In acute inpatient mental health services, patients commonly demonstrate extreme behaviours. A number of coercive practices, such as locked doors, enforced medication and seclusion, are used in these settings to control such behaviours. The aim of this report is to explore briefly some of the contemporary debates pertaining to seclusion. A perusal of the literature reveals a clarion call to end the practice of seclusion, without consideration of feasible alternatives. It is hoped that this brief report will encourage further evidence-based (...) discussion and research initiatives on this important ethical topic. (shrink)

Locked inpatient units are an increasing phenomenon, introduced in response to unforseen abscondences and suicides of patients. This paper identifies some value issues concerning the practice of locked psychiatric inpatient units. Broad strategies, practicalities and ethical matters that must be considered in inpatient mental health services are also explored. The authors draw on the published research and commentary to derive relevant information to provide to patients and staff regarding the aims and rationales of locked units. Further debate is warranted in (...) relation to best practice. Inpatient staff need to be aware of their practice values, be able to access education and supervision and negotiate apparent contradictions. Further patient/clinician focused enquiry is necessary to mitigate the negative and stigmatising effects of locked mental health units. (shrink)

When clinical services aspire to quality improvement, creative and innovative approaches to old problems are needed to drive such change. Whilst new ef orts should be applauded, information on this topic can be somewhat grey from an ethical and research point of view. Within the mental health profession there is currently an expectation to routinely evaluate care and disseminate i ndings. The notion of service enhancements under the guise of routine practice is an interesting and untested ethical issue. Should clinical (...) innovation continue to enjoy such impunity as patient autonomy is often compromised as they are often compelled to accept treatment under the coercion of mental health legislation? We believe that it should not. All involvement in any form of research is voluntary, thus patients should also have the right to decline participation in quality projects if they wish to do so. (shrink)

Although previous ethical analyses of management buyouts have presented useful insights, they have been flawed in three major ways. First, they define the transaction too narrowly, emphasizing the going private aspect and ignoring the leveraged aspect. Leveraging alters the nature of the transaction substantially and warrants additional ethical analysis. Second, these previous analyses ignore the impact of buyouts on non-stockholder constituents of the firm, an omission which renders their implicit utilitarian approach incomplete. Third, these analyses do not include Rawlsian, libertarian, (...) or Kantian perspectives on ethics. This paper addresses these shortcomings and finds the ethical status of leveraged management buyouts to be highly suspect. (shrink)

Background: The search for genetic variants between racial/ethnic groups to explain differential disease susceptibility and drug response has provoked sharp criticisms, challenging the appropriateness of using race/ethnicity as a variable in genetics research, because such categories are social constructs and not biological classifications.Objectives: To gain insight into how a group of genetic scientists conceptualise and use racial/ethnic variables in their work and their strategies for managing the ethical issues and consequences of this practice.Methods: In-depth semi-structured interviews were conducted with a (...) purposive sample of 30 genetic researchers who use racial/ethnic variables in their research. Standard qualitative methods of content analysis were used.Results: Most of the genetic researchers viewed racial/ethnic variables as arbitrary and very poorly defined, and in turn as scientifically inadequate. However, most defended their use, describing them as useful proxy variables on a road to “imminent medical progress”. None had developed overt strategies for addressing these inadequacies, with many instead asserting that science will inevitably correct itself and saying that meanwhile researchers should “be careful” in the language chosen for reporting findings.Conclusions: While the legitimacy and consequences of using racial/ethnic variables in genetics research has been widely criticised, ethical oversight is left to genetic researchers themselves. Given the general vagueness and imprecision we found amongst these researchers regarding their use of these variables, they do not seem well equipped for such an undertaking. It would seem imperative that research ethicist move forward to develop specific policies and practices to assure the scientific integrity of genetic research on biological differences between population groups. (shrink)

Theoretical and empirical research in bioethics frequently focuses on ethical dilemmas or problems. This paper draws on anthropological and phenomenological sources to develop an alternative framework for bioethical enquiry that allows examination of a broader range of how the moral is experienced in the everyday lives of individuals and groups. Our account of moral experience is subjective and hermeneutic. We define moral experience as “Encompassing a person's sense that values that he or she deem important are being realised or thwarted (...) in everyday life. This includes a person's interpretations of a lived encounter, or a set of lived encounters, that fall on spectrums of right-wrong, good-bad or just-unjust”. In our conceptualisation, moral experience is not limited to situations that are heavily freighted with ethically-troubling ramifications or are sources of debate and disagreement. Important aspects of moral experience are played out in mundane and everyday settings. Moral experience provides a research framework, the scope of which extends beyond the evaluation of ethical dilemmas, processes of moral justification and decision-making, and moral distress. This broad research focus is consistent with views expressed by commentators within and beyond bioethics who have called for deeper and more sustained attention in bioethics scholarship to a wider set of concerns, experiences and issues that better captures what is ethically at stake for individuals and communities. In this paper we present our conceptualisation of moral experience, articulate its epistemological and ontological foundations and discuss opportunities for empirical bioethics research using this framework. (shrink)

While pharmaceutical industry involvement in producing, interpreting, and regulating medical knowledge and practice is widely accepted and believed to promote medical innovation, industry-favouring biases may result in prioritizing corporate profit above public health. Using diabetes as our example, we review successive changes over forty years in screening, diagnosis, and treatment guidelines for type 2 diabetes and prediabetes, which have dramatically expanded the population prescribed diabetes drugs, generating a billion-dollar market. We argue that these guideline recommendations have emerged under pervasive industry (...) influence and persisted, despite weak evidence for their health benefits and indications of serious adverse effects associated with many of the drugs they recommend. We consider pharmaceutical industry conflicts of interest in some of the research and publications supporting these revisions, and in related standard-setting committees and oversight panels. We raise concern over the long-term impact of these multifaceted involvements. Rather than accept industry conflicts of interest as normal, needing only to be monitored and managed, we suggest challenging that normalcy, and ask: what are the real costs of tolerating such industry participation? We urge the development of a broader focus to fully understand and curtail the systemic nature of industry’s influence over medical knowledge and practice. (shrink)

It is generally accepted that farmers manage a complex farm system. In this article we seek answers to the following questions. How do farmers perceive and understand their farm system? Are they sufficiently aware of their farm system that they are able to represent it in the form of a map? The research reported describes how causal mapping was applied to sheep/beef farmers in New Zealand and shows that farmers can create maps of their farm systems in ways that allow (...) expression of both individual maps and the formation of group maps which represent the general character of farm systems. A group map was made for all the farmers studied and for subgroups using conventional, integrated, and organic management systems. The results are discussed in terms of the depth of meaning associated with individual elements of the map, map complexity and the limitations of causal mapping. Causal mapping has the potential to contribute to our knowledge of how farmers see their farm systems, and this can benefit farmers and other stakeholders concerned with the management of farms and their economic and environmental performance. (shrink)

Humanitarian health care practitioners working outside familiar settings, and without familiar supports, encounter ethical challenges both familiar and distinct. The ethical guidance they rely upon ought to reflect this. Using data from empirical studies, we explore the strengths and weaknesses of two ethical models that could serve as resources for understanding ethical challenges in humanitarian health care: clinical ethics and public health ethics. The qualitative interviews demonstrate the degree to which traditional teaching and values of clinical health ethics seem insufficient (...) for addressing all the realities of health care practice during humanitarian missions. They equally suggest that greater good orientations of public health ethics can thwart the best intentions of health care professionals wanting to attend to the interests of individual patients. Even though neither is complete on its own for helping guide health professionals on field missions, taken together these models have much to offer. At the same time, the narratives of the humanitarian health care workers illustrate how some of the crucial differences between public health ethics and clinical ethics generate tensions in humanitarian health practice. We offer an analysis of some of the complexities this creates for humanitarian health care ethics, and consider ways of adjudicating between the two models. (shrink)

This article explores the accounts of Canadian-trained health professionals working in humanitarian and development organizations who considered not treating a patient or group of patients because of resource limitations. In the narratives, not treating the patient(s) was sometimes understood as the right thing to do, and sometimes as wrong. In analyzing participants’ narratives we draw attention to how medications and equipment are represented. In one type of narrative, medications and equipment are represented primarily as scarce resources; in another, they are (...) represented as patient care. In the contexts respondents were working, medications and equipment were often both patient care interventions and scarce resources. The analytic point is that health professionals tend to emphasize one conceptualization over the other in coming to assert that not treating is right, or wrong. Rendering tacit ethical frameworks more explicit makes them available for reflection and debate. (shrink)

Health care professionals who travel from their home countries to participate in humanitarian assistance or development work experience distinctive ethical challenges in providing care and services to populations affected by war, disaster or deprivation. Limited information is available about organizational practices related to preparation and support for health professionals working with non-governmental organizations. In this article, we present one component of the results of a qualitative study conducted with 20 Canadian health care professionals who participated in international aid work. The (...) findings reported here relate to expatriate clinicians’ experiences and perceptions of ethics preparation, training and support. The strategies examined include pre-departure training and preparation, in-field supports and retrospective debriefing of ethical issues. Participants experienced a range of training and supports as beneficial for addressing ethical challenges in humanitarian assistance and development work. Participants also expressed ambivalence or scepticism about the benefits offered by specific modalities. This analysis can contribute to informing discussions of how organizations and individual practitioners can best develop, implement and utilize ethics training and support for international aid work. (shrink)

(No abstract is available for this citation).

The conduct of research in settings affected by disasters such as hurricanes, floods and earthquakes is challenging, particularly when infrastructures and resources were already limited pre-disaster. However, since post-disaster research is essential to the improvement of the humanitarian response, it is important that adequate research ethics oversight be available. We aim to answer the following questions: 1) what do research ethics committee members who have reviewed research protocols to be conducted following disasters in low- and middle-income countries perceive as the (...) key ethical concerns associated with disaster research?, and 2) in what ways do REC members understand these concerns to be distinct from those arising in research conducted in non-crisis situations? This qualitative study was developed using interpretative description methodology; 15 interviews were conducted with REC members. Four key ethical issues were identified as presenting distinctive considerations for disaster research to be implemented in LMICs, and were described by participants as familiar research ethics issues that were amplified in these contexts. First, REC members viewed disaster research as having strong social value due to its potential for improving disaster response, but also as requiring a higher level of justification compared to other research settings. Second, they identified vulnerability as an overarching concern for disaster research ethics, and a feature that required careful and critical appraisal when assessing protocols. They noted that research participants’ vulnerabilities frequently change in the aftermath of a disaster and often in unpredictable ways. Third, they identified concerns related to promoting and maintaining safety, confidentiality and data security in insecure or austere environments. Lastly, though REC members endorsed the need and usefulness of community engagement, they noted that there are significant challenges in a disaster setting over and above those typically encountered in global health research to achieve meaningful community engagement. Disaster research presents distinctive ethical considerations that require attention to ensure that participants are protected. As RECs review disaster research protocols, they should address these concerns and consider how justification, vulnerability, security and confidentially, and community engagement are shaped by the realities of conducting research in a disaster. (shrink)

There has been a rising interest in the study of Mary Wollstonecraft (1759-1797) in philosophy, political theory, literary studies and the history of political thought in recent decades. The Wollstonecraftian Mind seeks to provide a comprehensive survey of her work, not only placing it in its historical context but also exploring its contemporary significance. Comprising 38 chapters by a team of international contributors this handbook covers: the background to Wollstonecraft’s work Wollstonecraft’s major works the relationship between Wollstonecraft and other major (...) philosophers Wollstonecraftian philosophy Wollstonecraft’s legacy Essential reading for students and researchers in philosophy, Wollstonecraft’s work is central to the study of political philosophy, literature, French studies, political thought, and feminism. (shrink)

When Wittgenstein moved from Manchester to Cambridge he was following a path from the study of the natural sciences to the study of philosophy which was then not unusual, and has since become increasingly common. Russell had preceded him in that intellectual emigration and many more were to follow. Of the three philosophy departments I have been in, two were headed by natural scientists . Both my research supervisors in philosophy were natural scientists . Less surprising, but still significant, a (...) considerable proportion of Presidents of the British Society for the Philosophy of Science were originally trained as natural scientists. Yet it is a subject still unrecognized by the Royal Society. The editors of both the British Journal for the Philosophy of Science and the journal Analysis were both originally natural scientists. Eminent scientists seem to feel impelled to discuss there own subjects in a wider context of philosophy. Bohr, Schrodinger, Kilmister, Hoyle, Hawking and Penrose, are but a few from a long list. (shrink)

When Wittgenstein moved from Manchester to Cambridge he was following a path from the study of the natural sciences to the study of philosophy which was then not unusual, and has since become increasingly common. Russell had preceded him in that intellectual emigration and many more were to follow. Of the three philosophy departments I have been in, two were headed by natural scientists. Both my research supervisors in philosophy were natural scientists. Less surprising, but still significant, a considerable proportion (...) of Presidents of the British Society for the Philosophy of Science were originally trained as natural scientists. Yet it is a subject still unrecognized by the Royal Society. The editors of both the British Journal for the Philosophy of Science and the journal Analysis were both originally natural scientists. Eminent scientists seem to feel impelled to discuss there own subjects in a wider context of philosophy. Bohr, Schrodinger, Kilmister, Hoyle, Hawking and Penrose, are but a few from a long list. (shrink)

Abstract It is argued that the problem of the necessity and projectability of laws may be solved by distinguishing between the fact of necessity and explanations of its nature. This reduces the problem of necessity to that of induction, which in consequences must be solved without reference to necessity using ?self?supporting? arguments. The consequences for the analysis of ?counterfactual conditionals and the problem of language dependence is discussed.

Physical pain has always been part of human experience, and throughout history it is recorded that doctors and wise men and women have sought to ease pain. The attitudes of those suffering pain, however, have varied from stoical acceptance to sullen endurance. Today, most people consciously seek to avoid pain or to have their pain eased, although they do not always expect what in fact appears to be possible. This study of 13 patients with protracted pain was carried out at (...) The London Hospital by a professional group to see how patients regarded their own pain and the efforts of doctors and nurses to relieve it. The attitudes of the doctors and nurses were also studied, and the results, despite the limitations of the survey, suggest that: [List: see text]. (shrink)

This study examines ethics-related learning outcomes that emerged from an experience-based project in a personal selling and sales management course. Using qualitative research methods, we classified students’ experiences according to domains of ethical issues associated with personal selling and according to conceptualizations of learning identified in the education literature. Patterns we observed in our data suggest that the experience-based project encouraged learners to employ higher-order thinking about business ethics. Higher order problem-solving about ethical issues helps ensure that lessons students learn (...) about ethical decision making carry forward to their professional careers. Based on our findings, we recommend ways instructors can formulate ethics-related learning objectives, develop learning assessments that measure ethics-related learning outcomes, and design teaching and learning activities that help ensure students learn ethical concepts in a way that will carry forward to their careers. (shrink)

The world I grew up in believed that change and development in life are part of a continuous process of cause and effect, minutely and patiently sustained throughout the millenniums. With the exception of the initial act of creation ..., the evolution of life on earth was considered to be a slow, steady and ultimately demonstrable process. No sooner did I begin to read history, however, than I began to have my doubts. Human society and living beings, it seemed to (...) me, ought to be excluded from so calm and rational a view. The whole of human development, far from having been a product of steady evolution, seemed subject to only partially explicable and almost invariably violent mutations. Entire cultures and groups of individuals appeared imprisoned for centuries in a static shape which they endured with long-suffering indifference, and then suddenly, for no demonstrable cause, became susceptible to drastic changes and wild surges of development. It was as if the movement of life throughout the ages was not a Darwinian caterpillar but a startled kangaroo, going out towards the future in a series of unpredictable hops, stops, skips and bounds. Indeed, when I came to study physics I had a feeling that the modern concept of energy could perhaps throw more light on the process than any of the more conventional approaches to the subject. It seemed that species, society and individuals behaved more like thunder-clouds than scrubbed, neatly clothed and well-behaved children of reason. Throughout the ages life appeared to build up great invisible charges, like clouds and earth of electricity, until suddenly in a sultry hour the spirit moved, the wind rose, a drop of rain fell acid in the dust, fire flared in the nerve, and drums rolled to produce what we call thunder and lightening in the heavens and chance and change in human society and personality.LAURENS VAN DER POST, The Lost World of the Kalahari. (shrink)

This 1990 collection explores one recurrent theme connecting philosophy and politics: the relation between the nature of man and the structure of society. It does so by concentrating on the topical issue of the market economy as an attempt to resolve the clash between individual autonomy and collective action. Beginning with a historical and personal recollection by Enoch Powell and a response by Robert Skidelsky, the volume then provides a forum for political theorists and philosophers to take issue on the (...) fundamental topics of markets and morals; liberal man; and equality and libertarianism. It succeeds equally as a stimulating textbook and a book for the general reader who wishes to understand the philosophical issues arising in a market economy. (shrink)

The sounds of the college campus raise important questions of participation, identity, privilege, disability, and marginalization. During the 2019–2020 academic year, three university instructors from distinct disciplines (music, history, and political science) and a student research assistant (history) used sound as a method for inquiring into contested and erased sites on the campus of Western Carolina University, a regional comprehensive university located in the southeastern United States. The project came to be called Sonic Histories. Paid student volunteers were led on (...) a soundwalk and completed three online questionnaires that engaged questions of race and belonging on campus. This study presents findings on how students experience and interpret contested and erased sites through sounds heard and imagined. Sonic Histories explores two central questions. Historically, whose voices have been included and whose have been excluded on college campuses? How can sound promote awareness of racialized spaces and, in turn, achieve social engagement? The authors challenge the triumphant narrative of campus histories, which highlights racial reconciliation and progress while eliding the ways predominantly white campuses still exclude minorities. By re-centering minority voices in campus spaces, the authors explore the systemic exclusion of minorities that has occurred on college campuses across the country. At a time when places of higher education are refining and developing their commitment to diversity and inclusivity—while assessing their past in honest ways—the Sonic Histories project builds upon ongoing initiatives to position the college campus as a scholarly community that lives up to its democratic ideals of inclusion. (shrink)

The concept of evolvability—the capacity of a population to produce and maintain evolutionarily relevant variation—has become increasingly prominent in evolutionary biology. Paleontology has a long history of investigating questions of evolvability, but paleontological thinking has tended to neglect recent discussions, because many tools used in the current evolvability literature are challenging to apply to the fossil record. The fundamental difficulty is how to disentangle whether the causes of evolutionary patterns arise from variational properties of traits or lineages rather than being (...) due to selection and ecological success. Despite these obstacles, the fossil record offers unique and growing sources of data that capture evolutionary patterns of sustained duration and significance otherwise inaccessible to evolutionary biologists. Additionally, there exist a variety of strategic possibilities for combining prominent neontological approaches to evolvability with those from paleontology. We illustrate three of these possibilities with quantitative genetics, evolutionary developmental biology, and phylogenetic models of macroevolution. In conclusion, we provide a methodological schema that focuses on the conceptualization, measurement, and testing of hypotheses to motivate and provide guidance for future empirical and theoretical studies of evolvability in the fossil record. (shrink)