At every moment, somewhere in the world, a group of men and women are sitting around a table deliberating about an ethical issue posed by medicine and research, whether as a research ethics committee; a hospital or clinical ethics committee; a stem‐cell review committee; a gene transfer research committee; a biobank ethics committee; an ethics advisory committee for a medical or nursing association or nongovernmental organization; a state, provincial, national, or intergovernmental bioethics committee; or an ad hoc panel examining a (...) particular development or case. However, the last national committee in the United States, the Presidential Commission for the Study of Bioethical Issues, held its final meeting at the end of August 2016 and closed its doors. Should we regret its departure? I believe that the United States would benefit from having another national bioethics advisory body, but I do not think that the commission should simply have continued under a new president in the same form. Instead, looking at the experience of that commission and its six predecessors—who they were, how they worked, the functions they served, and the problems they experienced—we can derive some useful ideas for anyone planning to build the next commission. (shrink)

Mea culpa. In 1981 the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, of which I was the Executive Director, recommended to the President and Congress that all federal departments and agencies that conduct or support human subjects research adopt “as a common core” the HHS regulations, “while permitting additions needed by any department or agency that are not inconsistent with these core provisions.” The commission believed—rightly, I still think—that having uniformity would ease (...) administration, reduce regulatory burdens, simplify oversight, and make research more efficient. Yet our naïve expectation the task could be accomplished in 180 days meant that we failed to anticipate that if it took much longer—namely, the 10 years that passed before the Common Rule was issued—federal officials would thereafter be reluctant to change the regulations and that when they tried to do so twenty years later, with the issuance of the ANPRM in 2011, they would propose comprehensive revisions. I argue that was the wrong conclusion to draw from the difficulties in issuing the first Common Rule, and that the process of producing the new “final rule” on January 19, 2017—during which many of the proposed changes were either dumped or promulgated without being adequately vetted—reinforces the conclusion that a more incremental process, with ongoing involvement of the public through an advisory body like the President's Commission, would be a much better way to proceed. (shrink)

Feminist Geneaologies, Colonial Legacies, Democratic Futures provides a feminist anaylsis of the questions of sexual and gender politics, economic and cultural marginality, and anti-racist and anti-colonial practices both in the "West" and in the "Third World." This collection, edited by Jacqui Alexander and Chandra Talpade Mohanty, charts the underlying theoretical perspectives and organization practices of the different varieties of feminism that take on questions of colonialism, imperialism, and the repressive rule of colonial, post-colonial and advanced capitalist nation-states. It provides (...) a comparative, relational, historically grounded conception of feminist praxis that differs markedly from the liberal pluralist, multicultural understanding that sheapes some of the dominant version of Euro-American feminism. As a whole, the collection poses a unique challenge to the naturalization of gender based in the experiences, histories and practices of Euro-American women. (shrink)

____Feminist Geneaologies, Colonial Legacies, Democratic__ ____Futures__ provides a feminist anaylsis of the questions of sexual and gender politics, economic and cultural marginality, and anti-racist and anti-colonial practices both in the "West" and in the "Third World." This collection, edited by Jacqui Alexander and Chandra Talpade Mohanty, charts the underlying theoretical perspectives and organization practices of the different varieties of feminism that take on questions of colonialism, imperialism, and the repressive rule of colonial, post-colonial and advanced capitalist nation-states. It provides (...) a comparative, relational, historically grounded conception of feminist praxis that differs markedly from the liberal pluralist, multicultural understanding that sheapes some of the dominant version of Euro-American feminism. As a whole, the collection poses a unique challenge to the naturalization of gender based in the experiences, histories and practices of Euro-American women. (shrink)

In the article “A Conceptual Model for the Translation of Bioethics Research and Scholarship,” Debra Mathews and her colleagues want to apply to bioethics various translational concepts developed for biomedical research. According to experts in translational science, this would mean evaluating not only the extent to which research produces the “changes in thinking, practice, and policy” that interest Mathews et al. but also the appropriateness of bioethics training and the level of competency of people working in the field. Their proposal (...) thus raises two sets of questions. The first, which the authors recognize must be the starting point for their argument, is, what precisely is the field in question? The second is whether the tools of translational science provide the right means of measuring the achievements of bioethics. (shrink)

Does the practice of questioning the decision-making capacity of patients who disagree with recommended medical interventions amount to paternalism on the part of physicians who would not have raised questions about competence had these patients accepted the recommendation? Brudney and Siegler provide a nuanced argument why the practice can be both pragmatically and ethically justifiable, particularly if physicians follow a “decision tree” that they recommend for cases where disagreements occur. Nonetheless, the history of this subject shows that bioethicists have long (...) been worried that the “outcome approach” (challenging patient’s capacity because of substantive disagreements with their choices) undermines respect for autonomy, and the more refined version from Brudney and Siegler still creates some further concerns about the resulting inadequacies in communication and comprehension in the physician-patient relationship. (shrink)

Public health law courses typically focus a good deal of attention on two related topics: the duty of government agencies to control the spread of communicable diseases and their use of the police power to do so. While governments sometimes take forceful actions in responding to disease outbreaks, they can also act to prevent their occurrence. Indeed, one of the great triumphs of public health in the 20th century was the development of vaccines and their widespread use, which seemed on (...) course to relegate many formerly crippling or deadly diseases to the history books. Particular success occurred with vaccinations against childhood diseases such as polio, smallpox, and measles, outbreaks of which once routinely closed schoolrooms, playgrounds, and community swimming pools. By the last quarter of the century, completion of an elaborate schedule of immunizations was not merely the standard in pediatric practice but an official requirement for school enrollment. As a result, the range of communicable diseases that had once terrified parents had become threats to be feared only in memory. (shrink)

Biomedical and behavioral research is a complex, multidisciplinary, and highly varied enterprise with but a single goal: to produce and disseminate knowledge about the causes, effects, prevention, diagnosis, and treatment of human illnesses and impairments. Success requires public trust in the process. When that trust has been shaken (or worse), the response has been to establish offices to exercise oversight of the various actors and to require them to adhere to regulations that specify, with various levels of detail, what they (...) may or may not do.The two regulatory frameworks examined in this report by Barbara Bierer and Mark Barnes began separately, provoked by different scandals and abuses of public trust. (shrink)

Physician aid in dying is a broader topic than euthanasia in that the latter usually refers to active euthanasia, while physician assistance also encompasses the issue of assisted suicide. Volumes could be and have been written on physician-assisted death. But my purpose here is to address a specific aspect of the topic: the policy implications with regard to proposed legislation on physician-aided death.Although the title's reference to physician assistance suggests a focus on the role of the professional, what people often (...) take to be most important and at the heart of the topic is the issue of the patient's rights, usually seen as being manifested in four different ways. First is the right to a dignified death, as free from pain and suffering as possible. In crossing national boundaries and preceding the organization of the professions and the creation of societies, this right is viewed as one that ought to be recognized. (shrink)

Psychiatric practice is often faced with complex situations that seem to pose serious moral dilemmas for practitioners. Methods for solving these dilemmas have included the development of more objective rules to guide the practitioner such as utilitarianism and deontology. A more modern variant on this objective model has been 'Principlism' where 4 mid level rules are used to help solve these complex problems. In opposition to this, there has recently been a focus on more subjective criteria for resolving complex moral (...) dilemmas. In particular, virtue ethics has been posited as a more sensitive method for helping doctors to reason their way through difficult ethical issues. Here the focus is on the character traits of the practitioner. Bloch and Green advocated another way whereby more objective methods such as Principlism and virtue ethics are combined to produce what they considered sound moral reasoning in psychiatrists. This paper points out some difficulties with this approach and instead suggests that a better model of ethical judgment could be developed through the use of narratives or stories. This idea puts equal prima facie value on the patient's and the psychiatrist's version of the dilemma they are faced with. It has the potential to lead to a more genuine empathy and reflective decision-making. (shrink)

The gradual crowding out of singleton and small team science by large team endeavors is challenging key features of research culture. It is therefore important for the future of scientific practice to reflect upon the individual scientist’s ethical responsibilities within teams. To facilitate this reflection we show labor force trends in the US revealing a skewed growth in academic ranks and increased levels of competition for promotion within the system; we analyze teaming trends across disciplines and national borders demonstrating why (...) it is becoming difficult to distribute credit and to avoid conflicts of interest; and we use more than a century of Nobel prize data to show how science is outgrowing its old institutions of singleton awards. Of particular concern within the large team environment is the weakening of the mentor–mentee relation, which undermines the cultivation of virtue ethics across scientific generations. These trends and emerging organizational complexities call for a universal set of behavioral norms that transcend team heterogeneity and hierarchy. To this end, our expository analysis provides a survey of ethical issues in team settings to inform science ethics education and science policy. (shrink)

The advent of societies with low employment rates will present a challenge to education. Education must move away from the discourse of skills and towards the discourse of meaning and motivation. The paper considers three kinds of non-waged optional labor that may form the basis of the future economy: prosumption, volunteering, and self-design. All three require the ability of a worker to make meaning of his or her own life.

The extremely pernicious and paganly immoral principles stated by the Florentine secretary run counter to all national thought and have incontestably exercised a corrupting influence on it.F. SchlegelWe must be grateful to Machiavelli and other writers who like him have openly and without dissimulation shown not how men ought to act, but how they do normally act.F. BaconThe interpretation of Machiavelli's philosophy of history encounters specific difficulties. His contribution to the history of thought is unique and yet rooted in the (...) culture that was typical of the Renaissance; it constitutes—something rarely found among the creative spirits of the High Renaissance—the logical-historical limit of that culture, the critical point at which the contradictions that characterize it tragically come to light. (shrink)

This paper advocates for a shift from insular paternalism to developmental paternalism in education, contending that students' engagement with erroneous ideas is crucial for building the ability to resist harmful notions and support democracy. The proposed inoculative approach exposes students to problematic ideas, guiding them through the process of overcoming these beliefs using the pedagogy of relation. The author employs behavioral economics to explore the shortcomings of insular paternalism and the early Christian notion of metanoia to explain the importance of (...) changing one's mind. This developmentally-informed approach fosters rational thinking and curbs extremist ideologies. The paper asserts that prioritizing an inoculative approach over an insulatory one equips students to navigate the complexities of the modern world and uphold democratic values. (shrink)

The paper examines “Campbell’s Law”: “The more any quantitative social indicator is used for social decision-making, the more subject it will be to corruption pressures and the more apt it will be to distort and corrupt the social processes it is intended to monitor.” The examination of measurability leads to explaining the reason for existence of a class of unmeasurable phenomena. The author describes a kind of habitus in which a strong taboo against measuring must exist by necessity, not by (...) choice. The taboo is, in effect, a result of degradation of a certain kind of habitus. And finally, the paper demonstrates under which conditions the Campbell’s law is in effect, and how we can mitigate its effects in social decision-making. (shrink)

Five decades ago, Henry Knowles Beecher, a renowned professor of research anesthesiology, sought to solve a problem created by modern medicine. The solution proposed by Beecher and his colleagues on the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death proved very influential.1 Indeed, other contemporaneous medical developments magnified its significance yet also made the solution it offered somewhat problematic. As we mark this fiftieth anniversary, at a time when concerns about the conceptual model (...) on which its recommendations rested are being voiced by critics from medicine as well as philosophy, it is worthwhile to view the committee's report in relation to the problem that prompted its existence as well as the one to which it was quickly applied. (shrink)

The article provides a reply to critical remarks made during the discussion about creativity and scientific knowledge. The authors propose to consider their concept of creativity not as antagonistic or incommensurable with the alternative, but rather co-existing through the complementarity principle. Responding to a comment about the socio-cultural conditionality of a particular cognitive situation, the authors question whether globalization seriously influence this matter in science. They support the statement about the importance of the interaction between science and art, science and (...) philosophy as an opportunity to consider scientific problems from the outside, in an unusual way. Regarding the comment about serendipity, the authors note that in certain cases we need exactly epistemological randomization, since we cannot consciously induce serendipity. In conclusion, thanks are expressed to all participants in the discussion. (shrink)

This article attempts to comprehend the problem within the methodology of science. The authors compare the concepts of creativity and heuristics and suggest a semantic differentiation between them, and also offer their own viewpoint on the main types of activity corresponding to these concepts. The problem of creativity is associated with the characteristics that a person must have in order to solve tasks and problems. The authors consider the relationship between the problem and the task, as well as some major (...) techniques to tackle them. Here they substantiate the idea of a wider adaptation of randomization as a special tactic, that is, going beyond the narrow framework of mathematical statistics and empirical research. In this context, the authors introduce the notion of “epistemological randomization”, designed to denote the following of open rationality without abandoning the rational way of solving scientific problems. This technique is viewed as a phenomenon related to the counterfactual thinking. The last part of the article proposes a typology of personalities as problem and task solvers – adaptive, heuristic and creative personalities. It is assumed that the “heuristic” personality aims to complete tasks, which, unlike problems, have a final solution, while the “creative” personality aims to expand the problem field. The latter type is characterized as capable and inclined to use the “epistemological randomization”, the techniques of lateral thinking and other techniques that suggest several methods of solving problems and tasks at once. (shrink)

Based on increased user experience during stimulation, frequency-modulated steady-state visual evoked potentials have been suggested as an improved stimulation method for brain-computer interfaces. Adapting such a novel stimulation paradigm requires in-depth analyses of all different stimulation parameters and their influence on brain responses as well as the user experience during the stimulation. In the current manuscript, we assess the influence of different values for the modulation index, which determine the spectral distribution in the stimulation signal on FM-SSVEPs. We visually stimulated (...) 14 participants at different target frequencies with four different values for the modulation index. Our results reveal that changing the modulation index in a way that elevates the stimulation power in the targeted sideband leads to increased FM-SSVEP responses. There is, however, a tradeoff with user experience as increased modulation indices also lead to increased perceived flicker intensity as well as decreased stimulation comfort in our participants. Our results can guide the choice of parameters in future FM-SSVEP implementations. (shrink)