We argue for the need for a new language for business – one that is capable of changing the current business decision-making frame of wins and losses to a frame of community and social learning. This paper outlines a classroom exercise about Nelson Mandela’s leadership, involving movies, case studies and poetry, and shows how the more holistic approach helps shift student views of the triple bottom line. Since neuroscience literature has shown that poetry can help enhance learning, students carefully study (...) “Invictus,” a poem written by Victorian-era poet Henley and revered by Mandela. As students dig deeper into the case study through classroom discussion, they begin to see Mandela’s leadership through a new frame, and in doing so broaden their own views. This more holistic approach to studying leadership may allow decision makers to adjust both their goals and the focus of their analysis to go beyond monetary outcomes to include socially and environmentally sustainable outcomes. (shrink)

Publication date: 30 March 2017 Source: Author: Poonam Bala, Tanivir Kaur, Maninder Kaur This is an experimental study conducted on the upper primary school students in the district of S.B.S Nagar, Punjab. The study was conducted on the students of 6th and 7th class of an international School. Total of 100 students were enrolled for this experimental study who met the inclusion criteria and were randomly divided into 2 equal groups by simple randomization technique. They received either the lecture (...) method teaching or the smart class method teaching. For conducting the experiment, the investigator used pre-test and post-test comparison group design. For collection of data, a structured questionnaire and a structured teaching programme was used. t-test was used for analysis and interpretation of the data. The results of the study revealed that the lecture method of teaching was more effective as compared to a smart class method of teaching. (shrink)

Purpose Digital transformation leverages digital technologies to change current processes and introduce new processes in any organisation’s business model, customer/user experience and operational processes. Artificial intelligence plays a significant role in achieving DT. As DT is touching each sphere of humanity, AI led DT is raising many fundamental questions. These questions raise concerns for the systems deployed, how they should behave, what risks they carry, the monitoring and evaluation control we have in hand, etc. These issues call for the need (...) to integrate ethics in AI led DT. The purpose of this study is to develop an “AI led ethical digital transformation framework”. Design/methodology/approach Based on the literature survey, various existing business ethics decision-making models were synthesised. The authors mapped essential characteristics such as intensity and the individual, organisational and opportunity factors of ethics models with the proposed AI led ethical DT. The DT framework is evaluated using a thematic analysis of 23 expert interviews with relevant AI ethics personas from industry and society. The qualitative data of the interviews and opinion data has been analysed using MAXQDA software. Findings The authors have explored how AI can drive the ethical DT framework and have identified the core constituents of developing an AI led ethical DT framework. Backed by established ethical theories, the paper presents how DT pillars are related and sequenced to ethical factors. This research provides the potential to examine theoretically sequenced ethical factors with practical DT pillars. Originality/value The study establishes deduced and induced ethical value codes based on thematic analysis to develop guidelines for the pursuit of ethical DT. The authors identify four unique induced themes, namely, corporate social responsibility, perceived value, standard benchmarking and learning willingness. The comprehensive findings of this research, supported by a robust theoretical background, have substantial implications for academic research and corporate applicability. The proposed AI led ethical DT framework is unique and can be used for integrated social, technological and economic ethical research. (shrink)

The power of technology to transform religions, science, and political institutions has often been presented as nothing short of revolutionary. Does technology have a similarly transformative influence on societies’ morality? Scholars have not rigorously investigated the role of technology in moral revolutions, even though existing research on technomoral change suggests that this role may be considerable. In this paper, we explore what the role of technology in moral revolutions, understood as processes of radical group-level moral change, amounts to. We do (...) so by investigating four historical episodes of radical moral change in which technology plays a noteworthy role. Our case-studies illustrate the plurality of mechanisms involved in technomoral revolutions, but also suggest general patterns of technomoral change, such as technology’s capacity to stabilize and destabilize moral systems, and to make morally salient phenomena visible or invisible. We find several leads to expand and refine conceptual tools for analysing moral change, specifically by crystallizing the notions of ‘technomoral niche construction’ and ‘moral payoff mechanisms’. Coming to terms with the role of technology in radical moral change, we argue, enriches our understanding of moral revolutions, and alerts us to the depths of which technology can change our societies in wanted and unwanted ways. (shrink)

Moving forward rapidly in the clinical research phase, uterus transplantation may be a future treatment option for women with uterine factor infertility, which accounts for three per cent of all infertility in women. This new method of treatment would allow women, who currently rely on gestational surrogacy or adoption, to gestate and birth their own genetic offspring. Since uterus transplantation carries significant risk when compared with surrogacy and adoption as well as when compared with other organ transplants, it requires greater (...) justification because its goals are quality of life, not life-saving, in their scope. It is important to address questions regarding the physical, psychosocial and ethical risks and benefits of uterus transplantation for all three parties involved—the patient, the donor and the potential child—as well as discuss the regulatory implications as research on uterus transplantations moves forward. (shrink)

The environment impacts human health in profound ways, yet few theories define the form of the relationship between human physiology and the environment. It is conjectured that such complex systems cannot interact directly, but rather their interaction requires the formation of an intermediary “interface.” This position contrasts with current epidemiological constructs of causation, which implicitly assume that two complex systems transfer information directly while remaining separate entities. Further, it is contended that dynamic, process‐based interfaces incorporate components from all the interacting (...) systems but exhibit operational independence. This property has many consequences, the foremost being that characteristics of the interface cannot be fully resolved by only studying the systems involved in the interaction. The interface itself must be the subject of inquiry. Without refocusing the attention on biodynamic interfaces, how the environment impacts health cannot be discerned. Also see the video abstract here https://youtu.be/XeyjeZeyo4o. (shrink)

BackgroundResuscitation and treatment of critically ill newborn infants is associated with relatively high mortality, morbidity and cost. Guidelines relating to resuscitation have traditionally focused on the best interests of infants. There are, however, limited resources available in the neonatal intensive care unit, meaning that difficult decisions sometimes need to be made. This study explores the intuitions of lay people regarding resource allocation decisions in the NICU.MethodsThe study design was a cross-sectional quantitative survey, consisting of 20 hypothetical rationing scenarios. There were (...) 119 respondents who entered the questionnaire, and 109 who completed it. The respondents were adult US and Indian participants of the online crowdsourcing platform Mechanical Turk. Respondents were asked to decide which of two infants to treat in a situation of scarce resources. Demographic characteristics, personality traits and political views were recorded. Respondents were also asked to respond to a widely cited thought experiment involving rationing.ResultsThe majority of respondents, in all except one scenario, chose the utilitarian option of directing treatment to the infant with the higher chance of survival, higher life expectancy, less severe disability, and less expensive treatment. As discrepancy between outcomes decreased, however, there was a statistically significant increase in egalitarian responses and decrease in utilitarian responses in scenarios involving chance of survival, life expectancy, and cost of treatment. In the classic ‘lifeboat’ scenario, all but two respondents were utilitarian.ConclusionsThis survey suggests that in situations of scarcity and equal clinical need, non-health professionals support rationing of life-saving treatment based on probability of survival, duration of survival, cost of treatment or quality of life. However, where the difference in prognosis or cost is very small, non-health professionals preferred to give infants an equal chance of receiving treatment. (shrink)

The Green Revolution is often seen as epitomising the dawn of scientific and technological advancement and modernity in the agricultural sector across developing countries, a process that unfolded from the 1940s through to the 1980s. Despite the time that has elapsed, this episode of the past continues to resonate today, and still shapes the institutions and practices of agricultural science and technology. In Brazil, China, and India, narratives of science-led agricultural transformations portray that period in glorifying terms—entailing pressing national imperatives, (...) unprecedented achievements, and heroic individuals or organizations. These “epic narratives” draw on the past to produce meaning and empower the actors that deploy them. Epic narratives are reproduced over time and perpetuate a conviction about the heroic power of science and technology in agricultural development. By crafting history and cultivating a sense of scientific nationalism, exceptionalism, and heritage, these epic narratives sustain power-knowledge relations in agricultural science and technology, which are underpinned by a hegemonic modernization paradigm. Unravelling the processes of assemblage and reproduction of epic narratives helps us make sense of how science and technology actors draw on their subjective representations of the past to assert their position in the field at present. This includes making claims about their credentials to envision and deliver sustainable solutions for agriculture into the future. (shrink)

Research teams have made considerable progress in treating absolute uterine factor infertility through uterus transplantation, though studies have differed on the choice of either deceased or living donors. While researchers continue to analyze the medical feasibility of both approaches, little attention has been paid to the ethics of using deceased versus living donors as well as the protections that must be in place for each. Both types of uterus donation also pose unique regulatory challenges, including how to allocate donated organs; (...) whether the donor / donor's family has any rights to the uterus and resulting child; how to manage contact between the donor / donor's family, recipient, and resulting child; and how to track outcomes moving forward. (shrink)

As AI technologies are rolled out into healthcare, academia, human resources, law, and a multitude of other domains, they become de-facto arbiters of truth. But truth is highly contested, with many different definitions and approaches. This article discusses the struggle for truth in AI systems and the general responses to date. It then investigates the production of truth in InstructGPT, a large language model, highlighting how data harvesting, model architectures, and social feedback mechanisms weave together disparate understandings of veracity. It (...) conceptualizes this performance as an operationalization of truth, where distinct, often-conflicting claims are smoothly synthesized and confidently presented into truth-statements. We argue that these same logics and inconsistencies play out in Instruct’s successor, ChatGPT, reiterating truth as a non-trivial problem. We suggest that enriching sociality and thickening “reality” are two promising vectors for enhancing the truth-evaluating capacities of future language models. We conclude, however, by stepping back to consider AI truth-telling as a social practice: what kind of “truth” do we as listeners desire? (shrink)

Consumer complaining behavior (CCB) is an important stream of research and practice, as it links the domains of service failure and service recovery. CCB research, although extensive and temporally wide, exhibits a lack of concern for the underlying assumptions of scholarly inquiry. Researchers neither explicitly mention, nor consciously indicate their ontological, epistemological, and methodological assumptions. We systematically identify the extant CCB literature and map it to two well-accepted paradigmatic classifications (Burrell and Morgan 1979; Deetz Organization Science 7(2): 191–207, 1996). Normative (...) or functionalist paradigm with the assumptions of an objective external reality, a positivist epistemology, a determinist view of human nature, and nomothetic methodology emerges as the dominant CCB research paradigm. The implications of this dominance are discussed as a barometer of the future of CCB research and practice. (shrink)

Wearable self-tracking devices capture multidimensional health data and offer several advantages including new ways of facilitating research. However, they also create a conflict between individual interests of avoiding privacy harms, and collective interests of assembling and using large health data sets for public benefits. While some scholars argue for transparency and accountability mechanisms to resolve this conflict, an average user is not adequately equipped to access and process information relating to the consequences of consenting to further uses of her data. (...) As an alternative, this paper argues for fiduciary relationships, which put deliberative demands on digital health data controllers to keep the interests of their data subjects at the forefront as well as cater to the contextual nature of privacy. These deliberative requirements ensure that users can engage in collective participation and share their health data at a lower risk of privacy harms. This paper also proposes a way to balance the flexible and open-ended nature of fiduciary law with the specific nature and scope of fiduciary duties that digital health data controllers should owe to their data subjects. (shrink)

The world is witnessing a rise in speech-enabled devices serving as epistemic informants to their users. Some philosophers take the view that because the utterances produced by such machines can be phenomenologically similar to an equivalent human speech, and they may deliver the same function in terms of delivering content to their audience, such machine utterances should be conceptualized as “assertions”. This paper argues against this view and highlights the theoretical and pragmatic challenges faced by such a conceptualization which seems (...) to be based on a “functionalist” account of assertion. Instead, the paper argues that the view that some such machine utterances can be “proxy assertions”, made on behalf of the designers and/or deployers of such machines is more tenable. Existing accounts of such a view, however, need further refinement, which is provided here. The paper then discusses implications of this view for design of such machines, particularly those enabled and equipped with machine learning capabilities. (shrink)

This paper argues that the type of conscience claims made in last decade’s spate of cases involving pharmacists’ objections to filling birth control prescriptions and cases such as Ms. Means and Mercy Health Partners of Michigan, and even the Affordable Care Act and the Little Sisters of the Poor, as different as they appear to be from each other, share a common element that ties them together and makes them fundamentally different in kind from traditional claims of conscience about which (...) a practical consensus emerged in the 1980s and 1990s. This difference in kind is profoundly significant; so much so, we contend, that it puts them at odds with the normative basis for protecting conscience claims in United States health care settings in the first place, making them illegitimate. Finally, we argue that, given the illegitimacy of these contemporary claims of conscience, physicians and other health professionals must honor their well-established standing obligations to provide informed consent and refer or transfer care even if the service requested or needed is at odds with their own core moral beliefs—a requirement that is in line with the aforementioned practical consensus on traditional claims of conscience. (shrink)

Some scholars blame capitalism for the prevalence of modern slavery. However, data reveal that it is wrong to blame capitalism for a problem that long preceded it and would likely be much worse without it. We explain why this is the case.

Due to a history of coerced sterilization, a federal Medicaid sterilization policy mandates that a specific consent form be signed by a patient at least thirty days prior to when the patient undergoes sterilization. However, in contemporary obstetrical practice, the Medicaid sterilization policy serves as a policy‐level barrier to autonomously desired care. We review the clinical and ethical implications of the current Medicaid sterilization policy. After discussing the utility and impact of waiting periods for other surgical procedures, we explore the (...) psychology of time required for decision‐making and consider scientific understanding of regret. We argue that the current Medicaid sterilization waiting period is clinically and ethically unjustifiable and that the policy ought to be revised in light of the goals, preferences, and concerns of the people most affected by it. While the need for continued protection against coercion remains, the current mandated waiting period does little to enforce the high‐quality shared decision‐making that is desired for sterilization counseling. (shrink)

To study the development trend of embedded platforms in home appliances Internet of Things, an application of embedded Linux in the design of IoT gateway is designed. ARM microprocessor S3C2410, EM310 radio frequency module, and Ethernet DM9000A module are used to realize the home network information-processing platform. The platform utilizes existing network facilities, RF modules, and network interface modules to realize the interconnection of the home perception network through wireless or wired links. For experimental analysis, Ping the central server from (...) the IoT node B is set to twice: The first time ttl = 255 time = 1.9 ms, the second time: ttl = 255 time = 2.4 ms. After application verification, the system has the characteristics of low cost, small size, low power consumption, and vital ease of use. It can not only integrate the home Internet and the IoT gateway but also directly run application-layer communication protocols such as HTTP/mqtt between IoT nodes and Internet terminals. The design supports multi-hop communication and significantly increases the deployment range of IoT nodes without signal relay equipment, hence reducing the cost of IoT networking and the complexity of the network architecture. (shrink)

This paper explores ethical concerns arising in healthcare integration. We argue that integration is necessary imperative for meeting contemporary and future healthcare challenges, a far stronger evidence base for the conditions of its effectiveness is required. In particular, given the increasing emphasis at the policy level for the entire healthcare infrastructure to become better integrated, our analysis of the ethical challenges that follow from the logic of integration itself is timely and important and has hitherto received insufficient attention. We evaluated (...) an educational intervention which aims to improve child health outcomes by making transitions between primary to secondary care more efficient, ensuring children and parents are better supported throughout. The programme provided skills for trainee paediatricians and general practitioners in co-designing integrated clinical services. The key ethical challenges of integrated care that arose from a clinical perspective are: professional identity and autonomy in an integrated working environment; the concomitant extent of professional responsibility in such an environment; and the urgent need for more evidence to be produced on which strategies for integrating at scale can be based. From our analysis we suggest a tentative way forward, viewed from a normative position broadly situated at the intersection of deontology and care ethics. We adopt this position because the primary clinical ethical issues in the context of integrated care concern: how to ensure that all duties of care to individual patients are met in a newly orientated working environment where clinical responsibility may be ambiguous; and the need to orientate care around the patient by foregrounding their autonomous preferences and ensuring good patient clinician relationships in clinical decision-making. (shrink)

This account demonstrates the key challenges faced in producing engaging educational content for information and communication technologies deployed in rural India. The ‘Stills in Sync’ project aims to enhance literacy through the revival and proliferation of popular regional folksongs with social awareness themes in rural India. This product entails the use of the Same Language Subtitling karaoke feature that won the Worldbank Development Marketplace award in 2002 and the ‘Tech Laureate’ honor from the Technology Museum of Innovation in 2003. This (...) case study highlights the struggles faced in the production process as we sought to negotiate localism with scalability. The paper is meant to stimulate discussion and further research on the process of digitalizing cultural and educational content in muliple languages for literacy gains and empowerment. I attempt to give three‐dimensionality to current buzzwords in education content creation using ICT: localism, relevance and engagement. (shrink)

This paper plays with education through the analogy of karaoke to tease out the instructions of a situated educational practice. Here, Cremin's conceptualization of education as a deliberate, systematic and sustained effort is employed as a starting point to enable an understanding of educational practice between members elicited by karaoke. Using Garfinkel's ethnomethodological framework, the paper investigates modes of education through karaoke practice as part of the ‘live’ narrative, that of instructing and being instructed with the ‘curriculum’ of the event (...) at hand. (shrink)

Graphical AbstractWe can, for example, understand intimately how the human endocrine systems works, and likewise the chemical nature of compounds present in our environment; but the result of the interaction cannot be deduced from any simple combination of the two knowledge sets: it's not the interacting entities that we should be studying, but the process that creates the phenomena that we witness as a result of this interaction. This is the “biodynamic interface” to which Manish Arora, Alessandro Giuliani and (...) Paul Curtin refer in their article in this issue, and it is a conceptual structure that comes into being upon interaction of entities: a new way to study interactions in complex systems and better understand emergent phenomena. (shrink)

Opponents of male circumcision have increasingly used human rights positions to articulate their viewpoint. We characterize the meaning of the term “human rights.” We discuss these human rights arguments with special attention to the claims of rights to an open future and to bodily integrity. We offer a three-part test under which a parental decision might be considered an unacceptable violation of a child's right. The test considers the impact of the practice on society, the impact of the practice on (...) the individual, and the likelihood of adverse impact. Infant circumcision is permissible under this test. We conclude that infant circumcision may be proscribed as violating local norms, even though it does not violate human rights. (shrink)

Women with opioid use disorder (OUD) face unique challenges meeting their reproductive goals. Because the rate of unintended pregnancy in this population is almost 80 percent, there has been a push to increase the use of contraceptives among reproductive-aged women with OUD.1 The patient-level ethical issues of such initiatives, however, are often overlooked. This review discusses the ethical issues in two realms: obtaining contraception when it is desired and avoiding contraceptive coercion when contraception is not desired. It is important that (...) access to reproductive education and care be improved to ensure autonomous decision making by women with OUD. It is also necessary to be mindful of the history of oppressive and coercive contraception and sterilization policies in the United States. These policies have left a legacy of mistrust and continue to be manifested in the form of more subtly oppressive policies in contemporary medical practice. Such policies point to the ongoing stigmatization of, and implicit biases held against, women with OUD. Based on these ethical issues, solutions are suggested at the clinical, systemic, and societal levels. (shrink)

This paper plays with education through the analogy of karaoke to tease out the instructions of a situated educational practice. Here, Cremin's conceptualization of education as a deliberate, systematic and sustained effort is employed as a starting point to enable an understanding of educational practice between members elicited by karaoke. Using Garfinkel's ethnomethodological framework, the paper investigates modes of education through karaoke practice as part of the ‘live’ narrative, that of instructing and being instructed with the ‘curriculum’ of the event (...) at hand. (shrink)

While mass spectrometry (MS)‐based quantification of small molecules has been successfully used for decades, targeted MS has only recently been used by the proteomics community to investigate clinical questions such as biomarker verification and validation. Targeted MS holds the promise of a paradigm shift in the quantitative determination of proteins. Nevertheless, targeted quantitative proteomics requires improvisation in making sample processing, instruments, and data analysis more accessible. In the backdrop of the genomic era reaching its zenith, certain questions arise: is the (...) proteomic era about to come? If we are at the beginning of a new future for protein quantification, are we prepared to incorporate targeted proteomics at the benchside for basic research and at the bedside for the good of patients? Here, an overview of the knowledge required to perform targeted proteomics as well as its applications is provided. A special emphasis is placed on upcoming areas such as peptidomics, proteoform research, and mass spectrometry imaging, where the utilization of targeted proteomics is expected to bring forth new avenues. The limitations associated with the acceptance of this technique for mainstream usage are also highlighted. (shrink)

We examine the role of alignment between organizational social consciousness and the informal and formal institutions of a country in increasing female representation on boards. Using fixed-effects and Hausman Taylor regression methodology for endogenous covariate with panel data for the years 2006–2020, we find that the greater the alignment between organizational social consciousness and certain formal and informal institutions, the more progress there is toward gender representation on corporate boards in Europe. We also find that more socially conscious firms make (...) the most progress, often going beyond the minimum regulatory targets. By showing the complementarity of these factors, we address the enduring question of how the interplay of formal and informal institutions directly affects corporate behavior, thus contributing to the institutional, public policy/regulatory, and corporate governance literatures. We note the need for policymakers to go beyond mere codification of rules via quotas and simultaneously work toward raising national and organizational social consciousness levels on issues of gender equality. (shrink)

We demonstrate that the key components of cognitive architectures (declarative and procedural memory) and their key capabilities (learning, memory retrieval, probability judgment, and utility estimation) can be implemented as algebraic operations on vectors and tensors in a high‐dimensional space using a distributional semantics model. High‐dimensional vector spaces underlie the success of modern machine learning techniques based on deep learning. However, while neural networks have an impressive ability to process data to find patterns, they do not typically model high‐level cognition, and (...) it is often unclear how they work. Symbolic cognitive architectures can capture the complexities of high‐level cognition and provide human‐readable, explainable models, but scale poorly to naturalistic, non‐symbolic, or big data. Vector‐symbolic architectures, where symbols are represented as vectors, bridge the gap between the two approaches. We posit that cognitive architectures, if implemented in a vector‐space model, represent a useful, explanatory model of the internal representations of otherwise opaque neural architectures. Our proposed model, Holographic Declarative Memory (HDM), is a vector‐space model based on distributional semantics. HDM accounts for primacy and recency effects in free recall, the fan effect in recognition, probability judgments, and human performance on an iterated decision task. HDM provides a flexible, scalable alternative to symbolic cognitive architectures at a level of description that bridges symbolic, quantum, and neural models of cognition. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:From Impatience to EmpathyStephanie Pierce and Kavita Shah AroraWe gave J.H. a label the first time we met her, as many often do—“Uncooperative.” She was a patient with autism and intellectual delay who had presented to the emergency department (ED) with vaginal bleeding. After receiving the gynecology consult request from the emergency medicine physicians, we were already mentally formulating our recommendations based on the information they told us over (...) the phone. “Does not cooperate with exam,” “no acute surgical intervention is currently warranted,” and “recommend outpatient follow–up.”When we arrived in her room, she was sitting in the hospital bed surrounded by a protective shield of caregivers from her group home. We introduced ourselves as the gynecology team but it was obvious that J.H. could not communicate verbally. Upon speaking with her caregivers we learned that she had Cowden syndrome, a genetic disease that confers significantly increased risks for several types of cancer including endometrial, thyroid, and breast cancers. J.H. had also been having heavy vaginal bleeding, which was difficult for her caregivers to manage, and this was the reason she was brought into the emergency department. After attempting to gain as much information as we could from the caregivers, we started to perform an abdominal exam, which made J.H. extremely agitated. We quickly stopped the exam and the caregivers helped to calm J.H. We remember our mixture of emotions—bewilderment at the agitation and commotion in the exam room full of people, frustration at not being able to complete our exam fully, and annoyance that this “difficult patient” was taking up our limited time between surgical cases. Thankfully, these knee–jerk reactions were quickly replaced by feelings of concern for the patient and the realization of how frightening an experience this must be for her—being in a strange place with white walls and unfamiliar people, unable to communicate her thoughts.J.H.’s mother, her surrogate decision–maker, was not at the hospital that day but the caregivers told us that she had expressed a strong desire for her daughter to have a prophylactic hysterectomy due to her lifetime risk for developing uterine cancer as well as a permanent solution to the bleeding concerns. What had initially started as a simple ED consult was now turning into a complex question. The ethical and legal dilemma was obvious—whether to perform a major surgery that would irreversibly sterilize a patient who could not consent on her own behalf in order to minimize the potential risk of cancer later in life. While medical management could improve the bleeding and potentially reduce the risk of cancer, frequent exams would be necessary [End Page 19] to ensure that the medication was working and that premalignant changes were not occurring in J.H.’s uterus. However, based on our experience in the emergency department, J.H. would need anesthesia for such exams and it was doubtful the medications would completely normalize her elevated risk of uterine malignancy. We knew that in order to address this question, we would need to see J.H. again along with her mother to have a frank discussion about the risks and benefits of such a decision, and so we made plans to see her in our outpatient clinic.Several days later, J.H., her mother, and the group home caregivers arrived in the office. Anticipating a complex discussion, we had requested a representative from the hospital ethics committee to join us at the visit. We didn’t know what to expect meeting J.H.’s mother for the first time but as we sat in the room talking, it was obvious that she was truly trying to act in her daughter’s best interest. Similarly, it was touching to watch the faces of the caregivers from the group home as they nodded in solidarity with J.H.’s mother, also clearly wanting what was best for her and supporting her mother in this difficult decision. J.H., meanwhile, seemed content to sit silently with us during the discussion, surrounded as she was by people who cared deeply for her well–being.After extensive partnership with the ethics consultants... (shrink)

This essay addresses tensions within political philosophy between group rights, which allow historically marginalized communities some self-governance in determining its own rules and norms, and the rights of marginalized subgroups, such as women, within these communities. Community norms frequently uphold patriarchal structures that define women as inferior to men, assign them a subordinate status within the community, and cut them off from the individual rights enjoyed by women in other sections of society. As feminists point out, the capacity for voice (...) and exit cannot be taken for granted, for community norms may be organized in ways that deny women any voice in its decision-making forums as well as the resources they would need to survive outside the community. This essay draws on research among the Gond, an indigenous community in India, to explore this debate. Given the strength of the forces within the community militating against women’s capacity for voice or exit, the question motivating our research is: Can external organizations make a difference? We explore the impacts of two external development organizations that sought to work with women within these communities in order to answer this question. (shrink)

Since USA constitutional precedent established in 1976, adolescents have increasingly been afforded the right to access contraception without first obtaining parental consent or authorisation. There is general agreement this ethically permissible. However, long-acting reversible contraception methods have only recently been prescribed to the adolescent population. They are currently the most effective forms of contraception available and have high compliance and satisfaction rates. Yet unlike other contraceptives, LARCs are associated with special procedural risks because they must be inserted and removed by (...) trained healthcare providers. It is unclear whether the unique invasive nature of LARC changes the traditional ethical calculus of permitting adolescent decision-making in the realm of contraception. To answer this question, we review the risk–benefit profile of adolescent LARC use. Traditional justifications for permitting adolescent contraception decision-making authority are then considered in the context of LARCs. Finally, analogous reasoning is used to evaluate potential differences between permitting adolescents to consent for LARC procedures versus for emergency and pregnancy termination procedures. Ultimately, we argue that the invasive nature of LARCs does not override adolescents’ unique and compelling need for safe and effective forms of contraception. In fact, LARCs may oftentimes be in the best interest of adolescent patients who wish to prevent unintended pregnancy. We advocate for the specific enumeration of adolescents’ ability to consent to both LARC insertion and removal procedures within state policies. Given the provider-dependent nature of LARCs and the stigma regarding adolescent sexuality, special political and procedural safeguards to protect adolescent autonomy are warranted. (shrink)

Domestic violence is one of the most common forms of violence against women. Domestic violence during pregnancy is associated with adverse perinatal and maternal outcomes. We aimed to assess whether domestic violence was associated with mode of delivery, low birthweight and preterm birth in two sites in Nepal. In this prospective cohort study we consecutively recruited 2004 pregnant women during antenatal care at two hospitals between June 2015 and September 2016. The Abuse Assessment Screen was used to assess fear and (...) violence. Having ever experienced either fear or violence was defined as any domestic violence. Obstetric outcomes were obtained from hospital records for 1381 women, selecting singleton pregnancies only. Mode of delivery was assessed as birth by cesarean section or not. A birthweight of less than 2500 g was defined as low birthweight and preterm birth as birth before completion of 37 weeks gestation. Descriptive and multiple logistic regression analyses were performed to assess associations. Twenty percent of the women reported any domestic violence. Among all 1381 women, 37.6% gave birth by cesarean section. Of those women who delivered by cesarean section, 84.7% had an emergency cesarean section. Less than 10% of the babies were born prematurely and 13.5% were born with low birthweight. We found no significant association between exposure to any domestic violence during pregnancy and risk of a low birthweight baby or birth by cesarean section. However, having experienced both violence and fear was significantly associated with giving birth to a preterm infant [aOR 2.33 ]. Domestic violence is common in Nepal. This is a potential risk factor for severe morbidity and mortality in newborns. We found that the risk of having a preterm baby was higher for pregnant women who experienced both fear and violence. This should be recognized by the health sector. In this study, no significant differences were found in the rate of cesarean section nor low birthweight for women who had experienced any domestic violence compared to those who did not. (shrink)

Nongovernmental organizations (NGOs) and scientific controversies are often the common denominators in most of the cases that have significantly shaped science and society relationships in the Global South during the past two decades. National and international NGOs and their network have often facilitated the “opening up” of regulatory governance in multiple sectors. This article draws from three cases—the bottled water controversy, the agribiotechnology debates, and the nanotechnology initiatives—and charts out the role of the NGOs and controversies in (re)defining the science-society (...) relationship in India. The three cases illustrate how NGOs and controversies by their presence or absence at various stages of technology development shape the regulation-making exercise and the overall regulatory governance of science and technology. (shrink)

The fields of HIV care in pregnancy and reproductive genetics have always been ‘exceptional’ in that patients are highly concerned about the potential for stigma and the corresponding need for privacy and confidentiality. However, the two fields have diverged in how they have addressed these concerns. The systematic review analyzed 61 manuscripts for similarities and differences between the fields of HIV care in pregnancy and reproductive genetics in the United States, with respect to privacy, confidentiality, disclosure, and stigma. The systematic (...) review revealed that the field of HIV care in pregnancy has insufficiently addressed patient concerns about privacy, confidentiality, and stigma compared to the field of reproductive genetics. Failure to adequately protect confidentiality of HIV-positive patients, and failure to reduce stigma associated with HIV testing and treatment are deficiencies in the delivery of care to HIV-positive pregnant woman and barriers to reducing vertical transmission of HIV. Im.. (shrink)

In the limited literature on gender and climate change, two themes predominate – women as vulnerable or virtuous in relation to the environment. Two viewpoints become obvious: women in the South will be affected more by climate change than men in those countries and that men in the North pollute more than women. The debates are structured in specific ways in the North and the South and the discussion in the article focuses largely on examples from Sweden and India. The (...) article traces the lineage of the arguments to the women, environment and development discussions, examining how they recur in new forms in climate debates. Questioning assumptions about women's vulnerability and virtuousness, it highlights how a focus on women's vulnerability or virtuousness can deflect attention from inequalities in decision-making. By reiterating statements about poor women in the South and the pro-environmental women of the North, these assumptions reinforce North–South biases. Generalizations about women's vulnerability and virtuousness can lead to an increase in women's responsibility without corresponding rewards. There is need to contextualise debates on climate change to enable action and to respond effectively to its adverse effects in particular places. -/- . (shrink)

Despite research establishing emojis as sites of critical racial discourse, there is a paucity of literature examining their importance in the increasingly popular context of mobile payments. This is particularly important as new forms of social payment platforms such as Venmo bridge the seamlessness of mobile payments with the vibrant communicative practices of social networks. As such, they provide a unique medium to examine how emojis are used within the context of digital consumption, and by extension, self-representation. This study analyzes (...) approximately 325 million public transactions on the U.S. payment platform Venmo to understand whether emoji usage in mobile payments is more hedonic or utilitarian. We then explore how race is represented across emoji usage on Venmo via tone-modified emojis, a subset of emojis whereby users can choose a skin tone. We found that while emojis in general are used for more hedonic purposes than utilitarian ones, darker tone-modified emojis indicate a proportionately higher use in hedonic consumption as compared to lighter tone-modified emojis, and also show a higher representation of utilitarian categories in transactions. Thematic analysis revealed that subsets with darker tone-modified emojis have a greater lexical variety and engage in more playful uses of emoji in mobile payments. (shrink)