In 2008, researchers reported that Timothy Brown , a man with HIV infection and leukemia, received a stem-cell transplant that removed HIV from his body as far as can be detected. In 2013, an infant born with HIV infection received anti-retroviral treatment shortly after birth, but was then lost to the health care system for the next six months. When tested for HIV upon return, the child had no detectable viral load despite cessation of treatment. These remarkable clinical developments have (...) helped reinvigorate the field of ‘HIV cure’ research. (shrink)

Connecting people across the digital divide is as much a social effort as a technological one. We are developing a community-centred approach to learn how interaction techniques can compensate for poor communication across the digital divide. We have incorporated the lessons learned regarding social intelligence design in an abstraction and in a device called the SoftBridge. The SoftBridge allows communication to flow from endpoints through adapters, getting converted if necessary, and out to destination endpoints. Field trials are underway with two (...) communities in South Africa: disadvantaged Deaf users and an isolated rural community. Initial lessons learned show that we have to design user interfaces that allow users to understand and cope with delay. We also learned that social concerns are often more important than the technical issues in designing such systems. (shrink)

As in other societies, medical professionalism in the Peoples’ Republic of China has been rapidly evolving. One of the major events in this process was the endorsement in 2005 of the document, “Medical Professionalism in the New Millennium: A Physician Charter,” by the Chinese Medical Doctor Association (hereafter, the Charter). More recently, a national survey, the first on such a large scale, was conducted on Chinese physicians’ attitudes toward the fundamental principles and core commitments put forward in the Charter. Based (...) on empirical findings from that study and comparing them to the published results of a similar American survey, the authors offer an in-depth interpretation of significant cross-cultural differences and important transcultural commonalities. The broader historical, socio-economic, and ethical issues relating to salient Chinese cultural practices such as family consent, familism (the custom of deferring decisions to family members), and the withholding of medical information, as well as controversial topics such as not respecting patients’ autonomy, are examined. The Chinese Survey found that Chinese physicians supported the principles of the Charter in general. Here we argue that Chinese culture and traditional medical ethics are broadly compatible with the moral commitments demanded by modern medical professionalism. Methodologically and theoretically—recognizing the problems inherent in the hoary but still popular habit of dichotomizing cultures and in relativism—a transcultural approach is adopted that gives greater (due) weight to the internal moral diversity present within every culture, the common ground shared by different cultures, and the primacy of morality. Genuine crosscultural dialogue, including a constructive Chinese-American dialogue in the area of medical professionalism, is not only possible, but necessary. (shrink)

MARXISM AND LIBERALISM edited by Ellen Frankel Paul, Fred D. Miller, Jr., Jeffrey Paul and John Ahrens New York: Basil Blackwell, 1986. 223 pp., $14?95 (paper) LIBERALISM by John Gray Minneapolis: University of Minnesota Press, 1986. 106 pp., $9.95 (paper).

THE LEFT AND RIGHTS: A CONCEPTUAL ANALYSIS OF SOCIALIST RIGHTS by Tom Campbell Boston: Routledge and Kegan Paul, 1983. 296 pp., $12.95 Campbell's attempt to construct a socialist version of rights and the rule of law fails because it does not draw on individualism. Campbell's positive rights are ineffective barrien to both the schemes of Utopian visionaries who command political authority and more mundane sources of the abuse of power. He leaves unanswered the question of who will determine the extent (...) of the ?needs?; that would constitute socialist rights, in the absence of unlimited resources to fulfill them. And his rejection of individualism ¡eaves him no means of adjudicating among conflicting positive claim?rights. (shrink)

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In The Medical Right, Remaking Medicine in Their Image (2007) (Medical Right Report or Report), the Religious Coalition for Reproductive Choice (RCRC) applies the term "Medical Right" to refer to religiously influenced medical, bioethics and health policy organizations of the Religious Right. This extremely important, well researched Report examines how the political agenda of the Religious Right, a political force comprised of fundamentalists primarily in the Protestant and Roman Catholic traditions, impacts reproductive health care. The growing influence of medical associations (...) that apply fundamentalist Christian "biblical values" to research and policy affecting reproductive health care is explored. The Report reveals that many consortiums, think tanks, institutes, and programs apply Religious Right ideology to medical concerns under the mantle of "bioethics" or "biomedical ethics." These groups work with conservative advocacy, outreach, and legal organizations, along with politicians, to advance the policy agendas of the Religious Right. The confluence of conservative politics, fundamentalist religion, and ideologically influenced medicine and science, poses a threat to reproductive health care services, as discussed in detail in the Report. While the Report is comprehensive in its discussion of the Religious Right's involvement in reproductive health issues, it addresses in only a cursory fashion how the Medical Right engages health law and policy governing end-of-life care. The purpose of this paper is to explore this area of concern more thoroughly. (shrink)

Military metaphors are pervasive in biomedicine, including HIV research. Rooted in the mind set that regards pathogens as enemies to be defeated, terms such as “shock and kill” have become widely accepted idioms within HIV cure research. Such language and symbolism must be critically examined as they may be especially problematic when used to express scientific ideas within emerging health-related fields. In this article, philosophical analysis and an interdisciplinary literature review utilizing key texts from sociology, anthropology, history, and Chinese and (...) African studies were conducted to investigate the current proliferation of military metaphors. We found the use of these metaphors to be ironic, unfortunate, and unnecessary. To overcome military metaphors we propose to give them less aggressive meanings, and/or replace them with more peaceful metaphors. Building on previous authors' work, we argue for the increased use of “journey” metaphors as meaningful, cross-culturally app... (shrink)

This book is a collection of secondary essays on America's most important philosophic thinkers—statesmen, judges, writers, educators, and activists—from the colonial period to the present. Each essay is a comprehensive introduction to the thought of a noted American on the fundamental meaning of the American regime.

Background Community advisory boards have expanded beyond high-income countries and play an increasing role in low- and middle-income country research. Much research has examined CABs in HICs, but less is known about CABs in LMICs. The purposes of this scoping review are to examine the creation and implementation of CABs in LMICs, including identifying frequently reported challenges, and to discuss implications for research ethics. Methods We searched five databases for publications describing or evaluating CABs in LMICs. Two researchers independently reviewed (...) articles for inclusion. Data related to the following aspects of CABs were extracted from included publications: time, country, financial support, research focus, responsibilities, and challenges. Thematic analyses were used to summarize textual data describing challenges. Results Our search yielded 2005 citations, 83 of which were deemed eligible for inclusion. Most studies were published between 2010 and 2017. Upper-middle-income countries were more likely to have studies describing CABs, with South Africa, China, and Thailand having the greatest numbers. The United States National Institutes of Health was the main source of financial support for CABs. Many CABs focused on HIV research. Thirty-four studies reported how CABs influenced the informed consent process for clinical trials or other aspects of research ethics. CAB responsibilities were related to clinical trials, including reviewing study protocols, educating local communities about research activities, and promoting the ethical conduct of research. Challenges faced by CABs included the following: incomplete ethical regulations and guidance; limited knowledge of science among members of communities and CABs; unstable and unbalanced power relationships between researchers and local communities; poor CAB management, including lack of formal participation structures and absence of CAB leadership; competing demands for time that limited participation in CAB activities; and language barriers between research staff and community members. Several challenges reflected shortcomings within the research team. Conclusions Our findings examine the formation and implementation of CABs in LMICs and identify several ethical challenges. These findings suggest the need for further ethics training among CAB members and researchers in LMICs. (shrink)

Trust is indispensable not only for interpersonal relationships and social life, but for good quality healthcare. As manifested in the increasing violence and tension in patient-physician relationships, China has been experiencing a widespread and profound crisis of patient–physician trust. And globally, the crisis of trust is an issue that every society, either developing or developed, has to face in one way or another. Yet, in spite of some pioneering works, the subject of patient-physician trust and mistrust – a crucial matter (...) in healthcare especially because there are numerous ethical implications – has largely been marginalized in bioethics as a global discourse. Drawing lessons as well as inspirations from China, this paper demonstrates the necessity of a trust-oriented bioethics and presents some key theoretical, methodological and philosophical elements of such a bioethics. A trust-oriented bioethics moves beyond the current dominant bioethical paradigms through putting the subject of trust and mistrust in the central agenda of the field, learning from the social sciences, and reviving indigenous moral resources. In order for global bioethics to claim its relevance to the things that truly matter in social life and healthcare, trust should be as vital as such central norms like autonomy and justice and can serve as a potent theoretical framework. (shrink)

To investigate the phenomenon of patient–physician mistrust in China, a qualitative study involving 107 physicians, nurses and health officials in Guangdong Province, southern China, was conducted through semi-structured interviews and focus groups. In this paper we report the key findings of the empirical study and argue for the essential role of medical professionalism in rebuilding patient-physician trust. Health professionals are trapped in a vicious circle of mistrust. Mistrust leads to increased levels of fear and self-protection by doctors which exacerbate difficulties (...) in communication; in turn, this increases physician workloads, adding to a strong sense of injustice and victimization. These factors produce poorer healthcare outcomes and increasingly discontented and angry patients, escalate conflicts and disputes, and result in negative media coverage, all these ultimately contributing to even greater levels of mistrust. The vicious circle indicates not only the crisis of patient-physician relationship but the crisis of medicine as a profession and institution. Underlying the circle is the inherent conflict of interest in the healthcare system by which health professionals and hospitals have become profit-driven. This institutional conflict of interest seriously compromises the fundamental principle of medical professionalism—the primacy of patient welfare—as well as the traditional Chinese ideal of “medicine as the art of humanity”. Patient trust can be restored through rectifying this institutional conflict of interest and promoting medical professionalism via a series of recommended practical measures. (shrink)

HIV remission clinical researchers are increasingly seeking study participants who are diagnosed and treated during acute HIV infection—the brief period between infection and the point when the body creates detectable HIV antibodies. This earliest stage of infection is often marked by flu-like illness and may be an especially tumultuous period of confusion, guilt, anger, and uncertainty. Such experiences may present added ethical challenges for HIV research recruitment, participation, and retention. The purpose of this paper is to identify potential ethical challenges (...) associated with involving acutely diagnosed people living with HIV in remission research and considerations for how to mitigate them. We identify three domains of potential ethical concern for clinicians, researchers, and ethics committee members to consider: 1) Recruitment and informed consent; (2) Transmission risks and partner protection; and (3) Ancillary and continuing care. We discuss each of these domains with the aim of inspiring further work to advance the ethical conduct of HIV remission research. For example, experiences of confusion and uncertainty regarding illness and diagnosis during acute HIV infection may complicate informed consent procedures in studies that seek to recruit directly after diagnosis. To address this, it may be appropriate to use staged re-consent procedures or comprehension assessment. Responsible conduct of research requires a broad understanding of acute HIV infection that encompasses its biomedical, psychological, social, and behavioral dimensions. We argue that the lived experience of acute HIV infection may introduce ethical concerns that researchers and reviewers should address during study design and ethical approval. (shrink)

RÉSUMÉ: La pragmatique et la sémantique de l’historiographie révèlent une fragmentation croissante qui s’étend par-delà les écoles jusqu’aux historiens individuels. Alors que les scientifiques normalisent les données pour qu’elles s’ajustent aux théories, les historiens interprètent leurs théories, de manières incompatibles entre elles, pour qu’elles s’ajustent aux différents cas historiques. Les difficultés qui en découlent dans la communication historiographique remettent en cause les philosophies herméneutiques de l’historiographie et redonnent un nouvel intérêt à la question d’une historiographie scientifique. Mais les réponses existantes (...) sont philosophiquement obsolètes. Une façon de reformuler le problème est de partir de la complexité du chaos et de l’unicité de l’histoire. Seule la science peut évaluer si les propriétés d’un domaine donné en interdisent une approche scientifique. Or la science s’étend par réductions méthodologiques explicatives, en ramenant des propriétés d’événements complexes, chaotiques et uniques, qui sont familières, mais d’un niveau plus élevé, à des propriétés ou interrelations non familières et d’un niveau moins élevé. La culture disciplinaire de l’historiographie, cependant, empêche le développement par essais et erreurs de telles tentatives de réductions scientifiques, qui seules permettraient d’évaluer les possibilités d’une historiographie scientifique, laquelle, dans la situation présente, relève de la science-fiction. (shrink)

Human behavioral ecology (HBE) began as an attempt to explain human economic, reproductive, and social behavior using neodarwinian theory in concert with theory from ecology and economics, and ethnographic methods. HBE has addressed subsistence decision-making, cooperation, life history trade-offs, parental investment, mate choice, and marriage strategies among hunter-gatherers, herders, peasants, and wage earners in rural and urban settings throughout the world. Despite our rich insights into human behavior, HBE has very rarely been used as a tool to help the people (...) with whom we work. This article introduces a special issue of Human Nature which explores the application of HBE to significant world issues through the design and critique of public policy and international development projects. The articles by Tucker, Shenk, Leonetti et al., and Neil were presented at the 104th annual meeting of the American Anthropological Association (AAA) in Washington, D.C., in December 2005, in the first organized session of the nascent Evolutionary Anthropology Section (EAS). We conclude this introduction by summarizing some theoretical challenges to applying HBE, and ways in which evolutionary anthropologists can contribute to solving tough world issues. (shrink)

RÉSUMÉ: Une justification d’institutions morales ou politiques doit fournir aux gens une motivation pour agir en conformité avec ses diktats. Cela étant admis, je soutiens que le contractualisme est la seule méthode plausible par laquelle une telle justification puisse être fournie. Les contractualistes soutiennent que les institutions morales ou politiques sont justifiées dans la mesure où elles seraient le résultat d’une entente conclue par des agents rationnels. Les agents rationnels agissent de façon à maximiser leur utilité attendue. Lorsque tous les (...) facteurs sont pris en considération, une entente conclue par des agents rationnels doit donc maximiser leur utilité attendue. À partir de cela, et de l’observation du lieu commun selon lequel des personnes différentes ont des préférences différentes, je soutiens que les justifications contractualistes sont relatives à la fois sur le plan normatif et sur le plan méta-éthique. Tant les règles ainsi justifiées que la procédure employée pour produire la justification doivent être identifiées relativement à des populations particulières. (shrink)

RésuméUne justification d'institutions morales ou politiques doit fournir aux gens une motivation pour agir en conformité avec ses diktats. Cela étant admis, je soutiens que le contractualisme est la seule méthode plausible par laquelle une telle justification puisse être fournie. Les contractualistes soutiennent que les institutions morales ou politiques sont justifiées dans la mesure où elles seraient le résultat d'une entente conclue par des agents rationnels. Les agents rationnels agissent de façon à maximiser lew utilité attendue. Lorsque tous les facteurs (...) sont pris en considération, une entente conclue par des agents rationnels doit done maximiser leur utilité attendue. À partir de cela, et de l'observation du lieu commun selon lequel des personnes différentes ont des préférences différentes, je soutiens que les justifications contractualistes sont relatives à la fois sur le plan normatif et sur leplan méta-éthique. Tant les règies ainsi justifiées que la procédure employée pour produire la justification doivent être identifiées relativement à des populations particulières. (shrink)

This article develops a multidimensional approach for the investigation of the ethical codes of professional associations. The authors: (a) examine various ethical frameworks to identify ethical constructs, (b) select ethical constructs to apply to the assessment of professional codes of ethics, (c) content analyze conceptual and descriptive similarities and differences across a large sample of professional codes of ethics, (d) address organizational variables that affect the development of ethical codes, and (e) investigate through survey research the beliefs and attitudes of (...) association leadership toward ethical code issues. The content analysis and survey research results have implications for association leadership, its membership, public policy makers, the general public and for future research. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Original Tao: Inward Training and the Foundations of Taoist MysticismJohn A. TuckerOriginal Tao: Inward Training and the Foundations of Taoist Mysticism. By Harold D. Roth. New York: Columbia University Press, 1999. Pp. v + 268. Hardcover $29.50.Searching for the origins of things remains a perennial favorite of Western scholars. For millennia, this quest has been at the core of innumerable scholarly projects. However, it has had significantly less (...) appeal to Asian thinkers, many of whom are more accustomed to assuming a continual presence or an eternal, cyclical recurrence, rather than an absolute beginning or creation ex nihilo from which all could be traced. Harold Roth's Original Tao: Inward Training and the Foundations of Taoist Mysticism continues this time-honored line of investigation, applying it to Taoist mystical writings, in a search for what Roth calls "the original tao." While such a line of research might appear perfectly reasonable to Western minds, it seems a bit incongruous with much of Taoist thought, especially when the latter is accepted and explained in terms of its own categories. For Taoists, of course, the uncarved block, the great thoroughfare, the tao itself, is the origin of all things, including mystical approaches to it and the human predicament.Given this anti-genealogical outlook, with its radical de-emphasis of texts and historical individuals, it should come as no surprise that the origins of Taoism are as murky, and hints about the same as misleading, as any could possibly be. The legendary figure Lao Tzu, now widely recognized as a fabricated philosopher meant to supply a set of presumably whimsical origins, and thus mock the appeal to them, is a case in point. Another might be the Chuang Tzu's satirically progressive deconstruction of the notion of a "beginning to being" via positing an infinite regress of beginnings that have not yet begun to be.1 Despite this, there remains the determination (and Roth is by no means alone here) to discover what has been hidden, perhaps intentionally. Without meaning to compromise this quest, we nevertheless might well ask whether the search does not somehow impair its own integrity as a [End Page 307] statement about the subject being explored. Put another way, is not the way that can be discussed the true way?Methodologically, Roth's book is "a study in 'textual archaeology' " that seeks to uncover "long-lost or long-overlooked texts and the interpretation of their significance" (p. 3). Its focus is on a collection of philosophical verses titled Nei-yeh (Inward training), which, as Roth notes, A. C. Graham earlier characterized as "possibly the oldest mystical text in China" (p. 2). While basing his analyses in part on textual, historical, and hermeneutic insights that have resulted from the relatively recent discovery of the Ma-wang-tui manuscripts, Roth's purported discovery of "the original tao" emerged not from the literal, archaeological unearthing of a text hitherto unknown, but from a new level of interpretive, historical appreciation of a writing long known to exist, Inward Training.Inward Training had been known, however, as a portion of the Kuan Tzu, a work typically characterized as "legalist" in philosophical orientation. By analyzing Inward Training via a "mystical hermeneutic," Roth suggests that the verses composing it are not just so much ancient metaphysical poetry, but instead derived from a group of devoted practitioners of breathing meditation who conceptualized their discipline through metaphysical notions regarding both the cosmos and human nature. According to Roth, these practitioners subscribed to the "guiding and pulling" methods often associated with "dietary and sexual regimens," practices later criticized in texts such as the Chuang Tzu and Huai-nan Tzu. The cosmology generated by these practitioners, and recorded in Inward Training, was, notably enough, similar to what emerged later in the Lao Tzu, a text mistakenly considered, for millennia, to be the origin of the way. Thus Roth resituates Inward Training, moving it from the more recent peripheries of antiquity to the very headwaters of the ancient tradition, as the original way.In radically rethinking the beginnings of Taoism without invoking the traditionally accepted but apparently ahistorical claims of a Lao-Chuang filiation, Roth proposes a new... (shrink)

Il est èvidemment très difficile dans un compte rendu de deux pages de souligner les arêtes principales d'un livre, surtout lorsque celui-ci est ondoyant comme l'est Philosophy and Myth in Karl Marx de Robert Tucker. A première vue, on est saisi par l'unité du développement présenté et par la cohérence des arguments invoqués. Mais dans l'état actuel de la marxologie, est-il possible de ne pas sursauter devant les sereines prises de position de Tucker et d'oublier de mentionner qu'il (...) y a peut-être d'autres perspectives d'interprétation? (shrink)

A substantial guide providing an overview of both physicalism and metaphysical naturalism, reviewing both questions of formulation and justification for both doctrines. Includes a diagnostic strategy for understanding talk of naturalism as a metaphysical thesis.