The pull to coordinate with other individuals is fundamental, serving as the basis for our social connectedness to others. Discussed is a dynamical and ecological perspective to joint action, an approach that embeds the individual’s mind in a body and the body in a niche, a physical and social environment. Research on uninstructed coordination of simple incidental rhythmic movement, along with research on goal‐directed, embodied cooperation, is reviewed. Finally, recent research is discussed that extends the coordination and cooperation studies, examining (...) how synchronizing with another, and how emergent social units of perceiving and acting are reflected in people’s feelings of connection to others. (shrink)

Problem one: why, if God designed the human mind, did it take so long for humans to develop theistic concepts and beliefs? Problem two: why would God use evolution to design the living world when the discovery of evolution would predictably contribute to so much nonbelief in God? Darwin was aware of such questions but failed to see their evidential significance for theism. This paper explores this significance. Problem one introduces something I call natural nonbelief, which is significant because it (...) parallels and corroborates well-known worries about natural evil. Problems one and two, especially when combined, support naturalism over theism, intensify the problem of divine hiddenness, challenge Alvin Plantinga’s views about the naturalness of theism, and advance the discussion about whether the conflict between science and religion is genuine or superficial. (shrink)

Community engagement (CE) is gaining prominence in global health research. A number of ethical goals–spanning the instrumental, intrinsic, and transformative–have been ascribed to CE in global health research. This paper draws attention to an additional transformative value that CE is not typically linked to but that seems very relevant: solidarity. Both are concerned with building relationships and connecting parties that are distant from one another. This paper first argues that furthering solidarity should be recognized as another ethical goal for CE (...) in global health research. It contends that, over time, CE can build the bases of solidaristic relationships—moral imagination, recognition, understanding, empathy—between researchers and community members. Applying concepts from existing accounts of solidarity, the paper develops preliminary ideas about who should be engaged and how to advance solidarity. The proposed approach is compared to current CE practice in global health research. Finally, the paper briefly considers how solidaristic CE could affect how global health research is performed. (shrink)

Some philosophers have argued for what I call the reason-giving requirement for conscientious refusal in reproductive healthcare. According to this requirement, healthcare practitioners who conscientiously object to administering standard forms of treatment must have arguments to back up their conscience, arguments that are purely public in character. I argue that such a requirement, though attractive in some ways, faces an overlooked epistemic problem: it is either too easy or too difficult to satisfy in standard cases. I close by briefly considering (...) whether a version of the reason-giving requirement can be salvaged despite this important difficulty. (shrink)

There is wide agreement that community engagement is important for many research types and settings, often including interaction with ‘representatives’ of communities. There is relatively little published experience of community engagement in international research settings, with available information focusing on Community Advisory Boards or Groups (CAB/CAGs), or variants of these, where CAB/G members often advise researchers on behalf of the communities they represent. In this paper we describe a network of community members (‘KEMRI Community Representatives’, or ‘KCRs’) linked to a (...) large multi-disciplinary research programme on the Kenyan Coast. Unlike many CAB/Gs, the intention with the KCR network has evolved to be for members to represent the geographical areas in which a diverse range of health studies are conducted through being typical of those communities. We draw on routine reports, self-administered questionnaires and interviews to: 1) document how typical KCR members are of the local communities in terms of basic characteristics, and 2) explore KCR's perceptions of their roles, and of the benefits and challenges of undertaking these roles. We conclude that this evolving network is a potentially valuable way of strengthening interactions between a research institution and a local geographic community, through contributing to meeting intrinsic ethical values such as showing respect, and instrumental values such as improving consent processes. However, there are numerous challenges involved. Other ways of interacting with members of local communities, including community leaders, and the most vulnerable groups least likely to be vocal in representative groups, have always been, and remain, essential. (shrink)

BackgroundThe potential contribution of community engagement to addressing ethical challenges for international biomedical research is well described, but there is relatively little documented experience of community engagement to inform its development in practice. This paper draws on experiences around community engagement and informed consent during a genetic cohort study in Kenya to contribute to understanding the strengths and challenges of community engagement in supporting ethical research practice, focusing on issues of communication, the role of field workers in 'doing ethics' on (...) the ground and the challenges of community consultation.MethodsThe findings are based on action research methods, including analysis of community engagement documentation and the observations of the authors closely involved in their development and implementation. Qualitative and quantitative content analysis has been used for documentation of staff meetings and trainings, a meeting with 24 community leaders, and 40 large public and 70 small community group meetings. Meeting minutes from a purposive sample of six community representative groups have been analysed using a thematic framework approach.ResultsField workers described challenges around misunderstandings about research, perceived pressure for recruitment and challenges in explaining the study. During consultation, leaders expressed support for the study and screening for sickle cell disease. In community meetings, there was a common interpretation of research as medical care. Concerns centred on unfamiliar procedures. After explanations of study procedures to leaders and community members, few questions were asked about export of samples or the archiving of samples for future research.ConclusionsCommunity engagement enabled researchers to take account of staff and community opinions and issues during the study and adapt messages and methods to address emerging ethical challenges. Field workers conducting informed consent faced complex issues and their understanding, attitudes and communication skills were key influences on ethical practice. Community consultation was a challenging concept to put into practice, illustrating the complexity of assessing information needs and levels of deliberation that are appropriate to a given study. (shrink)

The importance of communities in strengthening the ethics of international collaborative research is increasingly highlighted, but there has been much debate about the meaning of the term ‘community’ and its specific normative contribution. We argue that ‘community’ is a contingent concept that plays an important normative role in research through the existence of morally significant interplay between notions of community and individuality. We draw on experience of community engagement in rural Kenya to illustrate two aspects of this interplay: (i) that (...) taking individual informed consent seriously involves understanding and addressing the influence of communities in which individuals’ lives are embedded; (ii) that individual participation can generate risks and benefits for communities as part of the wider implications of research. We further argue that the contingent nature of a community means that defining boundaries is generally a normative process itself, with ethical implications. Community engagement supports the enactment of normative roles; building mutual understanding and trust between researchers and community members have been important goals in Kilifi, requiring a broad range of approaches. Ethical dilemmas are continuously generated as part of these engagement activities, including the risks of perverse outcomes related to existing social relations in communities and conditions of ‘half knowing’ intrinsic to processes of developing new understandings. (shrink)

An exploratory model is presented as a heuristic to indicate how individual perceptions of corporate reputation (before joining) and corporate ethical values (after joining) generate specific individual organizational senses of fit. The paper suggests that an ethical dimension of person-organization fit may go some way in explaining superior acquisition and retention of staff by those who are attracted to specific organizations by levels of corporate social performance consonant with their ethical expectations, or who remain with them by virtue of better (...) personal ethical fits with extant organizational ethical values. Specifically, the model suggests that individual misfits that arise from ethical expectations that either exceed or fall short of perceived organizational ethical performances lead to problematic acquisition and retention behavioural outcomes. (shrink)

An exploratory model is presented as a heuristic to indicate how individual perceptions of corporate reputation (before joining) and corporate ethical values (after joining) generate specific individual organizational senses of fit. The paper suggests that an ethical dimension of person-organization fit may go some way in explaining superior acquisition and retention of staff by those who are attracted to specific organizations by levels of corporate social performance consonant with their ethical expectations, or who remain with them by virtue of better (...) personal ethical fits with extant organizational ethical values. Specifically, the model suggests that individual misfits that arise from ethical expectations that either exceed or fall short of perceived organizational ethical performances lead to problematic acquisition and retention behavioural outcomes. (shrink)

We report an experiment investigating the “special-process” theory of insight problem solving, which claims that insight arises from non-conscious, non-reportable processes that enable problem re-structuring. We predicted that reducing opportunities for speech-based processing during insight problem solving should permit special processes to function more effectively and gain conscious awareness, thereby facilitating insight. We distracted speech-based processing by using either articulatory suppression or irrelevant speech, with findings for these conditions supporting the predicted insight facilitation effect relative to silent working or thinking (...) aloud. The latter condition was included to investigate the currently contested effect of “verbal overshadowing” on insight, whereby thinking aloud is claimed to hinder the operation of special, non-reportable processes. Whilst verbal overshadowing was not evident in final solution rates, there was nevertheless support for verbal overshadowing up to and beyond.. (shrink)

In this paper I argue for a special kind of injustice I call “trust injustice.” Taking Miranda Fricker's work on epistemic injustice as my starting point, I argue that there are some ethical constraints on trust relationships. If I am right about this, then we sometimes have duties to maintain trust relationships that are independent of the social roles we play.

Recent work in the psychology of happiness has led some to conclude that we are unreliable assessors of our lives and that skepticism about whether we are happy is a genuine possibility worth taking very seriously. I argue that such claims, if true, have worrisome implications for procreation. In particular, they show that skepticism about whether many if not most people are well positioned to create persons is a genuine possibility worth taking very seriously. This skeptical worry should not be (...) confused with a related but much stronger version of the argument, which says that all human lives are very bad and not worth starting. I criticize the latter stance, but take seriously the former stance and hope it can be answered in future work. (shrink)

Controlled human malaria infection (CHMI) studies involve the deliberate infection of healthy volunteers with malaria parasites under controlled conditions to study immune responses and/or test drug or vaccine efficacy. An empirical ethics study was embedded in a CHMI study at a Kenyan research programme to explore stakeholders’ perceptions and experiences of deliberate infection and moral implications of these. Data for this qualitative study were collected through focus group discussions, in‐depth interviews and non‐participant observation. Sixty‐nine participants were involved, including CHMI study (...) volunteers, community representatives and research staff. Data were managed using QSR Nvivo 10 and analysed using an inductive‐deductive approach, guided by ethics literature. CHMI volunteers had reasonable understanding of the study procedures. Decisions to join were influenced by study incentives, trust in the research institution, their assessment of associated burdens and motivation to support malaria vaccine development. However, deliberate malaria infection was a highly unusual research strategy for volunteers, community representatives and some study staff. Volunteers’ experiences of physical, emotional and social burdens or harms were often greater than anticipated initially, and fluctuated over time, related to specific procedures and events. Although unlikely to deter volunteers' participation in similar studies in furture, we argue that the dissonance between level of understanding of the burdens involved and actual experiences are morally relevant in relation to community engagement, informed consent processes, and ongoing support for volunteers and research staff. We further argue that ethics oversight of CHMI studies should take account of these issues in deciding whether consent, engagement and the balance of benefits and harms are reasonable in a given context. (shrink)

This paper summarized the findings of a qualitative study that examines the perceptions of ethical leadership held by those who perceived themselves to be ethical leaders, and how life experiences shaped the values called upon when making ethical decisions. The experiences of 28 business executives were shared with the researcher, beginning with the recollection of a critical incident that detailed an ethical issue with which each executive had been involved. With the critical incident in mind, each executive told the personal (...) story that explained the development of the values he or she called upon when resolving the ethical issue described. The stories were analyzed through the use of constant comparison, which resulted in the development of two models: (1) a framework for ethical leadership illuminating valued aspects of ethical leaderships and the value perspectives called upon when making ethical decisions, and (2) a model explaining how the executives’ ethical frameworks developed. The paper concludes with a brief discussion on virtue ethics, experiential learning, and human resource development. (shrink)

In this paper, we will consider the neuro-cognitive systems involved in mediating morality. Five main claims will be made. First, that there are multiple, partially separable neuro-cognitive architectures that mediate specific aspects of morality: social convention, care-based morality, disgust-based morality and fairness/justice. Second, that all aspects of morality, including social convention, involve affect. Third, that the neural system particularly important for social convention, given its role in mediating anger and responding to angry expressions, is ventrolateral prefrontal cortex. Fourth, that the (...) neural systems particularly important for care-based morality are the amygdala and medial orbital frontal cortex. Fifth, that while Theory of Mind is not a prerequisite for the development of affect-based 'automatic moral attitudes', it is critically involved in many aspects of moral reasoning. (shrink)

Benefit sharing in health research has been the focus of international debates for many years, particularly in developing countries. Whilst increasing attention is being given to frameworks that can guide researchers to determine levels of benefits to participants, there is little empirical research from developing countries on the practical application of these frameworks, including in situations of extreme poverty and vulnerability. In addition, the voices of those who often negotiate and face issues related to benefits in practice - frontline researchers (...) and fieldworkers - are rarely included in these debates. Against this background, this paper reports on experiences of negotiating research participation and benefits as described by fieldworkers, research participants and researchers in two community based studies. (shrink)

In an original and provocative study of suicide, Ian Marsh examines the historical and cultural forces that have influenced contemporary thought, practices and policy in relation to this serious public health problem. Drawing on the work of French philosopher Michel Foucault, the book tells the story of how suicide has come to be seen as first and foremost a matter of psychiatric concern. Marsh sets out to challenge the assumptions and certainties embedded in our beliefs, attitudes and practices concerning suicide (...) and the suicidal, and the resulting account unsettles and informs in equal measure. The book will be of particular interest to researchers, professionals and students in psychology, history, sociology and the health sciences. (shrink)

The concept of “public participation” is currently one of great interest to researchers and policy makers. In response to a perceived need for greater public involvement in decision making and policy formation processes on the part of both policymakers and the general public, a variety of novel mechanisms have been developed, such as the consensus conference and citizens jury, to complement traditional mechanisms, such as the public meeting. However, the relative effectiveness of the various mechanisms is unclear, as efforts at (...) evaluation have been sparse. In this article, the authors describe an evaluation of a two-day “deliberative conference” on the topic of radiation dose assessment. The authors detail the evaluation framework that they adopt and describe the instruments that they have developed to determine the attainment of the evaluationcriteria stipulated in that framework. They then describe the participation exercise that they have evaluated. Finally, they apply the instruments to assess the effectiveness of the exercise, and discuss the results and their implications for the conduct of evaluations and the use of this particular participation mechanism. (shrink)

The challenge from religious diversity is widely thought to be one of the most important challenges facing religious belief. Despite this consensus, however, many epistemologists think that standard versions of the challenge fail because they threaten to implicate many seemingly reasonable yet highly controversial non-religious beliefs. In light of this we develop an alternative, less discussed, diversity challenge that does not generalize. This challenge concerns why so much religious diversity exists in the first place given common religious, and in particular (...) theistic, views. Although there are some interesting scientific explanations of such diversity, satisfying theistic explanations of its existence are still required. (shrink)

Many people think that the amount of evil and suffering we observe provides important and perhaps decisive evidence against the claim that a loving God created our world. Yet almost nobody worries about the ethics of human procreation. Can these attitudes be consistently maintained? This chapter argues that the most obvious attempts to justify a positive answer fail. The upshot is not that procreation is impermissible, but rather that we should either revise our beliefs about the severity of global arguments (...) from evil or develop new and better defenses of human procreation. Although both possibilities are worthy of pursuit, this chapter focuses on the latter possibility. (shrink)

In his article entitled 'Divine hiddenness and the demographics of theism' ("Religious Studies", 42 (2006), 177–191), Stephen Maitzen draws our attention to an important feature that is often overlooked in discussion about the argument from divine hiddenness (ADH). His claim is that an uneven distribution of theistic belief (and not just the mere existence of non-belief) provides an atheological challenge that cannot likely be overcome. After describing what I take to be the most pressing feature of the problem, I argue (...) that a hidden premise causes Maitzen to overlook a Molinist solution. The upshot is a softening of the atheological import of the demographic data. (shrink)

Ethical approval must be obtained before medical research can start. We describe the differences in EA for an pseudonymous, non-interventional, observational European study. Sixteen European national coordinators of the international study on very old intensive care patients answered an online questionnaire concerning their experience getting EA. N = 8/16 of the NCs could apply at one single national ethical committee, while the others had to apply to various regional ECs and/or individual hospital institutional research boards. The time between applying for (...) EA and the first decision varied between 7 days and 300 days. In 9/16 informed consent from the patient was not deemed necessary; in 7/16 informed consent was required from the patient or relatives. The upload of coded data to a central database required additional information in 14/16. In 4/16 the NCs had to ask separate approval to keep a subject identification code list to de-pseudonymize the patients if questions would occur. Only 2/16 of the NCs agreed that informed consent was necessary for this observational study. Overall, 6/16 of the NCs were satisfied with the entire process and 8/16 were unsatisfied. 11/16 would welcome a European central EC that would judge observational studies for all European countries. Variations in the process and prolonged time needed to get EA for observational studies hampers inclusion of patients in some European countries. This might have a negative influence on the external validity. Further harmonization of ethical approval process across Europe is welcomed for low-risk observational studies. Getting ethical approval for low-risk, non-interventional, observational studies varies enormously across European countries. (shrink)

The proposed framework by Lynch et al. (2021) for promoting ethical forms of payment in Human Infection Controlled Studies (HICS) in general and SARS-Cov-2 HICS in particular is an important contri...

School principals world-wide report high levels of strain and attrition resulting in a shortage of qualified principals. It is thus, crucial to identify psychosocial risk factors that reflect principals’ occupational wellbeing. For this purpose, we used the Copenhagen Psychosocial Questionnaire (COPSOQ-II), a widely used self-report measure covering multiple psychosocial factors identified by leading occupational stress theories. We evaluated the COPSOQ-II regarding factor structure and longitudinal, discriminant, and convergent validity using latent structural equation modeling in a large sample of Australian school (...) principals (N = 2,049). Results reveal that confirmatory factor analysis produced marginally acceptable model fit. A novel approach we call set exploratory structural equation modeling (ESEM-set), where cross-loadings were only allowed within a priori defined sets of factors, fit well, and was more parsimonious than a full ESEM. Further multitrait-multimethod models based on the set-ESEM confirm the importance of a principal’s psychosocial risk factors; Stressors and depression were related to demands and ill-being, while confidence and autonomy were related to wellbeing. We also show that working in the private sector was beneficial for showing a low psychosocial risk, while other demographics have little effects. Finally, we identify five latent risk profiles (high risk to no risk) of school principals based on all psychosocial factors. Overall the research presented here closes the theory application gap of a strong multi-dimensional measure of psychosocial risk-factors. (shrink)

BackgroundVerbal autopsy is a pragmatic approach for generating cause-of-death data in contexts without well-functioning civil registration and vital statistics systems. It has primarily been conducted in health and demographic surveillance systems (HDSS) in Africa and Asia. Although significant resources have been invested to develop the technical aspects of verbal autopsy, ethical issues have received little attention. We explored the benefits and burdens of verbal autopsy in HDSS settings and identified potential strategies to respond to the ethical issues identified.MethodsThis research was (...) based on a case study approach centred on two contrasting HDSS in Kenya and followed the Mapping-Framing-Shaping Framework for empirical bioethics research. Data were collected through individual interviews, focus group discussions, document reviews and non-participant observations. 115 participants were involved, including 86 community members (HDSS residents and community representatives), and 29 research staff (HDSS managers, researchers, census field workers and verbal autopsy interviewers).ResultsThe use of verbal autopsy data for research and public health was described as the most common potential benefit of verbal autopsy in HDSS. Community members mentioned the potential uses of verbal autopsy data in addressing immediate public health problems for the local population while research staff emphasized the benefits of verbal autopsy to research and the wider public. The most prominent burden associated with the verbal autopsy was emotional distress for verbal autopsy interviewers and respondents. Moral events linked to the interview, such as being unsure of the right thing to do (moral uncertainty) or knowing the right thing to do and being constrained from acting (moral constraint), emerged as key causes of emotional distress for verbal autopsy interviewers.ConclusionsThe collection of cause-of-death data through verbal autopsy in HDSS settings presents important ethical and emotional challenges for verbal autopsy interviewers and respondents. These challenges include emotional distress for respondents and moral distress for interviewers. This empirical ethics study provides detailed accounts of the distress caused by verbal autopsy and highlights ethical tensions between potential population benefits and risks to individuals. It includes recommendations for policy and practice to address emotional and moral distress in verbal autopsy. (shrink)

The aim of this volume is to critically assess the philosophical importance of phenomenology as a method for studying the normativity of meaning and its transcendental conditions. Using the pioneering work of Steven Crowell as a springboard, phenomenologists from all over the world examine the promise of phenomenology for illuminating long-standing problems in epistemology, the philosophy of mind, action theory, the philosophy of religion, and moral psychology. The essays are unique in that they engage with the phenomenological tradition not as (...) a collection of authorities to whom we must defer, or a set of historical artifacts we must preserve, but rather as a community of interlocutors with views that bear on important issues in contemporary philosophy. The book is divided into three thematic sections, each examining different clusters of issues aimed at moving the phenomenological project forward. The first section explores the connection between normativity and meaning, and asks us to rethink the relation between the factual realm and the categories of validity in terms of which things can show up as what they are. The second section examines the nature of the self that is capable of experiencing meaning. It includes essays on intentionality, agency, consciousness, naturalism, and moral normativity. The third section addresses questions of philosophical methodology, examining if and why phenomenology should have priority in the analysis of meaning. Finally, the book concludes with an afterword written by Steven Crowell. Normativity, Meaning, and the Promise of Phenomenology will be a key resource for students and scholars interested in the phenomenological tradition, the transcendental tradition from Kant to Davidson, and existentialism. Additionally, its forward-looking focus yields crucial insights into pressing philosophical problems that will appeal to scholars working across all areas of the discipline. ks us to rethink the relation between the factual realm and the categories of validity in terms of which things can show up as what they are. The second section examines the nature of the self that is capable of experiencing meaning. It includes essays on intentionality, agency, consciousness, naturalism, and moral normativity. The third section addresses questions of philosophical methodology, examining if and why phenomenology should have priority in the analysis of meaning. Finally, the book concludes with an afterword written by Steven Crowell. Normativity, Meaning, and the Promise of Phenomenology will be a key resource for students and scholars interested in the phenomenological tradition, the transcendental tradition from Kant to Davidson, and existentialism. Additionally, its forward-looking focus yields crucial insights into pressing philosophical problems that will appeal to scholars working across all areas of the discipline. (shrink)

The role of imagery in encoding event-based prospective memories has yet to be fully clarified. Herein, it is argued that imagery augments a cue-to-context association that supports event-based prospective memory performance. By this account, imagery encoding not only improves prospective memory performance but also reduces interference to intention-related information that occurs outside of context. In the current study, when lure words occurred outside of the appropriate responding context, the use of imagery encoding strategies resulted in less interference when compared with (...) a standard event-based intention condition. This difference was eliminated when participants were not given a specific context to associate their intention . These results support a cue-to-context association account of how imagery operates in certain event-based prospective memory tasks. (shrink)

Human Infection Studies have emerged as an important research approach with the potential to fast track the global development of vaccines and treatments for infectious diseases, including in low resource settings. Given the high level of burdens involved in many HIS, particularly prolonged residency and biological sampling requirements, it can be challenging to identify levels of study payments that provide adequate compensation but avoid ‘undue’ levels of inducement to participate. Through this embedded ethics study, involving 97 healthy volunteers and other (...) research stakeholders in a malaria HIS programme in Kenya, and using in-depth interviews, focus group discussions and observations during and after a malaria HIS, we give a grounded account of ethical issues emerging in relation to study payments in this setting. While careful community, national, international scientific and ethics review processes meant that risks of serious harm were highly unlikely, the levels of motivation to join HIS seen could raise concerns about study payments being too high. Particular value was placed on the reliability, rather than level, of study payment in this setting, where subsistence livelihoods are common. Study volunteers were generally clear about the study aims at the point of recruitment, and this knowledge was retained over a year later, although most reported experiencing more burdens than anticipated at enrolment. Strict study screening procedures, regular clinical and laboratory monitoring of volunteers, with prompt treatment with antimalarial at predetermined endpoints suggested that the risks of serious harm were highly unlikely. Ethical concerns emerged in relation to volunteers’ attempts to conceal symptoms, hoping to prolong residency periods and increase study payments; and volunteers making decisions that compromised important family relationships and personal values. Our findings support an interpretation that, although study volunteers were keen to join the study to access cash payments, they also paid attention to other features of the study and the general clinical research landscape, including levels of risk associated with study participation. Overall, our analysis shows that the ethical concerns emerging from the study payments can be addressed through practical measures, hinged on reducing burdens and strengthening communication, raising important issues for research policy and planning. (shrink)

Disability-positive philosophers often note a troubling tendency to dismiss what disabled people say about their well-being. This chapter seeks to get clearer on why this tendency might be troubling. It argues that recent appeals to lived experience, testimonial injustice, and certain challenges to adaptive-preference reasoning do not fully explain what is wrong with questioning the happiness of disabled people. It then argues that common attempts to debunk the claim that disabled people are happy are worrisome because they threaten everyone’s well-being (...) and are further challenged by an argument from moral risk. (shrink)

Empathy is a construct that is notoriously difficult to define. Murphy and colleagues argue for leaning into the construct's inherent fuzziness and reverting to what they term a classical definition informed by the observations of philosophers and clinicians: as a dynamic, “unfolding process of imaginatively experiencing the subjective consciousness of another person, sensing, understanding, and structuring the world as if one were that person.” Although consistent with some historical conceptualizations, this definition risks incorporating so many processes it would make empathy (...) difficult to operationalize or distinguish from any generally socially sensitive interaction. Defining empathy instead as the attempted representation, or simulation, of another's subjective internal experiences would increase its clarity and empirical utility. (shrink)

Empathy is a construct that is notoriously difficult to define. Murphy and colleagues argue for leaning into the construct's inherent fuzziness and reverting to what they term a classical definition informed by the observations of philosophers and clinicians: as a dynamic, “unfolding process of imaginatively experiencing the subjective consciousness of another person, sensing, understanding, and structuring the world as if one were that person.” Although consistent with some historical conceptualizations, this definition risks incorporating so many processes it would make empathy (...) difficult to operationalize or distinguish from any generally socially sensitive interaction. Defining empathy instead as the attempted representation, or simulation, of another's subjective internal experiences would increase its clarity and empirical utility. (shrink)

BackgroundCarefully planned research is critical to developing policies and interventions that counter physical, psychological and social challenges faced by young people living with HIV/aids, without increasing burdens. Such studies, however, must navigate a ‘vulnerability paradox’, since including potentially vulnerable groups also risks unintentionally worsening their situation. Through embedded social science research, linked to a cohort study involving Adolescents Living with HIV/aids (ALH) in Kenya, we develop an account of researchers’ responsibilities towards young people, incorporating concepts of vulnerability, resilience, and agency (...) as ‘interacting layers’.MethodsUsing a qualitative, iterative approach across three linked data collection phases including interviews, group discussions, observations and a participatory workshop, we explored stakeholders’ perspectives on vulnerability and resilience of young people living with HIV/aids, in relation to home and community, school, health care and health research participation. A total of 62 policy, provider, research, and community-based stakeholders were involved, including 27 ALH participating in a longitudinal cohort study. Data analysis drew on a Framework Analysis approach; ethical analysis adapts Luna’s layered account of vulnerability.ResultsALH experienced forms of vulnerability and resilience in their daily lives in which socioeconomic context, institutional policies, organisational systems and interpersonal relations were key, interrelated influences. Anticipated and experienced forms of stigma and discrimination in schools, health clinics and communities were linked to actions undermining ART adherence, worsening physical and mental health, and poor educational outcomes, indicating cascading forms of vulnerability, resulting in worsened vulnerabilities. Positive inputs within and across sectors could build resilience, improve outcomes, and support positive research experiences.ConclusionsThe most serious forms of vulnerability faced by ALH in the cohort study were related to structural, inter-sectoral influences, unrelated to study participation and underscored by constraints to their agency. Vulnerabilities, including cascading forms, were potentially responsive to policy-based and interpersonal actions. Stakeholder engagement supported cohort design and implementation, building privacy, stakeholder understanding, interpersonal relations and ancillary care policies. Structural forms of vulnerability underscore researchers’ responsibilities to work within multi-sectoral partnerships to plan and implement studies involving ALH, share findings in a timely way and contribute to policies addressing known causes of vulnerabilities. (shrink)

The American Journal of Bioethics, Volume 11, Issue 8, Page 31-33, August 2011.

Community engagement is increasingly emphasized in biomedical research, as a right in itself, and to strengthen ethical practice. We draw on interviews and observations to consider the practical and ethical implications of involving Community Health Workers (CHWs) as part of a community engagement strategy for a vaccine trial on the Kenyan Coast. CHWs were initially engaged as an important network to be informed about the trial. However over time, and in response to community advice, they became involved in trial information (...) sharing and identifying potential participants; thereby taking on roles that overlapped with those of employed fieldworkers (FWs). While CHWs involvement was generally perceived as positive and appreciated, there were challenges in their relations with FWs and other community members, partly related to levels and forms of remuneration. Specifically, payment of CHWs was not as high as for FWs and was based on ‘performance’. This extrinsic motivation had the potential to crowd out CHWs intrinsic motivation to perform their pre-existing community roles. CHWs remuneration potentially also contributed to CHWs distorting trial information to encourage community members to participate; and to researchers encouraging CHWs to utilize their social connections and status to increase the numbers of people who attended information giving sessions. Individual consent processes were protected in this trial through final information sharing and consent being conducted by trained clinical staff who were not embedded in study communities. However, our experiences suggest that roles and remuneration of all front line staff and volunteers involved in trials need careful consideration from the outset, and monitoring and discussion over time. (shrink)

International research guidance has shifted towards an increasingly proactive inclusion of children and adolescents in health research in recognition of the need for more evidence-based treatment. Strong calls have been made for the active involvement of children and adolescents in developing research proposals and policies, including in decision-making about research participation. Much evidence and debate on this topic has focused on high-income settings, while the greatest health burdens and research gaps occur in low-middle income countries, highlighting the need to take (...) account of voices from more diverse contexts. Between January and March 2014, 56 community representatives and secondary school students were involved in eight group discussions to explore views on the acceptability of involving children and adolescents in research, and how these groups should be involved in decision-making about their own participation. Discussions were voice-recorded and transcriptions analyzed using Framework Analysis, combining deductive and inductive approaches. Across these discussions, the idea of involving children and adolescents in decision-making about research participation was strongly supported given similar levels of responsibility carried in everyday life; existing capacity that should be recognized; the opportunity for learning involved; varying levels of parental control; and generational shifts towards greater understanding of science for adolescents than their parents. Joint decision-making processes were supported for older children and adolescents, with parental control influenced by perceptions of the risks involved in participation. Moves towards more active involvement of children and adolescents in planning studies and in making decisions about their participation are supported by these findings from Kenya. Important emerging considerations include the need to take account of the nature of proposed studies and prevailing attitudes and understanding of research in identifying children’s and adolescents’ roles. More research is needed to expand diversity and develop approaches to joint assent and consent processes that would fairly represent children’s and adolescents’ wishes and interests, towards their long term benefit. (shrink)

There is currently debate between deflationists and anti-deflationists about the ontology of persisting objects. Some deflationists think that disputes between, for example, four-dimensionalists (e.g. Ted Sider and David Lewis) and quasi-nihilists (e.g. Peter Van Inwagen and Trenton Merricks) are merely verbal disputes. Anti-deflationists deny this. Eli Hirsch is a deflationist who maintains that many ontological disputes are merely verbal. Theodore Sider maintains that the disputes are not merely verbal. Hirsch and Sider are thus engaged in a metaontological dispute. In this (...) paper, I argue that Hirsch's metaontological dispute with Sider is, by Hirsch's own lights, itself merely verbal. I conclude that the mere verbalness of his metaontological dispute with Sider suggests that Hirsch's account of what makes a dispute merely verbal may be problematic. (shrink)

Michael Oakeshott has long been recognized as one of the most important political philosophers of the twentieth century, but until now no single volume has been able to examine all the facets of his wide-ranging philosophy with sufficient depth, expertise, and authority. The essays collected here cover all aspects of Oakeshott’s thought, from his theory of knowledge and philosophies of history, religion, art, and education to his reflections on morality, politics, and law. The volume provides an authoritative and synoptic guide (...) to one of the most important philosophers of the twentieth century. (shrink)