ABSTRACT Digital mental health interventions have emerged as a promising means of expanding access to mental healthcare. Prospective participants reporting severe symptoms or suicidal ideation are often excluded from DMHI trials and may struggle to access alternative treatments. However, evidence suggests that DMHIs are efficacious for people reporting these characteristics. We suggest that there are risks to both including and excluding people from DMHI trials, and we urge researchers to ensure that their eligibility criteria are designed in an evidence-based and (...) ethically conscious manner. We also make specific recommendations for those working in various other capacities within the academic community. (shrink)

Successful tutoring depends in part on child tutors’ ability to recognise and interpret accurately signals of misunderstanding by their tutees. Age- and gender-related differences were investigated in a study which exposed 80 children to a video-recorded episode involving a target child receiving ambiguous instructions in her attempts to move a model car along a designated route on a playmat roadway from one destination to another. The results showed that explicit, general and facial modes of displaying puzzlement by the target child (...) were judged as equally powerful expressions of degree of puzzlement, but 8-10 year olds judged the target child as significantly more puzzled than did 7 year olds. Older children were also more likely to attribute the puzzlement of the target child to the ambiguous instructions than to her verbal or facial expression of puzzlement. Girls were generally more accurate than boys in judging facial expressions and less likely than boys to give wrong or alternatively ambiguous responses when given the opportunity to correct the video-recorded ambiguous instructions. The results throw some light on the developing sensitivities of boys and girls in recognising and attributing failures of understanding by other children. (shrink)

As the expansion of the Internet and the digital formatting of all kinds of creative works move us further into the information age, intellectual property issues have become paramount. Computer programs costing thousands of research dollars are now copied in an instant. People who would recoil at the thought of stealing cars, computers, or VCRs regularly steal software or copy their favorite music from a friend's CD. Since the Web has no national boundaries, these issues are international concerns. The contributors-philosophers, (...) legal theorists, and business scholars, among others-address questions such as: Can abstract ideas be owned? How does the violation of intellectual property rights compare to the violation of physical property rights? Can computer software and other digital information be protected? And how should legal systems accommodate the ownership of intellectual property in an information age? Intellectual Property is a lively examination of these and other issues, and an invaluable resource for librarians, lawyers, businesspeople, and scholars. (shrink)

Increasingly the body is a possession that does not belong to us. It is bought and sold, bartered and stolen, marketed wholesale or in parts. The professions - especially reproductive medicine, transplant surgery, and bioethics but also journalism and other cultural specialists - have been pliant partners in this accelerating commodification of live and dead human organisms. Under the guise of healing or research, they have contributed to a new 'ethic of parts' for which the divisible body is severed from (...) the self, torn from the social fabric, and thrust into commercial transactions -- as organs, secretions, reproductive capacities, and tissues -- responding to the dictates of an incipiently global marketplace. Breaking with established approaches which prioritize the body as 'text', the chapters in this book examine not only images of the body-turned-merchandise but actually existing organisms considered at once as material entities, semi-magical tokens, symbolic vectors and founts of lived experience. The topics covered range from the cultural disposal and media treatment of corpses, the biopolitics of cells, sperm banks and eugenics, to the international trafficking of kidneys, the development of 'transplant tourism', to the idioms of corporeal exploitation among prizefighters as a limiting case of fleshly commodity. This insightful and arresting volume combines perspectives from anthropology, law, medicine, and sociology to offer compelling analyses of the concrete ways in which the body is made into a commodity and how its marketization in turn remakes social relations and cultural meanings. (shrink)

In this paper I consider, in connection with dementia, two views of the person. One view of the person is derived from Locke and Parfit. This tends to regard the person solely in terms of psychological states and his/her connections. The second view of the person is derived from a variety of thinkers. I have called it the situated-embodied-agent view of the person. This view, I suggest, more readily squares with the reality of clinical experience. It regards the person as (...) embedded in a history and culture. The human person is also an embodied agent. I contend that this view encourages a more appropriate approach towards the ethical issues that arise in dementia and towards people with dementia. (shrink)

BackgroundIn the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort, participants underwent magnetic resonance imaging (MRI) of the brain, heart, and abdomen, that generated incidental findings (IFs). The approach to managing these unexpected results remain a complex issue. Our objectives were to describe the CAHHM policy for the management of IFs, to understand the impact of disclosing IFs to healthy research participants, and to reflect on the ethical obligations of researchers in future MRI studies.MethodsBetween 2013 and 2019, 8252 participants (...) (mean age 58 ± 9 years, 54% women) were recruited with a follow-up questionnaire administered to 909 participants (40% response rate) at 1-year. The CAHHM policy followed a restricted approach, whereby routine feedback on IFs was not provided. Only IFs of severe structural abnormalities were reported.ResultsSevere structural abnormalities occurred in 8.3% (95% confidence interval 7.7–8.9%) of participants, with the highest proportions found in the brain (4.2%) and abdomen (3.1%). The majority of participants (97%) informed of an IF reported no change in quality of life, with 3% of participants reporting that the knowledge of an IF negatively impacted their quality of life. Furthermore, 50% reported increased stress in learning about an IF, and in 95%, the discovery of an IF did not adversely impact his/her life insurance policy. Most participants (90%) would enrol in the study again and perceived the MRI scan to be beneficial, regardless of whether they were informed of IFs. While the implications of a restricted approach to IF management was perceived to be mostly positive, a degree of diagnostic misconception was present amongst participants, indicating the importance of a more thorough consent process to support participant autonomy.ConclusionThe management of IFs from research MRI scans remain a challenging issue, as participants may experience stress and a reduced quality of life when IFs are disclosed. The restricted approach to IF management in CAHHM demonstrated a fair fulfillment of the overarching ethical principles of respect for autonomy, concern for wellbeing, and justice. The approach outlined in the CAHHM policy may serve as a framework for future research studies.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/nct02220582. (shrink)

Ever since its inception, the theory of evolution has been reified into an “-ism”: Darwinism. While biologists today tend to shy away from the term in their research, the term is still actively used in the broader academic and societal contexts. What exactly is Darwinism, and how precisely are its various uses and abuses related to the scientific theory of evolution? Some call for limiting the meaning of the term “Darwinism” to its scientific context; others call for its abolition; yet (...) others claim the term refers to a myth-like story. In this paper we propose a conceptually grounded overview of the term. We show how the scientific dimension of Darwinism feeds into, and is influenced by, guises of Darwinism as a methodology and as an ethically and politically charged “worldview”. The full meaning of Darwinism, as well as how this meaning has changed over time, can only be understood through the complex interaction between these three dimensions. (shrink)

Sandia National Laboratories, located in Albuquerque, New Mexico, was originally a part of Los Alamos Laboratory. In 1949, AT&T agreed to manage Sandia, which they did for the next 44 years. During those Cold War years, Sandia was the prime weapons engineering laboratory for Los Alamos and Lawrence Livermore. As such, it bore prime responsibility for designing and adapting nuclear weapons for the military services' delivery systems, and ensuring the safety and reliability of the stockpile. The Labs' history has been (...) unevenly documented, hindered by the secret nature of its work and the desire of management to maintain a low public profile. There have been three history programs at Sandia: a restricted history published internally in 1963; another history program in the early 1980s that resulted in a history of the Labs' first decade; and the current history program dating from the mid-1990s, which has published a general history and several monographs. This article discusses the challenges and problems inherent in documenting the history of a national weapons laboratory during the last 50 years. (shrink)

In this volume, the sixth in Blackwell's Great Debates in Philosophy series, Smart and Haldane discuss the case for and against religious belief. The debate is unusual in beginning with the negative side. After a short jointly authored introduction, there is a fairly extended presentation of the atheist position by Smart. Haldane then offers an equally extended defense of theism. The authors respond to one another in the same order, and the book concludes with a brief co-authored treatment of antirealism, (...) which both reject. The discussion is broad-ranging, in part reflecting the size of the topic. It addresses the existence of God and the problem of evil, along with related issues having to do with God's nature and his involvement with the world: necessary being, eternity versus sempiternity, the relation between divine sovereignty and human freedom, and the possibility of miracles. But there is also discussion of subjects having to do with revealed religion, such as the reliability of scripture, and the roles of faith and reason in the life of the believer. The fact that the book commences with the case for atheism also contributes to its scope, since without a specific version of theism on which to focus, Smart has to aim broadly. The result is that topics that might otherwise have been ignored—moral arguments, and Pascal's wager, to cite two—are at least broached, though not pursued. (shrink)

Does the content of a physically dangerous job affect the moral permissibility of hiring for that job? To what extent may employers consider costs in choosing workplace safety measures? Drawing on Kantian ethical theory, this article defends two strong ethical standards of workplace safety. First, the content of a hazardous job does indeed affect the moral permissibility of offering it. Unless employees need hazard pay to meet basic needs, it is permissible to offer a dangerous job only if prospective employees (...) have a reason other than hazard pay to choose this job instead of safer alternatives. Second, employers typically cannot justify omitting expensive safety measures by paying employees more, even if employees prefer higher pay to greater safety. Employers offering dangerous jobs must meet these two standards to avoid treating their employees merely as means. (shrink)

Perhaps the change of title says it all. This is the revised edition of Agich’s Autonomy and Long Term Care, which was itself a seminal work. The new title gives us the main drift: if autonomy is important in old age, so too is dependence. Indeed, in the actual world in which Agich is keen to locate his study, autonomy and dependence intermingle as inescapable features of old age for real people. As he says: “Maintaining a sense of autonomous wellbeing (...) is consistent with dependencies on medication or professional care if those dependencies help to maintain a more basic sense of functional integrity in those areas of life that individuals value” .The present book retains and renews its standing as a first rate work in the field of philosophical medical ethics. It aims “to sketch a framework for respecting autonomy in long term care”, rather than to work out practical guidelines . Nevertheless, its strength lies in Agich’s ability to move from the real world of often dependent older people to the philosophical underpinnings of our thinking about how we care for them. In so doing, Agich mounts a powerful attack on what he sees as a prevailing tendency in bioethics. It is the tendency to define autonomy “primarily in terms of a concept of human persons as rational, independent agents and decision makers, who are assumed to be competent and who can be understood without serious reference to society or history” . As he says: “Influenced by liberal theory, autonomy is often treated in bioethics as a concept that primarily applies to the public realm …. (shrink)

Recently, dramatic price increases by several pharmaceutical companies have provoked public outrage. These scandals raise questions both about how pharmaceutical firms should be regulated and about how pharmaceutical executives ethically ought to make pricing decisions when drug prices are largely unregulated. Though there is an extensive literature on the regulatory question, the ethical question has been largely unexplored. This article defends a Kantian approach to the ethics of pharmaceutical pricing in an unregulated market. To the extent possible, pharmaceutical companies must (...) price drugs so that those who genuinely need them can get them without financial ruin. This requirement is an ethical side constraint, like the moral prohibitions on deception and theft, that takes precedence over a business’s interest in maximizing profit. That said, the requirement’s application is sensitive to the need to recoup the costs of research and to produce a return that financially justifies the original investment. It may not be either feasible or desirable for government to attempt to enforce the ethical requirements concerning just pharmaceutical pricing. Either price regulation or subsidy could fulfill government’s obligation to protect patients from being objectionably vulnerable to pricing decisions by private companies. (shrink)