BackgroundIn response to COVID-19 pandemic, the Government of Uganda adopted public health measures to contain its spread in the country. Some of the initial measures included refusal to repatriate citizens studying in China, mandatory institutional quarantine, and social distancing. Despite being a public health emergency, the measures adopted deserve critical appraisal using an ethics and human rights approach. The goal of this paper is to formulate an ethics and human rights criteria for evaluating public health measures and use it to (...) reflect on the ethical propriety of those adopted by the government of Uganda to contain the spread of COVID-19.Main bodyWe begin by illustrating the value of ethics and human rights considerations for public health measures including during emergencies. We then summarize Uganda’s social and economic circumstances and some of the measures adopted to contain the spread of COVID-19. After reviewing some of the ethics and human rights considerations for public health, we reflect upon the ethical propriety of some of Uganda’s responses to COVID-19. We use content analysis to identify the measures adopted by the government of Uganda to contain the spread of COVID-19, the ethics and human rights considerations commonly recommended for public health responses and their importance. Our study found that some of the measures adopted violate ethics and human rights principles. We argue that even though some human rights can sometimes be legitimately derogated and limited to meet public health goals during public health emergencies, measures that infringe on human rights should satisfy certain ethics and human rights criteria. Some of these criteria include being effective, strictly necessary, proportionate to the magnitude of the threat, reasonable in the circumstances, equitable, and least restrictive. We reflect on Uganda’s initial measures to combat the spread of COVID-19 and argue that many of them fell short of these criteria, and potentially limit their effectiveness.ConclusionThe ethical legitimacy of public health measures is valuable in itself and for enhancing effectiveness of the measures. Such legitimacy depends on the extent to which they conform to ethics and human rights principles recommended for public health measures. (shrink)

BackgroundThe return of genetics and genomics research results has been a subject of ongoing global debate. Such feedback is ethically desirable to update participants on research findings particularly those deemed clinically significant. Although there is limited literature, debate continues in African on what constitutes appropriate practice regarding the return of results for genetics and genomics research. This study explored perspectives and ethical considerations of Ugandan genomics researchers regarding the return of genetics and genomics research results.MethodsThis was a qualitative study that (...) employed in-depth interviews. Thirty participants were purposively selected based on their expertise as genomics researchers in Uganda. Data were analysed through content analysis along the main themes of the study using a comprehensive thematic matrix, to identify common patterns arising from the narratives. NVivo software 12 was used to support data analysis.ResultsThe return of genetics and genomics research results was generally acceptable to researchers, and some indicated that they had previously returned individual or aggregate results to participants and communities. The main reasons cited for sharing research results with participants included their clinical utility, actionability and overall benefit to society. Ethical considerations for appropriate return of results included a need for effective community engagement, genetic counselling prior to disclosure of the results, adequate informed consent, and proper assessment of the implications of, or consequences of returning of results. However, the approaches to return of results were perceived as unstandardized due to the lack of appropriate regulatory frameworks.ConclusionsThe return of genetic and genomic research results is generally acceptable to researchers despite the lack of appropriate regulatory frameworks. Ethical considerations for return of genetics and genomics research results are highly divergent, hence the need for national ethical guidelines to appropriately regulate the practice. (shrink)

BackgroundHuman biological materials are usually stored for possible future use in research because they preserve valuable biological information, save time and resources, which would have been spent on collection of fresh samples. However, use of these materials may pose ethical challenges such as unauthorized disclosure of genetic information, which can result in dire consequences for individuals or communities including discrimination, stigma, and psychological harm; has biosecurity implications; and loss of control or ownership of samples or data. To understand these problems (...) better, we evaluated the extent to which tuberculosis (TB) clinical research protocols that were used to collect and store biological materials for future use conform to the requirements stated in the Uganda national guidelines for research involving humans as participants.MethodsThis was a retrospective review of TB clinical research projects approved by the Uganda National Council for Science and Technology (UNCST) from 2011 to 2015, to examine whether they fulfilled the requirements for ethical collection and use of human materials. Data were abstracted through review of the project protocols using a template developed based on the informed consent and the Materials Transfer Agreement (MTA) requirements in the national guidelines.ResultsOut of 55 research protocols reviewed, most of the protocols 83.6% had been used to collect the stored samples (sputum, blood and sometimes urine), 28% had a section on specimen collection and 24% mentioned ownership of the biological materials. With respect to review of the consent forms used in the studies that stored materials for future use, only 9% of the protocols had a separate consent form for storage of materials, 4.5% of the consent forms explained the risks, 11.4% explained the purpose of the study while 6.8% mentioned the place of storage for the collected materials.ConclusionMany of the studies reviewed did not meet the requirements for collection and storage of biological materials contained in the national guidelines, which indicates a need to additional training on this topic. (shrink)

ABSTRACT The amount of biomedical research being conducted around the world has greatly expanded over the past 15 years, with particularly large growth occurring in low- and middle-income countries (LMICs). This increased focus on understanding and responding to disease burdens around the world has brought forth a desire to help LMIC institutions enhance their own capacity to conduct scientifically and ethically sound research. In support of these goals the Johns Hopkins-Fogarty African Bioethics Training Program (FABTP) has, for the past six (...) years, partnered with three research institutions in Africa (University of Botswana, Makerere University in Uganda, and the University of Zambia) to support research ethics capacity. Each partnership began with a baseline evaluation of institutional research ethics environments in order to properly tailor capacity strengthening activities and help direct limited institutional resources. Through the course of these partnerships we have learned several lessons regarding the evaluation process and the framework used to complete the assessments (the Octagon Model). We believe that these lessons are generalizable and will be useful for groups conducting such assessments in the future. (shrink)

BackgroundGenetics and genomics research (GGR) is increasingly being conducted around the world; yet, researchers and research oversight entities in many countries have struggled with ethical challenges. A range of ethics and regulatory issues need to be addressed through comprehensive policy frameworks that integrate with local environments. While important efforts have been made to enhance understanding and awareness of ethical dimensions of GGR in Africa, including through the H3Africa initiative, there remains a need for in-depth policy review, at a country-level, to (...) inform and stimulate local policy development and revision on the continent.MethodsTo identify and characterize existing ethics-related guidelines and laws applicable to GGR across much of Africa, we conducted a scoping review of English language policy documents identified through databases, repositories, and web searches. Thirty-six documents were included and coded using a framework that contained a range of themes across five analytical categories: (1) respect, (2) beneficence, (3) justice, (4) independent oversight, and (5) bans and prohibitions. Data analysis software (NVivo 12) was used to organize, code, and tabulate information according to document characteristics and topics. Illustrative examples of policy requirements were selected for inclusion.ResultsDocuments that met inclusion criteria spanned 20 years; published between 1996 and 2018, with the majority (58%) published after 2009. About two-thirds were denoted as “guidelines,” and slightly more than half were non-exclusive to GGR. Very few (six) country-level documents identified were specific to GGR. Requirements related to the principle of “respect” appeared most often across all documents, relative to other principles and processes. The most commonly stated ban was on reproductive cloning. Other prohibitions applied to germline editing, undue inducements in research, sample use for commercial purposes, employee mandatory DNA testing, fetal sex selection, stem cell use, eugenics, and research without public health benefits.ConclusionsEnforceable policies that are indispensable to the ethical conduct and review of GGR are either deficient or missing in many African countries. Existing international, GGR-specific ethics guidelines can be used to inform GGR policy development at a country-level, in conjunction with insight from country specific ethics committees and other local stakeholders. (shrink)

There is unanimous agreement regarding the need to ethically conduct research for improving therapy for patients admitted to hospital with acute conditions, including in emergency obstetric care. We present a conceptual analysis of ethical tensions inherent in the informed consent process for randomized clinical trials for emergency obstetric care and suggest ways in which these could be mitigated. A valid consenting process, leading to an informed consent, is a cornerstone of this aspect necessary for preservation and maintenance of respect for (...) autonomy and dignity. In emergency obstetric care research, obtaining informed consent can be problematic, leading to ethical tension between different moral considerations. Potential participants may be vulnerable due to severity of disease, powerlessness or impaired decisional capacity. Time for the consent process is limited, and some interventions have a narrow therapeutic window. These factors create ethical tension in allowing potentially beneficial research while avoiding potential harms and maintaining respect for dignity, human rights, justice and autonomy of the participants. Informed consent in emergency obstetric care in low- and middle-income countries poses numerous ethical challenges. Allowing research on vulnerable populations while maintaining respect for participant dignity and autonomy, protecting participants from potential harms and promoting justice underlie the ethical tensions in the research in emergency obstetric and newborn care. Those involved in research conduct or oversight have a duty of fair inclusion, to avoid denying participants the right to participate and to any potential research benefits. (shrink)

The amount of biomedical research being conducted around the world has greatly expanded over the past 15 years, with particularly large growth occurring in low- and middle-income countries. This increased focus on understanding and responding to disease burdens around the world has brought forth a desire to help LMIC institutions enhance their own capacity to conduct scientifically and ethically sound research. In support of these goals the Johns Hopkins-Fogarty African Bioethics Training Program has, for the past six years, partnered with (...) three research institutions in Africa to support research ethics capacity. Each partnership began with a baseline evaluation of institutional research ethics environments in order to properly tailor capacity strengthening activities and help direct limited institutional resources. Through the course of these partnerships we have learned several lessons regarding the evaluation process and the framework used to complete the assessments. We believe that these lessons are generalizable and will be useful for groups conducting such assessments in the future. (shrink)

Background: The process of obtaining informed consent continues to be a contentious issue in clinical and public health research carried out in resource-limited settings. We sought to evaluate this process among human research participants in randomly selected active research studies approved by the School of Medicine Research and Ethics Committee at the College of Health Sciences, Makerere University. Methods: Data were collected using semi-structured interviewer-administered questionnaires on clinic days after initial or repeat informed consent procedures for the respective clinical studies (...) had been administered to each study participant. Results: Of the 600 participants interviewed, two thirds (64.2 %, 385/600) were female. Overall mean age of study participants was 37.6 (SD = 7.7) years. Amongst all participants, less than a tenth (5.9 %, 35/598) reported that they were not given enough information before making a decision to participate. A similar proportion (5.7 %, 34/597) reported that they had not signed a consent form prior to making a decision to participate in the study. A third (33.7 %, 201/596) of the participants were not aware that they could, at any time, voluntarily withdraw participation from these studies. Participants in clinical trials were 50 % less likely than those in observational studies [clinical trial vs. observational; (odds ratio, OR = 0.5; 95 % CI: 0.35-0.78)] to perceive that refusal to participate in the parent research project would affect their regular medical care. Conclusions: Most of the participants signed informed consent forms and a vast majority felt that they received enough information before deciding to participate. On the contrary, several were not aware that they could voluntarily withdraw their participation. Participants in observational studies were more likely than those in clinical trials to perceive that refusal to participate in the parent study would affect their regular medical care. (shrink)

Background The globalization of clinical research in the last two decades has led to a significant increase in the volume of clinical research in developing countries. As of 2016, Uganda was the third largest destination for clinical trials in Africa. This requires adequate capacity and systems to facilitate ethical practice. Methods This was a retrospective study involving review of laws, guidelines, policies and records from 1896 to date. Results Modern medicine evolved from 1896 and by the time of Uganda's independence (...) in 1962, a 1500 bed national referral hospital was in place and a fully‐fledged medical school was established at the Makerere University. As the practice of medicine evolved in the country, so did medical research that addressed priority health issues. The growth in modern medicine was not matched with development of research infrastructure and regulatory systems. The first documented regulation of research activities was in 1970 while the first research ethics committee established in 1986 was to facilitate review of research related to the HIV/AIDs pandemic. In 1990 an Act of Parliament was passed to facilitate development and implementation of policies, hence the development of the national guidelines in 1997, training, establishment and accreditation of research ethics committees, conferences and research site monitoring. Conclusion Over the past 120 years, the implementation and structural aspects of research ethics in Uganda have evolved through 70 years of no regulation, followed by 30 years of rudimentary regulation while the last 20 years have shown significant growth in the regulatory system associated with supportive laws, institutionalization of regulatory and training processes. (shrink)

Research Ethics, Volume 18, Issue 3, Page 193-209, July 2022. This study aimed to explore experiences and practices of key research team members in obtaining informed consent for pharmacogenetics research and to identify the approaches used for enhancing understanding during the consenting process. Data collection involved 15 qualitative, in-depth interviews with key researchers who were involved in obtaining informed consent from HIV infected individuals in Uganda for participation in pharmacogenetic clinical trials. The study explored two prominent themes: approaches used to (...) convey information and enhance research participants’ understanding and challenges faced during the consenting process. Several barriers and facilitators for obtaining consent were identified. Innovative and potentially effective consenting strategies were identified in this study that should be studied and independently verified. (shrink)

The process of obtaining informed consent continues to be a contentious issue in clinical and public health research carried out in resource-limited settings. We sought to evaluate this process among human research participants in randomly selected active research studies approved by the School of Medicine Research and Ethics Committee at the College of Health Sciences, Makerere University.

Essays discuss cognition, perception, art, science, truth, metaphor, education, philosophy, and cognitive psychology.

How Classification Works attempts to bridge the gap between philosophy and the social sciences using as a focus some of the work of Nelson Goodman. Throughout his long career Goodman has addressed the question: are some ways of conceptualizing more natural than others? This book looks at the rightness of categories, assessing Goodman's role in modern philosophy and explaining some of his ideas on the relation between aesthetics and cognitive theory. Two papers by Nelson Goodman are included in (...) the collection and there are analyses of his work by seven leading academics in anthropology, philosophy, sociology and musicology. (shrink)

Miller (1956) summarized evidence that people can remember about seven chunks in short-term memory (STM) tasks. However, that number was meant more as a rough estimate and a rhetorical device than as a real capacity limit. Others have since suggested that there is a more precise capacity limit, but that it is only three to five chunks. The present target article brings together a wide variety of data on capacity limits suggesting that the smaller capacity limit is real. Capacity limits (...) will be useful in analyses of information processing only if the boundary conditions for observing them can be carefully described. Four basic conditions in which chunks can be identified and capacity limits can accordingly be observed are: (1) when information overload limits chunks to individual stimulus items, (2) when other steps are taken specifically to block the recoding of stimulus items into larger chunks, (3) in performance discontinuities caused by the capacity limit, and (4) in various indirect effects of the capacity limit. Under these conditions, rehearsal and long-term memory cannot be used to combine stimulus items into chunks of an unknown size; nor can storage mechanisms that are not capacity-limited, such as sensory memory, allow the capacity-limited storage mechanism to be refilled during recall. A single, central capacity limit averaging about four chunks is implicated along with other, noncapacity-limited sources. The pure STM capacity limit expressed in chunks is distinguished from compound STM limits obtained when the number of separately held chunks is unclear. Reasons why pure capacity estimates fall within a narrow range are discussed and a capacity limit for the focus of attention is proposed. Key Words: attention; enumeration; information chunks; memory capacity; processing capacity; processing channels; serial recall; short-term memory; storage capacity; verbal recall; working memory capacity. (shrink)

Diese Schriften kennzeichnen den Weg, auf dem Nelson - Kant folgend - sein Ziel einer "kritischen Philosophie" angestrebt hat. Es geht ihm darum, durch Kritik der Vernunft unmittelbare Erkenntnisse aus reiner Vernunft aufzusuchen, ihnen die Maßstäbe für wissenschaftliches Philosophieren zu entnehmen und so, im Selbstvertrauen der Vernunft, Ausblicke auf pädagogische Aufgaben und Weltanschauungsfragen zu gewinnen.

In his new foreword to this edition, Hilary Putnam forcefully rejects these nativist claims.

. . . Unlike Dewey, he has provided detailed incisive argumentation, and has shown just where the dogmas and dualisms break down." -- Richard Rorty, The Yale Review.

Required reading at more than 100 colleges and universities throughout North America.

summary, crtiques, strengths and limitation of the article.

With this third edition of Nelson Goodman's The Structure of Appear ance, we are pleased to make available once more one of the most in fluential and important works in the philosophy of our times. Professor Geoffrey Hellman's introduction gives a sustained analysis and appreciation of the major themes and the thrust of the book, as well as an account of the ways in which many of Goodman's problems and projects have been picked up and developed by others. Hellman (...) also suggests how The Structure of Appearance introduces issues which Goodman later continues in his essays and in the Languages of Art. There remains the task of understanding Good man's project as a whole; to see the deep continuities of his thought, as it ranges from logic to epistemology, to science and art; to see it therefore as a complex yet coherent theory of human cognition and practice. What we can only hope to suggest, in this note, is the b. road Significance of Goodman's apparently technical work for philosophers, scientists and humanists. One may say of Nelson Goodman that his bite is worse than his bark. Behind what appears as a cool and methodical analysis of the conditions of the construction of systems, there lurks a radical and disturbing thesis: that the world is, in itself, no more one way than another, nor are we. It depends on the ways in which we take it, and on what we do. (shrink)

This book is a philosophical exploration of the theoretical causes behind the collapse of classical cybernetics. Alcibiades Malapi-Nelson advances the idea that the cybernetic understanding of the nature of a machine entails ontological and epistemological consequences that create both material and theoretical conundrums. He proposes that, given our current state of materials, research, and practices, there might be a way for cybernetics to flourish. The book starts with a historical treatment of cybernetics, and proceeds with a philosophical explanation of (...) its collapse-emphasizing the work of Turing, Ashby and von Neumann-and connects it with the emerging technologies carrying its signature. The transhumanist metaphysics of both cybernetics and NBIC is then unveiled. Finally, avenues of research that may allow these technologies to circumvent the cybernetic fate are indicated. It is advanced that emerging technologies ultimately entail an affirmation of humanity. (shrink)

How much bacterial evolution occurs in our intestines and which factors control it are currently burning questions. The formation of new ecotypes, some of which capable of coexisting for long periods of time, is highly likely in our guts. Horizontal gene transfer driven by temperate phages that can perform lysogeny is also widespread in mammalian intestines. Yet, the roles of mutation and especially lysogeny as key drivers of gut bacterial adaptation remain poorly understood. The mammalian gut contains hundreds of bacterial (...) species, each with many strains and ecotypes, whose abundance varies along the lifetime of a host. A continuous high input of mutations and horizontal gene transfer events mediated by temperate phages drives that diversity. Future experiments to study the interaction between mutations that cause adaptation in microbiomes and lysogenic events with different costs and benefits will be key to understand the dynamic microbiomes of mammals. Also see the video abstract here: https://youtu.be/Zjqsiyb5Pk0. (shrink)

What if human joy went on endlessly? Suppose, for example, that each human generation were followed by another, or that the Western religions are right when they teach that each human being lives eternally after death. If any such possibility is true in the actual world, then an agent might sometimes be so situated that more than one course of action would produce an infinite amount of utility. Deciding whether to have a child born this year rather than next is (...) a situation wherein an agent may face several alternatives whose effects could well ramify endlessly on such suppositions, for the child born this year would be a different person—one who preferred different things, performed different actions, and had different descendants—from a child born next year. It has recently been suggested that traditional utilitarianism stumbles on such cases of infinite utility. Specifically, utilitarianism seems to require, for its application, that all experience of pleasure and pain cease at some time in the future or asymptotically approach zero.2 If neither of these conditions holds, then the utility produced by each of two alternative actions may turn out to be infinite, and utilitarianism thus loses its ability to discriminate morally between them. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Meaning in Spinoza’s MethodAlan Nelson and Noa SheinAaron V. Garrett. Meaning in Spinoza’s Method. New York: Cambridge University Press, 2003. Pp. xii + 240. Cloth, $60.00.This is a book about some fundamental aspects of Spinoza's mature metaphysics. The principal focus is on Part I of the Ethics concerning infinite substance, and on Part V concerning the intuitive knowledge that is the goal of philosophy. Within this focus, (...) Garrett concentrates on Spinoza's method. Garrett explains how he has been influenced by interpretations that stress the structural parallel between the synthetic, geometrical presentation of the Ethics and the relations among the ideas of the well-ordered mind. The Ethics proceeds by deriving propositions concerning substance's modes from definitions of substance and related notions while the mind, insofar as it is free from emotions, intuitively knows things as following from God. Garrett's distinctive thesis, however, is that Spinozistic enlightenment depends on the process of emending the intellect as described in one of Spinoza's earliest works, the Treatise on the Emendation of the Intellect. While this work strongly foreshadows many of Spinoza's mature doctrines, its exposition much more closely resembles the analytic, non-geometric approach of Descartes's Meditations. Spinoza's therapy for the emendation of our "inadequate" ideas closely parallels Descartes's analytic therapy for making what he calls confused ideas "clear and distinct."Garrett is on firm ground in arguing that the process of enlightenment cannot be an unbroken chain of intuitive deductions. For one thing, the definitions and axioms printed in a copy of the Ethics are first sensed by the reader and are not likely to produce immediately the requisite adequate ideas (172). An example of one of Garrett's interesting conclusions is that the definition of God as consisting of an infinity of attributes, the sixth of Part I of the Ethics (1D6), is preliminary and replaced in the process of therapeutic emendation by a definition of God as self caused. It is only after our ideas have become adequate at the end of the process that we are able to fully appreciate 1D6 (171).One might think that Garrett does not go far enough here because his point can be naturally extended. Definitions might assist us in the process of bringing our adequate ideas to light, but our cognitive goal is making these ideas themselves adequate. What then are the ideas we can make most adequate and exactly what distinguishes them from highly refined ideas that are nevertheless more inadequate than these? On one interpretation it is divine essence, that is, the attributes of thought and extension that are individually most adequately conceived after successful therapy. It is tempting to suppose that a single idea of God as both thinking and extended would be more adequate still, but Spinoza holds that our conceptions of these attributes are "really distinct" in a sense analogous to Descartes's(1P10). Spinoza's 1D6 definition of God as a substance consisting of both these attributes (and perhaps other inconceivable ones) thus seems to indicate a subsumption of the attributes we can conceive under the image of some printed or spoken words. Such an idea would be more inadequate than our adequate conceptions of the individual attributes. One is here strongly reminded of Descartes's characterization in Article 63 of the first Part of his Principles of Philosophy, "... we more readily understand extended substance or thinking substance than substance alone."In his seventh and concluding chapter, Garrett tackles the grand problems of intuitive knowledge or knowledge of "the third kind" and the sense in which Spinoza thought a part of the human mind is eternal. The discussion is necessarily complex, but one great advantage of Garrett's treatment is that he realizes intuitive knowledge cannot consist in the explicit deduction of particular things from God. The detailed determination of particular "everyday objects" requires sensory knowledge which is, of course, never perfectly determinate and therefore inherently inadequate. But we can acquire the "second kind" of adequate knowledge by understanding what our minds have in common with other determinate, finite things. This finally enables us to ascend to an appreciation of these... (shrink)

The purpose of this essay is to look at whether Aquinas teaches in De veritate [DV], q. 1, a. 4, that truth is a form inherent in things. I take up this investigation because I am examining Lawrence Dewan's account of Aquinas's teaching on truth.1 On Dewan's account, a significant development occurs in Aquinas's teaching as regards truth as it is found in things. Before the Summa theologiae [ST], Aquinas thought that in addition to truth being in the intellect, it (...) was also in things. In ST, most explicitly in I, q. 16, a. 6, Aquinas no longer thinks that it is in things, but only in the mind. When Dewan says that before the ST truth is "in things" and in the ST it is not "in things," in both cases, by "in things," Dewan means "as a form inherent in things." What exactly this means for Dewan will be gradually brought out as I examine the text Dewan thinks most clearly teaches that truth is a form inherent in things: DV, q. 1, a. 4. (shrink)

Commentators expressed a wide variety of views on whether there is a basic capacity limit of 3 to 5 chunks and, among those who believe in it, about why it occurs. In this response, I conclude that the capacity limit is real and that the concept is strengthened by additional evidence offered by a number of commentators. I consider various arguments why the limit occurs and try to organize these arguments into a conceptual framework or “metatheory” of storage capacity limits (...) meant to be useful in future research to settle the issue. I suggest that principles of memory representation determine what parts of the representation will be most prominent but that limits of attention (or of a memory store that includes only items that have been most recently attended) determine the 3- to 5-chunk capacity limit. (shrink)

Knowing and Making 1. Obstacles to Knowing The theory of knowledge to be sketched here rejects both absolutism and nihilism, both unique truth and the ...

In this highly original and accessible book, one of our leading philosophers of religion seeks to answer this question by analyzing the several states of mystic union as they are described and explained in the classical primary literature ...