It is both an ethical and a legal requirement that patients who participate in clinical trials must generally give their consent. As part of this process, patients must be provided with adequate information to enable them to decide whether or not to take part. In the UK, the pharmaceutical companies that sponsor such research, as well as Local Research Ethics Committees, specify in detail the information that must be given to trial participants. The researchers who conduct clinical trials inevitably form (...) views on the amount of information they are required to provide, and about patients’ comprehension of that information. The literature in this area suggests that some medical researchers may be unhappy with the amount of information that they must give patient participants. There have been, however, few systematic attempts to determine their views. This paper reports a study that explored researchers’ views as to (i) the amount of information provided to trial participants, and (ii) participants’ understanding of that information. Researchers generally felt that they were required to give trial participants an appropriate amount of information, and that most patients had at least a reasonable understanding of key aspects of the clinical trials’ process. However, there were differing views as to the level of information that they felt patients themselves wanted. The researchers did not generally feel that the patients’ inability to comprehend information rendered the process of obtaining ‘informed consent’ a waste of time. However, some did believe that they were required to burden patients with excessive information. (shrink)

The popularity and profitability of American gridiron football is beyond dispute. Recent polls put football as the overwhelming favorite of people who follow at least one sport and huge revenues are reported at both the professional and the university level. We know, however, that what is the case tells us little about what ought to be the case, and it is to the latter question that this paper is directed. I offer a three-pronged attack on the ethical acceptability of American (...) football, both amateur and professional, based on harm to the players, objectification of the players, and harm to others done by the players, leading to the conclusion that the sport, as currently constituted, is morally unacceptable. (shrink)

Background: According to the Declaration of Helsinki, patients who take part in a clinical trial must be adequately informed about the trial's aims, methods, expected benefits, and potential risks. The declaration does not, however, elaborate on what “adequately informed” might amount to, in practice. Medical researchers and Local Research Ethics Committees attempt to ensure that the information which potential participants are given is pitched at an appropriate level, but few studies have considered whether the patients who take part in such (...) trials feel they have been given adequate information, or whether they feel able to understand that information.Objectives: To explore trial participants' views on the amount of information provided, and of their own understanding of that information.Design: Structured interviews of patients participating in clinical trials for the treatment of chronic medical condition.Findings: Patients generally felt they were given an appropriate amount of information, and that they were able to understand all or most of it. They felt they were given adequate time to ask questions before agreeing to take part. In comparison with treatment given outwith the research setting, patients generally felt they received more information when participating in a clinical trial.Conclusions: Researchers sometimes complain that patients are given too much information during clinical trials, and have limited understanding of that information. The present study shows that this perception is not necessarily shared by patients. More research is needed in this area, particularly to gauge whether patient understanding is indeed accurate. (shrink)

Take Five' helps you tap the roots of an ancient diagnostic system of medical philosophy known as 'The Law of the Five Elements', based on Wood, Fire, Earth, Metal and Water and their respective seasons Spring, Summer, Late Summer, Autumn and Winter.

In response to calls for more research on how to prevent or detect fraud (ACAP, Final Report of the Advisory Committee on the Auditing Profession, United States Department of the Treasury, Washington, DC, 2008 ; AICPA, SAS No. 99: Consideration of Fraud in a Financial Statement Audit, New York, NY, 2002 ; Carcello et al., Working Paper, University of Tennessee, Bentley University and Kennesaw State University, 2008 ; Wells, Journal of Accountancy, 2004 ), we develop a framework that identifies three (...) psychological pathways to fraud, supported by multiple theories relating to moral intuition and disengagement, rationalization, and the role played by negative affect. The purpose of developing the framework is twofold: (1) to draw attention to important yet under-researched aspects of ethical decision-making, and (2) to increase our understanding of the psychology of committing fraud. Our framework builds on the existing fraud triangle (PCAOB, Consideration of fraud in a financial statement audit. AU Section 316, www.pcaobus.org , 2005 ) which is used by auditors to assess fraud risk. The fraud triangle is composed of three factors that, together, predict the likelihood of fraud within an organization: opportunity, incentive/pressure, and attitude/rationalization. We find that, when faced with the opportunity and incentive/pressure, there are three psychological pathways to fraud nestled within attitude/rationalization: (1) lack of awareness, (2) intuition coupled with rationalization, and (3) reasoning. These distinctions are important for fraud prevention because each of these paths is driven by a different psychological mechanism. This framework is useful in a number of ways. First, it identifies certain insidious situational factors in which individuals commit fraud without recognizing it. Second, it extends our knowledge of rationalization by theorizing that individuals use rationalization to avoid or reduce the negative affect that accompanies performing an unethical behavior. Negative affect is important because individuals wish to avoid it. Third, it identifies several other methods fraudsters use to reduce negative affect, each of which could serve as potential “psychological red flags” and helps predict future fraudulent behavior. Finally, our framework can be used as a theoretical foundation to explore several interventions designed to prevent fraud. (shrink)

As such, this volume establishes a renewed sense of aesthetic discourse and its usefulness as a tool for understanding culture.

We examine the impact of an ethics education program on reporting behavior using two groups of students: fourth year Masters of Accounting students who just completed a newly instituted ethics education program, and fifth year students in the same program who did not receive the ethics program. In an experiment providing both the opportunity and motivation to misreport for more money, we design two social condition treatments – anonymity and public disclosure – to examine whether or to what extent ethical (...) values are internalized by students. We find that when participants are anonymous, misreporting rates are nearly the same regardless of ethics program participation. However, when their reporting behavior is made public to the cohort, participants who completed the ethics program misreported at significantly lower rates than those who did not receive the ethics program. The results suggest that ethics education does not necessarily result in internalized ethical values, but it can impact ethical behavior. (shrink)

The term “Socratic method” is so pervasive in education across the disciplines that it has largely lost its meaning, and it has lost its roots in its originator—the historical Socrates. In this article we draw from the original source, Plato's ancient dialogues, to understand the theory and principles behind the questioning used in Socratic method. A deep understanding of Socratic method is particularly timely now as nursing leaders call for increased use of theory‐based debriefing across the nursing curriculum. Socratic questioning (...) is ideally suited as a method for debriefing in nursing classrooms because of its ability to enhance critical thinking and self‐reflection of the learner and because of its basis in care for the learner through a learner‐centred design. We present an analysis of the Socratic method in Plato's works and provide an overview of the key Socratic principles and techniques. We illustrate these principles and techniques with examples of how Socratic teaching can be applied in the nursing classroom, and we address the challenges and rewards for nursing faculty implementing Socratic method. Learning about Socratic method directly from Plato's dialogues can provide a richer and more robust understanding of this key pedagogical technique and help nurse educators practice more intentional and informed Socratic questioning and debriefing. (shrink)

We examine the impact of activated versus non-activated ethical norms on the aggressiveness of accounting decisions, in the presence of self-interest favoring aggressiveness. Using a case in which the accounting rules are ambiguous, we ask professional accountants to make an accounting decision as though they were in their own organization; we measure the ethical norms of their organization at the end of the experiment. Based on the focus theory of normative conduct, we argue that the general ethical norms of the (...) participants’ organizations are activated when the decision structure is such that the participant receives a recommendation from a subordinate, whereas those norms are not activated when the participant is making the decision alone. We find that higher ethical norms decrease aggressiveness when the decision maker receives a recommendation, whereas higher ethical norms have no impact on aggressiveness when the decision maker makes the decision alone. Our results demonstrate that general ethical norms, known to impact decisions having clear ethical content, can also curb accounting aggressiveness when these norms are activated. Furthermore, firm practices such as decision structure can activate norms. These findings are of interest to practitioners and regulators who seek to temper aggressive accounting. (shrink)

Several cases which have been considered by the courts in recent years have highlighted the legal dilemmas facing doctors whose decisions result in the ending of a patient's life. This paper considers the case of Dr Cox, who was convicted of attempting to murder one of his patients, and explores the roles of motive, diminished responsibility and consent in cases of "mercy killing". The Cox decision is compared to that of Tony Bland and Janet Johnstone, in which the patients were (...) in a persistent vegetative state. In all three cases, the doctors believed that their patients' quality of life was so poor that their continued existence was of no benefit to them, and decided that their lives should not be unduly prolonged, yet the doctor who was prosecuted was the one whose dying patient had requested that her death be hastened. The paper examines the law's seemingly contradictory approaches to such cases. (shrink)

Examines the relationship between making objects and knowing nature in Europe from the mid-15th to mid-19th centuries.

Since the early 1980’s, with the clinical advent of in vitro fertilization resulting in so-called “test tube babies,” a wide array of ethical considerations and concerns regarding artificial womb technology (AWT) have been described. Recent breakthroughs in the development of extracorporeal neonatal life support by means of AWT have reinitiated ethical interest about this topic with a sense of urgency. Most of the recent ethical literature on the topic, however, pertains not to the more imminent scenario of a physiologically improved (...) method of neonatal care through AWT, but instead to the remote scenario of “complete ectogenesis” that imagines human gestation occurring entirely outside of the womb. This scoping review of the ethical literature on AWT spans from more abstract concerns about complete ectogenesis to more immediate concerns about the soon-to-be-expected clinical life support of what we term the fetal neonate or fetonate. Within an organizing framework of different stages of human gestational development, from conception to the viable premature infant, we discuss both already identified and newly emerging ethical considerations and concerns regarding AWT and the care of the fetonate. (shrink)

Background Despite decades of anti-racism and equity, diversity, and inclusion (EDI) interventions in academic medicine, medical racism continues to harm patients and healthcare providers. We sought to deeply explore experiences and beliefs about medical racism among academic clinicians to understand the drivers of persistent medical racism and to inform intervention design. Methods We interviewed academically-affiliated clinicians with any racial identity from the Departments of Family Medicine, Cardiac Sciences, Emergency Medicine, and Medicine to understand their experiences and perceptions of medical racism. (...) We performed thematic content analysis of semi-structured interview data to understand the barriers and facilitators of ongoing medical racism. Based on participant narratives, we developed a logic framework that demonstrates the necessary steps in the process of addressing racism using if/then logic. This framework was then applied to all narratives and the barriers to addressing medical racism were aligned with each step in the logic framework. Proposed interventions, as suggested by participants or study team members and/or identified in the literature, were matched to these identified barriers to addressing racism. Results Participant narratives of their experiences of medical racism demonstrated multiple barriers to addressing racism, such as a perceived lack of empathy from white colleagues. Few potential facilitators to addressing racism were also identified, including shared language to understand racism. The logic framework suggested that addressing racism requires individuals to understand, recognize, name, and confront medical racism. Conclusions Organizations can use this logic framework to understand their local context and select targeted anti-racism or EDI interventions. Theory-informed approaches to medical racism may be more effective than interventions that do not address local barriers or facilitators for persistent medical racism. (shrink)

The 2011 Historical Materialism Conference in London saw the launch of a Marxist-Feminist set of panels. This issue is inspired by the success of those panels, and the remarkably sustained interest in reviving and moving beyond older debates and discussions. The special issue’s focus, Social-Reproduction Feminism, reflects and contextualises the ongoing work and engagement with that thematic that has threaded through the conferences in the 2010s. This Introduction provides a summary overview of the Social-Reproduction Feminism framework, situating it within Marxist-Feminist (...) thinking and politics more generally, and calls on readers to consider its promise and potential as an historical-materialist approach to understanding capitalist social relations in terms of an integrated totality. (shrink)

An extensive body of Chinese philosophical thought suggests a redefinition of international security in terms of a non-threatening formulation of Comprehensive Security. In one culture viewed as particularly 'strategic', i.e. Chinese culture, we find strong traditions of inclusive, non-aggressive forms of security. Mo Tzu and the school of Mohism (5th-3rd centuries BC) developed a rigorous body of thought and practice based on universal regard, the protection of small states, and disesteem for aggressive wars. This is paralleled by a more general (...) emphasis in the classical Chinese philosophical and political tradition on the means of civilisation (wen) over the methods of brute warfare (wu). In modem regional crises such as the dispute between Taiwan and the PRC (People's Republic of China), it is crucial to engage the wen (cultured) aspect of the political tradition. In this context, deterrence of aggression by reciprocal threats is only a short-term solution. (shrink)

This book examines the politics, philosophy, and history of Chinese power, focusing on social, strategic, and diplomatic trends that have shaped China for over three thousand years. By probing political and philosophical trends, it provides an alternative analysis for the rise of contemporary China.