This chapter contains sections titled: European Positivism Latin American Positivism Martí Rodó Vaz Ferreira Ingenieros References Further Reading.

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:The Evolution of Pragmatism in India: Ambedkar, Dewey, and the Rhetoric of Reconstruction by Scott R. StroudAlbert R. SpencerBy Scott R. StroudThe Evolution of Pragmatism in India: Ambedkar, Dewey, and the Rhetoric of Reconstruction Chicago and London: The University of Chicago Press, 2023. 302 pp., incl. indexMore scholarly attention needs to be paid to the mutual influences between Asian and American thought, especially with regards to the development, (...) legacy, and future of pragmatism. Fortunately, there have been several notable attempts. Throughout his works, Richard Shusterman frequently incorporates the perspectives of various East Asian philosophies into his articulation of somaesthetics. Multiple scholars have explored John Dewey’s lectures in China and their political and educational impact, such as Jessica Ching-Sze Wang’s John Dewey in China or The Democracy of the Dead by Roger T. Ames and David L. Hall. Still others have highlighted the influence of Indian thought on pragmatism’s forerunners, such as American Philosophy Before Pragmatism (Goodman 2015), American Pragmatism: An Introduction (Spencer 2020), and The Ethics of Oneness (Engles 2021). Perhaps the most interesting inquiries into this influence can be found in a special volume of The Journal of Aesthetic Education (Vol. 43, No. 1) where multiple scholars discuss pragmatism’s connections and comparisons to The Bhagavad Gita, Confucianism, and Taoism. Among these scholars is Scott Stroud whose most recent publication The Evolution of Pragmatism in India (2023) represents the culmination of nearly two decades of research on the subject with special attention to the continuities between pragmatism and Indian thought. In it, he meticulously explores the influence of John Dewey on one of his students, Bhimrao Ambedkar (1891–1956), who was a transformative figure in the founding of the nascent Republic of India. The result is a work of scholarship that shows the global relevance of pragmatism in the 20th Century, [End Page 456] introduces the fascinating philosophy of Ambedkar to a non-Indian audience, and provides an entry for further scholarship on this profound thinker and activist.Bhimrao Ambedkar was a critical figure in the birth of modern India. Born an “untouchable” due to the rigid caste system, he tirelessly advocated for the right of Dalits (“crushed” or “untouchables”). By the mid-20th century, he had greatly influenced Indian politics, safeguarded the interests of the oppressed, and played a key role in drafting the Indian Constitution. Separate to his role as a statesman, Ambedkar promoted Buddhism in the 1950s as an escape from caste oppression, culminating in his publication, The Buddha and His Dhamma (1957). While his name is less familiar outside of India, he was voted the “Greatest Indian” in a 2012 poll due to his profound impact on the nation’s post-independence development. These accomplishments were supported by an extensive education, but unlike most subjects of the British Empire, Ambedkar also studied in the United States. Stroud initiates his study by focusing on this formative period, specifically his time at Columbia University and the influence of the philosopher and psychologist John Dewey. While their relationship has been acknowledged, Stroud is the first to explore this relationship in depth and he not only reconstructs the influence of Dewey on Ambedkar’s Navayana Pragmatism but illuminates the ways that Ambedkar integrated, modified, and even resisted Dewey’s pragmatism.Stroud masterfully builds his reconstruction of this synergy between Dewey’s pragmatism and Ambedkar’s philosophy not out of ephemeral conjecture or pithy textual evidence, but through painstaking, detailed, and exhaustive scholarship. He draws on comparative evidence in their major and minor works, their private correspondence, interviews of Ambedekar’s cohort at Columbia, Dewey’s voluminous lecture notes, and even the marginalia and notecards found between the pages of Ambedkar’s pragmatism bookshelf. Indeed, I often found myself pleasantly distracted as I imagined Stroud’s academic pilgrimage throughout India, Columbia University, and the Center for Dewey Studies to find every scrap of relevant information. In our age of instant information and digital archives, it is refreshing and inspiring to encounter a scholar still willing to trek across the globe for answers to his inquiries. Despite his passion to uncover the influence of Dewey on Ambedekar, Stroud never reduces the... (shrink)

The FDA's new table of surrogate endpoints used for drug approvals is an important step forward for overseeing the use of biomarkers in clinical trials. Nevertheless, we present several ways in which the table can be improved.

Many hold that the so-called golden era of antibiotic discovery has passed, leaving only a limited clinical pipeline for new antibiotics. A logical conclusion of such arguments is that we need to reform the current system of antibiotic drug research—including clinical trials and regulatory requirements—to spur activity in discovery and development. The United States Congress in the past few years has debated a number of bills to address this crisis, including the 2012 Generating Antibiotic Incentives Now Act and the 2016 (...) 21st Century Cures Act. Experts have also sought to advance antibiotic development by encouraging greater use of trials with noninferiority hypotheses, which are thought to be easier to conduct. The goal underlying these proposals is to stave off the post-antibiotic era by expanding the pharmaceutical armamentarium as quickly as possible. But although new antibiotic agents are necessary to combat the long-term threat of drug-resistant disease, we argue that these research policies, which effectively lower the bar for antibiotic approval, are ethically problematic. Rather, given broader public health considerations related to the full lifecycle of antibiotic use—including development of resistance—we should reject an overly permissive approach to new antibiotic approval and instead set the bar for regulatory approval at a point that will naturally direct research resources toward the most transformative chemical or social interventions. (shrink)

In recent years, we have seen a new concern with ethics training for research and development professionals. Although ethics training has become more common, the effectiveness of the training being provided is open to question. In the present effort, a new ethics training course was developed that stresses the importance of the strategies people apply to make sense of ethical problems. The effectiveness of this training was assessed in a sample of 59 doctoral students working in the (...) biological and social sciences using a pre–post design with follow-up and a series of ethical decision-making measures serving as the outcome variable. Results showed not only that this training led to sizable gains in ethical decision making but also that these gains were maintained over time. The implications of these findings for ethics training in the sciences are discussed. (shrink)

“Evidence based medicine” is often seen as a scientific tool for quality improvement, even though its application requires the combination of scientific facts with value judgments and the costing of different treatments. How this is done depends on whether we approach the problem from the perspective of individual patients, doctors, or public health administrators. Evidence based medicine exerts a fundamental influence on certain key aspects of medical professionalism. Since, when clinical practice guidelines are created, costs affect the content (...) of EBM, EBM inevitably becomes a form of rationing and adopts a public health point of view. This challenges traditional professionalism in much the same way as managed care has done in the US. Here we chart some of these major philosophical issues and show why simple solutions cannot be found. The profession needs to pay more attention to different uses of EBM in order to preserve the good aspects of professionalism. (shrink)

This study examines a moderated/mediated model of ethical leadership on follower job satisfaction and affective organizational commitment. We proposed that managers have the potential to be agents of virtue or vice within organizations. Specifically, through ethical leadership behavior we argued that managers can virtuously influence perceptions of ethical climate, which in turn will positively impact organizational members’ flourishing as measured by job satisfaction and affective commitment to the organization. We also hypothesized that perceptions of interactional justice would moderate the (...) ethical leadership-to-climate relationship. Our results indicate that ethical leadership has both a direct and indirect influence on follower job satisfaction and affective commitment. The indirect effect of ethical leadership involves shaping perceptions of ethical climate, which in turn, engender greater job satisfaction and affective organizational commitment. Furthermore, when interactional justice is perceived to be high, this strengthens the ethical leadership-to-climate relationship. (shrink)

Ethical guidance in research is underpinned by the need to show respect for study participants by upholding autonomy in participant decision-making, and confidentiality and protection of individual rights, privacy and interests, yet decision-making could also be influenced by the participant’s sociocultural and belief systems. This calls for a more Africanised approach to research ethics where these values and beliefs are upheld. While national and international ethics guidelines do exist, there is little evidence that such a paradigm shift (...) in research ethics is adequately interrogated in the teaching and learning curricula in higher education, where research skills are developed and nurtured. Critical reflection is used to highlight opportunities to stimulate learning and debates underpinned by humanised pedagogy in higher education. (shrink)

Accurate estimation of risk and benefit is integral to good clinical research planning, ethical review, and study implementation. Some commentators have argued that various actors in clinical research systems are prone to biased or arbitrary risk/benefit estimation. In this commentary, we suggest the evidence supporting such claims is very limited. Most prior work has imputed risk/benefit beliefs based on past behavior or goals, rather than directly measuring them. We describe an approach – forecast analysis – that would enable direct (...) and effective measure of the quality of risk/benefit estimation. We then consider some objections and limitations to the forecasting approach. (shrink)

Skeletons drawn from archaeological contexts provide a fund of data for assessing disease in general and timing of epidemics in particular in past societies. The bioarchaeological record presents an especially important perspective on timing of some of the world's most catastrophic diseases, such as leprosy, tuberculosis, plague (Black Death), and treponematosis. Application of new developments in paleogenomics and paleogenetics presents new opportunities to document ancient pathogens' DNA (for example, Black Death), track their history, and assess their beginning and end points. (...) Paleopathological documentation of disease terminus is complex, in part owing to circumstances where past communities experienced overlapping epidemics, such as leprosy and plague. For most settings, these syndemics-whereby there is an interaction between two or more epidemic diseases-both exacerbate and enhance the burden of morbidity in a community or region. Fundamental to understanding the severity and duration of epidemics is the consideration of multiple factors that simultaneously influence the severity and duration of the specific infectious diseases in a community or region, including poor oral health, under-nutrition, iron deficiency anemia, and elevated parasite load. In our view, comprehending the beginning, the middle, and the end of epidemics requires understanding the wider context of syndemics, the multiple challenging circumstances that undermine health and community stability, and how biosocial factors differentially affect the immune competence of individuals. This article provides several examples of the application of bioarchaeology and syndemics theory in achieving an understanding of how epidemics end. Pathogens continue to circulate, even after what appears to be the end. In effect, then, there is no “end,” just evolution of opportunistic pathogens and our ability (or not) to mitigate them. (shrink)

The last 25 years have seen advances in our understanding of the neuroscience and neuropsychiatry of fear. From the basic brain mechanisms of fear to new evidence-based treatments for the pathologies of fear, the field has experienced progress towards an understanding of the underpinnings of fear in the brain and its influence on behaviors. Yet, to date, there has been less than ideal incorporation of these new findings, insights and models into the public policy and economic domains. Even when (...) notions of risk, uncertainty, and emotional decision-making are discussed, these discussions may not access insights from the latest contemporary neuroscience of fear, or clinical techniques in changing pathological fear responses. This paper will explore how a more complete incorporation of these advances may contribute to our understanding of fear and its management. Applying these advances in specific amenable policy areas may lead to new, more effective approaches to public and economic policies. (shrink)

Though almost forgotten today, Herbert Spencer ranks as one of the foremost individualist philosophers. His influence in the latter half of the nineteenth century was immense. Spencer's name is usually linked with Darwin's, for it was he who penned the phrase: survival of the fittest. Today in America he is most often admired for his trenchant essays in 'The Man Versus the State'. But Spencer himself considered THE PRINCIPLES OF ETHICS to be his finest work. In the (...) second volume, under 'Justice', is his final statement on the role of the state. His formula for justice is summed up in these words: "Every man is free to do that which he wills, provided he infringes not the equal freedom of any other man.". (shrink)

This paper examines the crisis in the nursing profession in Western industrial societies in the light of Max Weber's theory of rationalisation. The domination of instrumental rational action in modern industrial societies in evident in the field of modern medicine. The burgeoning mechanistic approach to the human body and health makes modern health care services increasingly devoid of human values. Although the nursing profession has been influenced by various changes that took place in health care during the last (...) few decades (for example greater reliance on technology), the underlying values of the nursing profession still emphasise a broad definition of the well-being of patients. Hence, in recent years the irrational consequences of growing technological medicine in North America has resulted in a serious crisis in the nursing profession. To resolve this crisis the authors propose a reorganisation of modern health care services on the basis of a new paradigm which is compatible with both the health care needs of the people and the main emphasis in education and training of the nursing profession. (shrink)

Since it implies a reduction in the quality and the quantity of the natural resources, environmental degradation is a present day problem that requires immediate solutions. This situation is driving firms to undertake an environmental transformation process with the purpose of reducing the negative externalities that come from their economic activities. Within this context, environmental marketing is an emerging business philosophy by which organizations can address sustainability issues. Moreover, environmental marketing and orientation are seen as valuable strategies to improve a (...) firm's competitiveness. However, the literature that has analyzed the link between environmental strategies and firms' results has been inconclusive and contradictory. In this study, we propose and test a model that analyses how the implementation of ecological issues within a firm's marketing strategy and orientation influences organizational results. Data were obtained through a survey sent to Spanish manufacturing firms. The results show that environmental marketing positively affects firms' operational and commercial performance and this improvement will influence their economic results. Moreover, environmental marketing is revealed as an excellent strategy to obtain competitive advantages in costs and in product differentiation. Thus, this study agrees with the researchers who affirm that environmental strategies positively affect firm's competitiveness while reducing environmental impact. (shrink)

Since it implies a reduction in the quality and the quantity of the natural resources, environmental degradation is a present day problem that requires immediate solutions. This situation is driving firms to undertake an environmental transformation process with the purpose of reducing the negative externalities that come from their economic activities. Within this context, environmental marketing is an emerging business philosophy by which organizations can address sustainability issues. Moreover, environmental marketing and orientation are seen as valuable strategies to improve a (...) firm's competitiveness. However, the literature that has analyzed the link between environmental strategies and firms' results has been inconclusive and contradictory. In this study, we propose and test a model that analyses how the implementation of ecological issues within a firm's marketing strategy and orientation influences organizational results. Data were obtained through a survey sent to Spanish manufacturing firms. The results show that environmental marketing positively affects firms' operational and commercial performance and this improvement will influence their economic results. Moreover, environmental marketing is revealed as an excellent strategy to obtain competitive advantages in costs and in product differentiation. Thus, this study agrees with the researchers who affirm that environmental strategies positively affect firm's competitiveness while reducing environmental impact. (shrink)

Rapid Ethical Assessment is an approach used to design context tailored consent process for voluntary participation of participants in research including human subjects. There is, however, limited evidence on the design of ethical assessment in studies targeting cancer patients in Ethiopia. REA was conducted to explore factors that influence the informed consent process among female cancer patients recruited for longitudinal research from Addis Ababa Population-based Cancer Registry. Qualitative study employing rapid ethnographic approach was conducted from May–July, 2017, (...) at the Tikur Anbessa Specialized Referral Hospital. In-depth and key informants’ interviews were conducted among purposively selected 16 participants. Regular de-briefings among the study team helped to identify emerging themes and ensure saturation. Interviews and debriefings were tape recorded in Amharic, and transcribed and translated to English. Coding of the transcripts was facilitated by use of NVivo software. Thematic analysis was employed to respond to the initial questions and interpret findings. Perceived barriers to voluntary study participation included lack of reporting back study results of previous studies, the decision making status of women, hopelessness or fatigue in the patients, shyness of the women, data collectors approach to the patient, and patient’s time constraints. Most of the patients preferred oral over written consent and face-to-face interview over telephone interview. Provision of detail information about the study, using short and understandable tool, competent, compassionate and respectful enumerators of the same gender were suggested to assure participation. Due to the perceived severity, the use of the term “cancer” was associated with fear and anxiety. Alternatively, uses of phrases like “breast or cervical illness/disease” were suggested during patient interviews. Voluntary participation is not straight forward but affected by different factors. Using competent, compassionate and respectful enumerators, short and precise questioning tools to limit the time of the interview could improve voluntary participation. Moreover, careful consideration of the patients and families concept of the disease such as wording and information has to be taken into account. This assessment helped in improving the consent process of the ongoing project on breast and cervical cancer patients. (shrink)

Software piracy has become recognized as a major problem for the software industry and for business. One research approach that has provided a theoretical framework for studying software piracy has been to place the illegal copying of software within the domain of ethical decision making assumes that a person must be able to recognize software piracy as a moral issue. A person who fails to recognize a moral issue will fail to employ moral decision making schemata. There is substantial (...) evidence that many individuals do not perceive software piracy to be an ethical problem. This paper applies social exchange theory, in particular equity theory, to predict the influence of situational factors on subjects' intentions to participate in software piracy. Consistent with the predictions of equity theory this study found that input and outcome situational variables significantly effect a person's intentions to commit software piracy. (shrink)

ObjectivesTo describe reporting of informed consent in pragmatic trials, justifications for waivers of consent and reporting of alternative approaches to standard written consent. To identify factors associated with (1) not reporting and (2) not obtaining consent.MethodsSurvey of primary trial reports, published 2014–2019, identified using an electronic search filter for pragmatic trials implemented in MEDLINE, and registered in ClinicalTrials.gov.ResultsAmong 1988 trials, 132 (6.6%) did not include a statement about participant consent, 1691 (85.0%) reported consent had been obtained, 139 (7.0%) reported a (...) waiver and 26 (1.3%) reported consent for one aspect (eg, data collection) but a waiver for another (eg, intervention). Of the 165 trials reporting a waiver, 76 (46.1%) provided a justification. Few (53, 2.9%) explicitly reported use of alternative approaches to consent. In multivariable logistic regression analyses, lower journal impact factor (p=0.001) and cluster randomisation (p<0.0001) were significantly associated with not reporting on consent, while trial recency, cluster randomisation, higher-income country settings, health services research and explicit labelling as pragmatic were significantly associated with not obtaining consent (all p<0.0001).DiscussionNot obtaining consent seems to be increasing and is associated with the use of cluster randomisation and pragmatic aims, but neither cluster randomisation nor pragmatism are currently accepted justifications for waivers of consent. Rather than considering either standard written informed consent or waivers of consent, researchers and research ethics committees could consider alternative consent approaches that may facilitate the conduct of pragmatic trials while preserving patient autonomy and the public’s trust in research. (shrink)

Introduction: Schools have become a primary setting for providing mental health care to youths in the U.S. School-based interventions have proliferated, but their effects on mental health and academic outcomes remain understudied. In this study we will implement and evaluate the effects of a flexible multidiagnostic treatment called Modular Approach to Therapy for Children with Anxiety, Depression, Trauma, or Conduct Problems on students' mental health and academic outcomes.Methods and Analysis: This is an assessor-blind randomized controlled effectiveness trial conducted across (...) five school districts. School clinicians are randomized to either MATCH or usual care treatment conditions. The target sample includes 168 youths referred for mental health services and presenting with elevated symptoms of anxiety, depression, trauma, and/or conduct problems. Clinicians randomly assigned to MATCH or UC treat the youths who are assigned to them through normal school referral procedures. The project will evaluate the effectiveness of MATCH compared to UC on youths' mental health and school related outcomes and assess whether changes in school outcomes are mediated by changes in youth mental health.Ethics and Dissemination: This study was approved by the Harvard University Institutional Review Board. We plan to publish the findings in peer-reviewed journals and present them at academic conferences.Clinical Trial Registration:ClinicalTrials.gov ID: NCT02877875. Registered on August 24, 2016. (shrink)

Recognition that the Principle of Respect for Autonomy fails to work in family-centric societies such as Singapore has recently led to the promotion of relational autonomy as a suitable framework within which to place healthcare decision making. However, empirical data, relating to patient and family opinions and the practices of healthcare professionals in Confucian-inspired Singapore, demonstrate clear limitations on the ability of a relational autonomy framework to provide the anticipated compromise between prevailing family decision-making norms and adopted Western led atomistic (...) concepts of autonomy. Evidence suggests that despite a growing infusion of Western influence, there is still little to indicate any major shift to individual decision making, particularly in light of the way society and healthcare are structured. Similarly, the lack of employing a shared decision-making model and data that discredit the notion that the complex psychosocial and cultural factors that affect the decision making may be considered “content neutral” not only prevents the application of relational autonomy but questions the viability of the values behind the Principle of Respect for Autonomy. Taking into account local data and drawing upon a wider concept of personhood that extends beyond prevailing family-centric ideals along with the complex interests that are focused upon the preservation of the unique nature of personhood that arises from the Ring Theory of Personhood, we propose and “operationalize” the employing of an authoritative welfare-based approach, within the confines of best interest decision making, to better meet the current care needs within Singapore. (shrink)

Randomized controlled trial trial designs exist on an explanatory-pragmatic spectrum, depending on the degree to which a study aims to address a question of efficacy or effectiveness. As conceptualized by Schwartz and Lellouch in 1967, an explanatory approach to trial design emphasizes hypothesis testing about the mechanisms of action of treatments under ideal conditions, whereas a pragmatic approach emphasizes testing effectiveness of two or more available treatments in real-world conditions. Interest in, and the number of, pragmatic trials has (...) grown substantially in recent years, with increased recognition by funders and stakeholders worldwide of the need for credible evidence to inform clinical decision-making. This increase has been accompanied by the onset of learning healthcare systems, as well as an increasing focus on patient-oriented research. However, pragmatic trials have ethical challenges that have not yet been identified or adequately characterized. The present study aims to explore the views of key stakeholders with respect to ethical issues raised by the design and conduct of pragmatic trials. It is embedded within a large, four-year project that seeks to develop guidance for the ethical design and conduct of pragmatic trials. As a first step, this study will address important gaps in the current empirical literature with respect to identifying a comprehensive range of ethical issues arising from the design and conduct of pragmatic trials. By opening up a broad range of topics for consideration within our parallel ethical analysis, we will extend the current debate, which has largely emphasized issues of consent, to the range of ethical considerations that may flow from specific design choices. Semi-structured interviews with key stakeholders, across multiple jurisdictions, identified based on their known experience and/or expertise with pragmatic trials. We expect that the study outputs will be of interest to a wide range of knowledge users including trialists, ethicists, research ethics committees, journal editors, regulators, healthcare policymakers, research funders and patient groups. All publications will adhere to the Tri-Agency Open Access Policy on Publications. (shrink)

A thorough examination of the role which David Hume''s writings played upon the founders of the United States.This book explores the reception of David Hume''s political thought in eighteenth-century America. It presents a challenge to standard interpretations that assume Hume''s thought had little influence in early America. Eighteenth-century Americans are often supposed to have ignored Hume''s philosophical writings and to have rejected entirely Hume''s "Tory" History of England. James Madison, if he used Hume''s ideas in Federalist No. 10, it (...) is commonly argued, thought best to do so silently -- open allegiance to Hume was a liability. Despite renewed debate about the impact of Hume''s political ideas in America, existing scholarship is often narrow and highly speculative. Were Hume''s works available in eighteenth-century America? If so, which works? Where? When? Who read Hume? To what avail? To answer questions of that sort, this books draws upon a wide assortment of evidence. Early American book catalogues, periodical publications, and the writings of lesser-light thinkers are used to describe Hume''s impact on the social history of ideas, an essential context for understanding Hume''s influence on many of the classic texts of early American political thought. Hume''s Essays and Treatises on Several Subjects, was readily available, earlier, and more widely, than scholars have supposed. The History of England was read most frequentlyof all, however, and often in distinctive ways. Hume''s History, which presented the British constitution as a patch-work product of chance historical developments, informed the origins of the American Revolution and Hume''ssubsequent reception through the late eighteenth century. The 326 subscribers to the first American edition of Hume''s History (published in Philadelphia in 1795-96) are more representative of the History''s friendlyreception in enlightened America than are its few critics. Thomas Jefferson''s latter-day rejection of Hume''s political thought foreshadowed Hume''s falling reputation in nineteenth-century America. MARK G. SPENCER is Associate Professor of History at Brock University where he holds a Chancellor''s Chair for Research Excellence. His books include Hume''s Reception in Early America (2002), Utilitarians and Their Critics in America, 1789-1914 (2005),and Ulster Presbyterians in the Atlantic World (2006). periodical publications, and the writings of lesser-light thinkers are used to describe Hume''s impact on the social history of ideas, an essential context for understanding Hume''s influence on many of the classic texts of early American political thought. Hume''s Essays and Treatises on Several Subjects, was readily available, earlier, and more widely, than scholars have supposed. The History of England was read most frequentlyof all, however, and often in distinctive ways. Hume''s History, which presented the British constitution as a patch-work product of chance historical developments, informed the origins of the American Revolution and Hume''ssubsequent reception through the late eighteenth century. The 326 subscribers to the first American edition of Hume''s History (published in Philadelphia in 1795-96) are more representative of the History''s friendlyreception in enlightened America than are its few critics. Thomas Jefferson''s latter-day rejection of Hume''s political thought foreshadowed Hume''s falling reputation in nineteenth-century America. MARK G. SPENCER is Associate Professor of History at Brock University where he holds a Chancellor''s Chair for Research Excellence. His books include Hume''s Reception in Early America (2002), Utilitarians and Their Critics in America, 1789-1914 (2005),and Ulster Presbyterians in the Atlantic World (2006).eputation in nineteenth-century America. MARK G. SPENCER is Associate Professor of History at Brock University where he holds a Chancellor''s Chair for Research Excellence. His books include Hume''s Reception in Early America (2002), Utilitarians and Their Critics in America, 1789-1914 (2005),and Ulster Presbyterians in the Atlantic World (2006). periodical publications, and the writings of lesser-light thinkers are used to describe Hume''s impact on the social history of ideas, an essential context for understanding Hume''s influence on many of the classic texts of early American political thought. Hume''s Essays and Treatises on Several Subjects, was readily available, earlier, and more widely, than scholars have supposed. The History of England was read most frequentlyof all, however, and often in distinctive ways. Hume''s History, which presented the British constitution as a patch-work product of chance historical developments, informed the origins of the American Revolution and Hume''ssubsequent reception through the late eighteenth century. The 326 subscribers to the first American edition of Hume''s History (published in Philadelphia in 1795-96) are more representative of the History''s friendlyreception in enlightened America than are its few critics. Thomas Jefferson''s latter-day rejection of Hume''s political thought foreshadowed Hume''s falling reputation in nineteenth-century America. MARK G. SPENCER is Associate Professor of History at Brock University where he holds a Chancellor''s Chair for Research Excellence. His books include Hume''s Reception in Early America (2002), Utilitarians and Their Critics in America, 1789-1914 (2005),and Ulster Presbyterians in the Atlantic World (2006). periodical publications, and the writings of lesser-light thinkers are used to describe Hume''s impact on the social history of ideas, an essential context for understanding Hume''s influence on many of the classic texts of early American political thought. Hume''s Essays and Treatises on Several Subjects, was readily available, earlier, and more widely, than scholars have supposed. The History of England was read most frequentlyof all, however, and often in distinctive ways. Hume''s History, which presented the British constitution as a patch-work product of chance historical developments, informed the origins of the American Revolution and Hume''ssubsequent reception through the late eighteenth century. The 326 subscribers to the first American edition of Hume''s History (published in Philadelphia in 1795-96) are more representative of the History''s friendlyreception in enlightened America than are its few critics. Thomas Jefferson''s latter-day rejection of Hume''s political thought foreshadowed Hume''s falling reputation in nineteenth-century America. MARK G. SPENCER is Associate Professor of History at Brock University where he holds a Chancellor''s Chair for Research Excellence. His books include Hume''s Reception in Early America (2002), Utilitarians and Their Critics in America, 1789-1914 (2005),and Ulster Presbyterians in the Atlantic World (2006).eputation in nineteenth-century America. MARK G. SPENCER is Associate Professor of History at Brock University where he holds a Chancellor''s Chair for Research Excellence. His books include Hume''s Reception in Early America (2002), Utilitarians and Their Critics in America, 1789-1914 (2005),and Ulster Presbyterians in the Atlantic World (2006).eputation in nineteenth-century America. MARK G. SPENCER is Associate Professor of History at Brock University where he holds a Chancellor''s Chair for Research Excellence. His books include Hume''s Reception in Early America (2002), Utilitarians and Their Critics in America, 1789-1914 (2005),and Ulster Presbyterians in the Atlantic World (2006). periodical publications, and the writings of lesser-light thinkers are used to describe Hume''s impact on the social history of ideas, an essential context for understanding Hume''s influence on many of the classic texts of early American political thought. Hume''s Essays and Treatises on Several Subjects, was readily available, earlier, and more widely, than scholars have supposed. The History of England was read most frequentlyof all, however, and often in distinctive ways. Hume''s History, which presented the British constitution as a patch-work product of chance historical developments, informed the origins of the American Revolution and Hume''ssubsequent reception through the late eighteenth century. The 326 subscribers to the first American edition of Hume''s History (published in Philadelphia in 1795-96) are more representative of the History''s friendlyreception in enlightened America than are its few critics. Thomas Jefferson''s latter-day rejection of Hume''s political thought foreshadowed Hume''s falling reputation in nineteenth-century America. MARK G. SPENCER is Associate Professor of History at Brock University where he holds a Chancellor''s Chair for Research Excellence. His books include Hume''s Reception in Early America (2002), Utilitarians and Their Critics in America, 1789-1914 (2005),and Ulster Presbyterians in the Atlantic World (2006).eputation in nineteenth-century America. MARK G. SPENCER is Associate Professor of History at Brock University where he holds a Chancellor''s Chair for Research Excellence. His books include Hume''s Reception in Early America (2002), Utilitarians and Their Critics in America, 1789-1914 (2005),and Ulster Presbyterians in the Atlantic World (2006).rough the late eighteenth century. The 326 subscribers to the first American edition of Hume''s History (published in Philadelphia in 1795-96) are more representative of the History''s friendlyreception in enlightened America than are its few critics. Thomas Jefferson''s latter-day rejection of Hume''s political thought foreshadowed Hume''s falling reputation in nineteenth-century America. MARK G. SPENCER is Associate Professor of History at Brock University where he holds a Chancellor''s Chair for Research Excellence. His books include Hume''s Reception in Early America (2002), Utilitarians and Their Critics in America, 1789-1914 (2005),and Ulster Presbyterians in. (shrink)

This study considers the potential for influencing business students to become ethical managers by directing their undergraduate learning environment. In particular, the relationship between business students’ academic cheating, as a predictor of workplace ethical behavior, and their approaches to learning is explored. The three approaches to learning identified from the students’ approaches to learning literature are deep approach, represented by an intrinsic interest in and a desire to understand the subject, surface approach, characterized by rote learning and memorization (...) without understanding, and strategic approach, associated with competitive students whose motivation is the achievement of good grades by adopting either a surface or deep approach. Consistent with the hypothesized theoretical model, structural equation modeling revealed that the surface approach is associated with higher levels of cheating, while the deep approach is related to lower levels. The strategic approach was also associated with less cheating and had a statistically stronger influence than the deep approach. Further, a significantly positive relationship reported between deep and strategic approaches suggests that cheating is reduced when deep and strategic approaches are paired. These findings suggest that future managers and business executives can be influenced to behave more ethically in the workplace by directing their learning approaches. It is hoped that the evidence presented may encourage those involved in the design of business programs to implement educational strategies which optimize students’ approaches to learning towards deep and strategic characteristics, thereby equipping tomorrow’s managers and business executives with skills to recognize and respond appropriately to workplace ethical dilemmas. (shrink)

The philosophical faculty of the Jesuit Berchmanskolleg in Pullach has long since made its mark in the publishing world, and the new series of philosophical studies from Father Lotz and his associates, of which these two volumes are an auspicious beginning, shows every sign of living up to the high standard we have come to expect. Volume I is a collection of five essays: a comparison between the Thomistic and Kantian theory of knowledge, by Fr. de Vries; the transcendental method (...) in Kant and in Scholasticism, by Fr. Lotz; the Absolute in the Kritik der reinen Vernunft, by Fr. Brugger; formalism in Kant’s ethics, by Dr. Schmucker; and the relationship between Kant and Heidegger, by Fr. Coreth. It concludes with a particularly useful bibliography of scholastic literature on Kant between 1920 and 1955, compiled by Fr. Brugger. After Jansen, Maréchal is the scholastic writer with most published studies on Kant to his credit, and it is not surprising that his influence should make itself felt in the present volume. His monumental Le point de départ de la métaphysique marked a definite turning–point in the scholastic attitude towards Kant, and one has only to read this collection of studies to realise how the atmosphere has changed in the course of the last fifty years. Fr. de Vries devotes almost two–thirds of his essay to what St. Thomas and Kant hold in common with regard to the discursive nature of human understanding, the structure of the sense–image and its relation to the intellectual concept, though he also brings out the fundamental difference between the two on the questions of self–consciousness, natural theology and the reality of the external world. Not only does he show a healthy respect for the many grains of truth in the philosophy of Kant, but he insists that Thomists have much to learn from the German philosopher on the question of strict, critical method. Scholastics of the traditional school were satisfied with what Fr. Lotz describes as the “objective method” and rejected the “subjective” as smacking of subjectivism or idealism. In the longest essay of the five, Fr. Lotz compares the Kantian and Scholastic methods. Kant himself described his Kritik der reinen Vernunft as a “treatise on method rather than a scientific system”, and in the course of the book he condemns the objective approach as dogmatic and uncritical, leaving only the subjective method, which rules out any possibility of metaphysics. Fr. Lotz rightly asserts that even the most modern scholastic cannot dispense with the objective method, but he maintains that it demands to be completed by the subjective. Many scholastics will agree with him on the usefulness of the latter, and indeed an amount of research has been done in this field in recent decades. But how many will agree when he says that scholastic objectivism includes the subjective or transcendental method as the only way, or the only basis on which objectivism can stand? Maréchal’s influence is evident in his treatment of the faculties of the soul. But, however one may quibble at individual points in the book, it nevertheless remains a very valuable contribution to the scholastic literature on Kant. (shrink)

Teaching medical ethics and law has become much more prominent in medical student education, largely as a result of a 1998 consensus statement on such teaching. Ethics is commonly taught at undergraduate level using lectures and small group tutorials, but there is no recognised method for transferring this theoretical knowledge into practice and ward-based learning. This reflective article by a Sheffield university undergraduate medical student describes the value of using a student-selected component to study practical clinical ethics (...) and the use of a clinical ethics checklist. The ethical checklist was proposed by Sokol as a tool for use by medical staff during the ward round to prompt the consideration of important ethical principles in relation to care. This paper describes additional uses for the checklist as a tool for teaching and learning about the practical application of ethical principles and for observing professional behaviours within a critical care and acute care environment. Evidence suggests that putting ethical behaviour into practice offers a far greater challenge to a newly qualified doctor than has been appreciated, and that more needs to be done at an undergraduate level to help combat this. This paper argues from a personal standpoint of an individual student experience that this can best be done in a clinical medical setting. (shrink)

Patient-reported outcomes are frequently used for medical decision making, at the levels of both individual patient care and healthcare policy. Evidence increasingly shows that PROs may be influenced by patients’ response shifts and dispositions. We identify how response shifts and dispositions may influence medical decisions on both the levels of individual patient care and health policy. We provide examples of these influences and analyse the consequences from the perspectives of ethical principles and theories of just distribution. If influences of (...) response shift and disposition on PROs and consequently medical decision making are not considered, patients may not receive optimal treatment and health insurance packages may include treatments that are not the most effective or cost-effective. We call on healthcare practitioners, researchers, policy makers, health insurers, and other stakeholders to critically reflect on why and how such patient reports are used. (shrink)

Background: Ethics support services are growing in Europe to help doctors in dealing with ethical difficulties. Currently, insufficient attention has been focused on the experiences of doctors who have faced ethical difficulties in these countries to provide an evidence base for the development of these services.Methods: A survey instrument was adapted to explore the types of ethical dilemma faced by European doctors, how they ranked the difficulty of these dilemmas, their satisfaction with the resolution of a recent ethically difficult (...) case and the types of help they would consider useful. The questionnaire was translated and given to general internists in Norway, Switzerland, Italy and the UK.Results: Survey respondents ranged in age from 28 to 82 years, and averaged 25 years in practice. Only a minority reported having access to ethics consultation in individual cases. The ethical difficulties most often reported as being encountered were uncertain or impaired decision-making capacity , disagreement among caregivers and limitation of treatment at the end of life . The frequency of most ethical difficulties varied among countries, as did the type of issue considered most difficult. The types of help most often identified as potentially useful were professional reassurance about the decision being correct , someone capable of providing specific advice , help in weighing outcomes and clarification of the issues . Few of the types of help expected to be useful varied among countries.Conclusion: Cultural differences may indeed influence how doctors perceive ethical difficulties. The type of help needed, however, did not vary markedly. The general structure of ethics support services would not have to be radically altered to suit cultural variations among the surveyed countries. (shrink)

Biomarkers can be powerful tools to guide diagnosis, treatment, and research. However, prudent use of biomarkers requires formal validation efforts. Although the data needed for biomarker validation has traditionally been hard to access, new research initiatives can ease this process.

The current empirical research and normative arguments on physician-assisted dying in the Netherlands seem insufficient to provide ethical guidance to general practitioners in the practice of PAD, due to a gap between the evidence and arguments on the one hand and the uncertainties and complexities as found in everyday practice on the other. This paper addresses the problems of current ethical arguments and empirical research and how both seem to be profoundly influenced by the Dutch legislative framework on PAD and (...) a certain view on ethics. Furthermore, the paper elaborates on how other approaches to empirical research in bioethics, such as found in the broad field of narrative research, could supplement the empirical and ethical evaluation of PAD in the Netherlands. This paper also addresses the challenging question of how empirical data—in this case narratives—relate to normativity. The paper is written in the form of a personal narrative of the author, a young Dutch general practitioner and researcher in bioethics. This style is intentionally chosen, to illustrate how work context and professional background influence the observations one makes and the questions one may ask about the topic of PAD. In addition, by using this style, this paper not only gives a different perspective on a much-contested bioethical issue, but also on the challenges faced when a physician–bioethicist has to navigate different disciplinary fields and epistemological paradigms, especially since the ‘empirical turn’ in bioethics. (shrink)

Utilitarianism is commonly assumed to be the most appropriate sub-structure for medical ethics. This view is challenged. It is suggested that the utilitarian approach to euthanasia works against the patient's individual advantage and is a corrupting influence in the relationship between the physician and society. Dignity for the individual patient is not easily achieved by assessing that person's worth against the yardstick of others' needs and wishes.

In many countries, health technology assessment organizations determine the economic value of new drugs and make recommendations regarding appropriate pricing and coverage in national health systems. In the US, recent policy proposals aimed at reducing drug costs would link drug prices to six countries: Australia, Canada, France, Germany, Japan, and the UK. We reviewed these countries’ methods of HTA and guidance on price and coverage recommendations, analyzing methods and guidance documents for differences in the methodologies HTA organizations use to conduct (...) their evaluations and considerations they use when making recommendations. We found important differences in the methods, interpretations of HTA findings, and condition-specific carve-outs that HTA organizations use to conduct evaluations and make recommendations. These variations have ethical implications because they influence the recommendations of HTA organizations, which affect access to the drug through national insurance and price negotiations with manufacturers. The differences in HTA approaches result from the distinct political, social, and cultural contexts of each organization and its value judgments. New cost-containment policies in the US should consider the ethical implications of the HTA reviews that they are considering relying on to negotiate drug prices and what values should be included in US pricing policy. (shrink)

Key messages The research environment has changed since clinical equipoise was first proposed 30 years ago New trial designs—such as umbrella and basket trials, adaptive platform trials, and cluster randomised trials—raise new ethical challenges for evaluating the state of scientific uncertainty and communicating about risks with patients and participants Clinical equipoise needs to evolve We propose the design of specific guidelines to provide ethics committees and trialists with instructions for how to evaluate equipoise in the context of new designs (...) and biomarkers and how to optimise communication with participants. (shrink)

Purpose This paper aims to expose the challenges facing the attempt by Jamaica to introduce a new digital ID system without adequate regard to public consultation and the rights of citizens. Design/methodology/approach The method used is critical text analysis and policy analysis, providing background and relevant factors leading up to the legislative changes under review. Extensive literature sources were consulted and the relevant sections of the Jamaican constitution referenced and analysed. Findings The case study may have national peculiarities not (...) applicable in other jurisdictions. Its introduction acknowledges that the Jamaican Government may amend and re-submit the legislation, absent the flawed clauses. The paper however will remain valid given its detailed analysis and exposure of risks associated with biometric data collection, face recognition technology and data storage flaws. Practical implications It will be a practical example of the risks associated with flawed biometric data collection and the role of Courts in reviewing such legislation. Referrals to the Courts can be used as a remedy, as occurred not only in Jamaica but also in many other jurisdictions, including India and Kenya. Social implications The paper foregrounds the rights of citizens to be consulted on the collection and storage of their sensitive biometric data. The social implications and risks of violating the constitutional rights of citizens were made evident, and can be an example to other jurisdictions. Originality/value The paper is the first of its kind to provide detailed data and analysis on an outright rejection by the Courts of a country's ID legislation on grounds that it violated the constitution and rights of citizens. It shows the ethical and social challenges in proposing and implementing legislation without adequate public consultation on such sensitive matters as biometric data. It also exposes some of the challenges of artificial intelligence and face recognition technologies in ID data collection, including flaws related to race, gender and coding. (shrink)

The Principles of Biomedical Ethics by Tom L Beauchamp and James F Childress which is now in its fourth edition has had a great influence on the development of bioethics through its exposition of a theory based on the four principles: respect for autonomy; non-maleficence; beneficence, and justice (1). The theory is developed as a common-morality theory, and the present paper attempts to show how this approach, starting from American common-morality, leads to an underdevelopment of beneficence and (...) justice, and that the methods offered for specification and balancing of principles are inadequate. (shrink)

Michael Walzer is one of the most distinguished political philosophers and social critics of this century. His ideas have had great import and influence in political philosophy and political discussion, yet very few of his ideas have been incorporated explicitly into the business ethics literature. We argue that Walzer’s work provides an important conceptual canvas for business ethics scholars that has not been adequately explored. Scholars in business ethics often borrow from political theory and philosophy to (...) generate new insights and develop new substantive contributions. Many valuable theoretical resources are already used extensively—particularly Aristotle, Kant, Marx and a variety of utilitarian philosophers. Walzer offers another set of resources to bring to the conversation of what business ethics is and how business ethicists add value. This paper provides an opportunity to delve further into Walzer’s writings, particularly themes that are tied to business ethics, and to illustrate how his ideas can be extended to reshape our understanding of the field and develop new perspectives on ethical issues in commerce. (shrink)

Personalized medicine with its promise of developing interventions tailored to an individual's health need and genetically related response to treatment might seem a promising antidote to the documented underutilization of standard depression treatments by African Americans. In addition, understanding depression not merely in biochemical terms but also in genetic terms might seem to counter cultural beliefs and stigma that attach to depression when conceived as a mood or behavioral problem under an individual's control. After all, if there is one thing (...) for which a person is not responsible and cannot be blamed, it is her genes. Nevertheless, for multiple reasons, a personalized medical approach to depression treatment, and its attendant conceptualization of depression and treatment response as genetically influenced, present the risk of exacerbating well-documented disparities in access to, and utilization of, treatment for depression among African-American and Caucasian elderly adults. (shrink)

Context: Constructivist approaches to cognition have mostly been descriptive, and now face the challenge of specifying the mechanisms that may support the acquisition of knowledge. Departing from cognitivism, however, requires the development of a new functional framework that will support causal, powerful and goal-directed behavior in the context of the interaction between the organism and the environment. Problem: The properties affecting the computational power of this interaction are, however, unclear, and may include partial information from the environment, exploration, distributed processing (...) and aggregation of information, emergence of knowledge and directedness towards relevant information. Method: We posit that one path towards such a framework may be grounded in these properties, supported by dynamical systems. To assess this hypothesis, we describe computational models inspired from swarm intelligence, which we use as a metaphor to explore the practical implications of the properties highlighted. Results: Our results demonstrate that these properties may serve as the basis for complex operations, yielding the elaboration of knowledge and goal-directed behavior. Implications: This work highlights aspects of interaction that we believe ought to be taken into account when characterizing the possible mechanisms underlying cognition. The scope of the models we describe cannot go beyond that of a metaphor, however, and future work, theoretical and experimental, is required for further insight into the functional role of interaction with the environment for the elaboration of complex behavior. Constructivist content: Inspiration for this work stems from the constructivist impetus to account for knowledge acquisition based on interaction. (shrink)

This paper provides a retrospective and prospective overview of TU Delft’s approach to engineering ethics education. For over twenty years, the Ethics and Philosophy of Technology Section at TU Delft has been at the forefront of engineering ethics education, offering education to a wide range of engineering and design students. The approach developed at TU Delft is deeply informed by the research of the Section, which is centered around Responsible Research and Innovation, Design for Values, (...) and Risk Ethics. These theoretical approaches are premised on the notion that technologies are inherently value-laden, and as such contain the possibility of fostering or hindering moral values. Each of these approaches encourages students to take a proactive attitude with respect to their projects and profession, thinking creatively about – and taking responsibility for – how to both prevent harm and do good via the technologies they help develop. To explain how this is put into practice, this paper sketches a brief history of ethics teaching at TU Delft, outlines current activities, and presents future plans for Bachelor and Master’s level engineering ethics education at TU Delft. (shrink)

Most theories of affective influences on judgement and choice take a valence-based approach, contrasting the effects of positive versus negative feeling states. These approaches have not specified if and when distinct emotions of the same valence have different effects on judgement. In this article, we propose a model of emotion-specific influences on judgement and choice. We posit that each emotion is defined by a tendency to perceive new events and objects in ways that are consistent with the original cognitive-appraisal (...) dimensions of the emotion. To pit the valence and appraisal-tendency approaches against one another, we present a study that addresses whether two emotions of the same valence but differing appraisals—anger and fear—relate in different ways to risk perception. Consistent with the appraisal-tendency hypothesis, fearful people made pessimistic judgements of future events whereas angry people made optimistic judgements. In the Discussion we expand the proposed model and review evidence supporting two social moderators of appraisal-tendency processes. (shrink)

Even though integrity is widely considered to be an essential aspect of research, there is an ongoing debate on what actually constitutes research integrity. The understanding of integrity ranges from the minimal, only considering falsification, fabrication and plagiarism, to the maximum, blending into science ethics. Underneath these obvious contrasts, there are more subtle differences that are not as immediately evident. The debate about integrity is usually presented as a single, universal discussion, with shared concerns for researchers, policymakers and (...) ‘the public’. In this article, we show that it is not. There are substantial differences between the language of research integrity in the scientific arena and in the public domain. Notably, scientists and policymakers adopt different approaches to research integrity. Scientists tend to present integrity as a virtue that must be kindled, while policy documents and newspapers stress norm enforcement. Rather than performing a conceptual analysis through philosophical reasoning and discussion, we aimed to clarify the discourse of ‘scientific integrity’ by studying its usage in written documents. To this end, large numbers of scientific publications, policy documents and newspaper articles were analysed by means of scientometric and content analysis techniques. The texts were analysed on their usage of the term ‘integrity’ and of frequently co-occurring terms and concepts. A comparison was made between the usage in the various media, as well as between different periods in which they were published through co-word analysis, mapping co-occurrence networks of significant terms and themes. (shrink)

Determinist thought with its sui generis view on life, nature and being as a whole is a point of view that could be observed in many different cultures and beliefs. It was thanks to Greek thought that it ceased to be a cultural element and transformed into a systematic cosmology. Schools such as Leucippos, then Democritos and Stoa attempted to integrate the determinist philosophy into ontology and cosmology. In the course of time, physics and metaphysics-based determinism approaches were introduced, and (...) a wide spectrum has emerged from genetics to behaviorism, from culture to psychology, from atomism to divinity. Determinism, whether physical or metaphysical origin, ignores freedom of will and deny agency competence over human behavior. Due to this feature, it is opposed by ethical theories, legal philosophies and religions. When the arguments for determinism are possible to disprove logically and philosophically, this is not so easy when the claims base themselves on scientific base. As the logical consequence of this novel fact, it is important to question the epistemological value of scientific knowledge and critically analyze the data of experiments and clinical studies in terms of methodology when answering any hypothesis such as neuro-biological, neuro-psychological, or neuro-theological argumentations. On the other hand, it is necessary to reach alternative experiments on the same subject or to show that it is possible to interpret them in different ways, as in the example of the Libet experiment. The neurobiological determinism based on biological reductionism, emerged as the result of ignoring the ontological difference of the mind, equating the mind with the brain, or defining mentality as an epiphenomenon of the brain. The main divergence stems from the acceptance of materialist philosophy. Paradigms that reduce existence only to matter do not take the metaphysical possibilities into account. In this case, although the problems called qualia or subjective experience stand there unresolved, the claim is preserved. Although many new developments such as the discovery of the entropy law, the big bang theory, and quantum physics have shaken the materialist philosophy, modern science resists an epistemological revision. However, with the current epistemology, it does not seem possible to grasp both the universe and the being as a whole. This is the most important reason why every attempt to understand the nature and spiritual side of human beings fails despite numerous experiments on the brain. However, the human brain is an organ that seems sophisticated and its secrets cannot be easily solved. Since there is not enough information about the brain, there is not enough evidence to claim that the brain, and therefore the mind, are part of the deterministic universe. Increasing brain researches since the last quarter of the twentieth century has revealed that genes, neurons and particularly brain chemistry claim much greater role than expected in human behavior. These results have been instrumentalized by some researchers for a radical claim that free will is an illusion, while by others it has led to the acceptance of will as less important over actions than was thought. Both ideas adopted a model of biological determinism in which freedom of will was ignored. Hypotheses based on controversial interpretations of various experiments raised concerns about religious, moral, and legal responsibility. Although man cannot be thought of as a non-free being from the point of view of common sense, the smog screen over the truth would not be lifted unless the scientific data in question had a correct interpretation. At first glance, it seems unreasonable to discuss universal determinism in the quantum universe. Nevertheless, the claim that strong causality prevails in the material world, including consciousness, remains in place. Therefore, firstly criticizing determinism and then examining biological determinism will help to fix the conceptual framework. This article aims to explain why genetics and neurobiology, while acknowledging their importance in the realization of behavior, can’t completely abolish moral agency. Some hypotheses attribute consciousness and free will to the physico-shimic structure of the brain, the random activity of neurons, or the ability to automatically transform inputs into outputs with the advantage of genetic information. This is the most sensitive and important point of being human; it attacks free will. Paradoxically, while global civilization of our time promises infinite freedom to human beings the science of the same age tries to prove that it is not free. (shrink)

ObjectiveTo assess the scientific and ethical basis for clinical innovation in psychopharmacology.MethodsWe conducted a literature review, utilizing MEDLINE search and bibliographic cross-referencing, and historical evidence regarding the discovery and development of new medications in psychiatry. Clinical innovation was defined as use of treatments in a clinical setting which have not been well-proven in a research setting.ResultsEmpirical data regarding the impact of clinical innovation in psychopharmacology are lacking. A conceptual and historical assessment of this topic highlights the ethical and scientific importance (...) of clinical innovation. Ethically, it touches a borderline that, in our judgment, is not adequately framed in contemporary mainstream bioethics. Currently, research is viewed as not at all benefiting the patients who participate in it, while clinical care is viewed as being solely for the benefit of patients. Clinical innovation straddles these two worlds, uncomfortably at times. While many argue that clinical innovation should either be avoided or folded into research projects, we argue that clinical innovation is necessary for progress in psychopharmacology research, and that it can prosper best when guided by the following ethical principles: 1.) The treatment should be based on a viable hypothesis. 2.) Whenever possible, one's clinical observations should be reported so they can be evaluated by the scientific community. 3.) One should be willing to report unexpected observations of drug effects. 4.) A high standard of informed consent should be maintained. Again, this proposal goes against the standard view among bioethicists that research and clinical care are categorically opposed activities, as made clear by the either-or dichotomy of the Belmont Report on bioethics. This approach has so polarized our profession into clinicians versus researchers, that many clinicians will not apply new knowledge produced by clinical research until it eventually gets incorporated into formal treatment guidelines, while researchers have little to guide them as to what kind of new knowledge it is most important to provide.SummaryClinical innovation brings out the ambiguities in our current ethical conceptions of research versus clinical care. Yet, historically, clinical innovation has been an important contributor to progress in psychopharmacology. We argue that clinical innovation should not be discouraged, but rather it should occur under certain ethical conditions."Almost everyone can and should do research...because almost everyone has a unique observational opportunity at some time in his life which he has an obligation to record....If one considers the fundamental operations or methods of research, one immediately realizes that most people do research at some time or another, except that they do not call their activity by that name. There are seven operations....In simple language they are counting, sorting, measuring, comparing, nature-study, guess testing, and reappraisal....Guess testing is of course what most people think of when the word research is mentioned; except that it is bad manners to call a guess a guess. It should be called an hypothesis. Let us make one plea. Guessing becomes merely a game unless it is done in the context of a plan for action. It is a waste of time elaborating untestable hypotheses [1]."John Cade. (shrink)

According to a widely credited model in the business ethics literature, ethical decisions are a function of two kinds of factors, personal(individual) and situational, and these factors interact with each other. According to a contrary view of decision making that is widely held in some areas of business research, individuals’ decisions about ethical issues (and subsequent actions) are purely a function of their self-interest.The laboratory experiment reported in this paper provides a test of the person-situation interactionist model, using the (...) general theoretical and experimental framework used in the experimental economics literature. One individual and two situational factors relating to moral intensity were examined which may influence decisions to misrepresent information in the course of business activities.The individual and one situational variable were significantly related to participants’ actions. The interactions among individual andsituation variables were not individually significant, although the model including interactions had a much higher level of statistical significance. Gender was significant, both directly and in interaction with moral development, suggesting that it may be worthy of further examination. (shrink)

This article addresses the issue of moral compunction among a sample of senior managers set against the background of their routine organizational participation. In considering what factors influence their moral sensibilities these managers were interviewed using an approach designed to elicit their perceptions concerning both the ethical and commercially imperative dimensions of their working lives. The qualitative data resulting from this inquiry, while tentative, indicates the primacy of the normative appeal of shareholder value, conditioned by the exigencies of (...) engagement in corporate bureaucracies, including the maintenance of career and livelihood responsibilities. These conclusions indicate the magnitude of the obstacle that the normative business ethics project requires to overcome in order to fulfil its promise. (shrink)

This article addresses the issue of moral compunction among a sample of senior managers set against the background of their routine organizational participation. In considering what factors influence their moral sensibilities these managers were interviewed using an approach designed to elicit their perceptions concerning both the ethical and commercially imperative dimensions of their working lives. The qualitative data resulting from this inquiry, while tentative, indicates the primacy of the normative appeal of shareholder value, conditioned by the exigencies of (...) engagement in corporate bureaucracies, including the maintenance of career and livelihood responsibilities. These conclusions indicate the magnitude of the obstacle that the normative business ethics project requires to overcome in order to fulfil its promise. (shrink)

Introduction Hundreds of thousands of premature neonates born in low-income countries are implicitly denied treatment each year. Studies from India show that treatment is rationed even for neonates born at 32 gestational age weeks (GAW), and multiple external factors influence treatment decisions. Is withholding of life-saving treatment for children born between 28 and 32 GAW acceptable from an ethical perspective? Method A seven-step impartial ethical analysis, including outcome analysis of four accepted priority criteria: severity of disease, treatment effect, cost (...) effectiveness and evidence for neonates born at 28 and 32 GAW. Results The ethical analysis sketches out two possibilities: (a) It is not ethically permissible to limit treatment to neonates below 32 GAW when assigning high weight to health maximisation and overall health equality. Neonates below 32 GAW score high on severity of disease and efficiency and cost-effectiveness of treatment if one gives full weight to early years of a newborn life. It is in the child's best interest to be treated. (b) It can be considered ethically permissible if high weight is assigned to reducing inequality of welfare and maximising overall welfare and/or not granting full weight to early years of newborns is considered acceptable. From an equity-motivated health and welfare perspective, we would not accept (b), as it relies on accepting the lack of proper welfare policies for the poor and disabled in India. Conclusion Explicit priority processes in India for financing neonatal care are needed. If premature neonates are perceived as worth less than other patient groups, the reasons should be explored among a broad range of stakeholders. (shrink)

Stakeholder theory is widely recognized as a management theory, yet very little research has considered its implications for individual managerial decision-making. In the two studies reported here, we used stakeholder theory to examine managerial decisions about balancing stakeholder interests. Results of Study 1 suggest that indivisible resources and unequal levels of stakeholder saliency constrain managers’ efforts to balance stakeholder interests. Resource divisibility also influenced whether managers used a within-decision or an across-decision approach to balance stakeholder interests. In Study 2 (...) we examined instrumental and normative implications of these two approaches. We conclude by considering the contributions of this research. (shrink)

Effective robots and autonomous systems must be trustworthy. This chapter examines models of trustworthiness from a philosophical and empirical perspective to inform the design and adoption of autonomous systems. Trustworthiness is a property of trusted agents or organisations that engenders trust in other agent or organisations. Trust is a complex phenomena defined differently depending on the discipline. This chapter aims to bring different approaches under a single framework for investigation with three sorts of questions: Who or what is trustworthy?–metaphysics. How (...) do we know who or what is trustworthy?–epistemology. What factors influence what or who should we trust?–normativity. A two-component model of trust is used that incorporates competence (skills, reliability and experience) and integrity (motives, honesty and character). It is supposed that human levels of competence yield the highest trust whereas trust is reduced at sub-human and super-human levels. The threshold for trustworthiness of an agent or organisation in a particular context is a function of their relationship with the truster and potential impacts of decisions. Building trustworthy autonomous systems requires obeying the norms of logic, rationality and ethics under pragmatic constraints–even though there is disagreement on these principles by experts. Autonomous systems may need sophisticated social identities including empathy and reputational concerns to build human-like trust relationships. Ultimately transdisciplinary research drawing on metaphysical, epistemological and normative human and machine theories of trust are needed to design trustworthy autonomous systems for adoption. (shrink)

Background Empirical studies of surrogate decision-making tend to assume that surrogates should make only a 'substituted judgement'—that is, judge what the patient would want if they were mentally competent. Objectives To explore what people want in a surrogate decision-maker whom they themselves select and to test the assumption that people want their chosen surrogate to make only a substituted judgement. Methods 30 undergraduate students were recruited. They were presented with a hypothetical scenario about their expected loss of mental capacity in (...) the future and asked to answer some questions about their choice of surrogate. These data were analysed qualitatively using thematic content analysis. Results Most respondents talked about choosing someone who was caring and competent in certain ways, giving interesting evidence for their judgements. Surprisingly few highlighted how well they thought their chosen surrogate knew their preferences and would be able to make a substituted judgement. Moreover, few specified that their chosen surrogate had similar attitudes and values to their own and so would make a similar decision to theirs in the circumstances presented. Some respondents also referred to the social role of their chosen surrogate or the social dynamics of their situation which influenced their choices, as well as to ideas of reciprocity and characteristics of honesty and loyalty. Conclusion In the event that they lose mental capacity, many people will not select a surrogate to decide about medical treatments on their behalf solely on the basis that they expect their surrogate to make a substituted judgement. (shrink)