This article provides ethical guidance on using race in health research as a variable or in defining the study population. To this end, a plain, non-exhaustive checklist is provided for researchers and research ethics committees, preceded by a brief introduction on the need for justification when using race as a variable or in defining a study population, the problem of exoticism, that distinctions pertain between race, ethnicity and ancestry, the problematic naming of races, and that race does not serve well (...) as a presumed biological construct in genetic research. (shrink)

The purpose of this article is to problematise a particular social transparency and disclosure regulation in the UK, that transcend national boundaries in order to control slavery in supply chains operating in the developing world. Drawing on notions from the regulatory and sociology literature, i.e. transparency and normativity, and by interviewing anti-slavery activists and experts, this study explores the limitations of the disclosure and transparency requirements of the UK Modern Slavery Act and, more specifically, how anti-slavery activists experience and interpret (...) the new regulations and the regulators’ implementation of the regulation. This research found limited confidence among anti-slavery activists regarding the Act’s call for transparency in relation to the elimination of slavery from global supply chains. The research also found that the limits of the transparency provisions within the Act appear to hinder the attainment of normativity. This study provides new and unique insights into the critical role that social activists play in exposing the lack of corporate transparency and failures of responsibility to protect workers within global supply chains. (shrink)

Distributional fairness of corporate distributions is an important social issue linked to accounting for equality. Value added and the information contained in the value added statement can conceptually be regarded as a reflection of how the company is managed for all stakeholders. We investigate value added information published in sustainability reports to determine if the information provided is useful for assessing distributional fairness between stakeholders. We find that the value added information disclosed lack conciseness, comparability and understandability. The divergence is (...) considerable and the explanations of the disclosed information so limited that the usefulness of the value added disclosures must be questioned. Our results suggest several obfuscating techniques in the disclosure of value added information, including disclosing information that is conceptually compromised, resulting in comparability issues and disclosing information that can’t be verified by reconciling back to the financial statements. Our findings have clear ethical and moral implications as they stress the societal issue of distributional fairness. It seems that companies are either reluctant to provide value added information that is useful, or deliberately use value added disclosures to obfuscate. Information reflecting distributional fairness is therefore compromised. (shrink)

The book discusses different models of world order, traditional and modern. Any practical application of the concept at issue will be affected by the prevailing power structure, and to some degree, reflect it. The reality of American preeminence in the world today needs to be reconciled with the demand for international legitimacy.

What renders some mentally disordered patients incapable of informed consent to medical interventions? It is argued that a patient is incapable of giving informed consent owing to mental disorder, if a mental disorder prevents a patient from understanding what s/he consents to; if a mental disorder prevents a patient from choosing decisively; if a mental disorder prevents a patient from communicating his/her consent; or if a mental disorder prevents a patient from accepting the need for a medical intervention. This paper (...) holds that a patient's capacity to give informed consent should be assessed clinically by using these conditions necessary for informed consent, and should be assessed specifically for each intervention and specifically at the time when the consent has to be given. The paper considers patients' incapacity to give informed consent to treatment, to give informed consent to be examined clinically, and to give informed consent to participate in research. (shrink)

THE FIRST PART OF MY RESPONSE to the commentaries on my earlier paper is about the place of language and logical systems in the understanding of the personal positions that recovering patients occupy in their life experiences. It includes the main reasons for using Frege's philosophy. Thereafter, I make the point that relational positions in recovery extend broader than positions of actor and patient.

This paper presents the philosophical theory underpinning an empirical study that found changes in the semantic usage of first person pronouns by recovering psychotherapy patients. The philosophical theory provided semantic variables that could serve as markers of recovery. It derived from the semantic theory by Gottlob Frege and the logic of relations, and accounts for the meaning expressed by the first person pronouns as distinct from their syntax and pragmatic symbolization. This distinction is worthwhile because empirical evidence was found for (...) change in the meaning expressed by these pronouns during recovery, but not for change in their syntax or pragmatic symbolization. Philosophical work on the concepts of illness and recovery was used to deduce that the semantic variables are markers of recovery in general rather than in psychotherapy only. As with the empirical study, the semantic variables were shown to change as follows when someone recovers: occupancy of alpha positions is taken up and occupancy of omega positions is relinquished. Potential applications of these findings were examined by which the tracking of the semantic variables may serve to improve the clinician's understanding of a patient, monitor a patient's progress, and enhance recovery. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 12.1 (2005) 77-78 [Access article in PDF] Language, Mind, and World Werdie (C. W.) Van Staden Keywords psychotherapy, linguistics, semantics, references, speech The paper by Mcconnell and Gillett touches, in a Lacanian way, on the connections between language, world, and the conscious and unconscious mind. Their paper brings together the influential ideas of Freud, philosophical phenomenology, existentialism, and structuralism in describing Lacan's approach to (...) these connections. Going further than Lacan's concerns in psychotherapy, their paper calls on us to consider the importance of these connections more generally in philosophy, psychiatry, and psychology.These connections matter substantially in the practice of psychiatry and psychology, for there we need to understand as much as possible of the ways in which language is intimately involved with the minds and brains of people and their biological and interpersonal worlds. Even at first glance, we can easily concede that people use language to express their troubled minds and their past, present, and anticipated relations with their biological and interpersonal worlds; that language use depends inescapably on brain functions (of the Broca and the Wernicke areas, for example); and that practitioners use language receptively and exploratively to access and examine the minds as well as the biological and interpersonal worlds of the people.Cognizant of the connections between language, mind, and world, language has received considerable attention in the psychotherapy literature and practice (e.g., Russell 1987), including from Lacan and his followers. In addition to these practices and theoretical expositions, empirical linguistic studies in psychotherapy have also been published recently (e.g., Van Staden in press; Van Staden and Fulford 2004; Spence 1995; Spence, Mayes, and Dahl 1994).There has been, furthermore, a growing interest in defining linguistic variables for empirical research in general psychiatry and psychology (Van Staden 2002; Thomas and Fraser 1994). The necessary and intimate role of language has also been reviewed recently in coming to a diagnostic understanding of people's difficulties (Van Staden 2003) and in conducting ethically sound assessments of mentally disordered people's capacity to give informed consent (Van Staden and Krüger 2003). Furthermore, the underlying connections between language, mind, and world, for example, have brought about the expectation that genetic factors in the etiology of schizophrenia would be related to the far-reaching capacity of human beings to use language (Crow 1997).A philosophical interest in the connections between language, mind, and world can be traced back to Plato. More recently, it has been taking a central place in analytic philosophy. The vast and sophisticated philosophical literature on this topic suggests that these connections are very [End Page 77] intricate and that we probably have an inchoate understanding of them. These connections are about theories of reference; theories of descriptions; semantic theories of truth; Kant's distinction between form and content; meaning; contextual content; linguistic pragmatism and speech act theories—all elaborate topics, of course, intertwined with various ontological commitments (cf. Luntley 1999).Lacan's contribution, driven by practical need albeit in the constrained area of psychotherapy, has not yet been taken up in analytic philosophy circles. The paper by McConnell and Gillett sets the scene for further philosophical examination that could determine whether Lacan's work does advance contemporary analytic philosophy on this topic. The most potential for such advance concerns probably, as indicated by McConnell and Gillet, insights about the unconscious mind.Notwithstanding a worthy philosophical examination of whether Lacan's work advances contemporary analytic philosophy on the connections between language, mind, and world, it may prove to be a challenging undertaking—probably even more challenging than the admirable groundwork done in the paper by McConnell and Gillett. The reason is, in my opinion, that the depth of Lacan's work is difficult to penetrate, in part because of the abundance of his esoteric terms, some of which are prima facie incommensurable with ordinary analytic language. The philosophical cogency of his work, moreover, is difficult to verify, because he often simply made conjectures, true as they might be, without explicating (sufficiently) the justification thereof.Lacan's work is commendable, however, even if... (shrink)

According to widespread opinion, the meaning of body part terms is determined by salient discontinuities in the visual image; such that hands, feet, arms, and legs, are natural parts. If so, one would expect these parts to have distinct names which correspond in meaning across languages. To test this proposal, we compared three unrelated languages—Dutch, Japanese, and Indonesian—and found both naming systems and boundaries of even basic body part terms display variation across languages. Bottom‐up cues alone cannot explain natural language (...) semantic systems; there simply is not a one‐to‐one mapping of the body semantic system to the body structural description. Although body parts are flexibly construed across languages, body parts semantics are, nevertheless, constrained by non‐linguistic representations in the body structural description, suggesting these are necessary, although not sufficient, in accounting for aspects of the body lexicon. (shrink)

The Oxford Handbook of Psychiatric Ethics is the most comprehensive treatment of the field in history. The volume is organized into ten sections which survey the scope of the text: Introduction, People Come First, Specific Populations, Philosophy and Psychiatric Ethics, Religious Contexts of Psychiatric Ethics, Social Contexts of Psychiatric Ethics, Ethics in Psychiatric Citizenship and the Law, Ethics of Psychiatric Research, Ethics and Values in Psychiatric Assessment and Diagnosis, Ethics and Values in Psychiatric Treatment. Written and edited by an international (...) team of experts, this landmark book provides a powerful and compelling review of psychiatric ethics in the 21st Century. (shrink)

Newborn screening involves a complex logistical process, which depends on the close cooperation of many professionals, such as midwives, laboratory technicians, general practitioners and pediatricians. These professionals may encounter moral problems in the process, which have not been systematically studied before. This study fills this gap. We conducted interviews with 36 professionals involved in NBS in the Netherlands and made an inventory of the moral problems they encounter, as well as of the ways in which they tend to respond to (...) them. The moral problems professionals encounter stem from interpersonal conflicts and intrapersonal conflicts. Given the complexity of the work of NBS professionals, the study suggests that the moral problems that occur on the work floor cannot easily be solved by means of offering better or more stringent policy guidelines. Rather, it should be appreciated that professionals contribute significantly to shaping the morality of NBS with the help of their daily choices, and they should be supported in carrying out this task—for example with the help of a moral training or regular multidisciplinary moral deliberation, facilitated by an ethicist. (shrink)

Political liberals ask citizens not to appeal to certain considerations, including religious and philosophical convictions, in political deliberation. We argue that political liberals must include a demanding requirement of intellectual modesty in their ideal of citizenship in order to motivate this deliberative restraint. The requirement calls on each citizen to believe that the best reasoners disagree about the considerations that she is barred from appealing to. Along the way, we clarify how requirements of intellectual modesty relate to moral reasons for (...) deliberative restraint. And we argue against attempts to weaken our requirement of intellectual modesty by emphasizing those moral reasons. (shrink)

Introduction: In The Netherlands, physicians have to be convinced that the patient suffers unbearably and hopelessly before granting a request for euthanasia. The extent to which general practitioners (GPs), consulted physicians and members of the euthanasia review committees judge this criterion similarly was evaluated. Methods: 300 GPs, 150 consultants and 27 members of review committees were sent a questionnaire with patient descriptions. Besides a “standard case” of a patient with physical suffering and limited life expectancy, the descriptions included cases in (...) which the request was mainly rooted in psychosocial or existential suffering, such as fear of future suffering or dependency. For each case, respondents were asked whether they recognised the case from their own practice and whether they considered the suffering to be unbearable. Results: The cases were recognisable for almost all respondents. For the “standard case” nearly all respondents were convinced that the patient suffered unbearably. For the other cases, GPs thought the suffering was unbearable less often (2–49%) than consultants (25–79%) and members of the euthanasia review committees (24–88%). In each group, the suffering of patients with early dementia and patients who were “tired of living” was least often considered to be unbearable. Conclusions: When non-physical aspects of suffering are central in a euthanasia request, there is variance between and within GPs, consultants and members of the euthanasia committees in their judgement of the patient’s suffering. Possible explanations could be differences in their roles in the decision-making process, differences in experience with evaluating a euthanasia request, or differences in views regarding the permissibility of euthanasia. (shrink)

In paediatric oncology, research and treatments are often closely combined, which may compromise voluntary informed consent of parents. We identified two key scenarios in which voluntary informed consent for paediatric oncology studies is potentially compromised due to the intertwinement of research and care. The first scenario is inclusion by the treating paediatric oncologist, the second scenario concerns treatments confined to the research context. In this article we examine whether voluntary informed consent of parents for research is compromised in these two (...) scenarios, and if so whether this is also morally problematic. For this, we employ the account of voluntary consent from Nelson and colleagues, who assert that voluntary consent requires substantial freedom from controlling influences. We argue that, in the absence of persuasion or manipulation, inclusion by the treating physician does not compromise voluntariness. However, it may function as a risk factor for controlling influence as it narrows the scope within which parents make decisions. Furthermore, physician appeal to reciprocity is not controlling as it constitutes persuasion. In addition, framing information is a form of informational manipulation and constitutes a controlling influence. In the second scenario, treatments confined to the research context qualify as controlling if the available options are restricted through manipulation of options. Although none of the influences is morally problematic in itself, a combination of influences may create morally problematic instances of involuntary informed consent. Therefore, safeguards should be implemented to establish an optimal environment for parents to provide voluntary informed consent in an integrated research-care context. (shrink)

Sections R1 to R3 attempt to take the sting out of hostile commentaries. Sections R4 to R5 engage Berlin and Kay and the World Color Survey to correct the record. Section R6 begins the formulation of a new theory of colour as an engineering project with a technological developmental trajectory. It is recommended that the colour space be abandoned.

In this target article the following hypotheses are discussed: (1) Colour is autonomous: a perceptuolinguistic and behavioural universal. (2) It is completely described by three independent attributes: hue, brightness, and saturation: (3) Phenomenologically and psychophysically there are four unique hues: red, green, blue, and yellow; (4) The unique hues are underpinned by two opponent psychophysical and/or neuronal channels: red/green, blue/yellow. The relevant literature is reviewed. We conclude: (i) Psychophysics and neurophysiology fail to set nontrivial constraints on colour categorization. (ii) Linguistic (...) evidence provides no grounds for the universality of basic colour categories. (iii) Neither the opponent hues red/green, blue/yellow nor hue, brightness, and saturation are intrinsic to a universal concept of colour. (iv) Colour is not autonomous. (shrink)