In many countries around the world, people who inject drugs remain at high risk of HIV acquisition not because effective forms of prevention are unknown, nor because they find effective prevention undesirable, but because those in charge, mainly politicians but also bureaucrats, find evidence-based practice politically unacceptable. The evidence for preventive efficacy of harm reduction strategies, most prominently needle and syringe programmes but also treatment programmes such as opiate substitution, is irrefutable.1 However, political responses to drug use issues are varied (...) and complex, so the will to implement appropriate harm reduction programmes in the interests of public health remains lacking in too many jurisdictions. As a consequence, the discussion of how best, in the context of research, to reduce HIV incidence in populations of people who inject drugs but are not offered comprehensive access to known prevention strategies is—tragically—an important one. Dawson et al 2 focus on access to sterile injecting equipment and recognise that this should remain the ‘default’ standard of prevention for HIV prevention trials involving people for whom injecting drug use is the primary risk factor for HIV acquisition. ‘Standard of prevention’ means the background or minimal HIV risk reduction interventions offered to all participants in a trial, regardless of what other investigational interventions they are assigned to receive. The standard of prevention concept is grounded in the ethical principle of beneficence—that researchers and sponsors are obliged to maximise benefits and minimise risks to participants in research studies.3 …. (shrink)

In clinical research there is a tension between the role of a doctor, who must serve the best interests of the patient, and the role of the researcher, who must produce knowledge that may not have any immediate benefits for the research participant. This tension is exacerbated in HIV research in low and middle income countries, which frequently uncovers comorbidities other than the condition under study. Some bioethicists argue that as the goals of medicine and those of research are distinct, (...) it is a mistake for researchers to assume therapeutic responsibilities while engaging in research. Others propose that there is a duty of care, but disagree as to how this is limited and specified. In this qualitative study, principal investigators from HIV prevention trials discuss their experience of providing medical benefits to participants within the context of conducting research into HIV biomedical prevention technologies. They describe the limitations imposed at times by funders and at times by infrastructure constraints, and canvass the importance of ancillary care provision and capacity building in trial communities. The views of the principal investigators are compatible with the perspective that there is a duty of care, limited by the nature of the research, the depth of the relationship between research and participant, and the capacity of the research site. The therapeutic orientation in HIV prevention trial appears to be indivisible from competent research practise by making concrete and appropriate benefits available to trial participants and their communities that support rather than compete with local infrastructure. (shrink)

This article examines the relationship between bioethics and the therapeutic standards in HIV prevention research in the developing world, focusing on the closure of the pre-exposure prophylaxis (PrEP) trials in the early 2000s. I situate the PrEP trials in the historical context of the vertical transmission debates of the 1990s, where there was protracted debate over the use of placebos despite the existence of a proven intervention. I then discuss the dramatic improvement in the clinical management of HIV and the (...) treatment access movement, and consider how these contexts have influenced research practice. I argue that as HIV prevention trials oblige researchers to observe the rate at which vulnerable people under their care acquire HIV, there is an obligation to provide antiretroviral treatment to seroconverters and other health care benefits that fall within the scope of researchers' entrustment, both to avoid exploitation and to enact reciprocal justice. I argue against propositions that the obligations to provide specific benefits are vague, fall only upon researchers and sponsors, and create injustices by privileging the few over the many. Finally, I contend that the realisation of a broader standard of care in HIV prevention research broadens the role of research from being a simple tool to produce knowledge to a complex intervention that can play a part in the reduction of health disparities. (shrink)

In their recent paper‘Undue inducement: a case study in CAPRISA 008’, Mngadi et al conclude that a participant in an HIV prevention study who deliberately concealed her pregnancy was not ‘unduly induced’ to participate by the offer of an experimental product. This paper argues that while the authors’ conclusion is sound, the framing of this case study is consistent with the preoccupation in research ethics with the concept of undue inducement, coupled with a highly risk-averse attitude to pregnancy. We suggest (...) that the critical research ethics question raised by Mngadi et al ’s case study is not ‘undue inducement’, but the exclusion of pregnant women from research studies where the risks are acceptable to the potential participant, and benefits likely. We also suggest that current regulatory paradigms regarding pregnancy are both overly paternalistic and value the fetus over the mother. In order to ensure timely provision of new HIV prevention agents, we argue that there is a need for expeditious testing of proven effective agents in pregnancy, with due consideration given to situations where preliminary efficacy data exist but fall short of licensure standards. This requires a paradigm shift from researchers, funders, regulators and ethical review bodies towards practices that critically examine the legitimacy of the exclusion of pregnant women on a study-by-study basis. (shrink)

Published data show that new HIV prevention strategies including treatment‐as‐prevention and pre‐exposure prophylaxis (PrEP) using oral antiretroviral drugs (ARVs) are highly, but not completely, effective if regimens are taken as directed. Consequently, their implementation may challenge norms around HIV prevention. Specific concerns include the potential for ARV‐based prevention to reframe responsibility, erode beneficial sexual norms and waste resources. This paper explores what rights claims uninfected people can make for access to ARVs for prevention, and whether moral claims justify the provision (...) of ARV therapy to those who do not yet clinically require treatment as a way of reducing HIV transmission risk. An ethical analysis was conducted of the two strategies, PrEP and treatment‐as‐prevention, using a public health stewardship model developed by the Nuffield Bioethics Council to consider and compare the application of PrEP and treatment‐as‐prevention strategies. We found that treating the person with HIV rather than the uninfected person offers advantages in settings where there are limited opportunities to access care. A treatment‐as‐prevention strategy that places all the emphasis upon the positive person's adherence however carries a disproportionate burden of responsibility. PrEP remains an important option for receptive partners who face increased biological vulnerability. We conclude that the use of ARV for prevention is ethically justified, despite imperfect global to drugs for those in clinical need. The determination of which ARV‐based HIV prevention strategy is ethically preferable is complex and must take into account both public health and interpersonal considerations. (shrink)

Vaccination is a highly effective public health strategy that provides protection to both individuals and communities from a range of infectious diseases. Governments monitor vaccination rates carefully, as widespread use of a vaccine within a population is required to extend protection to the general population through “herd immunity,” which is important for protecting infants who are not yet fully vaccinated and others who are unable to undergo vaccination for medical or other reasons. Australia is unique in employing financial incentives to (...) increase vaccination uptake, mainly in the form of various childcare payments and tax benefits linked to timely, age-appropriate vaccination. Despite relatively high compliance with the childhood vaccination schedule, however, the Australian government has determined that rates should be higher and has recently introduced policy that includes removing certain tax and childcare benefits for non-vaccinators and formally disallowing conscientious objection to vaccination. In addition, it has raised the possibility of banning unvaccinated children from childcare centres. This article examines the impact of coercive approaches to childhood vaccination and raises the question of the ethical justification of health policy initiatives based on coercion. We consider the current evidence regarding childhood vaccination in Australia, the small but real risks associated with vaccination, the ethical requirement for consent for medical procedures, and the potential social harms of targeting non-vaccinators. We conclude that the evidence does not support a move to an increasingly mandatory approach that could only be delivered through paternalistic, coercive clinical practices. (shrink)

In 2010, randomized controlled trials (RCTs) of two different biomedical strategies to prevent HIV infection had positive findings. However, despite ongoing very high levels of HIV infection in some countries and population groups, it has been made clear by regulatory authorities that the evidence remains insufficient to support either product being made available outside of research contexts in the developing world for at least two years. In addition, prevention trials in endemic areas will continue to test new interventions against placebo. (...) But the judgments of evidentiary standards are never value-neutral. Using the recent trials and their contexts as case studies, we examine the basis for these decisions, which will potentially delay access to scientific innovation to the people who are most urgently in need of it. (shrink)

Published data show that new HIV prevention strategies including treatment-as-prevention and pre-exposure prophylaxis (PrEP) using oral antiretroviral drugs (ARVs) are highly, but not completely, effective if regimens are taken as directed. Consequently, their implementation may challenge norms around HIV prevention. Specific concerns include the potential for ARV-based prevention to reframe responsibility, erode beneficial sexual norms and waste resources. This paper explores what rights claims uninfected people can make for access to ARVs for prevention, and whether moral claims justify the provision (...) of ARV therapy to those who do not yet clinically require treatment as a way of reducing HIV transmission risk. An ethical analysis was conducted of the two strategies, PrEP and treatment-as-prevention, using a public health stewardship model developed by the Nuffield Bioethics Council to consider and compare the application of PrEP and treatment-as-prevention strategies. We found that treating the person with HIV rather than the uninfected person offers advantages in settings where there are limited opportunities to access care. A treatment-as-prevention strategy that places all the emphasis upon the positive person's adherence however carries a disproportionate burden of responsibility. PrEP remains an important option for receptive partners who face increased biological vulnerability. We conclude that the use of ARV for prevention is ethically justified, despite imperfect global to drugs for those in clinical need. The determination of which ARV-based HIV prevention strategy is ethically preferable is complex and must take into account both public health and interpersonal considerations. (shrink)

The principle of providing post-trial access for research participants to successful products of that research is widely accepted and has been enshrined in various declarations and guidelines. While recent ethical guidelines recognise that the responsibility to provide post-trial access extends to sponsors, regulators and government bodies as well as to researchers, it is the researchers who have the direct duty of care to participants. Researchers may thus need to act as advocates for trial participants, especially where government bodies, sponsors, and (...) regulatory bodies have complex interests vested in decisions about whether or not new interventions are made available, how, and to whom. This paper provides an empirical account of post-trial access in the context of HIV prevention research. It describes both access to the successful products of research and the provision antiretroviral drugs for trial participants who acquire HIV. First, we provide evidence that, in the current system, there is considerable variation in the duration and timeliness of access. We then argue that by analysing the difficulties faced by researchers to this point, and their efforts to meet this obligation, much can be learned about how to secure post-trial access in HIV biomedical preventions trials. While researchers alone have a limited obligation, their advocacy on behalf of trial participants may be necessary to call the other parties to account. (shrink)

The successful demonstration that antiretroviral (ARV) drugs can be used in diverse ways to reduce HIV acquisition or transmission risks – either taken as pre-exposure prophylaxis (PrEP) by those who are uninfected or as early treatment for prevention (T4P) by those living with HIV – expands the armamentarium of existing HIV prevention tools. These findings have implications for the design of future HIV prevention research trials. With the advent of multiple effective HIV prevention tools, discussions about the ethics and the (...) feasibility of future HIV prevention trial designs have intensified. This article outlines arguments concerning the inclusion of newly established ARV-based HIV prevention interventions as standard of prevention in HIV prevention trials from multiple perspectives. Ultimately, there is a clear need to incorporate stakeholders in a robust discussion to determine the appropriate trial design for each study population. (shrink)

The American Journal of Bioethics, Volume 11, Issue 12, Page 48-50, December 2011.

Volume 20, Issue 10, October 2020, Page 47-49.

In his article ‘The Ebola Clinical Trials: a precedent for research ethics in disasters’, Philippe Calain constructs a compelling case as to why and how experiences from the recent Ebola epidemic should be used to develop a framework for disaster research ethics. In particular, Calain proposes a useful model for assessing whether or not an unproven intervention could be suitable for human use in a disaster context, and makes a powerful argument against the separation of patient care from research goals. (...) In this commentary, I argue that the separation of patient care goals from research goals is also unhelpful in the context of other forms of participant disadvantage even when that disadvantage is less severe than an ongoing public health emergency. I contend that recognising that research in disadvantaged populations is an intervention that could and should aim to produce positive outcomes for participants, just as it should in disaster contexts, therefore seems a well-justified lesson that can be extrapolated from the experience of the Ebola epidemic. (shrink)

In July 2012, based on evidence from two major trials, the United States Food and Drug Administration approved the use of combined oral tenofovir/emtricitabine as pre-exposure prophylaxis for people at high risk of HIV acquisition. PrEP effectiveness is marred by poor adherence, however, even in trial populations, thus it is not a magic bullet for HIV prevention. It is, however, the most effective biomedical HIV prevention intervention available for people at high risk of HIV, particularly those who have receptive sex (...) and lack the power to negotiate condom use. Accordingly, there are compelling reasons to compare future experimental HIV prevention interventions against PrEP. The interests both of trial participants and of science are served by using PrEP as comparator: Not only would HIV incidence be reduced, but also the question of whether new interventions were superior to best proven interventions, in a given setting, would be answered comprehensively. (shrink)

There is increasing interest in the need to address the ethical dilemmas related to the engagement of adolescents in sexual and reproductive health research. Research projects, including those that address issues related to STIs and HIV, adverse pregnancy outcomes, violence, and mental health, must be designed and implemented to address the needs of adolescents. Decisions on when an individual has adequate capacity to give consent for research most commonly use age as a surrogate rather than directly assessing capacity to understand (...) the issues and make an informed decision on whether to participate in research or not. There is a perception that adolescents participating in research are more likely to be coerced and may therefore not fully comprehend the risk they may be taking when engaging in research. This paper examines the various ethical issues that may impact stakeholders' decision making when considering engaging adolescents in SRH research in Nigeria. It makes a case for lowering the age of consent for adolescents. While some experts believe it is possible to extrapolate relevant information from adult research, studies on ethical aspects of adolescents' participation in research are still needed, especially in the field of sexual and reproductive health where there are often differences in knowledge, attitudes and practices compared to adults. The particular challenges of applying the fundamental principles of research ethics to adolescent research, especially research about sex and sexuality, will only become clear if more studies are conducted. (shrink)

Dental caries is the main oral health challenge for children in Nigeria. Concern about its negative impact makes screening for caries in children an attractive public health strategy. The ability to detect the preclinical phase of caries, the availability of screening tools with high accuracy, and the possibility of treatment before onset of clinical symptoms with significant cost and health benefits, makes it appropriate for screening. However in Nigeria, the poor availability of highly specific and sensitive screening tools, poor access (...) to oral health care and concerns with pre-screening consent, raise the question of the appropriateness of conducting screening programmes for children. We argue that a number of structural challenges associated with poor uptake of oral health care services need to be addressed before screening for caries can be considered ethically appropriate. These include facilitating access of children to quality oral health care and a systematic national approach to oral health impl... (shrink)

Geoffrey Hill’s prose has prompted longstanding critical controversy, much of which turns on the perceived difficulty, intransigence and anachronism of his œuvre as a whole. This paper proposes that new ways to navigate this controversy can be found in Hill’s preoccupation with the exemplary dimensions of writing – that is, in his interest in the poet’s capacity to offer examples (positive and negative) to a community of readers. The discussion pays particular attention to the connections Hill’s reviews establish between style (...) and ethical choice and between literary difficulty and democracy ; connections which are intertwined with his ethics of exemplarity in fundamental ways. The paper also engages with those dimensions of literary exemple-use which emerge in new or unusual ways in his prose : his presentation of “models” or ideals for the organisation of civil society ; his treatment of certain literary works as exemplars or embodiments of philosophical ideas ; and his procedural tic of “sampling” regularly for the purpose of chastisement the “bad example” set by some of the works he criticises. (shrink)

Geoffrey Hill’s prose has prompted longstanding critical controversy, much of which turns on the perceived difficulty, intransigence and anachronism of his œuvre as a whole. This paper proposes that new ways to navigate this controversy can be found in Hill’s preoccupation with the exemplary dimensions of writing – that is, in his interest in the poet’s capacity to offer examples (positive and negative) to a community of readers. The discussion pays particular attention to the connections Hill’s reviews establish between style (...) and ethical choice and between literary difficulty and democracy ; connections which are intertwined with his ethics of exemplarity in fundamental ways. The paper also engages with those dimensions of literary exemple-use which emerge in new or unusual ways in his prose : his presentation of “models” or ideals for the organisation of civil society ; his treatment of certain literary works as exemplars or embodiments of philosophical ideas ; and his procedural tic of “sampling” regularly for the purpose of chastisement the “bad example” set by some of the works he criticises. (shrink)

Visual research methods like photography and digital storytelling are increasingly used in health and social sciences research as participatory approaches that benefit participants, researchers, and audiences. Visual methods involve a number of additional ethical considerations such as using identifiable content and ownership of creative outputs. As such, ethics committees should use different assessment frameworks to consider research protocols with visual methods. Here, we outline the limitations of ethics committees in assessing projects with a visual focus and highlight the sparse knowledge (...) on how researchers respond when they encounter ethical challenges in the practice of visual research. We propose a situated approach in relation to visual methodologies that encompasses a negotiated, flexible approach, given that ethical issues usually emerge in relation to the specific contexts of individual research projects. Drawing on available literature and two case studies, we identify and reflect on nuanced ethical implications in visual research, like tensions between aesthetics and research validity. The case studies highlight strategies developed in-situ to address the challenges two researchers encountered when using visual research methods, illustrating that some practice implications are not necessarily addressed using established ethical clearance procedures. A situated approach can ensure that visual research remains ethical, engaging, and rigorous. (shrink)

Visual research methods like photography and digital storytelling are increasingly used in health and social sciences research as participatory approaches that benefit participants, researchers, and audiences. Visual methods involve a number of additional ethical considerations such as using identifiable content and ownership of creative outputs. As such, ethics committees should use different assessment frameworks to consider research protocols with visual methods. Here, we outline the limitations of ethics committees in assessing projects with a visual focus and highlight the sparse knowledge (...) on how researchers respond when they encounter ethical challenges in the practice of visual research. We propose a situated approach in relation to visual methodologies that encompasses a negotiated, flexible approach, given that ethical issues usually emerge in relation to the specific contexts of individual research projects. Drawing on available literature and two case studies, we identify and reflect on nuanced ethical implications in visual research, like tensions between aesthetics and research validity. The case studies highlight strategies developed in-situ to address the challenges two researchers encountered when using visual research methods, illustrating that some practice implications are not necessarily addressed using established ethical clearance procedures. A situated approach can ensure that visual research remains ethical, engaging, and rigorous. (shrink)

BackgroundThe global interest in developing therapies for Ebola infection management and its prevention is laudable. However the plan to conduct an emergency immunization program specifically for healthcare workers using experimental vaccines raises some ethical concerns. This paper shares perspectives on these concerns and suggests how some of them may best be addressed.DiscussionThe recruitment of healthcare workers for Ebola vaccine research has challenges. It could result in coercion of initially dissenting healthcare workers to assist in the management of EVD infected persons (...) due to mistaken beliefs that the vaccine offers protection. It could also affect equity and justice. For example, where people who are not skilled health care professionals but who provide care to patients infected with Ebola are not prioritized for vaccination. The possibility of study participants contracting Ebola infection despite the use of experimental vaccine, and the standard of care they would receive, needs to be addressed clearly, transparently and formalized as part of the ethics review process. Future access to study products in view of current status of the TRIPS agreement needs to be addressed. Finally, broad stakeholder engagement at local, regional and international levels needs to be promoted using available communication channels to engage local, regional and international support. These same concerns are applicable for current and future epidemics.SummarySuccessful Ebola vaccine development research requires concerted efforts at public dialogue to address misconceptions, equity and justice in participant selection, and honest discussions about risks, benefits and future access. Public dialogue about Ebola vaccine research plans is crucial and should be conducted by trusted locals and negotiated between communities, researchers and ethics committees in research study sites. (shrink)

HIV prevention is a critical health issue in Nigeria; a country that has one of the worst HIV epidemic profiles in the world. With 270,000 new infections in 2012, Nigeria is a prime site for HIV prevention research. One effect of the HIV epidemic has been to revolutionalise ethical norms for the conduct of research: it is now considered unethical to design and implement HIV related studies without community engagement. Unfortunately, there is very little commensurate effort in building the capacity (...) of local persons to engage actively with researchers, and there is no existing platform to facilitate dialogue between researchers and communities engaged in research in Nigeria. In an effort to address this gap, we undertook a series of three community dialogues and two community-researcher interface meetings in Nigeria. This paper aims to give an empirical account of the dialogue from these community engagement processes and provide a resulting critique of the implementation of research ethics practices in Nigeria. It is anticipated that the outputs will: support researchers in designing community-based research protocols; inform ethics committees of key considerations during research protocol reviews from a community perspective; and inform policy makers and research sponsors about issues of primary concern to communities with respect to HIV research. (shrink)

In late March 2020 in response to the COVID-19 pandemic, Australia introduced mandatory 14-day supervised quarantine at hotels and other designated facilities for all international arrivals. From July 2020, most states and territories introduced a fixed charge for quarantine of up to $3220 per adult. The introduction of the fee was rationalised on the basis that Australians had been allowed sufficient time to return and there was a need to recover some of the cost associated with administering the program. Drawing (...) on an empirical study of 58 returned Australian citizens and residents quarantined between March 2020 and January 2021, this paper aims to explore how people experienced paying for hotel quarantine, particularly with respect to fairness and relatedly, the principle of reciprocity. Reciprocity requires that the state has an obligation to assist individuals in discharging their duty to comply with public health measures and avoid disproportionate burdens accruing to populations or individuals. Though participants had varying opinions on whether they thought it fair to be charged for their quarantine, for many, the fee constituted a significant burden and source of stress. Given the undertaking of quarantine is primarily for the benefit of the public good, we argue the financial cost imposed on individuals does not meet the demands of reciprocity. It is imperative that future quarantine and isolation arrangements consider seriously the need to minimise burdens of individuals subject to such measures, and that fees do not become a new norm in public health and infectious disease control. (shrink)

Community engagement in research, including public health related research, is acknowledged as an ethical imperative. While medical care and public health action take priority over research during infectious disease outbreaks, research is still required in order to learn from epidemic responses. The World Health Organisation developed a guide for community engagement during infectious disease epidemics called the Good Participatory Practice for Trials of Emerging (and Re‐emerging) Pathogens that are Likely to Cause Severe Outbreaks in the Near Future and for which (...) Few or No Medical Counter‐Measures Exist (GPP‐EP). This paper identified priorities for community engagement for research conducted during infectious disease outbreaks drawing on discussions held with a purposive sample of bioethicists, social scientists, researchers, policy makers and laypersons who work with ethics committees in West Africa. These perspectives were considered in the light of the GPP‐EP, which adds further depth and dimension to discussions on community engagement frameworks. It concludes that there is no presumptive justification for the exclusion of communities in the design, implementation and monitoring of clinical trials conducted during an infectious disease outbreak. Engagement that facilitates collaboration rather than partnership between researchers and the community during epidemics is acceptable. (shrink)

ABSTRACT The aim of this study is to determine how stakeholder engagement can be adapted for the conduct of COVID‐19‐related clinical trials in sub‐Saharan Africa. Nine essential stakeholder engagement practices were reviewed: formative research; stakeholder engagement plan; communications and issues management plan; protocol development; informed consent process; standard of prevention for vaccine research and standard of care for treatment research; policies on trial‐related physical, psychological, financial, and/or social harms; trial accrual, follow‐up, exit trial closure and results dissemination; and post‐trial access (...) to trial products or procedures. The norms, values, and practices of collectivist societies in Sub‐Saharan Africa and the low research literacy pose challenges to the conduct of clinical trials. Civil‐society organizations, members of community advisory boards and ethics committees, young persons, COVID‐19 survivors, researchers, government, and the private sector are assets for the implementation and translation of COVID‐19 related clinical trials. Adapting ethics guidelines to the socio‐cultural context of the region can facilitate achieving the aim of stakeholder engagement. (shrink)

The Oceania region is home to some of the world's most restrictive abortion laws, and there is evidence of Pacific Island women's reproductive oppression across several aspects of their reproductive lives, including in relation to contraceptive decision‐making, birthing, and fertility. In this paper we analyse documents from court cases in the Pacific Islands regarding the illegal procurement of abortion. We undertook inductive thematic analysis of documents from eighteen illegal abortion court cases from Pacific Island countries.Using the lens of reproductive justice, (...) we discuss the methods of abortion, the reported context of these abortions, and the ways in which these women and abortion were constructed in judges' summing up, judgements, or sentencing. Our analysis of these cases reveals layers of sexual and reproductive oppression experienced by these women that are related to colonialism, women's socioeconomic disadvantage, gendered violence, limited reproductive control, and the punitive consequences related to not performing gender appropriately. (shrink)

The Oceania region is home to some of the world's most restrictive abortion laws, and there is evidence of Pacific Island women's reproductive oppression across several aspects of their reproductive lives, including in relation to contraceptive decision-making, birthing, and fertility. In this paper we analyse documents from court cases in the Pacific Islands regarding the illegal procurement of abortion. We undertook inductive thematic analysis of documents from eighteen illegal abortion court cases from Pacific Island countries.Using the lens of reproductive justice, (...) we discuss the methods of abortion, the reported context of these abortions, and the ways in which these women and abortion were constructed in judges' summing up, judgements, or sentencing. Our analysis of these cases reveals layers of sexual and reproductive oppression experienced by these women that are related to colonialism, women's socioeconomic disadvantage, gendered violence, limited reproductive control, and the punitive consequences related to not performing gender appropriately. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Recent Acquisitions, 2020–21Bridget Whittle and Kenneth BlackwellThe previous general update of acquisitions appeared in Russell in n.s. 39 (winter 2019): 188–90. The new listing covers items numbered 1,824 to 1,839, plus an addition to 840, with the latest items arriving in December 2021. Largely due to the Covid-19 pandemic, this update is smaller than usual as fewer items were received or available. Several items were received from other institutions (...) and through the generosity of researchers, to whom McMaster Library is very grateful. Internet prints are from the Hon. Russell Archivist. The following abbreviations are used: L(s). or l(s). = letter(s); X. = image copies of any kind.correspondenceArlott, John L. from BR, 1951, re “Rewards of Philosophy” (C48.06) and a cricket book for Conrad. X. Internet print. rec. acq. 1,831.Bell, A. S. L. from BR, 1967. Re Alys Russell’s l. to Haldane. X. Courtesy of Nicholas Bell. rec. acq. 1,827.Cambridge Daily News L. from BR requesting they issue a public statement to clarify use of his title, 1945. Re B&R C45.07a. X. Courtesy of Dr. David Harley. rec. acq. 1,824.Cousins, Norman 2 ls. from BR, re quoting History of the World in Epitome and Manchester speech, 1960. X. Courtesy of David Harley. rec. acq. 1,826.Davies, Mansel 19 documents including ls. to BR, from Edith Russell, drafts, and notes re the Bertrand Russell Peace Fund, 1963 and later; and Dora Russell, also cnd, 1958. rec. acq. 1,828.Dewey, John 3 ls., 1 pc to William Ernest Hocking, 1936–40. Re BR at ccny and Harvard. Purchase. rec. acq. 1,836.Duman, R. Douglas L. from BR, 1963. X. Courtesy of David Harley. rec. acq. 1,826.Furtado, Celso 2 ls. from BR re Goldwater, and American war crimes in Vietnam, 1964, 1967. X. Courtesy of Camilo Furado. rec. acq. 1,829.Greene, Graham L. from BR on a Vietnam statement, 1967. X. Internet print. rec. acq. 1,831.Haldane, Richard Burdon (1st Viscount) L. from Alys Russell regarding BR’s imprisonment status, 3 Mar. 1918. X. rec. acq. 1,827.Hocking, William Ernest 2 ls. from BR, 1939–40. Re Wm. James Lectures at Harvard. Purchase. rec. acq. 1,836. —. See also under Dewey, John.Jones, Lief (Lord Rhayader) L. from BR congratulating him on his election victory in North Westmoreland. 1904–05. Purchase. rec. acq. 1,831.Miller, Lawrence E. L. from BR enclosing signed photo (not present), 1963. X. Internet print. rec. acq. 1,831.Modern Forum (Herman Lissauer) L. from BR declining another us lecture tour, 1954. X. Courtesy of David Harley. rec. acq. 1,831.Newnham College Report from BR to extend G. E. M. Anscombe’s scholarship. He comments on her 2 dissertations. X. Courtesy of Rachel Wiseman. Original at Newnham. rec. acq. 1,831.Post, Stanley Deverin L. from BR, 1962. X. Internet print. rec. acq. 1,824.Russell, Frank L. to Bill/Bull, 1902. Promises to send him a copy of his speech. X. Internet print. Courtesy of Ruth Derham. rec. acq. 1,824.Russell, Patricia L. to Emrys Hughes, ed. of Forward, 1945. Re the war and peace settlement. X. Courtesy of National Library of Scotland. Added to rec. acq. 840.Ryckman, Mr. L. from BR, 1923. X. Internet print. rec. acq. 1,831.Schrödinger, Erwin L. from BR. X. Internet print. Online at U. of Vienna Library. rec. acq. 1,830.Silberstein, Ludwick 3ls. from BR,2in 1918, third in 1941. Silberstein had translated Problems into Polish, 1913. X. Internet print. rec. acq. 1,831.Silverstein, Louis L. from BR regarding nuclear weapons and the Kennedy administration, 1961. X. Internet print. rec. acq. 1,831.Spencer, Herbert L. to Lady Amberley, 1869. Re Spencer’s visit to Rodborough. Purchase. rec. acq. 1,833.Stetler, Jr., Russell Dearnley 20 ls. from BR; 30 from R. Schoenman, C. Farley, P. Wood; 1963–65. On opposing the Vietnam War. X. Donation of Russ Stetler. rec. acq. 1,838.Thirring, Hans 11 ls. from BR, 1 to BR, 1952–62. X. Internet print. Online at U. of Vienna Library. rec... (shrink)

This article draws attention to the limited amount of scholarship on what constitutes fairness and equity in resource allocation to health research by individual funders. It identifies three key decisions of ethical significance about resource allocation that research funders make regularly and calls for prioritizing scholarship on those topics – namely, how health resources should be fairly apportioned amongst public health and health care delivery versus health research, how health research resources should be fairly allocated between health problems experienced domestically (...) versus other health problems typically experienced by disadvantaged populations outside the funder's country, and how domestic and non-domestic health research funding should be further apportioned to different areas, e.g. types of research and recipients. These three topics should be priorities for bioethics research because their outcomes have a substantial bearing on the achievement of health justice. The proposed agenda aims to move discussion on the ethics of health research funding beyond its current focus on the mismatch between worldwide basic and clinical research investment and the global burden of disease. Individual funders’ decision-making on whether and to what extent to allocate resources to non-domestic health research, health systems research, research on the social determinants of health, capacity development, and recipients in certain countries should also be the focus of ethical scrutiny. (shrink)

In Archaic Athenian vase-painting, silens are often sexually aroused, but only sporadically satisfy their desires in a manner acceptable to most Athenian men. François Lissarrague persuasively argued that the sexuality of silens in vase-painting was probably laughable rather than awe-inspiring. What sort of laughter did the vase-paintings elicit? Was it the scornful laughter of a person who felt nothing in common with silens, or the laughter of one made to see something of himself in their behavior? For three reasons, I (...) argue for the latter interpretation. First, some vase-paintings are constructed so as to invite the viewer to adopt imaginatively the persona of a silen. Second, parallels for the less-than-triumphant sexuality of silens occur in Archaic iambic poetry. Like the vase-paintings, the poetry was often constructed so that performers of the poems are incorporated into the narratives as all-too-human protagonists. Third, certain formal features of classical satyr-play encouraged the audience to identify with the point of view of the satyr-chorus, while others reminded it that there were better role models than silens. In all three media, a negative characterization of male characters or silens is combined with a manner of presentation that invites the viewer or performer to see himself among those characters despite their negative traits. That form of humor may have been common in Archaic symposia, but its presence in satyr-play suggests that it may also be a fundamental characteristic of silens. (shrink)

Irish Supreme Court upholds paramountcy of parental right to determine a child's best interests at the expense of the rights of children themselvesCan a court force on parents who are careful and conscientious a view of their child's welfare which is rational, but quite contrary to the parents sincerely held but non-rational beliefs? The Supreme Court of Ireland has recently held that it cannot do so, and that the Irish Constitution requires that the right of the family to determine its (...) own direction must be respected except in the most narrow of circumstances, such as an immediate threat to the life of the child or risk of serious injury. The ruling leaves the assessment of a child's best interests to the wide discretion of parents, but at the same time fails to offer a means to resolve potential conflicts between the rights of the family and the rights of the child.FACTS OF THE CASEIn North Western Health Board v W 1 an action was brought by a local health board against the parents of 14 month old Paul, seeking a declaration that their refusal to submit their son to the heel prick test for phenylketonuria was a failure to vindicate their son's rights and that it would be lawful to proceed without parental consent. Phenylketonuria is a metabolic condition which can lead to severe and untreatable mental impairment if not detected in its early stages, but a simple variation in diet can stave off this outcome. While Paul's parents did not doubt the veracity of this medical opinion, nor indeed the importance of the test, they refused to subject their son to the invasive heel prick, offering instead samples of urine or hair, such that the test could be carried out by non-invasive means. These means, however, are considerably …. (shrink)

By any measure, Oliver Wendell Holmes, Jr., led a full and remarkable life. He was tall and exceptionally attractive, especially as he aged, with piercing eyes, a shock of white hair, and prominent moustache. He was the son of a famous father, a thrice-wounded veteran of the Civil War, a Harvard-educated member of Brahmin Boston, the acquaintance of Longfellow, Lowell, and Emerson, and for a time a close friend of William James. He wrote one of the classic works of American (...) legal scholarship, The Common Law, and he served with distinction on the Supreme Court of the United States. He was actively involved in the Court's work into his nineties. In Justice Oliver Wendell Holmes, G. Edward White, the acclaimed biographer of Earl Warren and one of America's most esteemed legal scholars, provides a rounded portrait of this remarkable jurist. We see Holmes's early life in Boston and at Harvard, his ambivalent relationship with his father, and his harrowing service during the Civil War. White examines Holmes's curious, childless marriage and he includes new information on Holmes's relationship with Clare Castletown. White not only provides a vivid portrait of Holmes's life, but examines in depth the inner life and thought of this preeminent legal figure. There is a full chapter devoted to The Common Law, for instance, and throughout the book, there is astute commentary on Holmes's legal writings. Indeed, White reveals that some of the themes that have dominated 20th-century American jurisprudence--including protection for free speech and the belief that "judges make the law"--originated in Holmes's work. Perhaps most important, White suggests that understanding Holmes's life is crucial to understanding his work, and he continually stresses the connections between Holmes's legal career and his personal life. For instance, his desire to distinguish himself from his father and from the "soft" literary culture of his father's generation drove him to legal scholarship of a particularly demanding kind. White's biography of Earl Warren was hailed by Anthony Lewis on the cover of The New York Times Book Review as "serious and fascinating," and The Los Angeles Times noted that "White has gone beyond the labels and given us the man." In Justice Oliver Wendell Holmes, White has produced an equally serious and fascinating biography, one that again goes beyond the labels and gives us the man himself. (shrink)

On Aen. 2. 277 DServius notes ‘non sine ratione etiam hoc de crinibus dolet Aeneas, quia illis maxime Hector commendabatur, adeo ut etiam tonsura ab eo nomen acceperit, sicut Graeci poetae docent.’ Fraenkel showed that the reference in Graeci poetae is to Lycophron , the source of the comment being provided by Eustathius 1276. 29, a scholion on Il. 22. 401 f. He adds a caution against supposing that Servius’ source referred not only to Lycophron but also to other Greek (...) poets, ‘e.g. some Attic comedians’. That such allusions were in fact made in Comedy is proved by Pollux. (shrink)

3 In live performances seated audiences have restricted opportunities for response. Some 4 responses are obvious, such as applause and cheering, but there are also many apparently 5 incidental movements including posture shifts, fixing hair, scratching and adjusting glasses. 6 Do these movements provide clues to people’s level of engagement with a performance? Our 7 basic hypothesis is that audience responses are part of a bi-directional system of audience- 8 performer communication. This communication is part of what distinguishes live from (...) recorded 9 performance and underpins live performers’ moment-to-moment sense of how well a performance 10 is going. Here we investigate the range of visible real-time movements of audiences in four live 11 contemporary dance performances. Video recordings of performers and audiences were analysed 12 using computer vision techniques for extracting face, hand and body movement data. The 13 meaning of audience movements were analysed by comparing clips of the audience at moments 14 of maximum and minimum movement to expert and novice judges. The results show that audience 15 clips with the lowest overall movement are judged as displaying the highest engagement. In 16 addition, we found that while there is no systematic relationship between audience and dancers 17 movement, hands seem to play an especially significant role since they move significantly more 18 compared to the rest of the body. We draw on these findings to argue that collective stillness is 19 an especially salient signal of audience engagement. (shrink)

From the pen of Professor Geach we have learnt to expect the fastidious art of the microscopist. Not microscopy for its own sake, however, but microscopy as the vigilant servant, ensuring that large views, if and when they are built, shall be built only from sound materials. The present volume is a collection of nine papers—some previously published in journals, and some appearing for the first time. They exhibit the author’s painstaking skill in logical analysis, and his predilection for the (...) paths trodden by Aquinas and the later Wittgenstein. If they invite the charge of lengthy and sometimes tedious hair-splitting, the author has his answer ready: often hair-splitting is the only way to attain the truth. (shrink)

“I beg of you, Doctor, please don’t let Dr. Moore see my mother again. My sisters and I do not want him talking with us anymore.”So concluded my first conversation with Samir Zadeh. Our meeting had been purely accidental; as I walked onto the elevator going down from the Surgical ICU, he and one of his sisters were already on, coming down from another one of our hospital’s ICUs, from a floor above. Samir was a man in his early 50s, (...) and his sister, whom I would learn was actually a few years older, appeared younger than he. They were talking quietly when the doors opened, but as is often the case in elevators, especially in a hospital, as soon as I entered, their conversation stopped. We rode down to the bottom floor in silence. As we exited, I let them go first, a courtesy I had been taught by my parents, and they both thanked me, in the usual social way, and walked out into the lobby and then out of the building. I walked the same way.It was when we were about 25 feet from the building that Mr. Zadeh and his sister stopped, so that I caught up to them. As I did, Mr. Zadeh, a large man, maybe 6 feet tall and 250 pounds, with thinning hair and a well-groomed mustache, turned and said my name aloud, “Dr. Finder, may you be so kind as to talk?”. (shrink)