Based on a survey of deans and marketing department chairs, this study explores the business and marketing curriculum in the areas of ethics, corporate social responsibility (CSR), and sustainability. The findings indicate that there was limited support for providing students with an understanding of these topics, in believing the concepts provide a competitive advantage in the job market, or would be utilized by students at a later point in their education. Finally, the value placed on research in these areas was (...) considerably less than on theory development or applied and pedagogical research. (shrink)

Published data show that new HIV prevention strategies including treatment‐as‐prevention and pre‐exposure prophylaxis (PrEP) using oral antiretroviral drugs (ARVs) are highly, but not completely, effective if regimens are taken as directed. Consequently, their implementation may challenge norms around HIV prevention. Specific concerns include the potential for ARV‐based prevention to reframe responsibility, erode beneficial sexual norms and waste resources. This paper explores what rights claims uninfected people can make for access to ARVs for prevention, and whether moral claims justify the provision (...) of ARV therapy to those who do not yet clinically require treatment as a way of reducing HIV transmission risk. An ethical analysis was conducted of the two strategies, PrEP and treatment‐as‐prevention, using a public health stewardship model developed by the Nuffield Bioethics Council to consider and compare the application of PrEP and treatment‐as‐prevention strategies. We found that treating the person with HIV rather than the uninfected person offers advantages in settings where there are limited opportunities to access care. A treatment‐as‐prevention strategy that places all the emphasis upon the positive person's adherence however carries a disproportionate burden of responsibility. PrEP remains an important option for receptive partners who face increased biological vulnerability. We conclude that the use of ARV for prevention is ethically justified, despite imperfect global to drugs for those in clinical need. The determination of which ARV‐based HIV prevention strategy is ethically preferable is complex and must take into account both public health and interpersonal considerations. (shrink)

Expressions of the form 'S is aware of the fact that p' are commonplace. This book provides a systematic exploration of the relation between knowledge and factual awareness, arguing that knowledge is but one species of factual awareness and that we can understand the possession of objective reasons, the normativity of knowledge, and the nature of knowledge in terms of factual awareness. In this way, the state of factual awareness is, structurally and substantively, a more basic type of state than (...) knowledge. If correct, this undermines a number of ways in which knowledge has been regarded as ‘first’ in recent epistemology. (shrink)

Vaccination is a highly effective public health strategy that provides protection to both individuals and communities from a range of infectious diseases. Governments monitor vaccination rates carefully, as widespread use of a vaccine within a population is required to extend protection to the general population through “herd immunity,” which is important for protecting infants who are not yet fully vaccinated and others who are unable to undergo vaccination for medical or other reasons. Australia is unique in employing financial incentives to (...) increase vaccination uptake, mainly in the form of various childcare payments and tax benefits linked to timely, age-appropriate vaccination. Despite relatively high compliance with the childhood vaccination schedule, however, the Australian government has determined that rates should be higher and has recently introduced policy that includes removing certain tax and childcare benefits for non-vaccinators and formally disallowing conscientious objection to vaccination. In addition, it has raised the possibility of banning unvaccinated children from childcare centres. This article examines the impact of coercive approaches to childhood vaccination and raises the question of the ethical justification of health policy initiatives based on coercion. We consider the current evidence regarding childhood vaccination in Australia, the small but real risks associated with vaccination, the ethical requirement for consent for medical procedures, and the potential social harms of targeting non-vaccinators. We conclude that the evidence does not support a move to an increasingly mandatory approach that could only be delivered through paternalistic, coercive clinical practices. (shrink)

In 2010, randomized controlled trials (RCTs) of two different biomedical strategies to prevent HIV infection had positive findings. However, despite ongoing very high levels of HIV infection in some countries and population groups, it has been made clear by regulatory authorities that the evidence remains insufficient to support either product being made available outside of research contexts in the developing world for at least two years. In addition, prevention trials in endemic areas will continue to test new interventions against placebo. (...) But the judgments of evidentiary standards are never value-neutral. Using the recent trials and their contexts as case studies, we examine the basis for these decisions, which will potentially delay access to scientific innovation to the people who are most urgently in need of it. (shrink)

The philosophical implication that guides the issue addressed here is the following: how does the principle of the common constitute a frontal apophasis to the principle of property in contemporary democracies? I do not pretend to offer an exhaustive answer to this problem. However, I use the argumentative strategy of dividing this paper into three sections: (i) theoretically investigate the dialectical tension between the principle of the common and the principle of property; (ii) analytically observe the premise that the behavioral (...) practices of exacerbated individualism contribute as an act of aversion to the principle of the common and (iii) dwell on the articulation of the notion of the principle of the common as a factor that is present on the threshold between the philosophical vulgar and philosophical universal. Finally, I form some considerations that problematize the naturalized notion of the principle of property in current democracies, in view of the constituent power that the principle of the common holds in the perspective of achieving the well-being of human agents in contemporary community life. (shrink)

The principle of providing post-trial access for research participants to successful products of that research is widely accepted and has been enshrined in various declarations and guidelines. While recent ethical guidelines recognise that the responsibility to provide post-trial access extends to sponsors, regulators and government bodies as well as to researchers, it is the researchers who have the direct duty of care to participants. Researchers may thus need to act as advocates for trial participants, especially where government bodies, sponsors, and (...) regulatory bodies have complex interests vested in decisions about whether or not new interventions are made available, how, and to whom. This paper provides an empirical account of post-trial access in the context of HIV prevention research. It describes both access to the successful products of research and the provision antiretroviral drugs for trial participants who acquire HIV. First, we provide evidence that, in the current system, there is considerable variation in the duration and timeliness of access. We then argue that by analysing the difficulties faced by researchers to this point, and their efforts to meet this obligation, much can be learned about how to secure post-trial access in HIV biomedical preventions trials. While researchers alone have a limited obligation, their advocacy on behalf of trial participants may be necessary to call the other parties to account. (shrink)

One legacy of post-Enlightenment dualism in the universe of academic discourse is the presence of two approached to notions of duality championed by two differing camps. One camp might arbitrarily be called debunkers; the other might be labeled rationalists. The strategies of the camps are conditioned by traditional notions of inside and outside. Debunkers consider themselves outsiders, beyond a deceptive show filled with tricky mirrors. Rationalists, by contrast, spend a great deal of time among mirrors, listening to explanations from the (...) overseers, attempting to absorb sideshow language, hoping to provide acceptable analytical accounts. If debunkers are intent on discovering generative and, presumably, hidden ideological inscriptions of a given discourse—its situation on what Amiri Baraka calls the “real side” of economic exchange and world exploitative power—rationalists are concerned to study discursive products, to decode or explain them according to forms and formulas that claim to avoid general views or judgments of ideology. Differentiating the camps also is what might be called a thermal gradient: the heat of the debunker’s passion is palpable. It is unnecessary to command him, in the manner of the invisible man’s tormentor, to “Get hot, boy! Get hot!” Rationalists, by contrast, do not radiate. They appear to have nothing personal at stake and remain coolly instructive and intelligently unflappable in their analyses.This tale of an Enlightenment legacy, as I have told it, contrasts a debunking body and rationalist soul. As I have suggested in my opening sentence, however, what is at issue is not so much two actual and substantially distinctive camps as two metonyms for dual approaches to a common subject—namely, notions of duality. My claim is that the Enlightenment reflexivity of academic discourse, devoted to, say, “the Other” and conceived in dualistic terms of self-and-other, expresses itself as an opposition. Thos whom I have called debunkers gladly accept the Other’s sovereignty as a bodily and aboriginal donnée; rationalists work to discover the dynamics of “othering” engaged in by a self-indulgent Western soul. The difficulty of producing usefully analytical or political results for either camp is occasioned by their joint situation within a post-Enlightenment field. Houston A. Baker, Jr. is the Albert M. Greenfield Professor of Human Relations at the University of Pennsylvania. He is a poet whose recent volume Blues Journeys Home appeared in 1985. He is also the author of a number of studies of Afro-American literature and culture, including the forthcoming Modernism and the Harlem Renaissance. (shrink)

The successful demonstration that antiretroviral (ARV) drugs can be used in diverse ways to reduce HIV acquisition or transmission risks – either taken as pre-exposure prophylaxis (PrEP) by those who are uninfected or as early treatment for prevention (T4P) by those living with HIV – expands the armamentarium of existing HIV prevention tools. These findings have implications for the design of future HIV prevention research trials. With the advent of multiple effective HIV prevention tools, discussions about the ethics and the (...) feasibility of future HIV prevention trial designs have intensified. This article outlines arguments concerning the inclusion of newly established ARV-based HIV prevention interventions as standard of prevention in HIV prevention trials from multiple perspectives. Ultimately, there is a clear need to incorporate stakeholders in a robust discussion to determine the appropriate trial design for each study population. (shrink)

Published data show that new HIV prevention strategies including treatment-as-prevention and pre-exposure prophylaxis (PrEP) using oral antiretroviral drugs (ARVs) are highly, but not completely, effective if regimens are taken as directed. Consequently, their implementation may challenge norms around HIV prevention. Specific concerns include the potential for ARV-based prevention to reframe responsibility, erode beneficial sexual norms and waste resources. This paper explores what rights claims uninfected people can make for access to ARVs for prevention, and whether moral claims justify the provision (...) of ARV therapy to those who do not yet clinically require treatment as a way of reducing HIV transmission risk. An ethical analysis was conducted of the two strategies, PrEP and treatment-as-prevention, using a public health stewardship model developed by the Nuffield Bioethics Council to consider and compare the application of PrEP and treatment-as-prevention strategies. We found that treating the person with HIV rather than the uninfected person offers advantages in settings where there are limited opportunities to access care. A treatment-as-prevention strategy that places all the emphasis upon the positive person's adherence however carries a disproportionate burden of responsibility. PrEP remains an important option for receptive partners who face increased biological vulnerability. We conclude that the use of ARV for prevention is ethically justified, despite imperfect global to drugs for those in clinical need. The determination of which ARV-based HIV prevention strategy is ethically preferable is complex and must take into account both public health and interpersonal considerations. (shrink)

When a belief is self-fulfilling, having it guarantees its truth. When a belief is self-defeating, having it guarantees its falsity. These are the cases of “self-impacting” beliefs to be examined below. Scenarios of self-defeating beliefs can yield apparently dilemmatic situations in which we seem to lack sufficient reason to have any belief whatsoever. Scenarios of self-fulfilling beliefs can yield apparently dilemmatic situations in which we seem to lack reason to have any one belief over another. Both scenarios have been used (...) independently to challenge Evidentialism, on which what we may rationally believe is all and only what fits our current evidence. Here we tie the two scenarios together and explore what a knowledge-sensitive evidentialist approach to one implies for the other. (shrink)

The study of metaphor is now firmly established as a central topic within cognitive science and the humanities. We marvel at the creative dexterity of gifted speakers and writers for their special talents in both thinking about certain ideas in new ways, and communicating these thoughts in vivid, poetic forms. Yet metaphors may not only be special communicative devices, but a fundamental part of everyday cognition in the form of 'conceptual metaphors'. An enormous body of empirical evidence from cognitive linguistics (...) and related disciplines has emerged detailing how conceptual metaphors underlie significant aspects of language, thought, cultural and expressive action. Despite its influence and popularity, there have been major criticisms of conceptual metaphor. This book offers an evaluation of the arguments and empirical evidence for and against conceptual metaphors, much of which scholars on both sides of the wars fail to properly acknowledge. (shrink)

The American Journal of Bioethics, Volume 11, Issue 12, Page 48-50, December 2011.

Charles Griswold has written a comprehensive philosophical study of Smith's moral and political thought. Griswold sets Smith's work in the context of the Enlightenment and relates it to current discussions in moral and political philosophy. Smith's appropriation as well as criticism of ancient philosophy, and his carefully balanced defence of a liberal and humane moral and political outlook, are also explored. This 1999 book is a major philosophical and historical reassessment of a key figure in the Enlightenment that will be (...) of particular interest to philosophers and political and legal theorists, as well as historians of ideas, rhetoric, and political economy. (shrink)

In many countries around the world, people who inject drugs remain at high risk of HIV acquisition not because effective forms of prevention are unknown, nor because they find effective prevention undesirable, but because those in charge, mainly politicians but also bureaucrats, find evidence-based practice politically unacceptable. The evidence for preventive efficacy of harm reduction strategies, most prominently needle and syringe programmes but also treatment programmes such as opiate substitution, is irrefutable.1 However, political responses to drug use issues are varied (...) and complex, so the will to implement appropriate harm reduction programmes in the interests of public health remains lacking in too many jurisdictions. As a consequence, the discussion of how best, in the context of research, to reduce HIV incidence in populations of people who inject drugs but are not offered comprehensive access to known prevention strategies is—tragically—an important one. Dawson et al 2 focus on access to sterile injecting equipment and recognise that this should remain the ‘default’ standard of prevention for HIV prevention trials involving people for whom injecting drug use is the primary risk factor for HIV acquisition. ‘Standard of prevention’ means the background or minimal HIV risk reduction interventions offered to all participants in a trial, regardless of what other investigational interventions they are assigned to receive. The standard of prevention concept is grounded in the ethical principle of beneficence—that researchers and sponsors are obliged to maximise benefits and minimise risks to participants in research studies.3 …. (shrink)

Remaining important tasks in finding and developing new drugs and vaccines for HIV/AIDS, malaria, cancer and other diseases require continued industry research and development. Industry’s research and development pipeline has produced drugs that have saved AIDS victims previously facing certain death, but still no cure nor vaccine is yet available. Experience with the process of research and development indicates that it requires more than a decade of development to produce a new drug with costs in the hundreds of millions of (...) dollars. Intellectual property protection is critically important in assuring that drug development continues. Partnerships between industry and the public sector have increased access to new therapies in developing countries and promise to enhance access to both patented and generic medicines in the future. (shrink)

[This is a paper that was originally written in 2017 and doesn't represent Silva's current thinking about degrees of confidence, conviction, and rationality.] Can there be knowledge and rational belief in the absence of a rational degree of confidence? Yes, and cases of "mistuned knowledge" demonstrate this. In this paper we leverage this normative possibility in support of advancing our understanding of the metaphysical relation between belief and credence. It is generally assumed that a Lockean metaphysics of belief that reduces (...) outright belief to degrees of confidence would immediately effect a unification of coarse-grained epistemology of belief with fine-grained epistemology of confidence. Scott Sturgeon has suggested that the unification is effected by understanding the relation between outright belief and confidence as an instance of the determinable-determinate relation. But determination of belief by confidence would not by itself yield the result that norms for confidence carry over to norms for outright belief unless belief and high confidence are token identical. We argue that this token-identity thesis is incompatible with the neglected phenomenon of “mistuned knowledge”—knowledge and rational belief in the absence of rational confidence. We contend that there are genuine cases of mistuned knowledge and that, therefore, epistemological unification must forego token identity of belief and high confidence. We show how partial epistemological unification can be secured given determination of outright belief by degrees of confidence even without token-identity. Finally, we suggest a direction for the pursuit of thoroughgoing epistemological unification. (shrink)

In clinical research there is a tension between the role of a doctor, who must serve the best interests of the patient, and the role of the researcher, who must produce knowledge that may not have any immediate benefits for the research participant. This tension is exacerbated in HIV research in low and middle income countries, which frequently uncovers comorbidities other than the condition under study. Some bioethicists argue that as the goals of medicine and those of research are distinct, (...) it is a mistake for researchers to assume therapeutic responsibilities while engaging in research. Others propose that there is a duty of care, but disagree as to how this is limited and specified. In this qualitative study, principal investigators from HIV prevention trials discuss their experience of providing medical benefits to participants within the context of conducting research into HIV biomedical prevention technologies. They describe the limitations imposed at times by funders and at times by infrastructure constraints, and canvass the importance of ancillary care provision and capacity building in trial communities. The views of the principal investigators are compatible with the perspective that there is a duty of care, limited by the nature of the research, the depth of the relationship between research and participant, and the capacity of the research site. The therapeutic orientation in HIV prevention trial appears to be indivisible from competent research practise by making concrete and appropriate benefits available to trial participants and their communities that support rather than compete with local infrastructure. (shrink)

Volume 20, Issue 10, October 2020, Page 47-49.

This papers deals with examples offered by Adams, Austin and others which seem to show that `if' does not conform to all of the laws of the conditional. These a reconciled by treating them as conjunctions with embedded modalities.

Interpreting Figurative Meaning critically evaluates the recent empirical work from psycholinguistics and neuroscience examining the successes and difficulties associated with interpreting figurative language. There is now a huge, often contradictory literature on how people understand figures of speech. Gibbs and Colston argue that there may not be a single theory or model that adequately explains both the processes and products of figurative meaning experience. Experimental research may ultimately be unable to simply adjudicate between current models in psychology, linguistics and philosophy (...) of how figurative meaning is interpreted. Alternatively, the authors advance a broad theoretical framework, motivated by ideas from 'dynamical systems theory', that describes the multiple, interacting influences which shape people's experiences of figurative meaning in discourse. This book details past research and theory, offers a critical assessment of this work and sets the stage for a new vision of figurative experience in human life. (shrink)

This article examines the relationship between bioethics and the therapeutic standards in HIV prevention research in the developing world, focusing on the closure of the pre-exposure prophylaxis (PrEP) trials in the early 2000s. I situate the PrEP trials in the historical context of the vertical transmission debates of the 1990s, where there was protracted debate over the use of placebos despite the existence of a proven intervention. I then discuss the dramatic improvement in the clinical management of HIV and the (...) treatment access movement, and consider how these contexts have influenced research practice. I argue that as HIV prevention trials oblige researchers to observe the rate at which vulnerable people under their care acquire HIV, there is an obligation to provide antiretroviral treatment to seroconverters and other health care benefits that fall within the scope of researchers' entrustment, both to avoid exploitation and to enact reciprocal justice. I argue against propositions that the obligations to provide specific benefits are vague, fall only upon researchers and sponsors, and create injustices by privileging the few over the many. Finally, I contend that the realisation of a broader standard of care in HIV prevention research broadens the role of research from being a simple tool to produce knowledge to a complex intervention that can play a part in the reduction of health disparities. (shrink)

This study investigated patient preferences for various types of physician persuasion strategies. Four types of persuasion strategies were utilized which involved combination of high and low levels of affectivity and information. In addition, patient variables, receiver apprehension and health beliefs were introduced to predict preference choices by patients. Results indicated that patients are influenced in their decision-making (preferences) by the type of persuasive strategy employed. Further, patients with different characteristics and predispositions prefer different persuasive strategies. The results of this study (...) suggest that the success of physician persuasiveness is dependent upon the type of strategy used and the type of patient being persuaded. (shrink)

Although the sunk‐cost effect is a well‐documented psychological phenomenon in monetary investments, existing literature investigating behavioral investments (e.g., time, effort) has not replicated this effect except when such investments relate to monetary values. The current explanation for this discrepancy proposes that purely behavioral sunk‐cost effects are unlikely to be observed because they are difficult to book, track, and balance in a mental account. Conversely, we argue that, through an effort‐justification mechanism, people account for the amount of behavioral resources invested when (...) selecting an alternative, in which case they may fall prey to purely behavioral sunk‐cost effects. The results of two experiments support this prediction. Because many decisions involve behavioral investments, behavioral sunk‐cost effects should be pervasive psychological phenomena. (shrink)

In his article ‘The Ebola Clinical Trials: a precedent for research ethics in disasters’, Philippe Calain constructs a compelling case as to why and how experiences from the recent Ebola epidemic should be used to develop a framework for disaster research ethics. In particular, Calain proposes a useful model for assessing whether or not an unproven intervention could be suitable for human use in a disaster context, and makes a powerful argument against the separation of patient care from research goals. (...) In this commentary, I argue that the separation of patient care goals from research goals is also unhelpful in the context of other forms of participant disadvantage even when that disadvantage is less severe than an ongoing public health emergency. I contend that recognising that research in disadvantaged populations is an intervention that could and should aim to produce positive outcomes for participants, just as it should in disaster contexts, therefore seems a well-justified lesson that can be extrapolated from the experience of the Ebola epidemic. (shrink)