We live in an era where our health is linked to that of others across the globe, and nothing brings this home better than the specter of a pandemic. This paper explores the findings of town hall meetings associated with the Canadian Program of Research on Ethics in a Pandemic , in which focus groups met to discuss issues related to the global governance of an influenza pandemic. Two competing discourses were found to be at work: the first was based (...) upon an economic rationality and the second upon a humanitarian rationality. The implications for public support and the long-term sustainability of new global norms, networks, and regulations in global public health are discussed. (shrink)

What is the relationship between evolutionary contingency and diversity? The evolutionary contingency thesis emphasizes dependency relations and chance as the hallmarks of evolution. While contingency can be destructive of, for example, the fragile and complex dynamics in an ecosystem, I will mainly focus on the productive or causal aspect of contingency for a particular sort of diversity. There are many sorts of diversities: Gould is most famous for his diversity-to-decimation model, which includes disparate body plans distinguishing different phyla. However, structural (...) diversity construed more broadly spans scales, such as organization in and among cells, structural arrangements and biomechanics on various scales, and even the profile of ancestor-descendent relationships or community structure of interactions within ecosystems. By focusing on stochastic processes in contingent evolution, I argue that contingency causes structural diversity. Specifically, I focus on the plurality of structural types of cells, genetic codes, and phyla diversity as case studies. (shrink)

‘Gouldian arguments’ appeal to the contingency of a scientific domain to establish that domain’s autonomy from some body of theory. For instance, pointing to evolutionary contingency, Stephen Jay Gould suggested that natural selection alone is insufficient to explain life on the macroevolutionary scale. In analysing contingency, philosophers have provided source-independent accounts, understanding how events and processes structure history without attending to the nature of those events and processes. But Gouldian Arguments require source-dependent notions of contingency. An account of contingency is (...) source-dependent when it is indexed to some pattern and some process. Positions like Gould’s do not turn on the mere fact of life’s contingency—that life’s shape could have been different due to its sensitivity to initial conditions, path-dependence or stochasticity. Rather, Gouldian arguments require that the contingency is due to particular kinds of processes: in this case, those which microevolutionary theory cannot account for. This source-dependent perspective clarifies both debates about the nature and importance of contingency, and empirical routes for testing Gould’s thesis. (shrink)

Recently, philosophers have sought to determine the nature of individuals relevant to evolution by natural selection or evolutionary individuals. The Evolutionary Contingency Thesis is a claim about evolution that emphasizes the role of contingency or dependency relations and chance-based factors in how evolution unfolds. In this article, I argue that if we take evolutionary contingency seriously, then we should be pluralists about the types of individuals in selection.

George G. Simpson (1902–1984) and Stephen J. Gould (1941–2002) were both engaged with the normative – i.e., social, cultural, political, and even ethical – consequences of their evolutionary theorizing. However, there is a normative point of departure between Simpson and Gould’s work in that regard that has received little attention. Yet, their motivations converge into a larger program of resistance and social protection from misconstrued and illegitimate overreaches of the biological sciences leading up to and after the peak of the (...) modern synthesis. (shrink)

In this dissertation, I explore the reach of the Evolutionary Contingency Thesis—a view that emphasizes the role of dependency relations and chance in evolution. Contingency produces diverse biological entities, processes, and mechanisms. I analyze the implications of evolution’s contingency in three areas. First, I address the problem of evolutionary individuality, which concerns the nature of entities that selection acts on. If we accept Lewontin’s 1970 view that individuals are selected, then what exactly are these individuals? I argue that evolutionary contingency (...) and its diversity of outcomes causes a plurality of individuality types. These types of individuals emerge, evolve, and disappear through evolution. Second, I defend a disunified model of major transitions in evolution. Major transitions mark pivotal turning points in life’s history, such as the transition from unicellularity to multicellularity. Philosophers and biologists aim to unify evolution’s transitions by establishing a property all major events share. I argue that evolutionary contingency’s emphasis on diversity supports a disunified model of transitions. That is, we should expect numerous kinds of major transitions given the diverse sets of outcomes caused by evolutionary contingency. Finally, I extend the contingency analysis to a topic in philosophy of medicine: The nature of cancer. It is common to view cancer as a by-product of our evolution as multicelled creatures. However, Lean and Plutynski argue that cancer is also a direct product of evolution by selection. In both cases, cancer is characterized in terms of how it functions as an object of selection. I argue that the diversity among cancers suggests philosophers should shift their focus to cancers’ structural differences rather than only their functional similarities. (shrink)

Objective: There is a demonstrated link between the mental health and substance use comorbidities experienced by young adults, however the vast majority of psychological interventions are disorder specific. Novel psychological approaches that adequately acknowledge the psychosocial complexity and transdiagnostic needs of vulnerable young people are urgently needed. A modular skills-based program for emotion regulation and impulse control addresses this gap. The current one armed open trial was designed to evaluate the impact that 12 weeks exposure to ERIC alongside usual care (...) had on young people's ability to regulate emotions, as well as examine potential moderating mechanisms.Methods: Seventy nine young people were enrolled to the 12 week intervention period. Twenty one practitioners from youth and community health services delivered relevant ERIC modules adjunct to usual care. Linear mixed effects regression was used to examine change over time across the primary outcome of emotion dysregulation and secondary outcomes of depression, anxiety, stress, experiential avoidance and mindfulness. Moderation analyses were conducted to test whether the magnitude of change in emotion dysregulation moderated change over time in secondary outcomes.Results: Analyses revealed significant improvement in the primary outcome of emotion dysregulation with a moderate effect size, in addition to decreases in the secondary outcomes of depression, anxiety, stress and experiential avoidance. No improvements in mindfulness were reported. Moderation analyses revealed that the residualised change over time in emotion dysregulation moderated the change over time in symptoms of distress, depression, anxiety, stress, experiential avoidance, and mindfulness.Conclusion: Reductions in the severity of emotion dysregulation, depression, anxiety, stress and experiential avoidance are promising, and were evident despite the complexity of the participants and the diversity of the service setting. The improvements found in each outcome were only observed for those young people whose emotion regulation also improved, providing preliminary evidence for the role of emotion regulation as a key treatment target in this population. (shrink)

Background Planning for the next pandemic influenza outbreak is underway in hospitals across the world. The global SARS experience has taught us that ethical frameworks to guide decision-making may help to reduce collateral damage and increase trust and solidarity within and between health care organisations. Good pandemic planning requires reflection on values because science alone cannot tell us how to prepare for a public health crisis. Discussion In this paper, we present an ethical framework for pandemic influenza planning. The ethical (...) framework was developed with expertise from clinical, organisational and public health ethics and validated through a stakeholder engagement process. The ethical framework includes both substantive and procedural elements for ethical pandemic influenza planning. The incorporation of ethics into pandemic planning can be helped by senior hospital administrators sponsoring its use, by having stakeholders vet the framework, and by designing or identifying decision review processes. We discuss the merits and limits of an applied ethical framework for hospital decision-making, as well as the robustness of the framework. Summary The need for reflection on the ethical issues raised by the spectre of a pandemic influenza outbreak is great. Our efforts to address the normative aspects of pandemic planning in hospitals have generated interest from other hospitals and from the governmental sector. The framework will require re-evaluation and refinement and we hope that this paper will generate feedback on how to make it even more robust. (shrink)

Social justice has strong historical roots in public health. This does not mean that we always understand what it entails when conducting an ethical analysis of a particular public health program. This article shows that Powers and Faden’s theory of social justice can provide important insights and nuance to such an analysis. The Ontario human papilloma virus vaccination program that is underway in Canada provides an important and timely case where we can surface ethical issues pertaining to social justice that (...) may otherwise remain unarticulated in the context of this program. This analysis focuses on the normative issues raised by the prioritization of a school-based program for girls only. It also examines the relevant domains of well-being identified in Powers and Faden’s theory to see whether the program is likely to enhance the well-being of those for whom it is most important. Finally, the role of vaccines in general in promoting well-being is discussed. (shrink)

Kate Storey is experienced in direct service, education and administration in both hospital and community settings. She is a family member; she was diagnosed with depression in 1980 and is “in recovery”. She is a doctoral student in the Faculty of Education at the University of Western Ontario with research interests in recovery education and empowerment. Tanya Shute is Executive Director of the Krasman Centre: a Consumer Survivor Initiative, which embraces a wellness and recovery focus. She is a social activist (...) who identii es as having personal experience with mental health challenges and substance abuse. Her undergraduate degree from York University is in Public Policy and Administration; she is completing her MSW in social policy at Laurentian University. Ann h ompson is a “survivor/ provider” trained in critical social work at York University, who is exploring the application of recovery principles in programs/organizations supporting consumer/survivors and family members. Ann is a certii ed Wellness Recovery Action Plan Facilitator and has adapted the WRAP framework to a family setting. She developed the Critical Perspectives in Mental Health curriculum in the Masters Social Work program at York University. (shrink)

**No longer the current version available on SEP; see revised version by Sharon Crasnow** -/- Feminists have a number of distinct interests in, and perspectives on, science. The tools of science have been a crucial resource for understanding the nature, impact, and prospects for changing gender-based forms of oppression; in this spirit, feminists actively draw on, and contribute to, the research programs of a wide range of sciences. At the same time, feminists have identified the sciences as a source as (...) well as a locus of gender inequalities: the institutions of science have a long tradition of excluding women as practitioners; feminist critics of science find that women and gender (or, more broadly, issues of concern to women and sex/gender minorities) are routinely marginalized as subjects of scientific inquiry, or are treated in ways that reproduce gender-normative stereotypes; and, closing the circle, scientific authority has frequently served to rationalize the kinds of social roles and institutions that feminists call into question. -/- Feminist perspectives on science therefore reflect a broad spectrum of epistemic attitudes toward and appraisals of science. Some urge the reform of gender inequities in the institutions of science and call for attention to neglected questions with the aim of improving the sciences in their own terms; they do not challenge the standards and practices of the sciences they engage. Others pursue jointly critical and constructive programs of research that, to varying degrees, aim at transforming the methodologies, substantive content, framework assumptions, and epistemic ideals that animate the sciences. The content of these perspectives, and the degree to which they generate transformative critique, depends not only on the types of philosophical and political commitments that inform them but also on the nature of the sciences and subject domains on which they bear. Feminist perspectives have had greatest impact on sciences that deal with inherently gendered subjects—the social and human sciences—and, secondarily, on sciences that study subjects characterized in gendered terms, metaphorically or by analogy (projectively gendered subjects), chiefly the biological and life sciences. Feminist perspectives are relevant to sciences that deal with non-gendered subject matters, but perspectives vary substantially in content and in critical import depending on the sciences and the particular research programs they engage. (shrink)

This study examined the role of reflection on personal cases for making ethical decisions with regard to new ethical problems. Participants assumed the position of a business manager in a hypothetical organization and solved ethical problems that might be encountered. Prior to making a decision for the business problems, participants reflected on a relevant ethical experience. The findings revealed that application of material garnered from reflection on a personal experience was associated with decisions of higher ethicality. However, whether the case (...) was viewed as positive or negative, and whether the outcomes, processes, or outcomes and processes embedded in the experience were examined, influenced the application of case material to the new problem. As expected, examining positive experiences and the processes involved in those positive experiences resulted in greater application of case material to new problems. Future directions and implications for understanding ethical decision making are discussed. (shrink)

Background The field of bioethics has evolved over the past half-century, incorporating new domains of inquiry that signal developments in health research, clinical practice, public health in its broadest sense and more recently sensitivity to the interdependence of global health and the environment. These extensions of the reach of bioethics are a welcome response to the growth of global health as a field of vital interest and activity. Methods This paper provides a critical interpretive review of how the term “global (...) health ethics” has been used and defined in the literature to date to identify ethical issues that arise and need to be addressed when deliberating on and working to improve the discourse on ethical issues in health globally. Results Selected publications were analyzed by year of publication and geographical distribution, journal and field, level of engagement, and ethical framework. Of the literature selected, 151 articles were written by authors in high-income countries, as defined by the World Bank country classifications, 8 articles were written by authors in low- or middle-income countries, and 13 articles were collaborations between authors in HIC and LMIC. All of the articles selected except one from 1977 were published after 1998. Literature on global health ethics spiked considerably from the early 2000s, with the highest number in 2011. One hundred twenty-seven articles identified were published in academic journals, 1 document was an official training document, and 44 were chapters in published books. The dominant journals were the American Journal of Bioethics, Developing World Bioethics, and Bioethics. We coded the articles by level of engagement within the ethical domain at different levels: interpersonal, institutional, international, and structural. The ethical frameworks at use corresponded to four functional categories: those examining practical or narrowly applied ethical questions; those concerned with normative ethics; those examining an issue through a single philosophical tradition; and those comparing and contrasting insights from multiple ethical frameworks. Conclusions This critical interpretive review is intended to delineate the current contours and revitalize the conversation around the future charge of global health ethics scholarship. (shrink)

Can you think of a meme that made you laugh or a political post that made you angry? These examples illustrate how social media use (SMU) impacts how people feel. Similarly, how people feel when they initiate SMU may impact the emotional effects of SMU. Someone feeling happy may feel more positively during SMU, whereas someone feeling sad may feel more negatively. Using an experimental design, we examined whether following SMU, those in a happy mood would experience increases in positive (...) affect (PA) and those in a sad mood would experience increases in negative affect (NA). A large sample of college students (N = 703) were randomly assigned to a happy, sad, or neutral mood induction before SMU. PA and NA were assessed at baseline, post-mood induction, and after SMU. Contrary to hypotheses, after SMU, people in happy moods experienced decreases in PA, and those in sad moods experienced decreases in NA, reflecting SMU having a dampening effect on emotions. PA and NA were significantly lower after SMU compared to baseline and did not vary by condition. How young adults feel when they log onto SMU matters in understanding how SMU impacts PA and NA, but on average, emotional experiences are dampened. (shrink)

Summary Coursework is an integral part of the GCSE framework, valued for its motivational qualities and its curricular validity. It is a common perception, widely reported in the national press and educational media, that coursework can be held at least partly accountable for differential performances at GCSE; coursework, it is argued, advantages girls. This article reports on an analysis of data arising from a project which offered an opportunity to study current and post-GCSE students’ perceptions of coursework. The outcomes indicate (...) that, when categorised by their relative levels of attainment, girls’ and boys’ perceptions show limited evidence of homogeneity. In other words, to suggest that girls’ and boys’ perceptions of coursework are a function of gender is a gross over-simplification. Other factors are at play and further, more specific and tailored research is essential if we are to understand how best to optimise the benefits that are claimed for coursework. (shrink)

The field of bioethics has evolved over the past half-century, incorporating new domains of inquiry that signal developments in health research, clinical practice, public health in its broadest sense and more recently sensitivity to the interdependence of global health and the environment. These extensions of the reach of bioethics are a welcome response to the growth of global health as a field of vital interest and activity. This paper provides a critical interpretive review of how the term “global health ethics” (...) has been used and defined in the literature to date to identify ethical issues that arise and need to be addressed when deliberating on and working to improve the discourse on ethical issues in health globally. Selected publications were analyzed by year of publication and geographical distribution, journal and field, level of engagement, and ethical framework. Of the literature selected, 151 articles were written by authors in high-income countries, as defined by the World Bank country classifications, 8 articles were written by authors in low- or middle-income countries, and 13 articles were collaborations between authors in HIC and LMIC. All of the articles selected except one from 1977 were published after 1998. Literature on global health ethics spiked considerably from the early 2000s, with the highest number in 2011. One hundred twenty-seven articles identified were published in academic journals, 1 document was an official training document, and 44 were chapters in published books. The dominant journals were the American Journal of Bioethics, Developing World Bioethics, and Bioethics. We coded the articles by level of engagement within the ethical domain at different levels: interpersonal, institutional, international, and structural. The ethical frameworks at use corresponded to four functional categories: those examining practical or narrowly applied ethical questions; those concerned with normative ethics; those examining an issue through a single philosophical tradition; and those comparing and contrasting insights from multiple ethical frameworks. This critical interpretive review is intended to delineate the current contours and revitalize the conversation around the future charge of global health ethics scholarship. (shrink)

The field of bioethics has evolved over the past half-century, incorporating new domains of inquiry that signal developments in health research, clinical practice, public health in its broadest sense and more recently sensitivity to the interdependence of global health and the environment. These extensions of the reach of bioethics are a welcome response to the growth of global health as a field of vital interest and activity. This paper provides a critical interpretive review of how the term “global health ethics” (...) has been used and defined in the literature to date to identify ethical issues that arise and need to be addressed when deliberating on and working to improve the discourse on ethical issues in health globally. Selected publications were analyzed by year of publication and geographical distribution, journal and field, level of engagement, and ethical framework. Of the literature selected, 151 articles were written by authors in high-income countries, as defined by the World Bank country classifications, 8 articles were written by authors in low- or middle-income countries, and 13 articles were collaborations between authors in HIC and LMIC. All of the articles selected except one from 1977 were published after 1998. Literature on global health ethics spiked considerably from the early 2000s, with the highest number in 2011. One hundred twenty-seven articles identified were published in academic journals, 1 document was an official training document, and 44 were chapters in published books. The dominant journals were the American Journal of Bioethics, Developing World Bioethics, and Bioethics. We coded the articles by level of engagement within the ethical domain at different levels: interpersonal, institutional, international, and structural. The ethical frameworks at use corresponded to four functional categories: those examining practical or narrowly applied ethical questions; those concerned with normative ethics; those examining an issue through a single philosophical tradition; and those comparing and contrasting insights from multiple ethical frameworks. This critical interpretive review is intended to delineate the current contours and revitalize the conversation around the future charge of global health ethics scholarship. (shrink)

This paper examines the outcomes of Preserving the Past Together, a workshop series designed to build the capacity of local heritage managers to engage in collaborative and community-based approaches to archaeology and historic preservation. Over the past two decades practitioners of these approaches have demonstrated the interpretive, methodological, and ethical value of integrating Indigenous perspectives and methods into the process and practice of heritage management and archaeology. Despite these benefits, few professional resources exist to support the development of collaborative relationships (...) between local heritage managers and Tribal nations. Filling this need, Preserving the Past Together’s interactive workshops and keynote lectures involved participants in a discussion of the central themes in collaborative and Indigenous approaches to archaeology today, highlighting the local challenges and opportunities that exist for archaeologists, heritage managers, and Tribal nations to work together to care for the past. This paper presents an overview of the event series’ goals, the strategies it used to foster collaboration among the diverse stakeholders of the Salish Sea, and the next steps the project’s co-directors are taking to further support communication and collaboration between stewards and stakeholders in the Pacific Northwest. (shrink)

The Edinburgh Medical Group Research Project is unique in Britain. Part of its function is to experiment with teaching medical ethics both inside and outside of the Medical School. The papers which follow have been written by two full-time reseach fellows working with the Project and two of the professional advisers, one nursing and one medical. Together they give a picture of the wide scope of exerimental teaching taking place in Edinburgh and present some preliminary results from these experiments.

The term “industrial action” includes any noncooperation with management, such as strict “working to rule,” refusal of certain duties, going slow, and ultimately withdrawal of labor. The latter form of action, striking, has posed particular problems for professional ethics, especially in those professions that provide healthcare, because of the potential impact on patients' well-being. Examination of the issues, however, displays a difference in response between the healthcare professions, in particular between doctors and nurses. In considering the ethics of industrial (especially (...) strike) action there are various aspects of professional ethics to consider: (1) whether there is a tension between industrial action and the very notion of professional ethics; (2) what specific issues arise in the case of healthcare professions; (3) what, if anything, can explain and/or justify different responses from the medical and nursing professions? (shrink)

This study examined the role of temporal orientation and affective frame in the execution of ethical decision-making strategies. In reflecting on a past experience or imagining a future experience, participants thought about experiences that they considered either positive or negative. The participants recorded their thinking about that experience by responding to several questions, and their responses were content-analyzed for the use of ethical decision-making strategies. The findings indicated that a future temporal orientation was associated with greater strategy use. Likewise, a (...) positive affective frame was associated with greater strategy use. Future orientation may permit better strategy execution than a past orientation because it facilitates more objective, balanced contemplation of the reflected-upon situation and minimizes potential self-threat associated with past behavior. A positive affective frame likely improves strategy execution because it facilitates active analysis of the experience. Future directions and implications of these findings are discussed. (shrink)

Drug regulatory bodies aim to ensure that patients have access to safe and effective drugs; however, no matter the quality of pre-licensure studies, uncertainty will remain regarding the safety and effectiveness of newly approved drugs until a large and diverse population uses those drugs. Recent analyses of Canada’s post-market drug surveillance system have found that Canada is not keeping pace with international requirements for PMDS, and have noted that efforts must be improved to monitor and address the safety and effectiveness (...) of approved drugs among vulnerable populations. Given the uncertainty that exists when drugs enter the market, some have suggested that the precautionary principle is relevant to guiding decision-making in this context. This paper responds to recommendations that the Canadian PMDS system should be responsive to the health needs of vulnerable populations by assessing the utility of deploying the precautionary principle to guide a post-market strategy for vulnerable populations. (shrink)

Summary: wenty years ago, philosopher Evan Thompson's aim is to "bring the experimental sciences of life and mind into a closer and more harmonious relationship with phenomenological investigations of experience and subjectivity." He wants to "make headway on one of the outstanding philosophical and scientific problems of our time -- the so-called explanatory gap between consciousness and nature. Exactly how are consciousness and subjective experience related to the brain and body?"... In conclusion, this is a rich, complex, and valuable (...) book in the constructivist tradition of philosophy and science -- and a book deserving of extended review and discussion. (shrink)