Background This pilot study evaluated the speaking book ‘What it means to be part of a clinical trial’. The book aims at empowering populations with information on their rights and responsibilities when enrolled in clinical research. Wide publication of the book—at significant cost—is anticipated. It is important that the book is evaluated within the communities for whom it is intended, and the necessary changes (if any) are made, before translation and large-scale publication takes place. Objective The objective of the study (...) was to measure the efficacy and ease of use of the book. Methods Participants were recruited from a catering company. Participants were questioned on their knowledge of clinical trials and were then given the book. Instructions for use of the book were given to one group (‘experimental’ group). The other group (‘control’ group) was not given any instructions. A week later, the investigators returned, repeated the knowledge questions and asked ‘ease of use’ questions. Results A two-way repeated measure of covariants showed a statistically significant positive increase in knowledge of clinical trials among the intervention group (p=0.02). Results for the control group displayed trends that were not statistically significant. Percentage analysis of ‘ease of use’ questions proved that the book is easy to use, although some changes would be beneficial. Conclusion This study revealed that the speaking book is easy to use. It significantly increased knowledge of clinical trials among the study sample if instructions on use of the book were provided. (shrink)

Utilising empirical ethics analysis, we evaluate the merits of systems proposed to increase deceased organ donation in South Africa. We conclude that SA should maintain its soft opt-in policy, and enhance it with ‘required transplant referral’ in order to maximise donor numbers within an ethically and legally acceptable framework. In SA, as is the case worldwide, the demand for donor organs far exceeds the supply thereof. Currently utilising a soft opt-in system, SA faces the challenge of how to increase donor (...) numbers in a context which is imbued with inequalities in access to healthcare, multiplicitous personal beliefs and practices, distrust of organ transplant and varying levels of education and health literacy. We argue that a hard opt-in, opt-out or mandated consent system would be problematic, and we present empirical data from Gauteng Province illustrating barriers to ethically sound practice in soft consent systems. Ultimately, we argue that in spite of some limitations, a soft opt-in system is most realistic for SA because its implementation does not require extensive public education campaigns at national level, and it does not threaten to further erode trust at a clinical level. However, to circumvent some of the clinical-level barriers identified in our empirical study, we propose a contextually sensitive option for “enabling” soft opt-in through “required transplant referral”. We argue that this system is legally defensible, enhances ethical practice and could also increase donor numbers as it has in many other countries. (shrink)

The world’s first living donor liver transplant from an HIV-positive mother to her HIV-negative child, performed by our team in Johannesburg, South Africa in 2017, was necessitated by disease profile and health system challenges. In our country, we have a major shortage of donor organs, which compels us to consider innovative solutions to save lives. Simultaneously, the transition of the HIV pandemic, from a death sentence to a chronic illness with excellent survival on treatment required us to rethink our policies (...) regarding HIV infection and living donor liver transplantation. Although HIV infection in the donor is internationally considered an absolute contraindication for transplant to an HIV-negative recipient, there have been a very small number of unintentional transplants from HIV-positive deceased donors to HIV-negative recipients. These transplant recipients do well on antiretroviral medication and their graft survival is not compromised. We have had a number of HIV-positive parents in our setting express a desire to be living liver donors for their critically ill children. Declining these parents as living donors has become increasingly unjustifiable given the very small deceased donor pool in SA; and because many of these parents are virally suppressed and would otherwise fulfil our eligibility criteria as living donors. This paper discusses the evolution of HIV and transplantation in SA, highlights some of the primary ethical considerations for us when embarking on this case and considers the new ethical issues that have arisen since we undertook this transplant. (shrink)

There is a mystery, present from conception, namely, how the human person, who transcends the individual elements of sperm and ovum, can nevertheless come to exist at the first instant of the sperm’s interaction with the ovum, an event marked by the formation of an “embryonic skin,” or wall. In this essay, the author holds that the full complexity of the human person implies such a profound unity-in-diversity of human being that we must, in the end, let the dialogue between (...) reason and revelation lead us to conclude that the first instant of embryonic life is the first instant that the person comes to exist: that the first sign of embryonic life is a “natural sacrament” of the internal act of God which brings the person to exist, one in soul and body. National Catholic Bioethics Quarterly 12.3 (Autumn 2012): 421–430. (shrink)

The Perceived Role of Ethics and Social Responsibility (PRESOR) instrument was developed in the United States by Singhapakdi et al. (1996b) as a reliable and valid scale to measure the perceived role of ethics and social responsibility in achieving organizational effectiveness. This study was carried out to confirm the factorial structure of the instrument and to assess its reliability and validity for use in Hong Kong, the finance and service heart of the Asia-Pacific region and a culture with clear differences (...) in ethical attitudes and perceptions from those of the United States. Constructive replication of the exploratory factor analytic procedure of the original study with a representative sample of Hong Kong managers failed to support the hypothesized scale structure but instead suggested a different, two-factor, structure. Confirmatory factor analysis defined the alternative model which comprised two interpretable, negatively intercorrelated factorial scales, "Importance of ethics and social responsibility" and "Subordination of ethics and social responsibility in the achievement of organizational effectiveness". The model showed a high level of goodness-of-fit for the population and the two subscales, comprised of five items and four items respectively, were shown to have acceptable internal consistency reliability. Correlational and multiple regression analysis showed highly significant levels of association with the ethical ideology dimensions of the EPQ (Forsyth, 1980), used in the validation of the original scale, and with two ethical philosophy subscales derived from the ATBEQ (Preble and Reichel, 1988). The instrument is short, easily administered, is psychometrically sound and has considerable potential in the study of the perceived role of ethics and social responsibility in the achievement of organizational effectiveness. (shrink)

Resource constraints in developing countries compel policy makers to ration the provision of healthcare services. This article examines one such set of Guidelines: A patient dialysing in the state sector in South Africa may not refuse renal transplantation when a kidney becomes available. Refusal of transplantation can lead to exclusion from the state-funded dialysis programme. This Guideline is legally acceptable as related to Constitutional stipulations which allow for rationing healthcare resources in South Africa. Evaluating the ethical merit of the Guideline, (...) and exploring the ethical dilemma it poses, proves a more complex task. We examine the actions of healthcare professionals as constrained by the Guideline. From a best interests framework, we argue that in these circumstances directing patient decision making is not necessarily unethical or unacceptably paternalistic. We then scrutinise the guideline itself through several different ethical ‘lenses’. Here, we argue that bioethics does not provide a definitive answer as to the moral merit of rationing dialysis under these circumstances, however it can be considered just in this context. We conclude by examining a potential pitfall of the Guideline: Unwilling transplant recipients may not comply with immunosuppressive medication, which raises questions for policies based on resource management and rationing. (shrink)

The ethical limbo in which frozen human embryos exist is, tragically, a real limbo, and in their untouchability lies an apparent contradiction: that God cannot rescue a person whom man, in his pride, has co-created outside the truly necessary incorporation within a family. The author explores the possibility that ethical objections to embryo adoption are based on a flawed conflation of two problems: the immorality, injustice, and harm of the procedure that supplants the marriage act; and the rights of the (...) child conceived outside the welcoming nature of the marriage act—the primary rights of every conceived person to completing, wholesome, and relational nurture. The author argues for the humanitarian right to embryo adoption, within marriage, from the point of view of the rights of the person conceived. (shrink)

This article aims to read feminist new materialisms (Barad), together with ‘postulated’ linguistic or cultural primacy of Queer Theory (Butler), to show how both are engaged in similar critical-ethical endeavours. The central argument is that the criticism of Barad and new materialisms misses Butler’s materialistic insights due to a narrow interpretation of Butler's alleged social-constructivist position. There is, therefore, a specific focus on where they both make similar ethical appeals. Moreover, the article relies on Adorno's negative dialectic to highlight an (...) interpretation of Barad and Butler as being part of the same dialectical movement, in which materialism and idealism fluctuate in their mutual criticisms, thus continuing the procession towards 'new knowledge' and emancipation, or freedom, through their motions back and forth. (shrink)

An English language translation accompanies the original Greek text of Aristotle's book about the nature of the state, constitutions, revolutions, democracy, and oligarchy.

The development of transplantation technology increasingly places before society a multitude of diverse, complex ethical and legal problems. The subject is the more complex because of the various divergent interests involved. There are the interests of the donor of organs, who has a right to protection of his legal position, and those of the patient in need of an often lifesaving organ. There are also the interests of the donor’s relatives, after his death, and those of the transplantation surgeons. The (...) international dimension of transplantation technology makes the picture even more complicated. Though this article is devoted to the European situation, the problems are similar all over the world. (shrink)

The development of transplantation technology increasingly places before society a multitude of diverse, complex ethical and legal problems. The subject is the more complex because of the various divergent interests involved. There are the interests of the donor of organs, who has a right to protection of his legal position, and those of the patient in need of an often lifesaving organ. There are also the interests of the donor’s relatives, after his death, and those of the transplantation surgeons. The (...) international dimension of transplantation technology makes the picture even more complicated. Though this article is devoted to the European situation, the problems are similar all over the world. (shrink)

This study described the relationships between academic class and student moral sensitivity and reasoning and between curriculum design components for ethics education and student moral sensitivity and reasoning. The data were collected from freshman (n = 506) and senior students (n = 440) in eight baccalaureate nursing programs in South Korea by survey; the survey consisted of the Korean Moral Sensitivity Questionnaire and the Korean Defining Issues Test. The results showed that moral sensitivity scores in patient-oriented care and conflict were (...) higher in senior students than in freshman students. Furthermore, more hours of ethics content were associated with higher principled thinking scores of senior students. Nursing education in South Korea may have an impact on developing student moral sensitivity. Planned ethics content in nursing curricula is necessary to improve moral sensitivity and moral reasoning of students. (shrink)

According to the orthodox treatment of risk preferences in decision theory, they are to be explained in terms of the agent's desires about concrete outcomes. The orthodoxy has been criticised both for conflating two types of attitudes and for committing agents to attitudes that do not seem rationally required. To avoid these problems, it has been suggested that an agent's attitudes to risk should be captured by a risk function that is independent of her utility and probability functions. The main (...) problem with that approach is that it suggests that attitudes to risk are wholly distinct from people's (non-instrumental) desires. To overcome this problem, we develop a framework where an agent's utility function is defined over chance propositions (i.e., propositions describing objective probability distributions) as well as ordinary (non-chance) ones, and argue that one should explain different risk attitudes in terms of different forms of the utility function over such propositions. (shrink)

Is the procreation asymmetry intuitively supported? According to a recent article in this journal, an experimental study suggests the opposite. Dean Spears (2020) claims that nearly three-quarters of participants report that there is a reason to create a person just because that person’s life would be happy. In reply, I argue that various confounding factors render the study internally invalid. More generally, I show how one might come to adopt the procreation asymmetry for the wrong reasons by misinterpreting one’s intuitions.

Philosophers ask just whose expression, if anyone’s, we hear in lyric poetry. Walton provides a novel possibility: it’s the reader who “uses” the poem (just as a speech giver uses a speech) who makes the language expressive. But worries arise once we consider poems in particular social or political settings, those which require a strong self-other distinction, or those with expressions that should not be disassociated from the subjects whose experience they draw from. One way to meet this challenge is (...) to consider the poem expressive of a plural subject, which frees us from looking for a particular individual whose voice we hear in the work, whether she be fictional or actual. Some lyrics give voice to a group whose experience is attended to in the work. This may be done through a posited fictional speaker, but the ontology of the speaker is shown to be less important. Attending to a group whose concerns are voiced allows us to explain how poems can manage to address our-worldly concerns even when lacking actual persons whose expressions we encounter in the poems. (shrink)

Chance Neutrality is the thesis that, conditional on some proposition being true, its chance of being true should be a matter of practical indifference. The aim of this article is to examine whether Chance Neutrality is a requirement of rationality. We prove that given Chance Neutrality, the Principal Principle entails a thesis called Linearity; the centerpiece of von Neumann and Morgenstern’s expected utility theory. With this in mind, we argue that the Principal Principle is a requirement of practical rationality but (...) that Linearity is not and, hence, that Chance Neutrality is not rationally required. (shrink)

The Shape of Thought: How Mental Adaptations Evolve presents a road map for an evolutionary psychology of the twenty-first century. It brings together theory from biology and cognitive science to show how the brain can be composed of specialized adaptations, and yet also an organ of plasticity. Although mental adaptations have typically been seen as monolithic, hard-wired components frozen in the evolutionary past, The Shape of Thought presents a new view of mental adaptations as diverse and variable, with distinct functions (...) and evolutionary histories that shape how they develop, what information they use, and what they do with that information. The book describes how advances in evolutionary developmental biology can be applied to the brain by focusing on the design of the developmental systems that build it. Crucially, developmental systems can be plastic, designed by the process of natural selection to build adaptive phenotypes using the rich information available in our social and physical environments. This approach bridges the long-standing divide between "nativist" approaches to development, based on innateness, and "empiricist" approaches, based on learning. It shows how a view of humans as a flexible, culturally-dependent species is compatible with a complexly specialized brain, and how the nature of our flexibility can be better understood by confronting the evolved design of the organ on which that flexibility depends. (shrink)

_Rabghūzī’s_ _Stories of the Prophets_, written in Khwarezmian Turkish (14th century) contains an account of the life of the biblical prophets and of the Prophet Muḥammed.

Jetzt beim Akademie Verlag: Sammlung Tusculum - die berühmte zweisprachige Bibliothek der Antike! Die 1923 gegründete Sammlung Tusculum umfasst ca. 200 klassische Werke der griechischen und lateinischen Literatur des Altertums und bildet damit das Fundament der abendländischen Geistesgeschichte ab. Die Werke Ciceros, Ovids und Horaz’ gehören ebenso zum Programm wie die philosophischen Schriften Platons, die Dramen des Sophokles oder die enzyklopädische Naturgeschichte des Plinius. Die Reihe bietet die weltliterarisch bedeutenden Originaltexte zusammen mit exzellenten deutschen Übersetzungen und kurzen Sachkommentaren. Von renommierten (...) Altphilologen betreut, präsentiert Tusculum zuverlässige Standardausgaben mit klassischer Einbandgestaltung für Wissenschaftler und Bibliotheken, Studenten und Lehrer sowie das allgemeine Publikum mit Interesse an antiker Dichtung und Philosophie. Der Name der Reihe geht auf die ehemalige Stadt Tusculum in Latium zurück, in der Cicero eine Villa besaß, die ihm als Refugium diente und in der er die Tuskulanen verfasste. Neben der hochwertig ausgestatteten Hauptreihe erscheinen in der Serie Tusculum Studienausgaben einschlägige Texte für Universität und Schule im Taschenbuch. Im Akademie Verlag startet die Reihe 2011 mit sieben wichtigen Neuerscheinungen. (shrink)

In this book, developed by a group of collaborating scholars in bioethics from different European countries, an overview is given of the most salient themes in present-day bioethics. The themes are discussed in order to enable the reader to have an in-depth overview of the state of the art in bioethics. Introductory chapters will guide the reader through the relevant dimensions of a particular area, while subsequent case discussions will help the reader to apply the ethical theories to specific clinical (...) problems and health policy queries. The book focuses on perspectives typical for the European context. This highlights not only particular bioethical themes such as social justice, choices in health care, and health policy (e.g., in post-communist countries), it also emphasizes specific approaches in ethical theory, in relation to Continental philosophies such as phenomenology and hermeneutics. Because of its articulation of what is typical for the European health care setting as well as for bioethical debate, this book is unique in comparison to existing textbooks in bioethics. The book is an introductory textbook acquainting the reader with the major issues in present-day health care as well as the various theoretical and practical approaches to clarify these issues. (shrink)

This paper offers a unified explanation for the procreation asymmetry and the non-identity thesis – two of the most intractable puzzles in population ethics. According to the procreation asymmetry, there are moral reasons not to create lives that are not worth living but no moral reasons to create lives that are worth living. I explain the procreation asymmetry by arguing that there are moral reasons to prevent the bad, but no moral reasons to promote the good. Various explanations for the (...) procreation asymmetry have failed to explain the non-identity thesis: if one could create a person with a good life or a different person with a better life, one has a moral reason to create the better life. I argue that reflections on the misfortune of unfulfilled potential allow us to circumvent the non-identity problem. (shrink)