In response to calls to expand the scope of research ethics to address justice in global health, recent scholarship has sought to clarify how external research actors from high-income countries might discharge their obligation to reduce health disparities between and within countries. An ethical framework—‘research for health justice’—was derived from a theory of justice (the health capability paradigm) and specifies how international clinical research might contribute to improved health and research capacity in host communities. This paper examines whether and how (...) external funders, sponsors, and researchers can fulfill their obligations under the framework. (shrink)

Community engagement is increasingly promoted as a marker of good, ethical practice in the context of international collaborative research in low-income countries. There is, however, no widely agreed definition of community engagement or of approaches adopted. Justifications given for its use also vary. Community engagement is, for example, variously seen to be of value in: the development of more effective and appropriate consent processes; improved understanding of the aims and forms of research; higher recruitment rates; the identification of important ethical (...) issues; the building of better relationships between the community and researchers; the obtaining of community permission to approach potential research participants; and, the provision of better health care. Despite these diverse and potentially competing claims made for the importance of community engagement, there is very little published evidence on effective models of engagement or their evaluation. (shrink)

It has been suggested that community advisory boards can play a role in minimising exploitation in international research. To get a better idea of what this requires and whether it might be achievable, the paper first describes core elements that we suggest must be in place for a CAB to reduce the potential for exploitation. The paper then examines a CAB established by the Shoklo Malaria Research Unit under conditions common in resource-poor settings – namely, where individuals join with a (...) very limited understanding of disease and medical research and where an existing organisational structure is not relied upon to serve as the CAB. Using the Tak Province Border Community Ethics Advisory Board as a case study, we assess the extent to which it might be able to take on a role minimising exploitation were it to decide to do so. We investigate whether, after two years in operation, T-CAB is capable of assessing clinical trials for exploitative features and addressing those found to have them. The findings show that, although T-CAB members have gained knowledge and developed capacities that are foundational for one-day taking on a role to reduce exploitation, their ability to critically evaluate studies for the presence of exploitative elements has not yet been strongly demonstrated. In light of this example, we argue that CABs may not be able to perform such a role for a number of years after initial formation, making it an unsuitable responsibility for many short-term CABs. (shrink)

Bioethicists have long debated the content of sponsors and researchers' obligations of justice in international clinical research. However, there has been little empirical investigation as to whether and how obligations of responsiveness, ancillary care, post-trial benefits and research capacity strengthening are upheld in low- and middle-income country settings. In this paper, the authors argue that research ethics guidelines need to be more informed by international research practice. Practical guidance on how to fulfil these obligations is needed if research groups and (...) other actors are to successfully translate them into practice because doing so is often a complicated, context-specific process. Case study research methods offer one avenue for collecting data to develop this guidance. The authors describe how such methods have been used in relation to the Shoklo Malaria Research Unit's vivax malaria treatment (VHX) trial (NCT01074905). Relying on the VHX trial example, the paper shows how information can be gathered from not only international clinical researchers but also trial participants, community advisory board members and research funder representatives in order to: (1) measure evidence of responsiveness, provision of ancillary care, access to post-trial benefits and research capacity strengthening in international clinical research; and (2) identify the contextual factors and roles and responsibilities that were instrumental in the fulfilment of these ethical obligations. Such empirical work is necessary to inform the articulation of obligations of justice in international research and to develop guidance on how to fulfil them in order to facilitate better adherence to guidelines' requirements. (shrink)

BackgroundCommunity engagement is increasingly promoted as a marker of good, ethical practice in the context of international collaborative research in low-income countries. There is, however, no widely agreed definition of community engagement or of approaches adopted. Justifications given for its use also vary. Community engagement is, for example, variously seen to be of value in: the development of more effective and appropriate consent processes; improved understanding of the aims and forms of research; higher recruitment rates; the identification of important ethical (...) issues; the building of better relationships between the community and researchers; the obtaining of community permission to approach potential research participants; and, the provision of better health care. Despite these diverse and potentially competing claims made for the importance of community engagement, there is very little published evidence on effective models of engagement or their evaluation.MethodsIn this paper, drawing upon interviews with the members of a Community Advisory Board on the Thai-Myanmar border, we describe and critically reflect upon an approach to community engagement which was developed in the context of international collaborative research in the border region.Results and conclusionsDrawing on our analysis, we identify a number of considerations relevant to the development of an approach to evaluating community engagement in this complex research setting. The paper also identifies a range of important ways in which the Community Advisory Board is in practice understood by its members to have morally significant roles and responsibilities beyond those usually associated with the successful and appropriate conduct of research. (shrink)

How international research might contribute to justice in global health has not been substantively addressed by bioethics. This article describes how the provision of ancillary care can link international clinical research to the reduction of global health disparities. It identifies the ancillary care obligations supported by a theory of global justice, showing that Jennifer Ruger’s health capability paradigm requires the delivery of ancillary care to trial participants for a limited subset of conditions that cause severe morbidity and mortality. Empirical research (...) on the Shoklo Malaria Research Unit’s (SMRU) vivax malaria treatment trial was then undertaken to demonstrate whether and how these obligations might be upheld in a resource-poor setting. Our findings show that fulfilment of the ancillary care obligations is feasible where there is commitment from chief investigators and funders and is strongly facilitated by SMRU’s dual role as a research unit and medical non-governmental organization. (shrink)

BackgroundThere is a growing concern about artificial intelligence (AI) applications in healthcare that can disadvantage already under-represented and marginalised groups (eg, based on gender or race).ObjectivesOur objectives are to canvas the range of strategies stakeholders endorse in attempting to mitigate algorithmic bias, and to consider the ethical question of responsibility for algorithmic bias.MethodologyThe study involves in-depth, semistructured interviews with healthcare workers, screening programme managers, consumer health representatives, regulators, data scientists and developers.ResultsFindings reveal considerable divergent views on three key issues. First, (...) views on whether bias is a problem in healthcare AI varied, with most participants agreeing bias is a problem (which we call the bias-critical view), a small number believing the opposite (the bias-denial view), and some arguing that the benefits of AI outweigh any harms or wrongs arising from the bias problem (the bias-apologist view). Second, there was a disagreement on the strategies to mitigate bias, and who is responsible for such strategies. Finally, there were divergent views on whether to include or exclude sociocultural identifiers (eg, race, ethnicity or gender-diverse identities) in the development of AI as a way to mitigate bias.Conclusion/significanceBased on the views of participants, we set out responses that stakeholders might pursue, including greater interdisciplinary collaboration, tailored stakeholder engagement activities, empirical studies to understand algorithmic bias and strategies to modify dominant approaches in AI development such as the use of participatory methods, and increased diversity and inclusion in research teams and research participant recruitment and selection. (shrink)

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

Perceptions of a firm’s stance on corporate social responsibility (CSR) are influenced by its corporate marketing efforts including branding, reputation building, and communications. The current research examines CSR from the consumer’s perspective, focusing on antecedents and consequences of perceived CSR. The findings strongly support the fact that particular cues, namely perceived financial performance and perceived quality of ethics statements, influence perceived CSR which in turn impacts perceptions of corporate reputation, consumer trust, and loyalty. Both consumer trust and loyalty were also (...) found to reduce the perceived risk that consumers experience in buying and using products. From these significant findings, we draw several conclusions and implications, including the importance of enhancing firm focus toward its ethical commitment and long-term reputation. (shrink)

Incidence and prevalence rates of dengue have increased over the years, and the disease is quickly becoming cause for concern within the public health community. Globally, 128 countries and slightly under four billion people are at risk of contracting dengue. In Sri Lanka, more than half of dengue cases originate in Colombo, which in previous years, used a manual pen-and-paper data management system, which meant that it was not possible to obtain or provide up-to-date information about the severity and spread (...) of dengue. In 2015, two versions of a mobile application called Mo-Buzz Dengue were developed and launched in Colombo, Sri Lanka in order to overcome the challenges of the traditional management system by capitalizing on the rising affordability and ubiquity of mobile phone technology. To keep up with the dynamic nature of disease outbreaks, real-time data need to be visualized in a manner which facilitates discerning and comprehending these patterns. Hence, we used health maps in Mo-Buzz to effectively present this information. The first version of Mo-Buzz was for public health inspectors, digitized data management as well as provided educational materials. The second version of Mo-Buzz was a source of information for the general public, a crowdsourcing platform to provide information relating to dengue transmission, and for health authorities to alert users to dengue-specific developments in their area. This paper illustrates the design considerations of the Mo-Buzz disease surveillance system for the general public. A draft scaled-down version of the PHI system was used to obtain feedback and make incremental design enhancements. Additionally, similar health maps were evaluated in terms of capability and usability. These findings were applied to identify future enhancements to the health map of Mo-Buzz Dengue. (shrink)

This paper is an update of the documents we have concerning the Acts of the Christian martyrs, focused on three main aspects: 1) the kind of acts we know of and their classification from the point of view of their historic value; 2) the versions or editions of the texts that are most accepted by scholars; 3) the relevance of the different parts that make up these documents in order to discern the original text from passages that were rewritten or (...) underwent later variations. In this way, the article offers an exhaustive list of the documents for use in researching Christian martyrs in the Roman period. (shrink)

In recent literature, panpsychism has been defended by appeal to two main arguments: first, an argument from philosophy of mind, according to which panpsychism is the only view which successfully integrates consciousness into the physical world (Strawson 2006; Chalmers 2013); second, an argument from categorical properties, according to which panpsychism offers the only positive account of the categorical or intrinsic nature of physical reality (Seager 2006; Adams 2007; Alter and Nagasawa 2012). Historically, however, panpsychism has also been defended by appeal (...) to a third argument based on considerations about the nature and observability of causation. This argument has not been much discussed in recent times. Here is a concise version from William James: "… the concrete perceptual flux, taken just as it comes, offers in our own activity-situations perfectly comprehensible instances of causal agency … If we took these experiences as the type of what actual causation is, we should have to ascribe to cases of causation outside of our life, to physical cases also, an inwardly experiential nature. In other words, we should have to espouse a so-called “pan-psychic” philosophy" (James 1911: 218). James here suggests that we have direct experience of causation in our own agency. He thereby directly contradicts David Hume, who famously denied that we have any experience of causation. James goes on to claim that if this experience is representative of causation in general, it follows that all causation is mental, and that panpsychism is true. This kind of argument for panpsychism can be called the argument from (experience of) causation. This chapter offers, first, a history of this argument and arguments closely related to it, and second, an analysis of the argument – is it valid, are its premises in any way defensible, and how does it relate to the other, more popular arguments for panpsychism from philosophy of mind and categorical properties? (shrink)

Ibn al-ʻArabī, 1165-1240; views on freedom; Sufism; Islamic philosophy.

Non-striving is an important aspect of mindfulness practice, but it has not been sufficiently researched. This study examine whether a strange loop based task — Infinite Water Scooping Task — performed for ten minutes, has an effect on non-striving behaviour and performance in a subsequent word length comparison task. Results showed that performance (number of correct trials) did not differ significantly between the two groups, though the experimental group tended to perform worse. However, participants in the experimental group took a (...) significantly shorter time to respond to the word length comparison task than those in the control group. It is inferred that shorter time taken reflects response without investing much effort to count with care, i.e. non-striving. The present study demonstrates that the brief strange loop task implemented in this study elicited non-striving behaviour compared to the effects of the control task and adds to the understanding of non-striving in the context of mindfulness. The Infinite Water Scooping Task may be useful for illustrating and teaching non-striving within mindfulness practice. (shrink)

In this paper, we analyse the current China urban and rural income disparity. Our analysis demonstrates that the Economic and Policy reforms instituted by the Chinese government over the past decade or so have had two primary aims: Firstly, to maintain political stability at all costs and secondly to transform China into a modern industrial state. To ensure political stability, it has eschewed the current Russian model for a unique Chinese model where state owned enterprises co-exist with market driven businesses. (...) This all began in 1978, after two disastrous near revolutions where the hard-line Marxist-Socialists had to concede that all was not well for the future of China, in a modern world. Beginning with the rural sector, where the pool of greatest poverty existed and improving in that sector firstly, allowed the market-oriented to greatly improve their incomes, thus changing the disparities between urban and rural economics. The period of 1985 to 2005 was a period of almost exponential growth, and the raising of millions out of poverty was only part of the positive results, but the greatest social negative was that inequality became worse, as is found in most Capitalist societies. There seems to be an initial jump in the incomes of rural China to jump out of poverty, but the effects have slowed, and it is now up to government agencies to aid the remaining impoverished to escape the traps of poverty through education and relocation incentives for industry, domestic and foreign. This does not mean throwing money at the problem, it means preventing destitution, as destitution adds to crime and other anti-social events and greatly increases instability, the anti-thesis of current Chinese policy. Perhaps the question ought to be a rethink of agricultural policies, to generate corporate farming, as opposed to collective farming, all in order to reduce rural poverty and make rural businesses into a proper and profitable sector of employment. (shrink)

Greek text, english translation and commentary on the surviving fragments of Empedocles (fragments as known in 1981, does not include more recent finds).

Contrary to Vaesen's argument that humans are unique with respect to nine cognitive capacities essential for tool use, we suggest that although such cognitive processes contribute to variation in tool use, it does not follow that these capacities arenecessaryfor tool use, nor that tool use shaped cognition per se, given the available data in cognitive neuroscience and behavioral biology.

Tom 1. Lekt︠s︡ii. Vospominanii︠a︡ -- t. 2. Filosofskai︠a︡ ontologii︠a︡ -- t. 3. Filosofskai︠a︡ ontologii︠a︡ segodni︠a︡; Nauchnye statʹi.

Wollstonecraft's early works express a coherent view of moral psychology, moral education and moral philosophy which guides the construction of her early fiction and educational works. It includes a valuable account of the relation between reason and feeling in moral development. Failure to recognize the complexity and coherence of the view and unhistorical readings have led to mistaken criticisms of Wollstonecraft's position. Part I answers these criticisms; Part II describes and textually supports her view.

What are conspiracy theories? And what, if anything, is epistemically wrong with them? I offer an account on which conspiracy theories are a unique way of holding a belief in a conspiracy. Specifically, I take conspiracy theories to be self-insulating beliefs in conspiracies. On this view, conspiracy theorists have their conspiratorial beliefs in a way that is immune to revision by counter-evidence. I argue that conspiracy theories are always irrational. Although conspiracy theories involve an expectation to encounter some seemingly disconfirming (...) evidence (allegedly planted by the conspirators), resistance to all counter- evidence cannot be justified on these grounds. (shrink)

There are obvious benefits to be gained from the study of logic: heightened ability to express ideas clearly and concisely, increased skill in defining one's terms, enlarged capacity to formulate arguments rigorously and to analyze them critically. But the greatest benefit, in my judgment, is the recognition that reason can be applied in every aspect of human affairs.

Should the insane and the mentally ill be held morally responsible for their actions? To answer ‘No’ to this question is to classify the mentally abnormal as not fully human: and indeed legal tradition has generally oscillated between assimilating the insane to brutes and assimilating them to children below the age of discretion, neither of these two categories being accountable in law for what they do. In what respect relevant to moral responsibility were the insane held to resemble brutes and (...) children? In the case of brutes, the answer seems to have been that the doings of the insane appeared to lack whatever it is that marks out human actions as distinctively human . What the insane did could not be thought of as issuing from deliberation, or as capable of having issued from deliberation, but seemed rather to be the result of the unbridled operation of nature — if a diseased nature. The natural comparison with insane killings seemed to be, for example, the killing of birds by cats. This distinction between animal doings and human actions does not depend on Cartesian views about the workings of animals; the operation of nature need not be thought of as mechanical. The thought is simply that where there is no room for deliberation there is no room for moral appraisal. Children, on the other hand, though capable of distinctively human action — i.e. of deliberating about what they do — were held not to be capable of the relevant kind of deliberation: for they were held ‘not to know the difference between right and wrong’. (shrink)

Should the insane and the mentally ill be held morally responsible for their actions? To answer ‘No’ to this question is to classify the mentally abnormal as not fully human: and indeed legal tradition has generally oscillated between assimilating the insane to brutes and assimilating them to children below the age of discretion, neither of these two categories being accountable in law for what they do. In what respect relevant to moral responsibility were the insane held to resemble brutes and (...) children? In the case of brutes, the answer seems to have been that the doings of the insane appeared to lack whatever it is that marks out human actions as distinctively human. What the insane did could not be thought of as issuing from deliberation, or as capable of having issued from deliberation, but seemed rather to be the result of the unbridled operation of nature — if a diseased nature. The natural comparison with insane killings seemed to be, for example, the killing of birds by cats. This distinction between animal doings and human actions does not depend on Cartesian views about the workings of animals; the operation of nature need not be thought of as mechanical. The thought is simply that where there is no room for deliberation there is no room for moral appraisal. Children, on the other hand, though capable of distinctively human action — i.e. of deliberating about what they do — were held not to be capable of the relevant kind of deliberation: for they were held ‘not to know the difference between right and wrong’. (shrink)