nature (that possessions should be stable, that possessions should be transferable by consent, and that promises or contracts should be kept) but that these laws of nations do not supersede the laws of nature; that is, they do not make the laws of nature irrelevant to relations among nation-states. In fact, the morality among nation-states involves the same kinds of obligations as morality among private persons, but the obligations are not as binding. The obligations of nation-states to each other can more readily be overridden by concerns of self-interest than would be legitimate in the case of private persons because nation-states are more nearly able to maintain themselves without external assistance than are individual persons. In Hume's words,... tho' the 47. morality of princes has the same extent, yet it has not the same force as that of private persons (T 558) because tho' the intercourse of different states be advantageous, and even sometimes necessary, yet it is not so necessary nor advantageous as that among individuals, without which 'tis utterly impossible for human nature ever to subsist. (T 569) In the last paragraph of this section Hume addresses himself to the question of the proportion these two species of morality bear to each other. (T 569) He says that we can never give any precise answer (T 569) and that the proper proportion is exhibited in the actual practice of the world. He takes this fact as showing that all men recognize that the rules of morality, both among private individuals and among nation-states, arise from human conventions, and from the interest, which we have in the preservation of peace and order. (T 569) When discussing the same issue in his Enquiry concerning the Principles of Morals Hume is more succinct. The observance of justice, though useful among them [nations], is not guarded by so strong a necessity as among individuals; and the moral obligation holds proportion with the usefulness. 2 """ The moral obligations of individuals to each other is thus greater than that of nations to each other because keeping the rules of justice is inore useful in the former case than in the latter. But Hume did not live in an age of atomic weapons, long-range missiles, and precision-guided munitions. Furthermore, the nations of the world are now much more interdependent than in his day, not only with regard to where they get the resources they need but also with regard to what they do with their wastes. There seems to be little roo.? _or dtubt that the utility of following the rules of justice among nations is much greater now than it was in the eighteenth 48. century. Since a nuclear war might mean the end of the human species, the utility of justice among nations seems to be approaching, perhaps even surpassing, the utility which moral rules have at the level of private persons. In view of this changed situation, I intend to review what Hume has... (shrink)

NCMRD initiated the Women in Management Research Program in January 1988. One of the objectives of the program is to help managers and policy makers deal with issues arising from women's increased participation in managerial and professional jobs backing research to help arrive at solutions to the problems being encountered both by institutions and by women themselves. Significant research funds have been raised from the private sector and ten projects have been funded to date. This article describes the early development (...) of the Program and its research mandate. (shrink)

The DAMA project is an observatory for rare processes and it is operative deep underground at the Gran Sasso National Laboratory of the I.N.F.N. In particular, the DAMA/LIBRA (Large sodium Iodide Bulk for RAre processes) set-up consists of highly radiopure NaI(Tl) detectors for a total sensitive exposed mass of ≃250 kg. Recent results, obtained by this set-up by exploiting the model independent annual modulation signature of Dark Matter (DM) particles, have confirmed and improved those obtained by the former DAMA/NaI experiment. (...) A model independent evidence for the presence of Dark Matter particles in the galactic halo is cumulatively obtained at 8.2 σ C.L. No systematics or side reactions able to account for the measured modulation amplitude and to contemporaneously satisfy all the many specific requirements of the signature have been found or suggested by anyone over more than a decade. An example of one of the many possible model dependent corollary quests for the candidate particles and for the related astrophysical, nuclear and particle physics scenarios is presented considering the whole cumulative exposure. Future perspectives are shortly addressed. (shrink)

The 2010 Nagoya Protocol is an international framework for access and benefit sharing (ABS) of the use of genetic and biological resources, with particular focus on indigenous communities. This is especially important in Africa, where local communities have a close reliance on environmental resources and ecosystems. However, national legislation and policies commonly lag behind international agreements, and this poses challenges for legal compliance as well as practical applications. This study reviews the academic literature on the Nagoya Protocol and ABS applications, (...) and then considers the implications of this analysis for research in Africa. Results show that there is uneven engagement with the principles of the Nagoya Protocol across different academic disciplines; local communities are sometimes sidelined in these studies; and only 8% of researchers in the literature analysed are located in Africa. Future developments should focus on ensuring national compliance with the Nagoya Protocol, and that researchers and industry work in partnership with local African communities on ABS issues. (shrink)

The National Institute of Mental Health (Bethesda, MD) reports that approximately 5.2 million Americans experience post-traumatic stress disorder (PTSD) each year. PTSD can be severely debilitating and diminish quality of life for patients and those who care for them. Studies have indicated that propranolol, a beta-blocker, reduces consolidation of emotional memory. When administered immediately after a psychic trauma, it is efficacious as a prophylactic for PTSD. Use of such memory-altering drugs raises important ethical concerns, including some futuristic dystopias put forth (...) by the President's Council on Bioethics. We think that adequate informed consent should facilitate ethical research using propranolol and, if it proves efficacious, routine treatment. Clinical evidence from studies should certainly continue to evaluate realistic concerns about possible ill effects of diminishing memory. If memory-attenuating drugs prove effective, we believe that the most immediate social concern is the over-medicalization of bad memories, and its subsequent exploitation by the pharmaceutical industry. (shrink)

Traditionally floods have been understood to be acts of God or nature, with localised impacts afflicting those who choose to live or to invest capital in lowland and coastal locations. This central idea of causation, located outside human agency, survives somewhat precariously today, but is reflected in the lack of any right to protection from flooding in England and Wales. However in 1930 new legislation institutionalised a social framing of the impact of floods as part of a wider national problem. (...) This related the interests of lowland agriculture and land drainage to the national economic and military interest. Modernising and expanding agricultural production was a political priority from the 1930s to the 1980s. The cost of preventing flooding and draining land was transferred from the affected landowners to the nation as a whole. River and coastal engineering was central to the new policy, and by the early 1970s much of the riverine and coastal environment was radically altered by flood defence structures and associated land drainage. As a result of food over-production and conflicts with conservation interests in the early 1980s, the emphasis has shifted from drainage to flood defence, while risk reduction and environmentalist values have also been promoted. The institutional arrangements from 1930 largely survive, however, and a new coherent social framing has failed to emerge. It is argued that for a risk-oriented framing to succeed, new assumptions about causation and a new ethical outlook are now needed. Emphasis on flood 'control' rather than 'defence', and a shift in priorities from economic benefits towards human rights and intrinsic value in nature are proposed as key elements in such a reframing. (shrink)

This article presents empirical evidence to address how some visitors build relationships with a wildland place over time. Insights are drawn from qualitative interviews of recreation visitors to the backcountry at Rocky Mountain National Park in Colorado. The article describes relationship to place as the active construction and accumulation of place meanings. The analysis is organized around three themes that describe how people develop relationships to place: time and experience accrued in place, social and physical interactions in and with the (...) setting, and an active reflective process of regulating sense of identity to affirm commitment to place. (shrink)

A cross-cultural survey experiment revealed a dominant tendency to rely on a rule’s letter over its spirit when deciding which behaviors violate the rule. This tendency varied markedly across (k = 15) countries, owing to variation in the impact of moral appraisals on judgments of rule violation. Compared with laypeople, legal experts were more inclined to disregard their moral evaluations of the acts altogether and consequently exhibited stronger textualist tendencies. Finally, we evaluated a plausible mechanism for the emergence of textualism: (...) in a two-player coordination game, incentives to coordinate in the absence of communication reinforced participants’ adherence to rules’ literal meaning. Together, these studies (total n = 5,794) help clarify the origins and allure of textualism, especially in the law. Within heterogeneous communities in which members diverge in their moral appraisals involving a rule’s purpose, the rule’s literal meaning provides a clear focal point—an identifiable point of agreement enabling coordinated interpretation among citizens, lawmakers, and judges. (shrink)

Engaged scholarship is an intellectual movement sweeping across higher education, not only in the social and behavioral sciences but also in fields of natural science and engineering. It is predicated on the idea that major advances in knowledge will transpire when scholars, while pursuing their research interests, also consider addressing the core problems confronting society. For a workable engaged agenda in science and technology studies, one that informs scholarship as well as shapes practice and policy, the traditional terms of engagement (...) must be renegotiated to be more open and mutual than has historically characterized the nature of inquiry in this field. At the same time, it is essential to protect individual privacy and preserve government confidentiality. Yet there is a scientific possibility for and benefit to introducing more collaborative and deliberative research approaches between scholar and subject in ways that will not violate these first-order ethics. To make the case, this article discusses the possibilities and perils of engaged science and technology scholarship by drawing on our own recent experiences to conduct and apply STS research while embedded in the National Science Foundation. Brief accounts of these experiences reveal the opportunities as well as the challenges of engaged scholarship. They also provide lessons for those fellow travelers who might follow the authors to this or other like host organizations with ambitions of increasing fundamental knowledge about and applying research to the policies, programs, and decisions of the scientific enterprise. (shrink)

Background Regarding controversial medical services, many have argued that if physicians cannot in good conscience provide a legal medical intervention for which a patient is a candidate, they should refer the requesting patient to an accommodating provider. This study examines what US physicians think a doctor is obligated to do when the doctor thinks it would be immoral to provide a referral. Method The authors conducted a cross-sectional survey of a random sample of 2000 US physicians from all specialties. The (...) primary criterion variable was agreement that physicians have a professional obligation to refer patients for all legal medical services for which the patients are candidates, even if the physician believes that such a referral is immoral. Results Of 1895 eligible physicians, 1032 (55%) responded. 57% of physicians agreed that doctors must refer patients regardless of whether or not the doctor believes the referral itself is immoral. Holding this opinion was independently associated with being more theologically pluralistic, describing oneself as sociopolitically liberal, and indicating that respect for patient autonomy is the most important bioethical principle in one's practice (multivariable ORs, 1.6–2.4). Conclusions Physicians are divided about a professional obligation to refer when the physician believes that referral itself is immoral. These data suggest there is no uncontroversial way to resolve conflicts posed when patients request interventions that their physicians cannot in good conscience provide. (shrink)

The ethical recruitment of participants with neurological disorders in clinical research requires obtaining initial and ongoing informed consent. The purpose of this study is to characterize barriers faced by research personnel in obtaining informed consent from research participants with neurological disorders and to identify strategies applied by researchers to overcome those barriers. This study was designed as a web-based survey of US researchers with an optional follow-up interview. A subset of participants who completed the survey were selected using a stratified (...) purposeful sampling strategy and invited to participate in an in-depth qualitative interview by phone or video conference. Data were analyzed using a mixed methods approach, including content analysis of survey responses and thematic analysis of interview responses. Over 1 year, 113 survey responses were received from US research personnel directly involved in obtaining informed consent from participants in neurological research. Frequently identified barriers to informed consent included: cognitive and communication impairments (e.g. aphasia), unrealistic expectations of research participants, mistrust of medical research, time constraints, literacy barriers, lack of available social support, and practical or resource-related constraints. Strategies to enhance informed consent included: involving close others to support participant understanding of study-related information, collaborating with more experienced research personnel to facilitate training in obtaining informed consent, encouraging participants to review consent forms in advance of consent discussions, and using printed materials and visual references. Beyond conveying study-related information, researchers included in this study endorsed ethical responsibilities to support deliberation necessary to informed consent in the context of misconceptions about research, unrealistic expectations, limited understanding, mistrust, and/or pressure from close others. Findings highlight the importance of training researchers involved in obtaining informed consent in neurological research to address disease-specific challenges and to support the decision-making processes of potential research participants and their close others. (shrink)

R J W Evans: Political Chronology; IntroductionJan Rychlík: Czech-Slovak Relations in Czechoslovakia, 1918-39Eagle Glassheim: Ambivalent Capitalists: The Roots of Fascist Ideology among Bohemian Nobles, 1880-1938Melissa Feinberg: The New 'Woman Question': Gender, Nation, and Citizenship in the First Czechoslovak RepublicRobert B. Pynsent: The Literary Representation of the Czechoslovak 'Legions' in RussiaCatherine Albrecht: Economic Nationalism in the Sudetenland, 1918-38R.J.W. Evans: Hungarians, Czechs and Slovaks: Some Mutual Perceptions, 1900-50Mark Cornwall: 'A Leap into Ice-Cold Water': the Manoeuvres of the Henlein Movement in Czechoslovakia, (...) 1933-8Vít Smetana: Old Wine in New Bottles? British Policy towards Czechoslovakia, 1938-9 and 1947-8Tatjana Tönsmeyer: The German Advisers in Slovakia, 1939-45: Conflict or Co-Operation?Mark Dimond: The Sokol and Czech Nationalism, 1918-48Jiri Kocian: The Czechs versus the Slovaks: Bilateral Relations, 1944-8Zdenk Radvanovský: The Transfer of Czechoslovakia's Germans and its Impact in the Border Region after the Second World WarKeith Robbins: Britain and Munich Reconsidered: A Personal Historical Journey. (shrink)

This book taps the best American thinkers to answer the essential American question: How do we sustain our experiment in government of, by, and for the people? Authored by an extraordinary and politically diverse roster of public officials, scholars, and educators, these chapters describe our nation's civic education problem, assess its causes, offer an agenda for reform, and explain the high stakes at risk if we fail.

Countermeasures for mpox (formerly known as monkeypox), primarily vaccines, have been in limited supply in many countries during outbreaks. Equitable allocation of scarce resources during public health emergencies is a complex challenge. Identifying the objectives and core values for the allocation of mpox countermeasures, using those values to provide guidance for priority groups and prioritisation tiers, and optimising allocation implementation are important. The fundamental values for the allocation of mpox countermeasures are: preventing death and illness; reducing the association between death (...) or illness and unjust disparities; prioritising those who prevent harm or mitigate disparities; recognising contributions to combating an outbreak; and treating similar individuals similarly. Ethically and equitably marshalling available countermeasures requires articulating these fundamental objectives, identifying priority tiers, and recognising trade-offs between prioritising the people at the highest risk of infection and the people at the highest risk of harm if infected. These five values can provide guidance on preferable priority categories for a more ethically sound response and suggest methods for optimising allocation of countermeasures for mpox and other diseases for which countermeasures are in short supply. Properly marshalling available countermeasures will be crucial for future effective and equitable national responses to outbreaks. (shrink)

The ratification of the United Nations Convention on the Rights of the Child (UNCRC) demands that those participating nations, adopt the aims of the convention as state responsibilities toward their child citizens. The central premise of the convention is clear: that it is the right of all children to develop to their full potential. The authors propose six basic interdependent developmental requirements if the child is to reach ‘full potential’. Without prioritising any one need, but instead concentrating on the facilitation (...) of complete care of the child, the paper aims to examine how the UNCRC may finally be realised. This is achieved by highlighting several key situations and associated factors, which contribute to deficient care. Whilst the factors leading to the creation of such situations are often culturally specific, the consequences for the child, and the implications for care providers (parents, aid agencies, and policy makers), are often very similar within and between continents. (shrink)

We asked whether and how generations vary in their perceptions on moral matters ranging from their justifications of crime and questions concerning bodily autonomy. In our exploratory study using data from the World Values Survey, we found that Generations Y and Z are more likely than their older counterparts to justify crimes, such as cheating on taxes or stealing property, and to favor greater bodily autonomy in issues such as suicide and abortion. They also rank lower the importance of God (...) and national pride. Implications are offered for employers who wish to motivate and incentivize a multi-generational workforce. (shrink)

The integration of ideas, methods, and data from diverse disciplines has been a transformative force in science and higher education, attracting policy interventions, program innovations, financial resources, and talented people. Much energy has been invested in producing a new generation of scientists trained to work fluidly across disciplines, sectors, and research problems, yet the success of such investments has been difficult to measure. Using the Integrative Graduate Education and Research Training (IGERT) program of the U.S. National Science Foundation as a (...) strategic research site, we conducted an experiment to determine whether and how the process and products of research of IGERT-trained scientists differ from those of scientists trained in disciplinary graduate programs. Among scientists in the early years of graduate study we found substantial and consistent differences suggesting that interdisciplinary training improved the quality and process of research, but this pattern was equally strongly reversed among students in the latter years of graduate study. Using systematic observation and other data we suggest why this might be so, then discuss the implications of these results for the design and conduct of graduate education and research. (shrink)

This article analyzes the contribution Christian ethics might be able to make to the ethical debate on policy and caregiving in health and social care in the United Kingdom. The article deals particularly with the concepts of solidarity and subsidiarity which are essential in Christian social ethics and health care ethics, and which may be relevant for the ethical debate on health and social caregiving in the United Kingdom. An important argument in the article is that utilitarian and market-driven policies (...) in the National Health Service (NHS) and the social care system have marginalized the position of the elderly and have seriously impoverished the quality of care for the elderly. The neglect of the elderly and other vulnerable groups is also the result of widespread consumerist attitudes among patients and of libertarian models of noninterference which are affirmed by a public ethos of self-sufficiency and counter-dependency. Those who need care dare not make their need known to others and ask for help, while simultaneously those who could help are so intimidated by the public affirmation of privacy and negative rights that they do not dare to offer help except if this is explicitly demanded. This distant and standoffish attitude is in an important way responsible for the fact that the voice of those in need is altogether lost to the public forum. Christian ethics puts much emphasis on responsibility and solidarity with the needy other but is not able to have much impact on the delivery of care in a secularized society and health care system like the NHS. Nonetheless, Christianity still has a powerful and respected voice, by speaking up for those who cannot speak for themselves, such as the elderly and the handicapped. Christians can find allies in the ethics of care and other relational approaches in health care ethics in order to combat libertarianism, consumerism, and utilitarianism. (shrink)

Objective: To explore the accounts and perspectives of junior doctors who were offered an HIV test by their employing National Health Service (NHS) trust and discuss ethical issues posed by this new policy. Design: Qualitative in-depth interview study. Setting: 4 NHS hospital trusts. Participants: 24 junior doctors who had been offered an HIV test as part of their pre-employment occupational health checks. Results: The manner in which HIV tests were offered to junior doctors varied both between and within the NHS (...) trusts. Overall, the doctors were highly critical of the way the HIV test was offered. Recurrent themes surrounding a lack of discussion and information regarding the indications for the test and implications of a positive result influenced the the doctors’ perception of their experiences. As a consequence of the shortcomings of how the test was offered, most of the doctors held the misperception that HIV testing was mandatory and many felt unable to decline the test. The majority of doctors referred to patient protection as adequate justification for being offered an HIV test. Conclusions: Junior doctors offered an HIV test under new Department of Health occupational health guidance were disparaging about how the test was offered. The findings of this study affect thousands of junior doctors in the UK, and the impact of these results is extensive. Participants’ suggestions regarding how the process of offering an HIV test can be improved are discussed and ethical issues regarding the new Department of Health policy are highlighted. (shrink)

(1996). What the prophet and the philosopher told their nations: A multi‐modal systems view of norms and civilisation. World Futures: Vol. 47, Unity and Diversity in Contemporary Systems Tinking: Systematic Pictures at an Exhibition, pp. 53-67.

The National Institute of Mental Health reports that approximately 5.2 million Americans experience post-traumatic stress disorder each year. PTSD can be severely debilitating and diminish quality of life for patients and those who care for them. Studies have indicated that propranolol, a beta-blocker, reduces consolidation of emotional memory. When administered immediately after a psychic trauma, it is efficacious as a prophylactic for PTSD. Use of such memory-altering drugs raises important ethical concerns, including some futuristic dystopias put forth by the President's (...) Council on Bioethics. We think that adequate informed consent should facilitate ethical research using propranolol and, if it proves efficacious, routine treatment. Clinical evidence from studies should certainly continue to evaluate realistic concerns about possible ill effects of diminishing memory. If memory-attenuating drugs prove effective, we believe that the most immediate social concern is the over-medicalization of bad memories, and its subsequent exploitation by the pharmaceutical industry. (shrink)

It was not until the nineteenth century that Western nations came to replace mutilation, corporal punishment, and banishment as the favored method of criminal punishment with the more humane concept of imprisonment. Even then, however, a convicted inmate was viewed as nothing more than a slave of the state, entitled only to the most basic of human rights and subject to the whim and peril of his jailor's desire. The shift to imprisonment gradually was accompanied by the additional humanitarian demand (...) that prisons avail their charges of some minimum standard of human decency and necessity, which, by the early part of the twentieth century, had come to encompass the provision of medical care. The courts later came to acknowledge this as a fundamental right grounded in the Eighth Amendment's proscription against cruel and unusual punishments.Although the scope of a prisoner's constitutional right to medical care has been the subject of much debate before the courts, the majority of cases have focused only on the circumstances under which the deprivation of care will amount to a violation of the rights guaranteed by the Eighth Amendment. (shrink)