Terminally ill patients in 10 states plus Washington, D.C. have the right to take prescribed medications to end their lives (medical aid in dying). But otherwise-eligible patients with neuromuscular disabilities (ALS and other illnesses) are excluded if they are physically unable to “self-administer” the medications without assistance. This exclusion is incompatible with disability rights laws that mandate assistance to provide equal access to health care. This contradiction between aid-in-dying laws and disability rights laws can force patients and clinicians into violating (...) one or the other, potentially creating an underclass of patients denied medical care that is available to those with other (less physically disabling) terminal illnesses. The immediacy of this issue is demonstrated by a lawsuit in Federal court filed in August 2021, requesting assistance in self-administration for terminally ill patients with neuromuscular diseases. This paper discusses the background of this conflict, the ethical issues at the heart of the dilemma, and recommends potential remedies. (shrink)

When people lose capacity to make a medical decision, the standard is to assess what their preferences would have been and try to honor their wishes. Dementia raises a special case in such situations, given its long, progressive trajectory during which others must make substituted judgments. The question of how to help surrogates make better‐informed decisions has led to the development of dementia‐specific advance directives, in which people are given tools to help them communicate what their preferences are while they (...) are still able. Such directives allow the perspective of the person to play a clearer role in guiding decisions about their care. Dementia directives can never serve as rigid algorithms. Rather, they can be used to help inform conversations, to help surrogates make decisions that are better aligned with the preferences the person would have had. This essay lays out the proposed utility of dementia‐specific directives and addresses some of the criticisms raised about them. (shrink)

Business Ethics: A European Review, EarlyView.

By exhibiting a violation of a novel form of the Bell-CHSH inequality, \.{Z}ukowski has recently established that the quantum correlations exploited in the standard perfect teleportation protocol cannot be recovered by any local hidden variables model. Allowing the quantum channel state in the protocol to be given by any density operator of two spin-1/2 particles, we show that a violation of a generalized form of \.{Z}ukowski's teleportation inequality can only occur if the channel state, considered by itself, violates a Bell-CHSH (...) inequality. On the other hand, although it is sufficient for a teleportation process to have a nonclassical fidelity---defined as a fidelity exceeding $2/3$---that the channel state employed violate a Bell-CHSH inequality, we show that such a violation does \emph{not} imply a violation of \.{Z}ukowski's teleportation inequality or any of its generalizations. The implication does hold, however, if the fidelity of the teleportation exceeds $2/3(1+1/2\sqrt{2})\approx .90$, suggesting the existence of a regime of nonclassical values of the fidelity, less than $.90$, for which the standard teleportation protocol can be modelled by local hidden variables. (shrink)

With its wealth of readily and often publicly available information about Web users’ lives, the Web has created new opportunities for conducting online research. Although digital data are easily accessible, ethical guidelines are inconsistent about how researchers should use them. Some academics claim that traditional ethical principles are sufficient and applicable to online research. However, the Web poses new challenges that compel researchers to reconsider concerns of consent, privacy and anonymity. Based on doctoral research into the investigation of online medicine (...) purchasing, this article presents a case study involving online forums, and reviews the existing ethical guidance surrounding the Web. The suggestion is that new ethical guidelines, particularly in relation to informed consent and participants’ own perceptions of what is public or private, are needed owing to the unique challenges of online research. (shrink)

Scientific research is subject to a number of regulations which impose incidental (time, place), rather than substantive (type of research), restrictions on scientific research and the knowledge created through such research. In recent years, however, the premise that scientific research and knowledge should be free from substantive regulation has increasingly been called into question. Some have suggested that the law should be used as a tool to substantively restrict research which is dual-use in nature or which raises moral objections. There (...) are, however, some problems with using law to restrict or prohibit certain types of scientific research, including (i) the inherent imprecision of law for regulating complex and rapidly evolving scientific research; (ii) the difficulties of enforcing legal restrictions on an activity that is international in scope; (iii) the limited predictability of the consequences of restricting specific branches of scientific research; (iv) inertia in the legislative process; and (v) the susceptibility of legislators and regulators to inappropriate factors and influence. Rather than using law to restrict scientific research, it may be more appropriate and effective to use a combination of non-traditional legal tools including norms, codes of conduct, restrictions on publication, and scientist-developed voluntary standards to regulate problematic scientific research. (shrink)

V. 1. Structures and processes -- v. 2. Domains and categories.

The Sarbanes–Oxley Act of 2002 requires company executives to certify financial statements and internal controls as a means of reducing fraud. Many companies have operationalized this by instituting a sub-certification process and requiring lower-level managers to sign certification statements. These lower-level organizational members are often the individuals who are aware of fraud and are in the best position to provide information on the fraudulent act. However, the sub-certification process may have the effect of reducing employees’ intentions to report wrongdoing. We (...) suggest that subordinates with knowledge of a superior who committed a fraudulent act and certified that there is no fraud will feel less personal responsibility to report the act, thus, decreasing reporting intentions. Additionally, we suggest that if the fraud is discovered subsequent to the reports being filed with the Securities and Exchange Commission, employees will perceive lower management responsiveness to investigate the fraud, which will reduce intentions to report. Using an experimental approach, we manipulate two between-participant variables: the presence or absence of sub-certification by the transgressor and the timing of fraud discovery, either before or after the reports have been filed with the SEC. We find that when sub-certification is present, perceived personal responsibility and intentions to report were diminished compared to when sub-certification is absent. Timing of the discovery of the fraudulent act did not influence perceived management responsiveness or reporting intentions. Supplemental analysis shows that personal responsibility partially mediates the relationship between sub-certification and reporting intentions. Our findings suggest that audit committees and senior executives may want to carefully consider the costs and benefits of the sub-certification process. (shrink)

This issue’s “Legal Briefing” column covers recent legal developments involving informed consent. We covered this topic in previous articles in The Journal of Clinical Ethics. But an updated discussion is warranted. First, informed consent remains a central and critically important issue in clinical ethics. Second, there have been numerous significant legal changes over the past year. We categorize recent legal developments into the following 13 categories: 1. Medical Malpractice Liability2. Medical Malpractice Liability in Wisconsin3. Medical Malpractice Liability in Novel Situations4. (...) Enforcement by Criminal Prosecutors5. Enforcement by State Medical Boards6. Enforcement through Anti-Discrimination Laws7. Statutorily Mandated Disclosures Related to End-of-Life Counseling8. Statutorily Mandated Disclosures Related to Aid in Dying9. Statutorily Mandated Disclosures Related to Abortion10. Statutorily Mandated Disclosures Related to Telemedicine11. Statutorily Mandated Disclosures Related to Other Interventions12. Statutorily Mandated Gag and Censorship Laws13. Informed Consent in the Research Context. (shrink)

O presente artigo apresenta a carnavalização proposta por Warat ao adotar a obra A Ciência Jurídica e seus dois maridos como marco de seu estilo narrativo e polifônico, multiplicador de metáforas, com vistas a revelar e superar o paradigma moderno dominante, representado pelo normativismo jurídico no campo do Direito. Para tanto, se reproduzem metáforas waratianas de modelos epistemológicos opostos mas complementares e se traça um paralelo com o duelo de modernidades. A partir da epistemologia crítica waratiana sua proposta pedagógica é (...) apresentada como indissociável para então se pensar no legado waratiano como um convite para a cumplicidade. (shrink)

Responses to the COVID-19 pandemic prompted people and institutions to turn to online virtual environments for a wide variety of social gatherings. In this perspectives article, we draw upon our previous work and interviews with Ghanaian Christian leaders to consider implications of this shift. Specifically, we propose that the shift from physical to virtual interactions mimics and amplifies the neoliberal individualist experience of abstraction from place associated with Eurocentric modernity. On the positive side, the shift from physical to virtual environments (...) liberates people to selectively pursue the most fulfilling interactions, free from constraints of physical distance. On the negative side, the move from physical to virtual space necessitates a shift from material care and tangible engagement with the local community to the psychologization of care and pursuit of emotional intimacy in relations of one’s choosing—a dynamic that further marginalizes people who are already on the margins. The disruptions of the pandemic provide an opportunity to re-set social relations, to design ways of being that better promote sustainable collective well-being rather than fleeting personal fulfillment. (shrink)

According to surveys of companies, branding is one of the main objectives of their corporate social responsibility. With advantageous data from Brand Finance, we address three contextual factors that may condition the relationship between CSR and brand value. First, we hypothesize that the relationship between CSR and brand value obtains across major world regions and industrial sectors. Second, we hypothesize that the relationship has weakened with time, as companies have had increasing difficulty using CSR to differentiate their brands in a (...) sea of CSR-espousing competitors. Third, we hypothesize that the relationship between CSR and brand value is weaker where a brand’s identity is different from that of its corporate owner, which may make it difficult for observers to readily link CSR with its potential brand beneficiaries. We support these hypotheses with random-effects, fixed-effects, and instrumental-variable regressions before ending with contributions, limitations, implications, and potential next steps. (shrink)

In the United States, authoritative legal guidance remains sparse on whether or when clinicians may stop life-sustaining treatment without consent. Fortunately, several significant legislative and judicial developments over the past two years offer some clarity. We group these legal developments into the following seven categories: 1. Lawsuits for Damages 2. Amendments to the Texas Advance Directives Act 3. Constitutional Attack on TADA 4. Legislation Prohibiting Clinicians 5. Legislation Authorizing Clinicians 6. Cases from Canada 7. Cases from the United Kingdom.

Antisocial behaviors including bullying, violence, and aggression have been an area of intense interest among researchers, clinicians, policy makers, and the general public because of their grievous consequences on individuals and society. Our understanding of the origins and development of these behaviors in individuals has recently progressed with the application of new scientific advancements and technologies such as neuroimaging, genomics, and research methods that capture behavioral changes in the first few years of life.The Origins of Antisocial Behavior: A Developmental Perspective (...) provides an overview of the recent research on the development of antisocial behavior and synthesizes this information to inform readers not only of the risks, but also how they interact, to result in antisocial and aggressive behavior. The volume is divided into three sections: advances in neuroscience, advances in behavioral and clinical research, and legal and policy implications. Specific topics include genetic markers and aggressive behavior, the use of fMRI to track adolescent brain development, the role of peer influences on aggression, parenting and temperament, screening tools for diagnosing antisocial behavior in toddlers and adolescents, and how new research will influence interventions, policy, and future study. Experts from genetics, neuroimaging, and developmental science discuss the insights these scientific approaches have provided in understanding how nature and the environment interact in the emergence of antisocial behavior. The Origins of Antisocial Behavior is an important and unique resource that will be of use to developmental scientists, mental health professionals, and policymakers involved in the juvenile justice system. (shrink)

Little attention has been paid in academic dishonesty literature to empirically testing the effectiveness of different instructor communication strategies to minimize cheating. Using a quasi-experimental design, we compared the effectiveness of instructor fear appeals and moral appeals on student cheating-related attitudes and behavior. Cheating was most strongly associated with neutralizing attitudes in the moral appeal condition. Also, the relationship between observation of others cheating and self-reported cheating behaviors was stronger in both treatment conditions than in the control condition. Although a (...) trend toward less cheating in the treatment conditions was evident, it did not attain statistical significance. (shrink)

The practice of modern craniomaxillofacial surgery has been defined by emergent technologies allowing for the acquisition, storage, utilization, and transfer of massive amounts of sensitive and identifiable patient data. This alone has thrust providers into an unlikely and unprecedented role as the stewards of vast databases of digital information. This data powers the potent surgical tool of virtual surgical planning, a method by which craniomaxillofacial surgeons plan and simulate procedural outcomes in a digital environment. Further complicating this new terrain is (...) the involvement of third‐party contractors—a necessary presence in bringing raw data to bear in the office, virtual space, and operating room. The individual privileges and responsibilities of patients, providers, and vendors towards data are situated within the most recent U.S. court rulings and regulations. This paper offers guidance for overseeing the safe and responsible transfer to third‐party contractors, and provides suggestions for negotiating the trinary relationship between physicians, their patients, and the vendors offering this transformative technology. (shrink)