Placebo-controlled surgical trials can provide important information about the efficacy of surgical interventions. However, they are ethically contentious as placebo surgery entails the risk of harms to recipients, such as pain, scarring or anaesthetic misadventure. This has led to claims that placebo-controlled surgical trials are inherently unethical. On the other hand, without placebo-controlled surgical trials, it may be impossible to know whether an apparent benefit from surgery is due to the intervention itself or to the placebo effect.

The relationships between captive primates and their caregivers are critical ones and can affect animal welfare. This study tested the effect of caregivers using chimpanzee behaviors or not, in daily interactions with captive chimpanzees. In the Chimpanzee Behavior condition the caregiver presented chimpanzee behaviors. In the Human Behavior condition the caregiver avoided using chimpanzee behaviors. The chimpanzees had individual patterns of response and had significant differences in their responses to each condition. These data are compared to a similar study conducted (...) at The Zoo Northwest Florida. Both groups of chimpanzees were sensitive and responsive to the differences in conditions. These data suggest ways to improve animal welfare. (shrink)

The relationships between captive primates and their caregivers are critical ones and can affect animal welfare. This study tested the effect of caregivers using chimpanzee behaviors or not, in daily interactions with captive chimpanzees. In the Chimpanzee Behavior condition the caregiver presented chimpanzee behaviors. In the Human Behavior condition the caregiver avoided using chimpanzee behaviors. The chimpanzees had individual patterns of response and had significant differences in their responses to each condition. These data are compared to a similar study conducted (...) at The Zoo Northwest Florida. Both groups of chimpanzees were sensitive and responsive to the differences in conditions. These data suggest ways to improve animal welfare. Keywords: chimpanzee behavior; animal welfare; species-specific behavior; husbandry. (shrink)

In July 2019, Stella Creasy MP and her team succeeded in attaching an amendment to a largely administrative bill which would require the UK government to liberalise abortion laws in Northern Ireland by 21 October 2019, provided the Northern Ireland government does not resume before that date.1 The amendment succeeded in the Commons, 332 votes to 99 and later, with some adjustments, in the Lords, 182 votes to 37. The Bill received Royal Assent on 24 July 2019. In Northern Ireland, (...) abortion remains a criminal offence punishable by up to life imprisonment in all except exceptional circumstances, that is, where it is ‘necessary to preserve the life of the woman’ or where there is a ‘risk of serious adverse effect which is either long term or permanent’.2 The law makes no provision for women who are pregnant as a result of rape, incest or in the case of fatal fetal abnormality. Because there is a lack of clarity around which circumstances or conditions would have a sufficiently ‘serious and long-term adverse effect’, it has been argued that the law has had a ‘chilling effect’ on service provision.3 As a result, only 13 abortions were performed in Northern Ireland in 2018/2019.4 Instead, more than 1000 women travelled from Northern Ireland to England to access legal abortion services.5 A recent review of the law in Northern Ireland concluded that this situation disadvantages women who cannot afford to or are unable to travel.3 Women are also reportedly purchasing abortifacients unlawfully online, exposing them to the risk of prosecution as well as to risks where the pills are unsafe or lead to complications. Creasey’s amendment requires the Secretary of State for …. (shrink)

The British Medical Association and Royal College of Physicians have published new guidance, endorsed by the General Medical Council, on decision-making about clinically assisted nutrition and hydration and adults who lack capacity to consent. The development of the guidance follows a series of legal cases which has created confusion about the precise circumstances in which an application to the court is required before CANH is withdrawn which has culminated with the decision of the Supreme Court in National Health Service Trust (...) versus Y. 1 This confirmed that there is no requirement to go to court, providing there is agreement as to the patient’s best interests, the provisions of the Mental Capacity Act 2005 have been observed, and the relevant professional guidance has been followed. The new guidance covers all decisions to start, restart, continue, or stop providing CANH in patients who are not imminently dying, in circumstances where CANH is the primary life-sustaining treatment being provided. It goes beyond the category of patients in permanent vegetative state or minimally conscious state who have previously been the subject of court applications, and also covers decisions for patients with neurodegenerative conditions and patients who have suffered a sudden onset brain injury in addition to having multiple comorbidities or general frailty which is likely to impact on life expectancy. It provides a clear statement of doctors’ legal responsibilities, covers the importance of robust best interests’ assessments and sets out the process to be followed for sufficient independent scrutiny of decisions. In light of some of the identified problems with decisions about CANH, a particular focus of the guidance is on the importance of regular best interests’ assessments, and it provides detailed practical guidance about how to approach these. The development of …. (shrink)

Current regulations and guidelines identify specific subject populations as vulnerable. Regulations and guidelines generally stipulate protections with regard to the process of informed consent. Recent clinical trials suggest that satisfying the legal requirements for additional safeguards may not protect subjects to the extent we may desire. We present proposed guidelines for the protection of decisionally impaired subjects throughout the course of the trial.

During a pandemic, where there is widespread human infection, various and varying measures are taken that are targeted at public health objectives. During the early stages of a pandemic, these objectives may focus on containing the disease and minimizing its spread, but they may switch to mitigation as the emergent infectious disease takes hold in a population. There has been considerable debate and elucidation of the ethical principles and framework for the various responses including the need to fast track research (...) and vaccine development. However, the measures imposed during a pandemic would have unintended and untoward effect on ongoing clinical research. For example, precautionary measures, such as social distancing, may hamper ongoing clinical research, because recruitment and participation of patients and healthy volunteers is a potential source of virus spread. In this paper, we argue that a framework is needed to ensure the continuity of such research. Such a framework that considers the pertinent issues would need the ‘buy in’ of the key stakeholders (policy makers, funding agencies, institutional authorities, researchers and subjects) to ensure that the issues that are ethically relevant to pandemic planning would not be neglected or overlooked. (shrink)

The partnership between a visually impaired runner (VIR) and sighted guide runner (SGR) constitutes a unique sporting dyad. The quality of these partnerships may profoundly impact the sport and physical activity (PA) experiences of visually impaired (VI) people, yet little is known about the experiences of VIRs and SGRs. This study aimed to explore qualitatively the running experiences of VIRs and SGRs. Five VIRs and five SGRs took part in in-depth, semi-structured interviews (M length = 62 minutes) exploring their running (...) journeys and perceptions of running-together. We analysed the dataset using reflexive thematic analysis. Four themes were generated, comprising: becoming and being a running team; a multifaceted intercorporeal experience; running-together promotes change; and disabling social interaction within running. Participants were generally positive about their running experiences, highlighting a range of benefits derived from the activity. Nevertheless, some examples of barriers to participation were also identified. Although the positive experiences described by the runners suggest guided running holds promise to increase PA in VI people, our findings illustrate the importance of directing attention towards developing high-quality relationships between VIRs and guides, alongside reinforcing the need for further change to promote inclusivity. (shrink)

This article explores the accounts of Canadian-trained health professionals working in humanitarian and development organizations who considered not treating a patient or group of patients because of resource limitations. In the narratives, not treating the patient(s) was sometimes understood as the right thing to do, and sometimes as wrong. In analyzing participants’ narratives we draw attention to how medications and equipment are represented. In one type of narrative, medications and equipment are represented primarily as scarce resources; in another, they are (...) represented as patient care. In the contexts respondents were working, medications and equipment were often both patient care interventions and scarce resources. The analytic point is that health professionals tend to emphasize one conceptualization over the other in coming to assert that not treating is right, or wrong. Rendering tacit ethical frameworks more explicit makes them available for reflection and debate. (shrink)

While rooted in careful study of Mead’s original writings and transcribed lectures and the historical context in which that work was carried out, the papers in this volume have brought Mead’s work to bear on contemporary issues in metaphysics, epistemology, cognitive science, and social and political philosophy.

Has biopolitics actually become thanatopolitics, a field of study obsessed with death? Is there something about the nature of biopolitical thought today that makes it impossibile to deploy affirmatively? If this is true, what can life-minded thinkers put forward as the merits of biopolitical reflection? These questions drive Improper Life.Campbell argues that a "crypto-thanatopolitics" can be teased out of Heidegger's critique of technology and that some of the leading scholars of biopolitics---including Michel Foucault, Giorgio Agamben, and Peter Sloterdijk---have been (...) substansively influenced by Heidegger's thought, particularly his reading of proper and improper writing. In fact, Campbell shows how all of these philosophers have pointed toward a tragic, thanatopolitical destination as somehow an inevitable result of technology. But in Improper Life he articulates a corrective biopolitics that can begin with rereadings of Foucault, Freud, and Gilles Deleuze. Throughout Improper Life, Campbell insists that biopolitics can become more positive and productively asserts an affirmation techne not thought through thanatos but rather through bios. (shrink)

First published in 2002. Routledge is an imprint of Taylor & Francis, an informa company.

First published in 2002. Routledge is an imprint of Taylor & Francis, an informa company.

Despite pronouncements about the inevitable diffusion of artificial intelligence and autonomous technologies, in practice, it is human behavior, not technology in a vacuum, that dictates how technology seeps into—and changes—societies. To better understand how human preferences shape technological adoption and the spread of AI-enabled autonomous technologies, we look at representative adult samples of US public opinion in 2018 and 2020 on the use of four types of autonomous technologies: vehicles, surgery, weapons, and cyber defense. By focusing on these four diverse (...) uses of AI-enabled autonomy that span transportation, medicine, and national security, we exploit the inherent variation between these AI-enabled autonomous use cases. We find that those with familiarity and expertise with AI and similar technologies were more likely to support all of the autonomous applications we tested (except weapons) than those with a limited understanding of the technology. Individuals that had already delegated the act of driving using ride-share apps were also more positive about autonomous vehicles. However, familiarity cut both ways; individuals are also less likely to support AI-enabled technologies when applied directly to their life, especially if technology automates tasks they are already familiar with operating. Finally, we find that familiarity plays little role in support for AI-enabled military applications, for which opposition has slightly increased over time. (shrink)

The 2015 Paris Agreement set a global warming limit of 2°C above preindustrial levels. Corporations play an important role in achieving this objective, and methods have recently been developed to map global climate targets to specific industries, and individual corporations within those industries. In this article, we assess whether Sustainability ratings capture corporate performance in meeting the 2°C target. We analyze nine rating schemes used by investors and three commonly used in academic studies. Most rating schemes do consider corporate greenhouse (...) gas emissions in their analysis, whereas only a minority scale emissions by factors that have the potential to allow benchmarking against science-based targets. None take the final step of mapping climate indicators against the 2°C target. Furthermore, we find a lack of consistency in the climate change ratings of the databases used in academic studies. These results are concerning in the context of being able to meet global climate change goals. (shrink)

This anthology collects the texts that defined the concept of biopolitics, which has become so significant throughout the humanities and social sciences today. The far-reaching influence of the biopolitical—the relation of politics to life, or the state to the body—is not surprising given its centrality to matters such as healthcare, abortion, immigration, and the global distribution of essential medicines and medical technologies. Michel Foucault gave new and unprecedented meaning to the term "biopolitics" in his 1976 essay "Right of Death and (...) Power over Life." In this anthology, that touchstone piece is followed by essays in which biopolitics is implicitly anticipated as a problem by Hannah Arendt and later altered, critiqued, deconstructed, and refined by major political and social theorists who explicitly engaged with Foucault's ideas. By focusing on the concept of biopolitics, rather than applying it to specific events and phenomena, this Reader provides an enduring framework for assessing the central problematics of modern political thought. _Contributors_. Giorgio Agamben, Hannah Arendt, Alain Badiou, Timothy Campbell, Gilles Deleuze, Roberto Esposito, Michel Foucault, Donna Haraway, Michael Hardt, Achille Mbembe, Warren Montag, Antonio Negri, Jacques Rancière, Adam Sitze, Peter Sloterdijk, Paolo Virno, Slavoj Žižek. (shrink)

The aim of this book is “to point how far the Arabian philosophers succeeded in their attempt to integrate the Semitic and Muslim conception of revelation with Greek wisdom.” The problem is precisely that which confronted the Catholic theologians of the 13th century. Seeing the efforts of the Arabian philosophers side by side with the achievement of St. Thomas we can better appreciate what St. Thomas succeeded in doing.

First published in 2002. Routledge is an imprint of Taylor & Francis, an informa company.

In February 2020, the British Medical Association will be surveying members for their views on what the BMA’s position on physician-assisted dying should be. The BMA is currently opposed to physician-assisted dying in all its forms, a position that was agreed in 2006 at the annual representative meeting, the Association’s policy-making conference.1 As previously reported in Ethics briefing,2 the decision to survey members follows a motion passed at last year’s ARM which called on the BMA to “carry out a poll (...) of members to ascertain their views on whether the BMA should adopt a neutral position with respect to a change in the law on assisted dying”. The results from the survey will not determine BMA policy. Rather, the results be published ahead of this year’s ARM and provided to those attending to inform a debate and discussion on the BMA’s policy position. More information about the survey, including a briefing pack of useful information, and information for BMA members on how to participate can be found online at www.bma.org.uk/PAD. ### High Court rejects Judicial reviews on assisted suicide The High Court has refused permission for two separate challenges to the law on assisted suicide in the UK to proceed to a full hearing. In the first case, Phil Newby, who has motor neuron disease, applied for judicial review of the law on assisted suicide and asked for the court to carry out a detailed examination of what he termed “legislative facts” – that is, an examination of the existing evidence on the “costs, risks and benefits” of regulating assisted suicide – including a cross-examination of relevant expert witnesses.1 Handing down the judgement, Lord Justice Irwin and Mrs Justice May, held that assisted dying …. (shrink)

Healthcare professionals are currently working under extreme pressure as they respond to the pandemic outbreak of COVID-19. At the time of writing, there is currently no effective vaccine or anti-viral treatment. The pandemic is fast-moving, relatively unpredictable and of uncertain duration. In many countries, it is placing an enormous stress on healthcare resources and providing care to existing standards is proving difficult. Unfortunately, in some countries, health services have been overwhelmed. The impact of the pandemic on resource-poor countries is of (...) particular concern. This extraordinary situation is raising, or has the potential to raise, many ethical challenges for doctors delivering care to patients. It is possible, for example, that there may be points in this pandemic where decisions need to be made about who should have access to finite specialised intensive care beds, drugs and equipment. This has happened in some countries and, despite efforts by the UK Government to reduce demand and increase supply, it is still possible that this could happen in the UK. Some hospital trusts in the UK are already reporting concerningly low supplies of oxygen and vital medicines such as propofol and alfentanil.1 In these circumstances, where not everyone can be treated, difficult ethical decisions will have to made. For example, can some patients be prioritised over others? How should a doctor decide on which patients to treat? Can treatment be withdrawn from patients who are currently being treated, but are not responding, in order to offer treatment to those who may have a better chance of benefiting? The UK is also reporting concerningly low supplies of vital personal protective equipment for frontline workers, raising the question - what are a doctor’s obligations to treat patients, in circumstances that present a high …. (shrink)

Middle childhood, the period from 6 to 12 years of age, is defined socially by increasing autonomy and emotional regulation, somatically by the development of anatomical structures for subsistence, and endocrinologically by adrenarche, the adrenal production of dehydroepiandrosterone (DHEA). Here I suggest that DHEA plays a key role in the coordinated development of the brain and body beginning with middle childhood, via energetic allocation. I argue that with adrenarche, increasing levels of circulating DHEA act to down-regulate the release of glucose (...) into circulation and hence limit the supply of glucose which is needed by the brain for synaptogenesis. Furthermore, I suggest the antioxidant properties of DHEA may be important in maintaining synaptic plasticity throughout middle childhood within slow-developing areas of the cortex, including the insula, thamalus, and anterior cingulate cortex. In addition, DHEA may play a role in the development of body odor as a reliable social signal of behavioral changes associated with middle childhood. (shrink)