The voluntary and informed consent of subjects has been the central focus of concern in research reviews, overshadowing the importance of all other considerations. The Nuremberg Code, with its rights-based protection of the subject's autonomy above all else, made it difficult to justify research with no intended benefit when subjects are incompetent to make a valid informed choice to participate. Subsequent codes providing for research with incompetent subjects followed the lead of Nuremberg, substituting the informed authorization of a proxy for (...) the informed consent of the subject. (shrink)

Some authors argue that the ethics of medical care and the ethics of research differ, and that it is a mistake to conflate the two. They propose “that medical research and medical treatment are two distinct forms of activities, governed by different ethical principles.” This raises the question of whether physicians who are also clinical investigators may separate their role as physician from that of researcher when they are involved in clinical trials, thereby avoiding the obligations required in the physician-patient (...) relationship. Miller and Brody suggest that medical training is to blame for what they believe is the physicians’ tendency to confound the obligations of research and practice. “Physician-investigators, after all, went to medical school” they explain. They believe that considering research with patients outside the ethical framework of the physician-patient relationship may be “difficult and threatening” to physicians who have “psychological needs” to consider the ethical obligations flowing from their relationship with their patients. (shrink)

Some authors argue that the ethics of medical care and the ethics of research differ, and that it is a mistake to conflate the two. They propose “that medical research and medical treatment are two distinct forms of activities, governed by different ethical principles.” This raises the question of whether physicians who are also clinical investigators may separate their role as physician from that of researcher when they are involved in clinical trials, thereby avoiding the obligations required in the physician-patient (...) relationship. Miller and Brody suggest that medical training is to blame for what they believe is the physicians’ tendency to confound the obligations of research and practice. “Physician-investigators, after all, went to medical school” they explain. They believe that considering research with patients outside the ethical framework of the physician-patient relationship may be “difficult and threatening” to physicians who have “psychological needs” to consider the ethical obligations flowing from their relationship with their patients. (shrink)

Advances in medicine depend not only on the generation of information but also on its dissemination. Clinically relevant data must be transmitted to the practitioners who will use it. Health care professionals in North America are aware of their ethical and legal obligations to inform patients adequately concerning interventions and treatments so that they may make informed choices about medical care. This obligation has been well described and defined by the courts and in the literature of medicine, ethics, and law. (...) But do investigators and others who are responsible for disseminating information have any obligation to divulge adequately the results of clinical trials to practitioners so that the latter might offer the choice of appropriate care to their patients? Can incomplete disclosure of trial outcomes result in harm to patients? If this is the case, what possible avenues are available to avoid such harm? (shrink)

Advances in medicine depend not only on the generation of information but also on its dissemination. Clinically relevant data must be transmitted to the practitioners who will use it. Health care professionals in North America are aware of their ethical and legal obligations to inform patients adequately concerning interventions and treatments so that they may make informed choices about medical care. This obligation has been well described and defined by the courts and in the literature of medicine, ethics, and law. (...) But do investigators and others who are responsible for disseminating information have any obligation to divulge adequately the results of clinical trials to practitioners so that the latter might offer the choice of appropriate care to their patients? Can incomplete disclosure of trial outcomes result in harm to patients? If this is the case, what possible avenues are available to avoid such harm? (shrink)

This article reviews four areas of pediatric research in which we have identified questionable levels of allowable risk, exceeding those foreseen by the Commission. They are the following: the categorization of increasingly risky interventions as minimal risk in a variety of protocols; the increasing number of applications for federal panel review of research not otherwise approvable because of higher projected risk levels; research on asymptomatic at risk children; and the inclusion of children and adolescents in placebo-controlled trials for participants of (...) all ages without performing subgroup analysis. While embracing the imperative to include children in research is an encouraging step towards providing the pediatric population with effective medical care and finally eradicating the therapeutic orphan, we must ensure that this research does not become overly permissive. (shrink)

Placebo-controlled trials are held by many, including regulators at agencies like the United States Food and Drug Administration, to be the gold standard in the assessment of new medical interventions. Yet the use of placebo controls in clinical trials has been the focus of considerable controversy. In this two-part article, we challenge a number of common beliefs concerning the value of placebo controls. Part I critiques statistical and other scientific justifications for the use of placebo controls in clinical research. The (...) continued use of placebo controls in clinical trials on diseases for which accepted treatment exists raises equally important ethical, legal, and regulatory issues for which various justifications have been given. Defense of this practice relies on normative as well as empirical myths.In their attack on the prevailing use of placebo controls, Kenneth Rothman and Karin Michels emphasize that this practice stands in violation of the World Medical Association's guidelines on the ethics of human experimentation, most commonly known as the Helsinki Declaration. (shrink)

The use of statistics in medical research has been compared to a religion: it has its high priests, supplicants, and orthodoxy. Although the comparison may be more unfair to religion than to research, a useful lesson can nonetheless be drawn: the practice of clinical research may benefit—as does the spirit—from critical self-examination. Arguably, no aspect of the conduct of clinical trials is currently more controversial—and thus in as dire need of critical examination—than the use of placebo controls. The ethical and (...) scientific controversies associated with placebo-controlled trials, never far below the surface, have once again seized public attention. Clearly, concern about these issues within the professional community runs deep and wide, as evidenced by the volume of response generated by Kenneth Rothman and Karin Michels's recent Critique. Criticisms of the use of placebo controls in clinical research are scattered through the literatureo; our objective is to present the case against placebos in a compendious form that takes account of scientific and statistical as well as normative issues. (shrink)

The use of statistics in medical research has been compared to a religion: it has its high priests, supplicants, and orthodoxy. Although the comparison may be more unfair to religion than to research, a useful lesson can nonetheless be drawn: the practice of clinical research may benefit—as does the spirit—from critical self-examination. Arguably, no aspect of the conduct of clinical trials is currently more controversial—and thus in as dire need of critical examination—than the use of placebo controls. The ethical and (...) scientific controversies associated with placebo-controlled trials, never far below the surface, have once again seized public attention. Clearly, concern about these issues within the professional community runs deep and wide, as evidenced by the volume of response generated by Kenneth Rothman and Karin Michels's recent Critique. Criticisms of the use of placebo controls in clinical research are scattered through the literatureo; our objective is to present the case against placebos in a compendious form that takes account of scientific and statistical as well as normative issues. (shrink)

The continuous pursuit and support of medical research on both a societal and individual level is frequently presupposed as laudable, or even obligatory. However, some critics have challenged the assumption that medical research ought to be conducted. These critics reject claims that there is a moral obligation to pursue research, and that medical research may always be justifiable given adequate safeguards and regulations. We align ourselves with critics of the research imperative to the extent that we believe that medical research (...) may only be an imperfect obligation, grounded in the principle of beneficence. Our central purpose in this article, however, is not to advance an original argument concerning the .. (shrink)

Over the past several decades, geneticists have succeeded in identifying the genetic mutations associated with disease. New strategies for treatment, including gene transfer and gene therapy, are under development. Although genetic science has been welcomed for its potential to predict and treat disease, interventions may become ethically objectionable if they threaten to alter characteristics that are distinctively human. Before we can determine whether or not a genetic technique carries this risk, we must clarify what it means to be “human”. This (...) paper inquires how “humanness” has been defined within various academic fields. The views of several legal theoreists, scientists, bioethicists, psychologists, philosophers and anthropologists whose works seem to best reflect how “humanness” is understood in their respective fields of study are considered. Our survey attempts to chart a path for a more detailed study on the meaning of “humanness” in the future. (shrink)

We examine how the shift to remote work altered responsibilities for domestic labor among partnered couples and single parents. The study draws on data from a nationally representative survey of 2,200 US adults, including 478 partnered parents and 151 single parents, in April 2020. The closing of schools and child care centers significantly increased demands on working parents in the United States, and in many circumstances reinforced an unequal domestic division of labor.

The revelation that data obtained for the US-based National Surgical Adjuvant Breast and Bowel Project (NSABP) from subjects enrolled at Hôpital Saint-Luc in Montreal was falsified has eroded public trust in research. Institutions can educate researchers and help prevent unethical research practices by establishing procedures to monitor research involving human subjects. Research monitoring encompasses four categories of activity: annual reviews of continuing research, monitoring of informed consent, monitoring of adherence to approved protocols and monitoring of the integrity of data. The (...) authors describe characteristics of research projects that may call for monitoring procedures in each category. The form taken by such monitoring depends on the nature of the protocol. Although appropriate research monitoring requires substantial investment of personnel and financial resources, it is required under guidelines regulating research involving human subjects in Canada. Research monitoring is a step forward in re-establishing public confidence in medical research. (shrink)

Anonymity is a form of nonidentifiability which I define as noncoordinatability of traits in a given respect. This definition broadens the concept, freeing it from its primary association with naming. I analyze different ways anonymity can be realized. I also discuss some ethical issues, such as privacy, accountability and other values which anonymity may serve or undermine. My theory can also conceptualize anonymity in information systems where, for example, privacy and accountability are at issue.

This book explores the scope and limits of the concept of personDS a vexed question in contemporary philosophy. The author begins by questioning the methodology of thought-experimentation, arguing that it engenders inconclusive and unconvincing results, and that truth is stranger than fiction. She then examines an assortment of real-life conditions, including infancy, insanity andx dementia, dissociated states, and split brains. The popular faith in continuity of consciousness, and the unity of the person is subjected to sustained criticism. The author concludes (...) with a look at different views of the person found in Homer, Aristotle, the post-Cartesians, and contemporary cognitive science. (shrink)

This article describes a team-taught environmental studies course called Animal Metaphors. Focusing on animal metaphors in literature and film, the course emphasizes various cognitive and perceptual biases that lead humans to place ourselves above and beyond nature, making us more likely to engage in practices destructive to the environment. Whereas the first iteration of the course underscored various ways in which humans are less rational or moral than we imagine, the new iteration shifted more of the focus to what inspires (...) and motivates humans, gives us emotional resilience, and best creates conditions for mental well-being as we cooperate and collaborate. This seemed an appropriate tack to take in an age commonly referred to as the “Anthropocene.” We thus continued to examine our status as evolved animals while also calling more attention to spiritual or ecstatic experience, music, humor, and the uniquely human ability for shared intentionality. (shrink)

Scientists depend on complex computational systems that are often ineliminably opaque, to the detriment of our ability to give scientific explanations and detect artifacts. Some philosophers have s...

In an era of fake news, alternative truths and leaked secrets making constant headlines, we are telling stories about ourselves all the time, and we are telling them in so many different ways. From vlogs and blogs to tweets and posts, from photos and gifs to live streams. From instant updates that disappear to rash words that last for ever and data trails that chart every step we take. While people around her shake their heads and mutter bad things about (...) the new levels of day-to-day deceit, Kathleen Wyatt is busy marvelling at how society manages it. How do we do this extraordinary thing - often under the most ordinary of circumstances? How do we convince each other to suspend disbelief? And why do we do it? In this brilliant, wide-ranging study of lies and lying, Wyatt introduces us to a cast of professionals and professional liars - from scientists to investigators, from double agents to journalists, from toddler specialists to a fallen titan of industry - all to help her prove a remarkable thesis: lies hold us together as much as they push us apart and may be vital in a healthy society"--Publisher's description. (shrink)

A popular approach to defining fictive utterance says that, necessarily, it is intended to produce imagining. I shall argue that this is not falsified by the fact that some fictive utterances are intended to be believed, or are non-accidentally true. That this is so becomes apparent given a proper understanding of the relation of what one imagines to one's belief set. In light of this understanding, I shall then argue that being intended to produce imagining is sufficient for fictive utterance (...) as well. (shrink)

This book explores the scope and limits of the concept of personDS a vexed question in contemporary philosophy. The author begins by questioning the methodology of thought-experimentation, arguing that it engenders inconclusive and unconvincing results, and that truth is stranger than fiction. She then examines an assortment of real-life conditions, including infancy, insanity andx dementia, dissociated states, and split brains. The popular faith in continuity of consciousness, and the unity of the person is subjected to sustained criticism. The author concludes (...) with a look at different views of the person found in Homer, Aristotle, the post-Cartesians, and contemporary cognitive science. (shrink)

This article examines the complaint that arbitrary algorithmic decisions wrong those whom they affect. It makes three contributions. First, it provides an analysis of what arbitrariness means in this context. Second, it argues that arbitrariness is not of moral concern except when special circumstances apply. However, when the same algorithm or different algorithms based on the same data are used in multiple contexts, a person may be arbitrarily excluded from a broad range of opportunities. The third contribution is to explain (...) why this systemic exclusion is of moral concern and to offer a solution to address it. (shrink)

The primary aim of this study is to dissolve the mind-body problem. It shows how the ‘problem’ separates into two distinct sets of issues, concerning ontology on the one hand, and explanation on the other, and argues that explanation – whether or not human behaviour can be explained in physical terms – is the more crucial. The author contends that a functionalist methodology in psychology and neurophysiology will prove adequate to explain human behaviour. Defence of this thesis requires: an examination (...) of the mental/physical dichotomy, and its rejection in favour of a distinction between psychological and physical terms; a description and discussion of functionalism in psychology and neurophysiology, showing how the notorious problem of the necessary intensionality of psychological terms may be circumvented; an examination of the role of computer simulation in psycho-physical research; and an explanation of how the phenomena of sentience fit the functional framework. The book concludes that the thesis presented is in all essentials that of Aristotle; Aristotle had no ‘mind-body problem’, and were it not for a subsequent over-obsession with Cartesian scepticism, we need not have had one either. (shrink)

In this work, Kathleen V. Wider discusses Jean-Paul Sartre's analysis of consciousness in Being and Nothingness in light of recent work by analytic philosophers ...

The concept of a relational self has been prominent in feminism, communitarianism, narrative self theories, and social network theories, and has been important to theorizing about practical dimensions of selfhood. However, it has been largely ignored in traditional philosophical theories of personal identity, which have been dominated by psychological and animal theories of the self. This book offers a systematic treatment of the notion of the self as constituted by social, cultural, political, and biological relations. The author's account incorporates practical (...) concerns and addresses how a relational self has agency, autonomy, responsibility, and continuity through time in the face of change and impairments. This cumulative network model of the self incorporates concepts from work in the American pragmatist and naturalist tradition. The ultimate aim of the book is to bridge traditions that are often disconnected from one another--feminism, personal identity theory, and pragmatism--to develop a unified theory of the self. (shrink)