Crutchfield and Redinger (2024) propose that the use of a chemical restraint that affects only a particular conscious state is ethically permissible if, and only if, (1) it is the least restrictive...

Treatment pressures are communicative strategies that mental health professionals use to influence the decision-making of mental health service users and improve their adherence to recommended treatment. Szmukler and Appelbaum describe a spectrum of treatment pressures, which encompasses persuasion, interpersonal leverage, offers and threats, arguing that only a particular type of threat amounts to informal coercion. We contend that this account of informal coercion is insufficiently sensitive to context and fails to recognize the fundamental power imbalance in mental healthcare. Based on (...) a set of counterexamples, we argue that what makes a proposal coercive is not whether service users will actually be made worse off if they reject the proposal, but rather whether they have the justified belief that this is the case. Whether this belief is justified depends on the presence of certain contextual factors, such as strong dependency on professionals and the salient possibility of formal coercion. (shrink)

The ethics review of qualitative health research poses various challenges that are due to a mismatch between the current practice of ethics review and the nature of qualitative methodology. The process of obtaining ethics approval for a study by a research ethics committee before the start of a research study has been described as “procedural ethics” and the identification and handling of ethical issues by researchers during the research process as “ethics in practice.” While some authors dispute and other authors (...) defend the use of procedural ethics in relation to qualitative health research, there is general agreement that it needs to be supplemented with ethics in practice. This article aims to provide an illustration of research ethics in practice by reflecting on the ways in which we identified and addressed ethical and methodological issues that arose in the context of an interview study with mental health service users and relatives. We describe the challenges we faced and the solutions we found in relation to the potential vulnerability of research participants, the voluntariness of consent, the increase of participant access and the heterogeneity of the sample, the protection of privacy and internal confidentiality, and the consideration of personal and contextual factors. (shrink)

Bioethics increasingly recognizes the impact of discriminatory practices based on social categories such as race, gender, sexual orientation or ability on clinical practice. Accordingly, major bioethics associations have stressed that identifying and countering structural discrimination in clinical ethics consultations is a professional obligation of clinical ethics consultants. Yet, it is still unclear how clinical ethics consultants can fulfill this obligation. More specifically, clinical ethics needs both theoretical tools to analyze and practical strategies to address structural discrimination within clinical ethics consultations. (...) Intersectionality, a concept developed in Black feminist scholarship, is increasingly considered in bioethical theory. It stresses how social structures and practices determine social positions of privilege and disadvantage in multiple, mutually co-constitutive systems of oppression. This article aims to investigate how intersectionality can contribute to addressing structural discrimination in clinical ethics consultations with a particular focus on mental healthcare. To this end, we critically review existing approaches for clinical ethics consultants to address structural racism in clinical ethics consultations and extend them by intersectional considerations. We argue that intersectionality is a suitable tool to address structural discrimination within clinical ethics consultations and show that it can be practically implemented in two complementary ways: 1) as an analytic approach and 2) as a critical practice. (shrink)

The fundamental tenet of modern empiricism is the view that all non-analytic knowledge is based on experience. Let us call this thesis the principle of empiricism. [1] Contemporary logical empiricism has added [2] to it the maxim that a sentence makes a cognitively meaningful assertion, and thus can be said to be either true or false, only if it is either (1) analytic or self-contradictory or (2) capable, at least in principle, of experiential test. According to this so-called empiricist criterion (...) of cognitive meaning, or of cognitive significance, many of the formulations of traditional metaphysics and large parts of epistemology are devoid of cognitive significance--however rich some of them may be in non-cognitive import by virtue of their emotive appeal or the moral inspiration they offer. Similarly certain doctrines which have been, at one time or another, formulated within empirical science or its border disciplines are so contrived as to be incapable of test by any conceivable evidence; they are therefore qualified as pseudo- [p. 42:] hypotheses, which assert nothing, and which therefore have no explanatory or predictive force whatever. This verdict applies, for example, to the neo-vitalist speculations about entelechies or vital forces, and to the "telefinalist hypothesis" propounded by Lecomte du Noüy. (shrink)

1. Object of this note . In his lively essay, “Between Analytic and Empirical,” , Mr. J. W. N. Watkins challenges the empiricist identification of synthetic statements with empirical ones by arguing that there exists an important class of statements which are synthetic, i.e. not analytically true or false, and yet not empirical. I find Mr. Watkins's arguments very stimulating, but I do not think they provide a sound basis for his contention. In the present note, I wish to indicate (...) what seem to me the principal flaws in Mr. Watkins's reasoning, and to make some additional comments on the issues raised by his discussion. (shrink)

Christine Battersby rethinks questions of embodiment, essence, sameness and difference, self and "other", patriarchy and power. Using analyses of Kant, Adorno, Irigaray, Butler, Kierkegaard and Deleuze, she challenges those who argue that a feminist metaphysics is a a contradiction in terms. This book explores place for a metaphysics of fluidity in the current debates concerning postmodernism, feminism and identity politics.

Different types of consent are used to obtain human biospecimens for future research. This variation has resulted in confusion regarding what research is permitted, inadvertent constraints on future research, and research proceeding without consent. The National Institutes of Health Clinical Center's Department of Bioethics held a workshop to consider the ethical acceptability of addressing these concerns by using broad consent for future research on stored biospecimens. Multiple bioethics scholars, who have written on these issues, discussed the reasons for consent, the (...) range of consent strategies, and gaps in our understanding, and concluded with a proposal for broad initial consent coupled with oversight and, when feasible, ongoing provision of information to donors. This article describes areas of agreement and areas that need more research and dialogue. Given recent proposed changes to the Common Rule, and new guidance regarding storing and sharing data and samples, this is an important and tim.. (shrink)

The volume relates the controversy concerning competing knowledge claims to truth.

The interdisciplinary field of neurorobotics looks to neuroscience to overcome the limitations of modern robotics technology, to robotics to advance our understanding of the neural system’s inner workings, and to information technology to develop tools that support those complementary endeavours. The development of these technologies is still at an early stage, which makes them an ideal candidate for proactive and anticipatory ethical reflection. This article explains the current state of neurorobotics development within the Human Brain Project, originating from a close (...) collaboration between the scientific and technical experts who drive neurorobotics innovation, and the humanities and social sciences scholars who provide contextualising and reflective capabilities. This article discusses some of the ethical issues which can reasonably be expected. On this basis, the article explores possible gaps identified within this collaborative, ethical reflection that calls for attention to ensure that the development of neurorobotics is ethically sound and socially acceptable and desirable. (shrink)

Aristotle believes that an agent lacks virtue unless she enjoys the performance of virtuous actions, while Kant claims that the person who does her duty despite contrary inclinations exhibits a moral worth that the person who acts from inclination lacks. Despite these differences, this chapter argues that Aristotle and Kant share a distinctive view of the object of human choice and locus of moral value: that what we choose, and what has moral value, are not mere acts, but actions: acts (...) done for the sake of ends. Morally good actions embody a kind of intrinsic value that inspires us to do them from duty (in Kant) or for the sake of the noble (in Aristotle). The chapter traces the difference in their attitudes about doing one's duty with pleasure to a difference in their attitudes towards pleasure itself: Aristotle sees it as a perception of the good, while Kant thinks of it as mere feeling. (shrink)

This article explores the ways in which competing institutional logics influence the knowledge base of the police, ideas about good police practice and organizational identities. A tension between the humanistic professional police logic and the instrumental New Public Management (NPM) logic is discussed in the context of policing. While the humanistic professional police logic gradually emerged in the 1960s and 70s, over the past twenty years the police force has been reformed in line with the NPM logic. Through qualitative interviews (...) and a quantitative study of the police force, the article investigates the ways in which the ideas of what constitutes a normative good practice are shaped in relation to these two, opposing, logics. A central finding is that despite many years of NPM as the dominant steering logic, a humanistic professional logic persists. However, the shift towards the NPM logic transforms the knowledge base in a more evidence-oriented direction and affects the ideas of normative good practice, especially among police management. (shrink)

Purpose/methods: This study investigated the relationship between ethics education and training, and the use and usefulness of ethics resources, confidence in moral decisions, and moral action/activism through a survey of practicing nurses and social workers from four United States (US) census regions. Findings: The sample (n = 1215) was primarily Caucasian (83%), female (85%), well educated (57% with a master's degree). no ethics education at all was reported by 14% of study participants (8% of social workers had no ethics education, (...) versus 23% of nurses), and only 57% of participants had ethics education in their professional educational program. Those with both professional ethics education and in-service or continuing education were more confident in their moral judgments and more likely to use ethics resources and to take moral action. Social workers had more overall education, more ethics education, and higher confidence and moral action scores, and were more likely to use ethics resources than nurses. Conclusion: Ethics education has a significant positive influence on moral confidence, moral action, and use of ethics resources by nurses and social workers. (shrink)

This review argues that the role of technology in business and society debates has predominantly been examined from the limited, narrow perspective of technology as instrumental, and that two additional but relatively neglected perspectives are important: technology as value-laden and technology as relationally agentic. Technology has always been part of the relationship between business and society, for better and worse. However, as technological development is frequently advanced as a solution to many pressing societal problems and grand challenges, it is imperative (...) that technology is understood and analyzed in a more nuanced, critical, and comprehensive way. The two additional perspectives invite a broader research agenda, one that includes questions, such as “Which values and whose interests has technology come to emulate?”; “How do these values and interests play out in stabilizing the status quo?”; and, importantly, “How can it be contested, disrupted, and changed?” Any research that endorses green, sustainable, environmental, or climate mitigating technologies potentially contributes to maintaining the very thing that it seeks to change if questions such as these are not being addressed. (shrink)

Study of the multiplicity of interactions between invertebrate hosts and their parasites helps to define the aspects of the host immune systems that have ecological and evolutionary significance. Such study, however, reveals how much is yet unknown. For instance, the costs of mounting an immune response, the nature of the long-lasting protection sometimes attained, and the high degree of specificity observed in certain hosts are phenomena that still await full explanation. An additional puzzle is the high degree of specificity achieved (...) in light of the apparent low degree of specificity in the recognition and effector mechanisms of insect immune systems. Furthermore, while protective immunity is typically associated with vertebrate adaptive immune systems, invertebrates may have analogous capacities, whose nature is still largely unknown. This review will illustrate how the traditional host-centred view of immune defence can be usefully extended by taking account of parasite immune evasion strategies and the variation that such strategies create in the observed outcomes of infection. BioEssays 27:1026–1034, 2005. © 2005 Wiley Peiodicals, Inc. (shrink)

The concept of moral distress comes from nursing ethics, and was initially defined as ‘…when one knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right course of action’. There is a large body of literature associated with moral distress, yet multiple definitions now exist, significantly limiting its usefulness. We undertook a systematic review of the argument-based bioethics literature on this topic as the basis for a critical appraisal, identifying 55 papers for analysis. (...) We found that moral distress is most frequently framed around individual experiences of distress in relation to local practices and constraints, and understood in terms of power relations and workplace hierarchies. This understanding is directly derived from, and often still seen as specific to, nursing. Frequently the perspective of the morally distressed individual is privileged. Understandings of moral distress have evolved towards an ‘occupational health approach’, with the assumption that moral distress should be measured and prevented. Counter-perspectives were identified, highlighting conceptual problems. Based on our review, we propose a redefinition of moral distress: ‘Ethical unease or disquiet resulting from a situation where a clinician believes they have contributed to avoidable patient or community harm through their involvement in an action, inaction or decision that conflicts with their own values’. This definition is specific enough for research use, anchored in clinicians’ professional responsibilities and concerns about harms to patients, framed relationally rather than hierarchically, and amenable to multiple perspectives on any given morally distressing situation. (shrink)

In this paper, we consider the question of whether there exists an essential relation between emotions and wellbeing. We distinguish three ways in which emotions and wellbeing might be essentially related: constitutive, causal, and epistemic. We argue that, while there is some room for holding that emotions are constitutive ingredients of an individual’s wellbeing, all the attempts to characterise the causal and epistemic relations in an essentialist way are vulnerable to some important objections. We conclude that the causal and epistemic (...) relation between emotions and wellbeing is much less strong than is commonly thought. (shrink)

Sound moves us. Nowhere is this more apparent than in our responses to genuine emotional vocalizations, be they heartfelt distress cries or raucous laughter. Here, we present perceptual ratings and a description of a freely available, large database of natural affective vocal sounds from human infants, adults and domestic animals, the Oxford Vocal (OxVoc) Sounds database. This database consists of 173 non-verbal sounds expressing a range of happy, sad, and neutral emotional states. Ratings are presented for the sounds on a (...) range of dimensions from a number of independent participant samples. Perceptions related to valence, including distress, vocalizer mood, and listener mood are presented in Study 1. Perceptions of the arousal of the sound, listener motivation to respond and valence (positive, negative) are presented in Study 2. Perceptions of the emotional content of the stimuli in both Study 1 and 2 were consistent with the predefined categories (e.g., laugh stimuli perceived as positive). While the adult vocalizations received more extreme valence ratings, rated motivation to respond to the sounds was highest for the infant sounds. The major advantages of this database are the inclusion of vocalizations from naturalistic situations, which represent genuine expressions of emotion, and the inclusion of vocalizations from animals and infants, providing comparison stimuli for use in cross-species and developmental studies. The associated website provides a detailed description of the physical properties of each sound stimulus along with cross-category descriptions. (shrink)

In this paper, I set an aspect of what it is to live a flourishing life against the backdrop of neo liberal trends that continue to influence educational policy across the globe. The view I set out is in sharp contrast to any narrow assumption that education’s main task is the measurement of high performing individuals who will thus contribute to an economically viable society. Instead, I explore and argue for a conception of what constitutes a flourishing life that is (...) embedded in a more pragmatist analysis of what education may be. The argument begins with developing the centrality of embodiment to aesthetic sensibility and goes on to suggest how collective understanding of this within a community could constitute a sense of performance and thus contribute to the educational aim of developing a full and flourishing life. The argument is that this way of seeing life could have implications for educational practice, the role of the teacher and could help to reconfigure how education is experienced by the young. (shrink)