This paper is intended to stimulate debate amongst stakeholders in the international research community on the topic of returning individual genetic research results to study participants. Pharmacogenetics and disease genetics studies are becoming increasingly prevalent, leading to a growing body of information on genetic associations for drug responsiveness and disease susceptibility with the potential to improve health care. Much of these data are presently characterized as exploratory (non‐validated or hypothesis‐generating). There is, however, a trend for research participants to be permitted (...) access to their personal data if they so choose. Researchers, sponsors, patient advocacy groups, ethics committees and regulatory authorities are consequently confronting the issue of whether, and how, study participants might receive their individual results. Noted international ethico‐legal guidelines and public policy positions in Europe and the United States are reviewed for background. The authors offer ‘Points‐to‐Consider’ regarding returning research results in the context of drug development trials based on their knowledge and experience. These considerations include: the clinical relevance of data, laboratory qualifications, informed consent procedures, confidentiality of medical information and the competency of persons providing results to participants. The discussion is framed as a benefit‐to‐risk assessment to balance the potential positive versus negative consequences to participants, while maintaining the integrity and feasibility of conducting genetic research studies. (shrink)

ABSTRACT This paper is intended to stimulate debate amongst stakeholders in the international research community on the topic of returning individual genetic research results to study participants. Pharmacogenetics and disease genetics studies are becoming increasingly prevalent, leading to a growing body of information on genetic associations for drug responsiveness and disease susceptibility with the potential to improve health care. Much of these data are presently characterized as exploratory (non‐validated or hypothesis‐generating). There is, however, a trend for research participants to be (...) permitted access to their personal data if they so choose. Researchers, sponsors, patient advocacy groups, ethics committees and regulatory authorities are consequently confronting the issue of whether, and how, study participants might receive their individual results. Noted international ethico‐legal guidelines and public policy positions in Europe and the United States are reviewed for background. The authors offer ‘Points‐to‐Consider’ regarding returning research results in the context of drug development trials based on their knowledge and experience. These considerations include: the clinical relevance of data, laboratory qualifications, informed consent procedures, confidentiality of medical information and the competency of persons providing results to participants. The discussion is framed as a benefit‐to‐risk assessment to balance the potential positive versus negative consequences to participants, while maintaining the integrity and feasibility of conducting genetic research studies. (shrink)

The inclusion of elite transwomen athletes in sport is controversial. The recent International Olympic Committee guidelines allow transwomen to compete in the women’s division if their testosterone is held below 10 nmol/L. This is significantly higher than that of cis-women. Science demonstrates that high testosterone and other male physiology provides a performance advantage in sport suggesting that transwomen retain some of that advantage. To determine whether the advantage is unfair necessitates an ethical analysis of the principles of inclusion and fairness. (...) Particularly important is whether the advantage held by transwomen is a tolerable or intolerable unfairness. We conclude that the advantage to transwomen afforded by the IOC guidelines is an intolerable unfairness. This does not mean transwomen should be excluded from elite sport but that the existing male/female categories in sport should be abandoned in favour of a more nuanced approach satisfying both inclusion and fairness. (shrink)

Ethnic nepotism theory predicts that even in times of communal peace altruism is more pronounced within than between ethnic groups. The present study tested the hypothesis that altruism in the form of alms giving would be greater within than between ethnic groups, and greater between more closely related groups than between more distant groups. The three groups chosen for study were ethnic Russians, Moldavians, and Gypsies. Russians are genetically closer to Moldavians than to Gypsies. Observations were made of 128 ethnic (...) Russian, 25 Moldavian, and 25 Gypsy beggars receiving gifts from ethnic Russians in Moscow trains. The Gypsies were mainly girls, contrary to the Russian sample. Multivariate analysis identified three main strategies: active, personified, and appeasing-undirected. Russian strategies were most variable. Gypsies presented strong charity releasers: 84% were children who played music and sang and showed appeasing-undirected behavior. The few adults were highly submissive or friendly. Nevertheless, their success was limited compared with that of ethnic Russians despite the latter’s demanding behavior and their being mostly mature or elderly persons. Moldavians received an intermediate amount of charity. The hypothesis was supported. (shrink)

Cage-Fighting, also known as Mixed Martial Arts, is a combat sport that allows participants to grapple, punch, kick, elbow and knee—a combination of elements from many martial arts. While it...

ABSTRACT Corporate Social Responsibility denotes a movement away from shareholder theories of the corporation, and refers to a set of practices designed to have an economic, environmental, and social impact. Public companies report on their CSR practices annually in the form of multimodal reports which are made available on the companies’ websites, and are typically read by investors who seek standardisation across this genre. Thus, most companies across the globe follow the Global Reporting Initiative framework for reporting, a framework developed (...) within the Global North. The dominance of the Global North in CSR practices is also evident in the academic literature – while applied linguists have gone some way in highlighting the generic, interpersonal, and ideational features of reports, such studies have predominantly focused on multinational corporations. There is, comparatively, very little literature on the CSR practices and discourses circulating in the Global South or former colonial contexts and because of this we have limited insight into how companies operating in these contexts discursively represent themselves, their employees and their suppliers within the same context. To address this shortcoming, this study draws on analytical approaches developed within Critical Discourse Analysis coupled with postcolonial theory in order to comment on the ideational features of the four most recent CSR reports of one South African company. (shrink)

This paper describes the process of reception of Catholic Modernism in Poland as well as the Polish contribution to this movement. It shows the Polish antimodernist perspective on modernistic thought. The neglect of Polish modernism was caused by the nationalistic character of the Polish theology and has resulted in absence of historical studies of Polish Catholic Modernism. Based on the results of archival and literature research the paper presents a variety of Polish Catholic Modernists and non-Catholic supporters of the modernist (...) thought. A unique place among Polish modernists belongs to Marian Zdziechowski (1861–1938) who was the only Polish participant of the international intellectual debate on the “modernisation” of Roman Catholicism. The paper analyses the development of Zdziechowski’s thought and shows that his main demand throughout the modernist debates was to create a new, more efficient apologetics, which would be grounded in the religious experience of the individual. (shrink)

This paper describes the process of reception of Catholic Modernism in Poland as well as the Polish contribution to this movement. It shows the Polish antimodernist perspective on modernistic thought. The neglect of Polish modernism was caused by the nationalistic character of the Polish theology and has resulted in absence of historical studies of Polish Catholic Modernism. Based on the results of archival and literature research the paper presents a variety of Polish Catholic Modernists and non-Catholic supporters of the modernist (...) thought. A unique place among Polish modernists belongs to Marian Zdziechowski (1861–1938) who was the only Polish participant of the international intellectual debate on the “modernisation” of Roman Catholicism. The paper analyses the development of Zdziechowski’s thought and shows that his main demand throughout the modernist debates was to create a new, more efficient apologetics, which would be grounded in the religious experience of the individual. (shrink)

In his latest paper, Loland1 tackles the question of whether athletes with differences of sexual development may compete in the women’s division. The topic is one of the most complex in sport and, as such, is fraught with debate. On one hand, the higher testosterone levels of athletes with DSD means they have an unfair performance advantage over their female competitors. On the other hand, it is argued that women with DSD should be able to compete in the gender division (...) with which they identify, especially as many will have been raised with a clear gender identity. Loland uses the Rawlsian notion of ‘fair equality of opportunity’ in which individuals with similar talents and ambitions should have roughly equivalent prospects for competitive success. For example, in most situations in society, one’s age, biological sex, ethnic and religious background, colour of skin, or sexual orientation are irrelevant to whether an individual should be given a job or is eligible for social welfare. In addition to being irrelevant, these factors are also stable—they are inequalities that ‘individuals cannot control or impact in any significant way’.1 However, Loland recognises that some stable inequalities, such as biological sex and body size, are relevant to FEO in sport. For example, a featherweight boxer may have similar talents and …. (shrink)

Legal precedent, professional‐society statements, and even many medical ethicists agree that some situations may call for a clinician to engage in an act of lying or nonlying deception of a patient or patient's family member. Still, the moral terrain of clinical deception is largely uncharted, and when it comes to practical guidance for clinicians, many might think that ethicists offer nothing more than the rule never to deceive. This guidance is insufficient to meet the real‐world demands of clinical practice, and (...) this article endeavors to articulate a framework to help clinicians better navigate the ethics of clinical deceit. The framework articulates four morally relevant dimensions of a potential deceptive act that should be examined to better determine the moral justification that might be required: the target of the act, the nature of the information, the nature of the act, and the context of the act. (shrink)

How we experience space by listening: the concepts of aural architecture, with examples ranging from Gothic cathedrals to surround sound home theater. We experience spaces not only by seeing but also by listening. We can navigate a room in the dark, and "hear" the emptiness of a house without furniture. Our experience of music in a concert hall depends on whether we sit in the front row or under the balcony. The unique acoustics of religious spaces acquire symbolic meaning. Social (...) relationships are strongly influenced by the way that space changes sound. In Spaces Speak, Are You Listening?, Barry Blesser and Linda-Ruth Salter examine auditory spatial awareness: experiencing space by attentive listening. Every environment has an aural architecture.The audible attributes of physical space have always contributed to the fabric of human culture, as demonstrated by prehistoric multimedia cave paintings, classical Greek open-air theaters, Gothic cathedrals, acoustic geography of French villages, modern music reproduction, and virtual spaces in home theaters. Auditory spatial awareness is a prism that reveals a culture's attitudes toward hearing and space. Some listeners can learn to "see" objects with their ears, but even without training, we can all hear spatial geometry such as an open door or low ceiling. Integrating contributions from a wide range of disciplines—including architecture, music, acoustics, evolution, anthropology, cognitive psychology, audio engineering, and many others—Spaces Speak, Are You Listening? establishes the concepts and language of aural architecture. These concepts provide an interdisciplinary guide for anyone interested in gaining a better understanding of how space enhances our well-being. Aural architecture is not the exclusive domain of specialists. Accidentally or intentionally, we all function as aural architects. (shrink)

Our aim in this article is to bring some clarity to the clinical ethics expertise debate by critiquing and replacing the taxonomy offered by the Core Competencies report. The orienting question for our taxonomy is: Can clinical ethicists offer justified, normative recommendations for active patient cases? Views that answer “no” are characterized as a “negative” view of clinical ethics expertise and are further differentiated based on (a) why they think ethicists cannot give justified normative recommendations and (b) what they think (...) ethicists can offer, if they cannot offer recommendations. Views that answer “yes” to the orienting question are characterized as a “positive” view of clinical ethics expertise. Positive views are distinguished according to four additional questions. First (P1), how are those recommendations generated? Second (P2), what is the nature of the recommendations? Third (P3), we ask, how are the recommendations justified? And finally (P4), how are the recommendations communicated? (shrink)

Author looks into the problem of Marian Zdziechowski’s cooperation with the journal „Nový život”, the newsletter for Czech Catholic modernists. The background for author’s considerations is a historical outline of The Modernist Crisis, its intellectual origins and historic consequences. From 1902 to 1905 five Zdziechowski’s essays were translated and published in „Nový život”. The ideas of the Polish philosopher significantly influenced the development of the Catholic modernism in Bohemia. Zdziechowski discussed such issues as: the crisis and the revival of religion (...) at the turn of the 19th and 20th centuries, the significance of the Catholic Modernism for the renewal of Roman Catholic Church and the relation between religion and modern art. (shrink)

The aim of this study is to discuss in what sense one can speak about universal character of logic. The authors argue that the role of logic stands mainly in the generality of its language and its unrestricted applications to any field of knowledge and normal human life. The authors try to precise that universality of logic tends in: (a) general character of inference rules and the possibility of using those rules as a tool of justification of theorems of every (...) science, (b) principles of correct formulating of thoughts and using language, and (c) general deductive method of reasoning, i.e in the study of language syntax and semantics. The authors present two theories of language syntax and semantics as exemplifications based on the Tarski’s famous results in metalogic: (1) a formalization of universal syntax system by Andrzej Grzegorczyk based on a new primitive notion of quotation-marks operator, and (2) an enlarged system of axiomatic theory of syntax of any categorial language of Urszula Wybraniec-Skardowska’s in which the main role plays the relation of concatenation understood as a set-theoretical function. The study concludes in arguing that the importance of the result (2) lies not only in solving some philosophical problems but also in different fields of knowledge and spheres of human life as ex. in discussion and education as well. (shrink)

This paper sketches or signals some ideas, results, and proposals connected with the theoretical issues related to the categorial approach to language which originated from the first author and which form the basis for further research by the second author. The main aims are the following: 1) to bring into common use some Polish ideas concerned with classical categorial grammar; 2) to take into consideration a universal and simultaneously formal-logical perspective; 3) to consider Peirce's well-known differentiation of linguistic objects, i.e. (...) their twofold ontological status as tokens and types and, according to this, to consider the biaspectual formalization of language dealing with the two main orientations in the controversy between nominalism and Platonism; 4) to characterize language according to Frege's ontological canons, according to which each expression of language corresponds to its denotation. All of these factors make possible not only the syntactic characterization of language but also the introduction of syntactic and semantic definitions of a true expression and its denotation. These notions correspond here to the old classical, but not necessarily standard, understanding of semantic concepts. The paper is divided into four sections: the first contains a brief characterization of the categorial approach to syntax; the second presents two strains of this approach; the third touches on certain general semantic issues connected with the notion of truth; and the last gives some final remarks. (shrink)

Empathy is commonly regarded as an essential attribute for doctors and there is a conviction that empathy must be taught to medical students. Yet it is not clear exactly what empathy is, from a philosophical or sociological point of view, or whether it can be taught. The meaning, role and relevance of empathy in medical education have tended to be unquestioningly assumed; there is a need to examine and contextualise these assumptions. This paper opens up that debate, arguing that ‘empathy’, (...) as it is commonly understood, is neither necessary nor sufficient to guarantee good medical or ethical practice. (shrink)

This paper undertakes the question concerning methodological consequences of understanding phenomenology from the viewpoint of the category of the gift. In regard to the philosophical enterprise of Jean-Luc Marion, manifestation is understood as an act of givenness, which has a radically non-objective character. Next, this paper points out the classical source of the concept of givenness. It also mentions that givenness is a result of material interpretation of the Husserlian term “Gegebenheit.” Then, givenness is presented as a figure that requires (...) a phenomenological method to bracket mere terms that phenomenology employs. This mechanism helps to describe reduction as a radical method of bracketing metaphysics. (shrink)

We argue against Christopher Meyers’s call for clinical ethicists to participate in deceiving patients, surrogate decision-makers, or family members. While we acknowledge that some forms of deception may be ethically appropriate in highly circumscribed situations, the type of case Meyers describes as involving justifiable deception differs in at least two important ways. First, Meyers fails to distinguish acts of deception based on the critical feature of who is being deceived—patient, surrogate, or family member—and the overarching duty to respect the autonomy (...) of relevant decision-makers to make rationally-informed decisions. Second, Meyers’s analysis relies on an assessment of harm, a value-laden concept which health care professionals and ethicists should not presumptively assess without considering how the patient, surrogate, or family might assess specific harms. (shrink)

Dog ownership is believed to benefit owner wellbeing but, contrary to popular belief, there is limited evidence to suggest that simply owning a dog is associated with improved mental health. This mixed-methods study investigates whether dog owners with stronger relationships with their dogs experience better mental health. Participants completed an online survey. Owners’ health was measured using the validated PROMIS questions regarding depression, anxiety, emotional support, and companionship. The dog–owner relationship was measured using the validated MDORS scale, which has three (...) subscales: interaction, emotional closeness, and perceived costs. Univariable and multivariable linear regression analyses were conducted, adjusting for confounding factors. Additionally, positive and negative impacts of dog ownership on mental wellbeing were coded from open questions using thematic analysis. A stronger dog–owner relationship was associated with greater feelings of emotional support and companionship but poorer mental health in terms of anxiety or depression. However, the perceived costs subscale was consistently associated with better mental health outcomes. Direction of causality cannot be inferred as people with poor mental health may acquire dogs to help relieve symptoms, which qualitative analysis supported. Key themes included positive impacts on owner wellbeing and happiness through providing purpose, companionship and self-acceptance, pleasure and distraction, as well as lessening emotional pain and suffering and reducing risk behaviors. However, negative impacts of a strong relationship include anticipatory grief over loss of the dog, and concerns regarding the burden of responsibility and ability to meet dog’s needs. Perceived ability to adequately meet dog’s needs promoted personal growth and positive relationships with others, whereas perceived inability led to feelings of guilt, or anger/frustration, and reduced autonomy and sense of environmental mastery. Dog ownership contributes to both hedonic and eudaimonic wellbeing in multiple ways, including supporting owners through periods of poor mental health and providing purpose. However, the burden of responsibility and owner and dog characteristics can create challenges, and owners may benefit from support in caring for their dogs and reducing problematic behaviors. (shrink)

The siren call of individualism is compelling. And although we have recognized its dangerous allure in the realm of adult decision-making, it has had profound and yet unnoticed dangerous effects in pediatric decision-making as well. Liberal individualism as instantiated in the best interest standard conceptualizes the child as independent and unencumbered and the goal of child rearing as rational autonomous adulthood, a characterization that is both ontologically false and normatively dangerous. Although a notion of the individuated child might have a (...) place in establishing a threshold of care obligated and enforced by the state, beyond this context we should turn our attention more explicitly to the relational interests of children. (shrink)

ABSTRACTHow should judges reason in a well-ordered constitutional democracy? According to John Rawls’s famous remarks in Political Liberalism, they ought to do so in accordance with the idea of pub...

Teaching healthcare ethics at the doctoral level presents a particular challenge. Ethics is often taught to medical students, but rarely is medicine taught to graduate students in health care ethics. In this paper, Medicine for Ethicists [MfE] — a course taught both didactically and experientially — is described. Eight former MfE students were independently interviewed in a semi-structured, open-ended format regarding their experience in the experiential component of the course. Themes included concrete elements about the course, elements related to the (...) broader PhD student learning experience, and themes related to the students’ past and future career experiences. Findings are related to the educational philosophy of John Dewey and David Kolb’s experiential learning theory. Broader implications of this work are explored. (shrink)

Freezing is a common sign of panic, a response to accidents or events that overflow our capacity to react. Just as all civil airspace was cleared after the 9/11 attacks, the US-Canada border was also frozen, causing economic slowdowns. Border policies are caught between these two panics: security failures and economic crisis. To escape this paradox, American and Canadian authorities have implemented a series of security measures to make the border ‘smarter’, notably the implementation of biometric identity documents and surveillance (...) by UAV Predator drones. Psychoanalytic theory can help us explain why the Canadian and American governments have invested so much money for so little evident or measurable increase in either security or economic flows. The article uses the notion of phantastic objects to explain these (over-)reactions to risk management at the US-Canada border. (shrink)

This paper considers the question of whether journalism can be considered to be a social practice. After considering some of the goods of journalism the paper moves to investigate how external goods can corrupt the practice and make it somewhat ineffective. The paper therefore looks to consider ways in which the goods claimed have been better served in ‘radical’ journalism. Bristol Independent Media Centre is then evaluated as an example of an active project in which the goods of community are (...) pursued through an inclusive form of participatory journalism. (shrink)

In this article, we give much needed attention to the nature and value of corporate prayer by drawing together insights from theology, philosophy, and psychology. First, we explain what it is that distinguishes corporate from private prayer by drawing on the psychological literature on joint attention and the philosophical notion of shared situations. We suggest that what is central to corporate prayer is a “sense of sharedness,” which can be established through a variety of means—through bodily interactions or through certain (...) environments. Second, we argue that corporate prayer, when understood as a kind of shared situation, enables common knowledge, as well as a kind of alignment between participants. Through this process, participants’ attention is focused on the same target and affiliation between participants increases. Thus, we suggest, one benefit of understanding corporate prayer as a shared situation is that it establishes and deepens a sense of community in such a way that common purposes and goals can be enacted more effectively. (shrink)

This book approaches the topic of the subjective, lived experience of hate crime from the perspective of Husserlian phenomenology. It provides an experientially well-grounded account of how and what is experienced as a hate crime, and what this reveals about ourselves as the continually reconstituted “subject” of such experiences. The book shows how qualitative social science methods can be better grounded in philosophically informed theory and methodological practices to add greater depth and explanatory power to experiential approaches to social sciences (...) topics. The Authors also highlight several gaps and contradictions within Husserlian analyses of prejudice, which are exposed by attempts to concretely apply this approach to the field of hate crimes. Coverage includes the difficulties in providing an empathetic understanding of expressions of harmful forms of prejudice underlying hate crimes, including hate speech, arising from our own and others’ ‘life worlds’. The Authors describe a ‘Husserlian-based’ view of hate crime as well as a novel interpretation of the value of the comprehensive methodological stages pioneered by Husserl. The intended readership includes those concerned with discrimination and hate crime, as well as those involved in qualitative research into social topics in general. The broader content level makes this work suitable for undergraduate and postgraduate students, even professionals within law enforcement. (shrink)

This article enumerates and critically examines the potential grounds on which we might treat the case of a patient with an advance directive who attempted suicide, differently from one whose injuries were the result of an accident. Grounds for differentiation are distilled into two potential justifications. The first addresses the concern that withholding or withdrawing care from a patient with self-inflicted injuries would be aiding and abetting suicide. The second examines concerns about the patient’s decisionmaking capacity. Ultimately, it is argued (...) that while there might be legitimate reasons to hold the advance directive of a suicidal patient to a different standard of scrutiny, the fact that the patient’s medical state was self-inflicted should not, in and of itself, necessarily invalidate the guidance of the directive. Finally, four practical recommendations are offered for negotiating similar cases. (shrink)

Whether adolescents should be allowed to make their own medical decisions has been a topic of discussion in bioethics for at least two decades now. Are adolescents sufficiently capacitated to make their own medical decisions? Is the mature-minor doctrine, an uncommon legal exception to the rule of parental decision-making authority, something we should expand or eliminate? Bioethicists have dealt with the curious liminality of adolescents—their being neither children nor adults—in a variety of ways. However, recently there has been a trend (...) to rely heavily, and often exclusively, on emerging neuroscientific and psychological data to answer these questions. Using data from magnetic resonance imaging and functional MRI studies on the adolescent brain, authors have argued both that the adolescent brain isn't sufficiently mature to broadly confer capacity on this population and that the adolescent brain is sufficiently mature to assume adolescent capacity. Scholars then accept these data as sufficient for concluding that adolescents should or should not have decision-making authority. Two critical mistakes are being made here. The first is the expectation that neuroscience or psychology is or will be able to answer all our questions about capacity. The second, and more concerning, mistake is the conflation of decision-making capacity with decision-making authority. (shrink)

The global development of human embryonic stem cell science and its therapeutic applications are dependent on the nature of its engagement at national and international levels with key cultural values and beliefs concerning the moral status of the early human embryo. This article argues that the political need to reconcile the promise of new health technologies with the cultural costs of scientific advance, dependent in this case on the use of the human embryo, has been met by the evolution of (...) bioethics as a political community, transnational network, and bureaucratic device. Bioethics has become the political means for the creation of a global moral economy where the trading and exchange of values is normalized and legitimated. As a result of such trading, value compromises are produced capable of legitimizing the regulatory policies necessary for maintaining public trust in the new science. (shrink)

Through an exploration of the experience of severe and profound intellectual disability, this essay will attempt to expose the predominant, yet usually obscured, medical anthropology of the child and examine its effects on pediatric bioethics. I will argue that both modern western society and modern western medicine do, actually, have a robust notion of the child, a notion which can find its roots in three influential thinkers: Aristotle, Immanuel Kant and Jean Piaget. Together, these philosophers offer us a compelling vision: (...) the child is primarily a future rational, autonomous adult. While this tacit understanding has arguably widespread effects on such things as our concept of good parenting, of proper schooling, and so on, I will focus on the effect is has on the treatment of children with severe developmental disabilities. When examined in light of this population, the dominant medical anthropology of the child will be shown to be deficient. Instead, I argue for an expansion—indeed, a full reimagining—of our notions of childhood, not only to re-infuse dignity into the lives of children with SDD, but to better represent the goods of childhood, generally. (shrink)

In this paper we suggest a revisionist perspective on two significant figures in early modern life science and philosophy: William Harvey and John Locke. Harvey, the discoverer of the circulation of the blood, is often named as one of the rare representatives of the ‘life sciences’ who was a major figure in the Scientific Revolution. While this status itself is problematic, we would like to call attention to a different kind of problem: Harvey dislikes abstraction and controlled experiments (aside from (...) the ligature experiment in De Motu Cordis), tends to dismiss the value of instruments such as the microscope, and emphasizes instead the privileged status of ‘observed experience’. To use a contemporary term, Harvey appears to rely on, and chiefly value, ‘tacit knowledge’. Secondly, Locke’s project is often explained with reference to the image he uses in the Epistle to the Reader of his Essay, that he was an “underlabourer” of the sciences. In fact, despite the significant medical phase of his career, Locke’s ‘empiricism’ turns out to be above all a practical (i.e. ‘moral’) project, which focuses on the delimitation of our powers in order to achieve happiness, and rejects the possibility of naturalizing knowledge. When combined, these two cases suggest a different view of some canonical moments in early modern natural philosophy. (shrink)

This article examines the role of context in the development and deployment of standards of medical decision-making. First, it demonstrates that bioethics, and our dominant standards of medical decision-making, developed out of a specific historical and philosophical environment that prioritized technology over the person, standardization over particularity, individuality over relationship and rationality over other forms of knowing. These forces de-contextualize the patient and encourage decision-making that conforms to the unnatural and contrived environment of the hospital. The article then explores several (...) important differences between the home health care and acute care settings. Finally, it argues that the personalized, embedded, relational and idiosyncratic nature of the home is actually a much more accurate reflection of the context in which real people make real decisions. Thus, we should work to “re-contextualize” patients, in order that they might be better equipped to make decisions that harmonize with their real lives. (shrink)

Assisted reproductive technology is a global market engaging a variety of local moral economies where the construction of the demand–supply relationship takes different forms through the operation of the politics of value. This paper analyzes how the market–culture relationship works in different settings, showing how power and resources determine what value will, or will not, accrue from that relationship. A commodity’s potential economic value can only be realized through the operation of the market if its cultural status is seen to (...) be legitimate. At the same time, local moral economies and their associated social orders are potentially susceptible to the destabilizing implications of new commodities. The formal or informal organization of power relationships in the market–culture interaction can enable potential value to become manifest and tangible over time or block its path. The interaction is steered through national institutional sources of cultural authority embedded in state and religion, where the visible contest in the politics of value is conducted. Increasingly, that interaction finds its expression in transnational institutions of governance where the struggle for control of the cultural agenda reflects the global nature of the ART market. (shrink)

As Post observes, accounting firms are unique among multinationals. They are more likely than firms in almost any other category to go abroad. They also have less choice in location as their expansion is determined largely by the desired locations of their clients. Given the widespread global presence of such firms, it can be argued that the global audit firm is uniquely at risk from variations in ethical perceptions across nations. This study extends the U.S. accounting literature on determinants of (...) cheating among accounting students to the U.K. Based on the work of Cohen et al. it develops a model that suggests that students in lower "uncertainty avoidance" countries will be both less likely to cheat, and when they do cheat, will be driven by internal rather than external mode. Our results supported the model as proposed as our results indicated that U.S. students were more likely to cheat and were more responsive to external stimuli than were the U.K. students. (shrink)

The relationship between the neurobiology of speech and music has been investigated for more than a century. There remains no widespread agreement regarding how (or to what extent) music perception utilizes the neural circuitry that is engaged in speech processing, particularly at the cortical level. Prominent models such as Patel’s Shared Syntactic Integration Resource Hypothesis (SSIRH) and Koelsch’s neurocognitive model of music perception suggest a high degree of overlap, particularly in the frontal lobe, but also perhaps more distinct representations in (...) the temporal lobe with hemispheric asymmetries. The present meta-analysis study used activation likelihood estimate analyses to identify the brain regions consistently activated for music as compared to speech across the functional neuroimaging (fMRI and PET) literature. Eighty music and 91 speech neuroimaging studies of healthy adult control subjects were analyzed. Peak activations reported in the music and speech studies were divided into four paradigm categories: passive listening, discrimination tasks, error/anomaly detection tasks and memory-related tasks. We then compared activation likelihood estimates within each category for music versus speech, and each music condition with passive listening. We found that listening to music and to speech preferentially activate distinct temporo-parietal bilateral cortical networks. We also found music and speech to have shared resources in the left pars opercularis but speech-specific resources in the left pars triangularis. The extent to which music recruited speech-activated frontal resources was modulated by task. While there are certainly limitations to meta-analysis techniques particularly regarding sensitivity, this work suggests that the extent of shared resources between speech and music may be task-dependent and highlights the need to consider how task effects may be affecting conclusions regarding the neurobiology of speech and music. (shrink)

Grotius argued that it was sometimes permissible to excuse from punishment those who commit crimes out of extreme poverty. The grounds for doing so were separate from the grounds of the right of necessity. Leniency was possible because the seriousness of the crime and the degree of guilt of the offender were separate considerations. Punishment should be related to guilt, which, according to Grotius, was partly a matter of the circumstances and motives of the offender. He thought there were some (...) circumstances, such as extreme poverty, which people cannot be reasonably expected to endure. Smith's retributivist theory ruled out the possibility of moderating punishment for crimes committed out of extreme poverty. Justice requires the self-command to endure our personal hardships rather than harm the innocent. Smith was optimistic about the capacity of people to endure harsh conditions and also about the possibility of improving them. (shrink)

This case analysis examines the pediatric clinical ethics issues of adolescent autonomy and parental authority in medical decision–making. The case involves a dying adolescent whose parents request that the medical team withhold diagnosis and prognosis information from the patient. The analysis engages two related ethical questions: Should Annie be given information about her medical condition? And, who is the proper decision–maker in Annie’s case? Ultimately, four practical recommendations are offered.

Objectives To characterize the prevalence and content of pediatric triage policies.Methods We surveyed and solicited policies from U.S. hospitals with pediatric intensive care units. Policies were analyzed using qualitative methods and coded by 2 investigators.Results Thirty-four of 120 institutions (28%) responded. Twenty-five (74%) were freestanding children’s hospitals and 9 (26%) were hospitals within a hospital. Nine (26%) had approved policies, 9 (26%) had draft policies, 5 (14%) were developing policies, and 7 (20%) did not have policies. Nineteen (68%) institutions shared (...) their approved or draft policy. Eight (42%) of those policies included neonates. The polices identified 0 to 5 (median 2) factors to prioritize patients. The most common factors were short- (17, 90%) and long- (14, 74%) term predicted mortality. Pediatric scoring systems included Pediatric Logistic Organ Dysfunction-2 (12, 63%) and Score for Neonatal Acute Physiology and Perinatal Extensions-II (4, 21%). Thirteen (68%) policies described a formal algorithm. The most common tiebreakers were random/lottery (10, 71%) and life cycles (9, 64%). The majority (15, 79%) of policies specified the roles of triage team members and 13 (68%) precluded those participating in patient care from making triage decisions.Conclusions While many institutions still do not have pediatric triage policies, there appears to be a trend among those with policies to utilize a formal algorithm that focuses on short- and long-term predicted mortality and that incorporates age-appropriate scoring systems. Additional work is needed to expand access to pediatric-specific policies, to validate scoring systems, and to address health disparities. (shrink)