The growing practice of returning individual results to research participants has revealed a variety of interpretations of the multiple and sometimes conflicting duties that researchers may owe to participants. One particularly difficult question is the nature and extent of a researcher’s duty to facilitate a participant’s follow-up clinical care by placing research results in the participant’s medical record. The question is especially difficult in the context of genomic research. Some recent genomic research studies — enrolling patients as participants — boldly (...) address the question with protocols dictating that researchers place research results directly into study participants’ existing medical records, without participant consent. Such privileging of researcher judgment over participant choice may be motivated by a desire to discharge a duty that researchers perceive themselves as owing to participants. However, the underlying ethical, professional, legal, and regulatory duties that would compel or justify this action have not been fully explored. (shrink)

The need for greater privacy protections in the United States has never been greater. In their work, “Ethical Responsibilities for Companies That Process Personal Data”, McCoy et al. (2023) correct...

The Genetic Information Nondiscrimination Act of 2008 was passed to encourage patients to seek genetic testing that could improve health outcomes and provide opportunities for preventive measures. GINA protects individuals from discrimination based upon genetic information, but not upon manifested diseases and conditions. Because the manifestation of a disease establishes a threshold of protection for individuals under GINA, the definition of manifestation is crucial to understanding the scope of the bill. This paper examines the range of possible legal definitions of (...) disease manifestation and explores the historical struggle that courts have faced when trying to apply these different definitions. Specifically, the paper examines three frameworks that courts have used in the past to interpret the manifestation of a disease; “manifestation as apparent symptoms,”“manifestation as patient action,” and “manifestation as physician action.” We argue that the “manifestation as physician action” is the best framework to utilize in this law generally, but that the definition of manifestation should be read in the light most favorable to a plaintiff in order to achieve the underlying goals of GINA. (shrink)

Congress passed the Genetic Information Nondiscrimination Act of 2008 in order to remove a perceived barrier to clinical genetic testing. By banning health insurance companies and employers from discriminating against an individual based on his or her genetic information, legislators hoped that patients would be encouraged to seek genetic testing that could improve health outcomes and provide opportunities for preventive measures. Their explicit legislative goal was to fully protect the public from discrimination and allay their concerns about the potential for (...) discrimination, thereby allowing individuals to take advantage of genetic testing, technologies, research, and new therapies.However, GINA left a number of issues unresolved, most notably failing to define the concept of disease manifestation. GINA was structured such that it only provides protection against misuse of genetic information up until the point when an individual's disease has manifested. It protects an individual with a genetic predisposition for a disease, but not an individual actively suffering from that disease. (shrink)

The growing practice of returning individual results to research participants has revealed a variety of interpretations of the multiple and sometimes conflicting duties that researchers may owe to participants. One particularly difficult question is the nature and extent of a researcher’s duty to facilitate a participant’s follow-up clinical care by placing research results in the participant’s medical record. The question is especially difficult in the context of genomic research. Some recent genomic research studies — enrolling patients as participants — boldly (...) address the question with protocols dictating that researchers place research results directly into study participants’ existing medical records, without participant consent. Such privileging of researcher judgment over participant choice may be motivated by a desire to discharge a duty that researchers perceive themselves as owing to participants. However, the underlying ethical, professional, legal, and regulatory duties that would compel or justify this action have not been fully explored. (shrink)

Background: A growing literature has raised—skeptically—the question of whether cutting-edge scientific research can identify and address broader ethical and policy considerations in real time. In genomics, the question is: Can ELSI contribute to genomics in real time, or will it be relegated to its historical role of after-the-fact outsider critique? We address this question against the background of a genomic screening project where we participated as embedded, real-time ELSI researchers and observers, from its initial design through its conclusion.Methods: As part (...) of the ELSI study design, the project included an ongoing reflexive ethnography in which the authors studied the process of its design and implementation. The authors were true participant observers, serving as members of various task-oriented groups while recording meetings and other events for ongoing qualitative analysis. We also conducted and analyzed interviews of multiple participants at the conclusion of the project.Results: Our real-time ELSI initiative had a mixed record of successes and challenges. If we define success as ELSI researchers having had an opportunity to participate fully in the project and to make the ELSI perspective heard, then our assessment is largely positive. If, however, we define successes as instances where real-time ELSI contributions changed the direction of the genomic or public health aspects of the GeneScreen project or, after careful deliberation, confirmed the appropriateness of the status quo, then we can identify only a few examples. While we had a seat at the table, we were, for the most part, tolerated guests.Conclusions: We conclude that there are significant barriers to real-time ELSI influence. The difficulty does not reside in any intended exclusion of an ELSI perspective, but in factors endemic to genomic research, including knowledge disparities, epistemological biases, and the pressures of time and money. (shrink)

The concept of a communal type of privacy shared by interconnected social groups has wide applications in the healthcare field, specifically in genetic testing and genetic data privacy (Pyrrho, Cam...

Anti-selection occurs when information asymmetry exists between insurers and applicants. When an applicant knows they are at high risk of loss, but the insurer does not, the applicant may try to use this knowledge differential to secure insurance at a lower premium that does not match risk.

Bowman-Smart et al. (2023) argue for a framework to examine the ethical issues associated with genetic screening for non-medical traits in the context of noninvasive prenatal testing (NIPT). Such s...

What were Shakespeare's final thoughts on history, tragedy, and comedy? Shakespeare's Last Plays focuses much needed scholarly attention on Shakespeare's "Late Romances." The work--a collection of newly commissioned essays by leading scholars of classical political philosophy and literature--offers careful textual analysis of Pericles, Prince of Tyre, Cymbeline, The Winter's Tale, The Tempest, All is True, and The Two Noble Kinsmen. The essays reveal how Shakespeare's thought in these final works compliments, challenges, fulfills, or transforms previously held conceptions of the (...) playwright and his political-philosophical views. (shrink)

For forty years, Harvey Mansfield has been worth reading. Whether plumbing the depths of MachiavelliOs Discourses or explaining what was at stake in Bill ClintonOs impeachment, MansfieldOs work in political philosophy and political science has set the standard. In Educating the Prince, twenty-one of his students, themselves distinguished scholars, try to live up to that standard. Their essays offer penetrating analyses of Machiavellianism, liberalism, and America., all of them informed by MansfieldOs own work. The volume also includes a bibliography (...) of MansfieldOs writings. (shrink)

The authors were involved in developing an ethical framework to assist the Queens Region Board (Prince Edward Island, Canada) set priorities in health and health care. Two and one half years after the adoption of this framework, the authors undertook an evaluation of the framework. This paper will discuss: a) the historical background of regionalization in Canada, and in particular the circumstances leading up to the institution of regional boards in Prince Edward Island; b) the sorts of ethical (...) issues facing the Queens Regional Board; c) issues arising in connection with the use and development of ethics frameworks for managing ethical issues in priority setting; d) the framework adopted by the Queens Board and the process that led to its development; e) issues arising as concerns implementation of the framework; f) questions and issues pertinent to other boards and bodies considering similar initiatives. (shrink)

The public expects members of the medical profession to conduct themselves according to the terms of the Hippocratic oath, yet few physicians and virtually no laypersons know what is in that oath. For the oath to reach beyond its symbolic importance, ethical conduct must be learned and practised. There are many texts on the practice of medicine, surgery and all of the related disciplines, yet one is hard pressed to find anything on ethical practice in any of them. Scholarly texts (...) on ethics tend to deal with the landmark issues and dilemmas that have occurred within particular jurisdictions or religions. This book is intended as a student-friendly text that seeks not to turn students into ethics scholars but to provide them with a practical guide to ethical conduct in everyday medical practice. and discussion are provided for each of the following areas: Ethical Practices in Health Care Law and Ethics Rights of Patients and Responsibilities of Health-Care Providers The Rights of Health-Care Professionals The Duty of Care Confidentiality Consent to Treatment Life and Death Research Ethics Ethics in Public Health Practice Ethical Practice in Everyday Health Care is useful, practical and student friendly. The exercises and discussions will stimulate thought about ethical conduct and help students to develop and translate ethical principles into their daily practice as health-care workers. Dr Walrond offers a ready and concise source of information for medical students on ethical issues. The text is simple, comprehensive and factual, addressing issues encountered in everyday medical practices. Case studies provide practical illustrations of complex ethical issues. (shrink)

The last phase of Greek philosophy has until recently been less intelligently studied than any other, and in our understanding of its development there are still lamentable lacunae. Three errors in particular have in the past prevented a proper appreciation of Plotinus' place in the history of philosophy. The first was the failure to distinguish Neoplatonism from Platonism: this vitiates the work of many early exponents from Ficinus down to Kirchner. The second was the belief that the Neoplatonists, being ‘mystics,’ (...) were necessarily incomprehensible to the plain man or even to the plain philosopher. To have encouraged the persistence of this superstition in the nineteenth century is the least pardonable of Creuzer's many sins. The third was the chronological confusion involved in the ascription to Saint Paul's contemporary of the works of the pretended Dionysius Areopagita, which contain a fully-developed Neoplatonic theology. Though the fraud had been exposed by Scaliger, these writings continued down to the beginning of the nineteenth century to be used as evidence that the ‘Nsoplatonic trinity’ was an inferior imitation of the Christian one. When this false trail was at length abandoned the fashion for orientalizing explanations persisted in another guise: to the earliest historians of Neoplatonism, Simon and Vacherot, the school of Plotinus was ‘the school of Alexandria,’ and its inspiration was mainly Egyptian. Vacherot says of Neoplatonism that it is ‘essentially and radically oriental, having nothing of Greek thought but its language and procedure.’ Few would be found to-day to subscribe to so sweeping a pronouncement; but the existence of an important oriental element in Plotinus' thought is still affirmed by many French and German writers. (shrink)

Much of the legal and social interest in new neuroimaging techniques stems from the belief that they can deliver on the materialist understanding of the relationship between the brain and the mind. This article looks at predictions about the future both of scientific advances and of social reactions to those predictions. It looks at the likely technical limits on neuroscience-based mindreading, then at the likely limits in how the law might use such technologies. It describes three kinds of technical barriers (...) to detailed and useful mindreading: the likely impossibility of making a complete and accurate model of a human brain in light of its incredible complexity, the problems of interpersonal and intrapersonal plasticity, and the problem of trying to read, now, someone's past mental state. The potential changes to the operation of the law, through the use of mindreading as evidence of pain, deception, or bias, among other things, could be extremely important. (shrink)

The responses to the questions of why? when?, how?, where?, and in what ways? business ethics should be taught in the BusinessEthics classroom inundate the scholarly literature. Yet, to date, despite some very interesting ideas, with respect to the answers givento the above question, not only has nothing even close to consensus been reached, but this particular area of pedagogy is instagnation—authors still challenge both the very idea of teaching business ethics as well as the practical value of such courses (...) for ourstudents once they graduate to the corporate world.In this paper I will suggest that the reason for this lack of pedagogical progress is that there has been a serious oversight regarding the most important teaching question of all: Who? I will show that the pedagogical issue of whom should be teaching Business Ethics has been largely ignored, skirted or answered incorrectly. I will then boldly argue that the only necessary condition for successful courses inBusiness Ethics is that they be taught by experts in ethics, i.e., Ph.D.s in philosophy. (shrink)

The responses to the questions of why? when?, how?, where?, and in what ways? business ethics should be taught in the BusinessEthics classroom inundate the scholarly literature. Yet, to date, despite some very interesting ideas, with respect to the answers givento the above question, not only has nothing even close to consensus been reached, but this particular area of pedagogy is instagnation—authors still challenge both the very idea of teaching business ethics as well as the practical value of such courses (...) for ourstudents once they graduate to the corporate world.In this paper I will suggest that the reason for this lack of pedagogical progress is that there has been a serious oversight regarding the most important teaching question of all: Who? I will show that the pedagogical issue of whom should be teaching Business Ethics has been largely ignored, skirted or answered incorrectly. I will then boldly argue that the only necessary condition for successful courses inBusiness Ethics is that they be taught by experts in ethics, i.e., Ph.D.s in philosophy. (shrink)

Because corporate social responsibility can be beneficial to both companies and its stakeholders, interest in factors that support CSR performance has grown in recent years. A thorough integration of CSR in core business processes is particularly important for achieving effective long-term CSR practices. Here, we explored the individual CSR-related competencies that support CSR implementation in a corporate context. First, a systematic literature review was performed in which relevant scientific articles were identified and analyzed. Next, 28 CSR directors and managers were (...) interviewed. The literature review complemented with interview data resulted in the following eight distinct CSR-related competencies: Anticipating CSR challenges; Understanding CSR-relevant systems and subsystems; Understanding CSR-relevant standards; CSR management competencies, including Leading CSR programs, Managing CSR programs, and Identifying and realizing CSR-related business opportunities; Realizing CSR-supportive interpersonal processes; Employing CSR-supportive personal characteristics and attitudes; Personal value-driven competencies, including Ethical normative competencies, Balancing personal ethical values and business objectives, and Realizing self-regulated CSR-related behaviors and active involvement; and Reflecting on personal CSR views and experiences. Based on these results, implications for further research on this topic, as well as implications for practitioners, are discussed. (shrink)

This line has been thought corrupt by most editors, though there is no agreement on the remedy. The Herald is plainly asking why the people at home are despondent: picks up the Chorus's phrase . But as Wilamowitz says, ‘ de populo aut senatu Argivorum accipi non potest’: it can only mean the army at Troy, as in lines 538 and 545. The usual inference is that arparw is corrupt.

Continuous recordings of brain electrical activity were obtained from a group of 176 patients throughout surgical procedures using general anesthesia. Artifact-free data from the 19 electrodes of the International 10/20 System were subjected to quantitative analysis of the electroencephalogram (QEEG). Induction was variously accomplished with etomidate, propofol or thiopental. Anesthesia was maintained throughout the procedures by isoflurane, desflurane or sevoflurane (N = 68), total intravenous anesthesia using propofol (N = 49), or nitrous oxide plus narcotics (N = 59). A set (...) of QEEG measures were found which reversibly displayed high heterogeneity of variance between four states as follows: (1) during induction; (2) just after loss of consciousness (LOC); (3) just before return of consciousness (ROC); (4) just after ROC. Homogeneity of variance across all agents within states was found. Topographic statistical probability images were compared between states. At LOC, power increased in all frequency bands in the power spectrum with the exception of a decrease in gamma activity, and there was a marked anteriorization of power. Additionally, a significant change occurred in hemispheric relationships, with prefrontal and frontal regions of each hemisphere becoming more closely coupled, and anterior and posterior regions on each hemisphere, as well as homologous regions between the two hemispheres, uncoupling. All of these changes reversed upon ROC. Variable resolution electromagnetic tomography (VARETA) was performed to localize salient features of power anteriorization in three dimensions. A common set of neuroanatomical regions appeared to be the locus of the most probable generators of the observed EEG changes. (shrink)

Objective: To report results from a national survey of coordinators and managers of clinical research studies in the US on their perceptions of and experiences with scientific misconduct.Methods: Data were collected using the Scientific Misconduct Questionnaire-Revised. Eligible responses were received from 1645 of 5302 surveys sent to members of the Association of Clinical Research Professionals and to subscribers of Research Practitioner, published by the Center for Clinical Research Practice, between February 2004 and January 2005.Findings: Overall, the perceived frequency of misconduct (...) was low. Differences were noted between workplaces with regard to perceived pressures on investigators and research coordinators, and on the effectiveness of the regulatory environment in reducing misconduct. First-hand experience with an incident of misconduct was reported by 18% of respondents. Those with first-hand knowledge of misconduct were more likely to report working in an academic medical setting, and to report that a typical research coordinator would probably do nothing if aware that a principal investigator or research staff member was involved in an incident of misconduct.Conclusion: These findings expand the knowledge on scientific misconduct by adding new information from the perspective of research coordinators. The findings provide some data supporting the influence of workplace climate on misconduct and also on the perceived effectiveness of institutional policies to reduce scientific misconduct. (shrink)

the aidos of phaedra and the meaning of the hyppolytus.

The present political structure of Nigeria has proved unfavourable to Nigerians. This has led to catastrophic situations in Nigeria. This article evaluates the role of the Church in the fight to curb these catastrophes in the form of rising spates of insecurity, corruption, separatist agitation and marginalisation. These challenges have led to serious underdevelopment, poverty and unemployment, mostly in South-East Nigeria. Nigeria’s inefficiency as a nation stems from a long history of poor leadership from the time of colonial rule until (...) today, partly because of the unbalanced political structure in the country. The history of poor leadership has denied Nigerians the opportunity of achieving a new Nigeria like other countries of the world. The study uses a descriptive historical approach to investigate this challenging situation. As a result of the lack of true federalism demonstrated in the lack of a proper political structure in the country, the study advocated for restructuring the country’s political structure to meet the immediate and long-term needs of all, especially in South-East Nigeria. Contribution: Many Nigerian scholars have researched on the need to restructure Nigerian polity, but there is a paucity of literature on the role of the Church to achieve this, leading to a dire want of research materials in this regard. This research, therefore, contributes its quota to the search for the lingering problems of Nigeria as a nation. (shrink)

This paperback edition of Dodds's standard edition of Plato's Gorgias is designed to meet the needs both of undergraduates and professional scholars. The text and apparatus criticus are based on a fresh survey of the evidence: two major manuscripts are here for the first time fully collated, and account has been taken both of new papyri and of the exceptionally rich indirect tradition. The text is supplemented by a full introduction giving details on the subject and structure of the dialogue, (...) its characters and intended historical setting, the real date of composition, and the background to Plato and Athens at the time of composition. The commentary, besides explaining Platonic usages and discussing textual points, aims to treat the historical, philosphical, and literary questions which arise from the text. (shrink)

This original and lively book explores Greek ideas about health and disease and their influence on Greek thought. Fundamental issues such as causation and responsibility, purification and pollution, mind-body relations and gender differences, authority and the expert and who can challenge them, reality and appearances, good government, happiness, and good and evil themselves are deeply implicated. Using the evidence not just from Greek medical theory and practice but also from epic, lyric, tragedy, historiography, philosophy, and religion, G. E. R. Lloyd (...) offers the first comprehensive account of the influence of Greek thought about health and disease on the Greek imagination. (shrink)

The attempts of Verrall and Tucker to discover, without resorting to emendation, a construction for the participles in v. 285 have convinced only their authors. All other recent scholars either postulate a lacuna before this line or transpose it to follow v. 288, if they do not delete it altogether. All alike assume that both participles describe the behaviour of the victim of the underworld powers.

As the later phases of Greek thought are at last beginning to receive in England and Ireland the attention they merit, it is hoped that the following critical notes on Plotinus may be of interest to a few readers. Some involve points of doctrine; others are intended to illustrate certain shortcomings of the German school, who have hitherto been practically the sole workers in the textual field.