Many authors examine the governmental, the scientific, and the sexual politics of AIDS. Many of these same authors tell the AIDS story within the context of decrying homophobia. The implications of that story, however, have a troubling significance for women. This essay proposes to move the discussion of the sexual politics of AIDS beyond the confines of homophobia and to highlight issues not widely discussed outside of AIDS activist circles-issues which are having, and will continue to have, profound effects on (...) women. (shrink)

Developments in neuroscience have raised the possibility that pharmaceuticals may be used to enhance memory, mood, and attention in people who do not have an illness or disorder, a practice known as “cognitive enhancement.” We describe historical experiences with two medicinal drugs for which similar enhancement claims were made, cocaine in the late 19th and early 20th centuries, and amphetamines in the mid 20th century. These drugs were initially introduced as medicinal agents in Europe and North America before becoming more (...) widely used for a variety of purposes, including what would nowadays be considered cognitive enhancement. Their trajectory of use conformed to the typical use cycle of psychotropic drugs. There was an initial steep rise in prescribing for medical use, followed by expanded nonmedical use that was fueled by enthusiasm for the drugs’ effects. As the number of regular users increased, problems related to use (such as addiction) became apparent, societal concern increased, and laws were passed banning nonmedical use and eventually, medical use. This historical experience draws attention to the adverse side effects of enhancement use that only become apparent with regular, wide-scale use of a drug. We highlight the similarities between the enthusiasms for cocaine and amphetamines and the current enthusiasms for using prescription stimulants for cognitive enhancement. We argue bioethicists should not encourage the cognitive enhancement use of drugs such as methylphenidate in the absence of evidence on the efficacy and safety of their use for cognitive enhancement purposes. (shrink)

A series of letters between a professor of philosophy and an eleven-year-old girl.

Over the past several decades, medical ethics has gained a solid foothold in medical education and is now a required course in most medical schools. Although the field of medical ethics is by nature eclectic, moral philosophy has played a dominant role in defining both the content of what is taught and the methodology for reasoning about ethical dilemmas. Most educators largely rely on the case‐based method for teaching ethics, grounding the ethical reasoning in an amalgam of theories drawn from (...) moral philosophy, including consequentialism, deontology, and principlism.In this article we hope to make a case for augmenting the focus of education in medical ethics. We propose complementing the traditional approach to medical ethics with a more embedded approach, one that has been described by others as “microethics,” the ethics of everyday clinical practice. (shrink)

Epistemologies have power. They have the power not only to transform worlds, but to create them. And the worlds that they create can be better or worse. For many people, the worlds they create are predictably and reliably deadly. Epistemologies can turn sacred land into ‘resources’ to be bought, sold, exploited, and exhausted. They can turn people into ‘labor’ in much the same way. They can not only disappear acts of violence but render them unnamable and unrecognizable within their conceptual (...) architectures. Settler systems of epistemic and conceptual resources and the relations among them are constructed to preclude certain forms of knowledge. This is not an accident; it is a central goal of colonial violence. Colonization and land dispossession would not be possible without the violent disruption of Indigenous knowledge systems and ongoing organized attempts to disrupt their survival. Violently disrupting the relationships of people to land is as much an epistemic project as it is a material one, and these two projects are inherently linked. The task of theorizing epistemic oppression is not only about epistemic oppression. Epistemic oppression is a story that gives language to a phenomenon in order to get past it, to carry on with the maintaining and reviving the forms of Indigenous and diasporic knowledge that colonialism has worked tirelessly to corrupt and silence. (shrink)

Patient and family emotional harm after medical errors may be profound. At an Agency for Healthcare Research and Quality conference to establish a research agenda on this topic, the authors used visual images as a gateway to personal reflections among diverse stakeholders. Themes identified included chaos and turmoil, profound isolation, organizational denial, moral injury and betrayal, negative effects on families and communities, importance of relational skills, and healing effects of human connection. The exercise invited storytelling, enabled psychological safety, and fostered (...) further collaborative discussion. The authors discuss implications for quality/safety, educational innovation, and qualitative research. (shrink)

Human cooperation is highly unusual. We live in large groups composed mostly of non-relatives. Evolutionists have proposed a number of explanations for this pattern, including cultural group selection and extensions of more general processes such as reciprocity, kin selection, and multi-level selection acting on genes. Evolutionary processes are consilient; they affect several different empirical domains, such as patterns of behavior and the proximal drivers of that behavior. In this target article, we sketch the evidence from five domains that bear on (...) the explanatory adequacy of cultural group selection and competing hypotheses to explain human cooperation. Does cultural transmission constitute an inheritance system that can evolve in a Darwinian fashion? Are the norms that underpin institutions among the cultural traits so transmitted? Do we observe sufficient variation at the level of groups of considerable size for group selection to be a plausible process? Do human groups compete, and do success and failure in competition depend upon cultural variation? Do we observe adaptations for cooperation in humans that most plausibly arose by cultural group selection? If the answer to one of these questions is “no,” then we must look to other hypotheses. We present evidence, including quantitative evidence, that the answer to all of the questions is “yes” and argue that we must take the cultural group selection hypothesis seriously. If culturally transmitted systems of rules that limit individual deviance organize cooperation in human societies, then it is not clear that any extant alternative to cultural group selection can be a complete explanation. (shrink)

The ethical culture of any organization is not simply a reflection of its mission statement or even its code of conduct. Rather, the real ethics of institutions are often embedded in their reward systems. We suggest how ethics professors can lead students to develop a greater understanding of rewards by providing a review of various forms of organizational rewards. We also offer insights into how professors can compare reward systems in their classes. We conclude by addressing a number of pedagogical (...) approaches that are useful in equipping ethics students with awareness and understanding of reward systems’ power and influence on employee attitudes and behaviors surrounding ethical decision making. (shrink)

The increasing use of cluster randomised trials in low-resource settings raises unique ethical issues. The Ottawa Statement on the Ethical Design and Conduct of Cluster Randomised Trials is the first international ethical guidance document specific to cluster trials, but it is unknown if it adequately addresses issues in low-resource settings. In this paper, we seek to identify any gaps in the Ottawa Statement relevant to cluster trials conducted in low-resource settings. Our method is to analyse a prototypical cluster trial conducted (...) in a low-resource setting with the Ottawa Statement; to identify ethical issues in the design or conduct of the trial not captured adequately and to make recommendations for issues needing attention in forthcoming revisions to the Ottawa Statement. Our analysis identified six ethical aspects of cluster randomised trials in low-resource settings that require further guidance. The forthcoming revision of the Ottawa Statement should provide additional guidance on these issues: streamlining research ethics committee review for collaborating investigators who are affiliated with other institutions; the classification of lay health workers who deliver study interventions as health providers or research participants; the dilemma experienced by investigators when national standards seem to prohibit waivers of consent; the timing of gatekeeper engagement, particularly when researchers face funding constraints; providing ancillary care in health services or implementation trials when a routine care control arm is known to fall below national standards and defining vulnerable participants needing protection in low-resource settings. (shrink)

Social networks play a significant role in learning and thus in farmers’ adoption of new agricultural technologies. This study examined the effects of social network factors on information acquisition and adoption of new seed varieties among groundnut farmers in Uganda and Kenya. The data were generated through face-to-face interviews from a random sample of 461 farmers, 232 in Uganda and 229 in Kenya. To assess these effects two alternative econometric models were used: a seemingly unrelated bivariate probit model and a (...) recursive bivariate probit model. The statistical evaluation of the SUBP shows that information acquisition and adoption decisions are interrelated while tests for the RBP do not support this latter model. Therefore, the analysis is based on the results obtained from the SUBP. These results reveal that social network factors, particularly weak ties with external support, partially influence information acquisition, but do not influence adoption. In Uganda, external support, gender, farm size, and geographic location have an impact on information acquisition. In Kenya, external support and geographic location also have an impact on information acquisition. With regard to adoption, gender, household size, and geographic location play the most important roles for Ugandan farmers, while in Kenya information from external sources, education, and farm size affect adoption choice. The study provides insight on the importance of external weak ties in groundnut farming, and a need to understand regional differences along gender lines while developing agricultural strategies. This study further illustrates the importance of farmer participation in applied technology research and the impact of social interactions among farmers and external agents. (shrink)

BackgroundThe boundaries between health-related research and practice have become blurred as initiatives traditionally considered to be practice increasingly use the same methodology as research. Further, the application of different ethical requirements based on this distinction raises concerns because many initiatives commonly labelled as “non-research” are associated with risks to patients, participants, and other stakeholders, yet may not be subject to any ethical oversight. Accordingly, we sought to develop a tool to facilitate the systematic identification of risks to human participants and (...) determination of risk level across a broad range of projects and health-related contexts. This paper describes the development of the Public Health Ontario Risk Screening Tool.MethodDevelopment of the PHO Risk Screening Tool included: preparation of a draft risk tool ; expert appraisal; internal stakeholder validation; external validation; pilot testing and evalution of the draft tool; and revision after 1 year of testing.ResultsA risk screening tool was generated consisting of 20 items organized into five risk domains: Sensitivity; Participant Selection, Recruitment and Consent; Data/Sample Collection; Identifiability and Privacy Risk; and Commercial Interests. The PHO Risk Screening Tool is an electronic tool, designed to identify potential project-associated risks to participants and communities and to determine what level of ethics review is required, if any. The tool features an easy to use checklist format that generates a risk score associated with a suggested level of ethics review once all items have been completed. The final score is based on a threshold approach to ensure that the final score represents the highest level of risk identified in any of the domains of the tool.ConclusionsThe PHO Risk Screening Tool offers a practical solution to the problem of how to maintain accountability and appropriate risk oversight that transcends the boundaries of research and practice. We hope that the PHO Risk Screening Tool will prove useful in minimizing the problems of over and under protection across a wide range of disciplines and jurisdictions. (shrink)

The ethical culture of any organization is not simply a reflection of its mission statement or even its code of conduct. Rather, the real ethics of institutions are often embedded in their reward systems. We suggest how ethics professors can lead students to develop a greater understanding of rewards by providing a review of various forms of organizational rewards. We also offer insights into how professors can compare reward systems in their classes. We conclude by addressing a number of pedagogical (...) approaches that are useful in equipping ethics students with awareness and understanding of reward systems’ power and influence on employee attitudes and behaviors surrounding ethical decision making. (shrink)

This article addresses the question: how do Norwegian Jewish parents reflect on _brit milah_ (circumcision) in a context where this practice is frequently criticised? The data are derived from twenty-five in-depth interviews. Drawing on the perspectives of Catherine Bell and Joseph Bulbulia, the text explores circumcision as part of social life. The parental narratives uncover ongoing negotiations occurring between parents and the minority/majority population. The article argues that circumcision serves as a rite of passage as much for parents as for (...) the infant. For most parents, circumcision is utilised to strengthen a Jewish identity and as a cultural strategy to recreate a Jewish cosmos, even if it entails a costly signal, owing to ambivalence and/or majority opposition. Some individuals find the costs too high and discontinue the practice. However, they all desire to manifest Jewish identity, whether through bodily adaptation or the lack thereof. In this manner, bodies speak louder than words. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Books ReceivedAt the Eleventh Hour: The Biography of Swami Rama. By Pandit Rajmani Tigunait, Ph.D. Honesdale, Pennsylvania: Himalayan Institute Press, 2002. Pp. 427. Hardcover $18.95.Awakening and Insight: Zen Buddhism and Psychotherapy. Edited by Polly Young Eisendrath and Shoji Muramoto. Hove, England: Brunner-Routledge, 2002. Pp. xii + 275. Paper $24.95.Beyond Metaphysics Revisited: Krishnamurti and Western Philosophy. By J. Richard Wingerter. Lanham, Maryland: University Press of America, 2002. Pp. vii + (...) 391. Hardcover $71.00.Bhāmatī and Vivaraṇa Schools of Advaita Vedānta: A Critical Approach. By Pulasth Soobah Roodurmun, foreword by V. N. Jha, and edited by Kanshi Ram. New Delhi: Motilal Banarsidass Publishers, 2002. Pp. xv + 297. Price not given.A Bibliography of Ananda Kentish Coomaraswamy. By James S. Crouch. New Delhi: Indira Gandhi National Centre for the Arts and Manohar Publishers and Distributors, 2002. Pp. 430. Price not given.Crisis Theory and World Order: Heideggerian Reflections. By Norman K. Swazo. Albany: State University of New York Press, 2002. Pp. x + 289. Hardcover $78.50. Paper $26.95.Devotional Literature in South Asia: Current Research 1997-2000: Proceedings of the Eighth International Conference on Early Literature in New Indo-Aryan Languages, Leuven, 23-26 August 2000. Edited by Winand M. Callewaert and Dieter Taillieu. New Delhi: Manohar Publishers and Distributors, 2002. Pp. xxii + 324. Price not given.Dharma Bell and Dhāraṇī Pillar: Li Po's Buddhist Inscriptions. By Paul W. Kroll. Kyoto: Italian School of East Asian Studies, 2001. Pp. viii + 95. Price not given.Essays on the Moral Philosophy of Mengzi. Edited, with introduction, by Xiusheng Liu and Philip J. Ivanhoe. Indianapolis and Cambridge: Hackett Publishing Company, 2002. Pp. xiv + 249. Hardcover $39.95. Paper $16.95. Professional price $12.95.Ethical Questions: East and West. Edited by Bina Gupta. Lanham, Maryland: Rowman and Littlefield Publishers, 2002. Pp. vi + 279. Hardcover $70.00. Paper $26.95.Ethical Relativism and Universalism. By Saral Jhingran. New Delhi: Motilal Banarsidass Publishers, 2001. Pp. xiv + 385. Price not given.Genius-In Their Own Words: The Intellectual Journeys of Seven Great 20th Century [End Page 431] Thinkers. Edited and with introduction by David Ramsay Steele, foreword by Arthur C. Danto. Chicago and La Salle: Open Court, 2002. Pp. xxii + 366. Paper $24.95.The Hatha Yoga Pradipika. The original Sanskrit by Svatmarama, an English translation by Brian Dana Akers. Woodstock, New York: YogaVidya.com, 2002. Pp. xii + 115. Hardcover $19.95. Paper $11.95.Human Rights and Chinese Thought: A Cross-Cultural Inquiry. By Stephen C. Angle. New York: Cambridge University Press, 2002. Pp. xviii + 285. Hardcover $65.00. Paper $23.00.Indestructible Truth: The Living Spirituality of Tibetan Buddhism. By Reginald A. Ray. Boston and London: Shambhala Publications, 2002. Pp. x + 495. Paper $17.95.Introduction to Eastern Thought. By Marietta Stepaniants. Edited by James Behuniak and translated by Rommela Kohanovskaya. Lanham, Maryland: AltaMira Press, a division of Rowman and Littlefield Publishers, 2002. Pp. xiv + 293. Hardcover $69.00. Paper $24.95.Jainism and Ecology: Nonviolence in the Web of Life. Edited by Christopher Key Chapple. Cambridge: Harvard University Press for the Center for the Study of World Religions, 2002. Pp. xliv + 252. Hardcover $32.95. Paper $22.95.Mediating the Power of Buddhas: Ritual in the Mañjuśrīmūlakalpa. By Glenn Wallis. Albany: State University of New York Press, 2002. Pp. xiii + 263. Hardcover $86.50. Paper $29.95.Methodology in Religious Studies: The Interface with Women's Studies. Edited by Arvind Sharma. Albany: State University of New York Press, 2002. Pp. xi + 253. Hardcover $78.50. Paper $26.95.Persons and Valuable Worlds: A Global Philosophy. By Eliot Deutsch. Lanham, Maryland: Rowman and Littlefield Publishers, 2002. Pp. x + 309. Hardcover $80.00. Paper $34.95.Philosophy and Art in Gurdjieff's Beelzebub: A Modern Sufi Odyssey. By Anna T. Challenger. Amsterdam and New York: Editions Rodopi B.V., 2002. Pp. xi + 145. Paper EUR 27,00, U.S. $25.00.The Pratyabhijñā Philosophy. By G. V. Tagare. New Delhi: Motilal Banarsidass Publishers, 2002. Pp. xii + 165. Price not given.Reflections on Reality: The Three Natures and Non-Natures in the Mind-Only School: Dynamic Responses to ong-ka-a's The... (shrink)

I Norge har vi hatt kontroverser omkring regulering avhumanmedisinsk bioteknologi siden 1980-tallet. Denneartikkelen analyserer et lite utsnitt av disse reguleringsdebattene,nærmere bestemt kontroversen omkring forskningpå befruktede egg. Med utgangspunkt i skriftlig materialeknyttet til tre reguleringsrunder undersøker vi her hvordan ulike aktører arbeidet forå ramme inn denne kontroversen, bl.a. ved hjelp av ulikevitenskapelige og politiske representasjoner av det befruktedeegget.Vi finner at det i perioden 1987–2007 ble arbeidet medulike innramminger som utgangspunkt for retoriske ogpolitiske strategier: På den ene siden ser vi forsøk på (...) å innrammekontroversen i et risikorammeverk som først ogfremst fokuserte på de potensielle negative sidene vedhumanmedisinsk bioteknologi, og som spesielt vektlarespekten for det ufødte liv. På den andre siden ser vi atman arbeidet med en forventningsinnramming som lahovedvekten på håpet om nye behandlingsregimer foralvorlig syke mennesker.Forbudet mot forskning på befruktede egg som ble vedtatti 1987, ble opprettholdt i 1994 og 2003. Med lovendringeni 2008 fikk vi imidlertid et markant brudd i dennorske lovgivningspraksisen, da forskning på befruktedeegg ble tillatt på visse premisser. Vi argumenterer for at den viktigste årsaken til denne lovendringen var Mehmet-saken, en sak som medførtesåkalte «oversvømmelser» i begge innrammingsforsøkenesom er omtalt ovenfor. Mehmet-saken eksponerte samtidig et generelt demokratiskdilemma. Saken illustrerte hvor sårbare lovregler og etiske prinsippkan være for det som for allmennheten fremstår som helt urimelig, og dennesaken etterspør slik sett mer hybride måter å tenke forholdet mellom det universelleog det partikulære, mellom prinsipiell etikk og lekmannsskjønn, mellomfakta og verdier som utgangspunkt for politikkutforming.Nøkkelord: humanmedisinsk bioteknologi, forskning på befruktede egg,kontrovers, representasjoner, Mehmet-sakenEnglish abstract: Effective representations? Concerns and expectationsregarding research on fertilized eggsSince the 1980s, there have been several debates and controversies concerningthe regulation of medical biotechnology. In this article, we analyze three suchinstances in Norway, mainly the debates concerning research on fertilizedeggs. Analyzing the debates surrounding the regulations of 1994, 2003/2004and 2008, we investigate how different stakeholders strived to mobilize whatwe call different framings of the controversy, utilizing the different scientificand political representations of the fertilized egg.Framing involves creating baselines for rhetorical and political stratagems.Two framings appear more pronounced than others in the Norwegian debate.On one hand, we find attempts of framing the controversy in a risk centricframework, which mostly emphasizes the potential negative effects of medicalbiotechnology as it focuses on the universal reverence for the unborn life. Onthe other hand, we see attempts to mobilize a positive frame of expectationthat emphasizes on the hope of finding new and effective treatment options forthe severely ill.The ban against research on fertilized eggs that was passed in Norway in1987 was repeated in 1994 and 2003. However, with the changes introducedto the law in 2008, there was a noticeable shift in Norwegian legislation, asresearch on fertilized eggs became permissible if specific conditions were met.We argue that the turning point in this regulative change was the Mehmentcase, a particular case that entailed the so-called «overflowing» in both the negative and the positive frame. The Mehmet case exposed a moregeneral democratic and political dilemma. In our opinion, it illustrates howvulnerable can regulation that is based on general ethical principles be in theface of what appears to the laity as unreasonable. Thus, we argue that thisactualizes the need for more hybridized ways to view the relationship betweenthe universal and the particular, between principle-based ethics and theunderstandings of lay people, between facts, and values and actual cases inpolicy shaping and practice. (shrink)

We discuss the existence of universal spaces (either in the sense of embeddings or continuous images) for some classes of scattered Eberlein compacta. Given a cardinal κ, we consider the class Sκ of all scattered Eberlein compact spaces K of weight ≤ κ and such that the second Cantor-Bendixson derivative of K is a singleton. We prove that if κ is an uncountable cardinal such that κ = 2<κ, then there exists a space X in Sκ such that every member (...) of Sκ is homeomorphic to a retract of X. We show that it is consistent that there does not exist a universal space (either by embeddings or by mappings onto) in Sω₁. Assuming that ∂ = ω₁, we prove that there exists a space X ∈ Sω₁, which is universal in the sense of embeddings. We also show that it is consistent that there exists a space X ∈ Sω₁, universal in the sense of embeddings, but Sω₁ does not contain an universal element in the sense of mappings onto. (shrink)

K.B. is a woman working for the United Kingdom National Health Service with a transsexual male partner. Her partner's male gender was not legally recognised in the United Kingdom and consequently they could not marry. Whilst the NHS pension scheme provides for the payment of a survivor's pension, this is only in respect of married partners. The European Court of Justice held that the combination of circumstances that prevented K.B.'s partner from receiving the survivor's pension amounted to sex discrimination in (...) pay contrary to Article 141 of the Treaty establishing the European Community. At first sight, this decision appears to represent a strengthening of the concept of gender equality in European Union law. Yet, the reasoning provided by the Court lacks clarity and coherence. Moreover, the reach of equality is compromised by the Court's determination to exclude any confrontation with the privileged status of heterosexual marriage. (shrink)

The catastrophe of the eye -- A new view of seeing -- Applying the new view of seeing -- The illusion of seeing everything -- Some contentious points -- Towards consciousness -- Types of consciousness -- Phenomenal consciousness, raw feel, and why they're hard -- Squeeze a sponge, drive a porsche : a sensorimotor account of feel -- Consciously experiencing a feel -- The sensorimotor approach to color -- Sensory substitution -- The localization of touch -- The phenomenality plot -- (...) Consciousness. (shrink)