In lieu of an abstract, here is a brief excerpt of the content:Ought We to Require Emotional Capacity as Part of Decisional Competence?Paul S. Appelbaum* (bio)AbstractThe preceding commentary by Louis Charland suggests that traditional cognitive views of decision-making competence err in not taking into account patients’ emotional capacities. Examined closely, however, Charland’s argument fails to escape the cognitive bias that he condemns. However, there may be stronger arguments for broadening the focus of competence assessment to include emotional capacities, centering on (...) the ways in which emotions aid humans in processing information. Before emotional capacities are added to the list of functions essential for decisional competence, though, the feasibility and utility of such a reorientation must be demonstrated.To what extent ought persons’ capacities to experience emotion be taken into account when determining whether they should be deemed competent to make their own decisions? In the previous article, Louis Charland (1998) argues that traditional models of decision-making competence—of which the MacArthur Competence Treatment Study is a typical example—are mistaken in focusing narrowly on persons’ cognitive abilities to the neglect of emotional factors. In contrast, he suggests, constructs of competence ought explicitly to require a capacity to experience emotions, which he believes is central to meaningful decision making, before deeming persons competent.Charland, as he acknowledges, is not the first to suggest that the presence of some degree of emotional capacity is a necessary element of competence, but his argument is among the most elaborate to date and is certainly worth closer examination. Looked at carefully, however, Charland’s argument does not make quite the case for the determination of emotional capacity in competence assessment that he claims for it. Indeed, as I demonstrate below, Charland may share the same “pernicious [End Page 377] cognitive bias” that he ascribes to more traditional approaches. However, despite what I identify as the problems in Charland’s argument, others have raised more disturbing questions about the lack of attention to emotional issues in competence assessment. Thus, I am not ready to reject entirely the possibility that determinations of decisional competence ought to consider emotional factors. I conclude by outlining the questions that remain to be answered to identify more clearly the potential benefits of such an approach.The Construct of Decision-Making CompetenceSome preliminary comments about the nature of the dominant construct of decision-making competence may provide a useful frame for my response to Charland’s paper. Contemporary ideas of competence are tied inextricably to the ideal of self-determination in modern Western societies. Such societies are committed to respect for individual choice, both as a good in its own right and on the grounds that each person knows best what choices will maximize his or her own welfare. In general, therefore, states will not intervene to prevent persons from acting on their decisions, even when the choices they make—like the decision to smoke or to refuse potentially life-saving medical care—may objectively be thought to be detrimental to them.In some cases, however, the presumption that people will act in their own interests, as well as the notion that there is something intrinsically valuable in respecting their choices, fails (Buchanan and Brock 1989). When people’s minds are so disordered that they cannot be said to be making meaningful choices, other values come into play. Such people are called “incompetent.” When persons reach that point, the state’s interest in protecting its citizens becomes primary and someone else must make decisions on their behalf. Note that the size of this group must be sharply limited, lest a liberal society’s commitment to self-determination be undermined: There is no more profound infringement of the rights of citizens than the determination that they are incompetent. Thus, the criteria for incompetence must be selected in a deliberately narrow fashion—alternately, one might say that the standards for competence are made intentionally broad—so that all but a tiny percentage of citizens will be permitted to make decisions on their own.In the Anglo-American world, the process of formulating criteria of competence by and large has been left to the common law courts. Over the course of centuries they have identified the capacities that are, in... (shrink)

Decision‐aiding software is probably the most important technological innovation from the perspective of lawyer decision‐making, as contrasted to efficient office management. That kind of technological breakthrough can be helpful to lawyers in negotiating settlements favorable to their clients without expensive litigation. The technology makes use of benefit‐cost analysis, multi‐criteria decision analysis, spreadsheet software, and especially super‐optimizing analysis whereby plaintiffs, defendants, and other parties can all come out ahead of their best initial expectations simultaneously. Decision‐aiding software can also be helpful (...) to lawyers in evaluating alternative precedents, statutes, regulations, and other legal policies to arrive at versions favorable to their clients without an expensive adoption campaign. (shrink)

In this paper I argue that a narrow view of justice dominates the bioethics literature. I urge a broader view. As bioethicists, we often conceive of justice using a medical model. This model focuses attention at a particular point in time, namely, when someone who is already sick seeks access to scarce or expensive services. A medical model asks how we can fairly distribute those services. The broader view I endorse requires looking upstream, and asking how disease and suffering came (...) about. In contrast to a medical model, a social model of justice considers how social determinants affect the health of a population. For example, social factors such as access to clean drinking water, education, safe workplaces, and police protection, profoundly affect risk for disease and early death. I examine one important social determinant of health, health care coverage, to show the limits of a medical model and the merits of a broader view. (shrink)

The Securities and Exchange Commission requires publicly held US corporations to disclose all information, whether it is positive or negative, that might be relevant to an investor's decision to buy, sell, or hold a company's securities. The decisions made by corporate managers to disclose such information can significantly affect the judgments and decisions of investors. This paper examines academic accounting research on corporate managers' voluntary disclosures of earnings forecasts and non-GAAP earnings measures. Much of the evidence from this research indicates (...) that some managers engage in opportunistic disclosure behavior that often benefits one group (managers and shareholders) at the expense of other groups (often other investors). The paper concludes by discussing the ethical implications of this behavior. (shrink)

In this paper I argue that a narrow view of justice dominates the bioethics literature. I urge a broader view. As bioethicists, we often conceive of justice using a medical model. This model focuses attention at a particular point in time, namely, when someone who is already sick seeks access to scarce or expensive services. A medical model asks how we can fairly distribute those services. The broader view I endorse requires looking upstream, and asking how disease and suffering came (...) about. In contrast to a medical model, a social model of justice considers how social determinants affect the health of a population. For example, social factors such as access to clean drinking water, education, safe workplaces, and police protection, profoundly affect risk for disease and early death. I examine one important social determinant of health, health care coverage, to show the limits of a medical model and the merits of a broader view. (shrink)

Should the nation provide expensive care and scarce organs to convicted felons? We distinguish between two fields of justice: Medical Justice and Societal Justice. Although there is general acceptance within the medical profession that physicians may distribute limited treatments based solely on potential medical benefits without regard to nonmedical factors, that does not mean that society cannot impose limits based on societal factors. If a society considers the convicted felon to be a full member, then that person would be entitled (...) to at least a decent minimum level of care — which might include access to scarce life-saving organs. However, if criminals forfeit their entitlement to the same level of medical care afforded to all members of society, they still would be entitled to a kind of rudimentary decent minimum granted to all persons on simple humanitarian grounds. Almost certainly this entitlement would not include access to organ transplants. (shrink)

The Doctrine of Double Effect [DDE] states roughly that it is harder to justify causing or allowing harm as a means to an end than it is to justify conduct that results in harm as a side effect. This chapter argues that a theory of deontological constraints on harming needs something like the DDE in order to avoid the charge that it reflects a narcissistic obsession with the cleanliness of our own hands. Unfortunately, the DDE is often interpreted as maintaining (...) that we must avoid acting with certain intentions, which, this chapter contends, embodies an equally narcissistic obsession with the purity of our own hearts. The chapter argues that the DDE is better interpreted as a denial of the Machiavellian idea that beneficial ends justify harmful means. On this view, the objective fact that our conduct will secure benefits for some individuals at the expense of other individuals weakens the extent to which those benefits count as reasons to engage in that conduct. The chapter argues that this version of the DDE provides a plausible, non-narcissistic foundation for deontological constraints. (shrink)

IntroductionThanks to Dominic Wilkinson, a formidable clinician-philosopher, for his considered response, and especially for highlighting my work's translatability outside of an theological context. In part, because bioethics’ pioneers were theologians, the discipline misses something important when theology is not an integral part of the conversation. I do not have the space to do an in-depth response,i so the best I can do is use some assertions to gesture at a few key points.Relational anthropology and the best interests of the patientWilkinson (...) spends significant time critiquing my claim that the Social Quality of Life Model is consistent with a healthcare provider acting in the best interest of her patient. And though he notes that my general argument goes through without this claim, the idea that clinicians should always act in the best interests of their patients is so commonly held that this topic deserves sustained attention. Wilkinson highlights my relational anthropology as the foundation of my claims about the sQOL, but this anthropology is not founded, as he suggests, on a crude naturalism. Ultimately, it is founded on the first principle that human beings are made in the image of a Triune God who is intrinsically relational. Many different kinds of thinkers have a similar anthropology. We may see the interconnectedness and social nature of human beings as empirical evidence which supports our position, but it is not sufficient to produce the anthropology itself without the naturalistic fallacy Wilkinson rightly mentions.Much of Wilkinson's disagreement comes down to anthropological first principles. He appears to have an enlightenment view which begins with the person, an individual subject of benefits and burdens. Someone with …. (shrink)

This chapter analyzes the ethical issues that arise in the context of the use of physical enhancement techniques, i.e.techniques that aim at enhancing one or more physical functions of human beings. First, it discusses the different types of physical enhancement and points doping in sports is only a minor part of the whole enhancement field. Considerable attention is devoted to enhancement in sports, primarily because of the extensive extant literature. Then, the chapter moves on to problematize the concept of enhancement. (...) It shows that deciding whether something should count as an enhancement is not a matter for pure personal decision. The chapter engages with the ethical arguments put forward in the enhancement debate, showing that the validity of both the pro‐ and the anti‐enhancement arguments is context‐dependent and the growth hormone treatment can only be justifiably claimed if it aims at giving someone a height in the normal range. (shrink)

This book offers an original contribution towards a new theory of intersubjectivity which places ethics of breath, hospitality and non-violence in the forefront. Emphasizing Indian philosophy and religion and related cross-cultural interpretations, it provides new intercultural interpretations of key Western concepts which traditionally were developed and followed in the vein of re-conceptualizations of Greek thought, as in Nietzsche and Heidegger, for example. The significance of the book lies in its establishment of a new platform for thinking philosophically about intersubjectivity, so (...) as to nudge contemporary philosophy towards a more sensitive approach, which is needed in our times. Intended for philosophers, feminists and others concerned with intercultural philosophy, the book will appeal to readers interested in contemporary ethical and political theories. A Breath of Proximity will benefit all who seek a more sensitive approach in philosophy and often-neglected practical layers of our everyday intersubjective relations. Life as breath: such is the grand theme of Lenart Škof's wonderful new book. Ranging from Indian Vedic writings to Heidegger and Irigaray, Breath of Proximity cuts across the tired analytic/continental distinction in philosophy and proposes an ethical cosmology based on our human dwelling. A breath of fresh air! Kevin Hart is Professor of Christian Studies at the University of Virginia Lenart Škof wrote a very interesting book on breath and breathing which expresses and analyzes the essence of human existence. The breath or wind is the core point of humans. As you know, you will read in John 3.8 that the humans are born from the wind. The breath and wind have something to do with the ethics of being human, because humans live with breath and breathing. Ethics is essentially a way of life through breathing. Tadashi Ogawa is Professor of Philosophy Emeritus at Kyoto University Breath and breathing are central themes of Asian philosophies since ancient times. This was also the case in ancient Europe. But we forgot about this dimension in our academic discourse. The book of Lenart Škof brings into sight that well known Western philosophers of the 20th century picked this topic up again. The book is the most notable and far-reaching attempt to rediscover the fundamental dimension of breath and breathing for the contemporary discourse of philosophy. Rolf Elberfeld is Professor of Philosophy at the University of Hildesheim. (shrink)

South Africa shared with the world the warning of a new strain of SARS-CoV2, Omicron, in November 2021. As a result, many high-income countries (HICs) instituted complete travel bans on persons leaving South Africa and other neighbouring countries. These bans were unnecessary from a scientific standpoint, and they ran counter to the International Health Regulations. In short, South Africa was penalized for sharing data. Data sharing during pandemics is commonly justified by appeals to solidarity. In this paper, we argue that (...) solidarity is, at best, an aspirational ideal to work toward but that it cannot ground an obligation to share data. Instead, low-and-middle income countries (LIMCs) should be guided by the principle of reciprocity, which states that we ought to return good for good received. Reciprocity is necessarily a conditional principle. LMICs, we argue, should only share data during future pandemics on the condition that HICs provide enforceable assurances that the benefits of data sharing will be equitably distributed and that LMICs won’t be penalized for sharing information. (shrink)

Review of Cynthia Daniels, 'At Women's Expense: State Power and the Politics of Fetal Rights'.

I compare two different arguments for the importance of bringing new voices into science: arguments for increasing the representation of women, and arguments for the inclusion of the public, or for “citizen science”. I suggest that in each case, diversifying science can improve the quality of scientific results in three distinct ways: epistemically, ethically, and politically. In the first two respects, the mechanisms are essentially the same. In the third respect, the mechanisms are importantly different. Though this might appear to (...) suggest a broad similarity between the cases, I show that the analysis reveals an important respect in which efforts to include the public are more complex. With citizen science programs, unlike with efforts to bring more women into science, the three types of improvement are often in conflict with one another: improvements along one dimension may come at a cost on another dimension, suggesting difficult trade-offs may need to be made. (shrink)

Iyengar Yoga Wisdom & Practice" is a practical and an inspiring anthology of Iyengar's insights into yoga, life and the path to peace and happiness. Yoga practice lies at the heart of the book, and it is illustrated with over 60 new step-by-step sequences of yoga postures specially shot in India and accompanied by Iyengar's illuminating observations on technique, their significance, and their benefits. This book not only presents Iyengar's practical advice on how to perform key yoga postures, but also (...) draws on a wide range of other material taken from interviews and world lecture tours, to the many texts Iyengar has written about yoga and about his own life's journey. (shrink)

Human Research Ethics Committee (HREC) reviewers often provide similar feedback across applications, which suggests that the problem lies in researcher awareness of key issues rather than novel, unsolvable challenges. If common problems can be addressed before lodgement by applicants referencing clear evidence-based supports (e.g., FAQs on common application shortcomings), it would improve efficiency for HREC members and expedite approvals. We aim to inform such supports by analysing the patterns in the most frequent feedback made by HREC members during review processes. (...) We collected every instance (N = 4,195) of feedback made on N = 197 ‘low-risk’ protocols by all HREC staff (N = 16) at one institution over the course of a full year (2019). Reflexive thematic analysis to identify themes (and content analysis to determine relative frequency) revealed that the top three themes are consistent with existing literature: Consent, Administrative, and Methodological concerns. However, we identified important new themes that are not captured in previous research, including ‘Risk to Researchers’, ‘Commercial benefit, scope and scale’, ‘Diversity’ (covering issues of cultural sensitivity, language and accessibility), as well as fair right to a complaints process. Our thorough exploration of information-rich primary data marks an important methodological improvement over previous studies and offers a theoretical contribution to understanding themes that have heretofore been overlooked in the ethics review process. By identifying the common challenges experienced in HREC review we can better inform tailored supports to applicants (by extension reducing workload burdens on HREC systems) and reduce their perceived barriers to engaging in challenging but meaningful research. (shrink)

_From the president of Wesleyan University, an illuminating history of the student, spanning from antiquity to Zoom “[Roth] has a clear vision for what it ought to mean to be a student: Learn what you love to do, get better at it, and then share it with others.”—David Perry, _Washington Post__ In this sweeping book, Michael S. Roth narrates a vivid and dynamic history of students, exploring some of the principal models for learning that have developed in very different contexts, (...) from the sixth century BCE to the present. Beginning with the followers of Confucius, Socrates, and Jesus and moving to medieval apprentices, students at Enlightenment centers of learning, and learners enrolled in twenty-first-century universities, he explores how students have been followers, interlocutors, disciples, rebels, and children becoming adults. There are many ways to be a student, Roth argues, but at their core is developing the capacity to think for oneself by learning from others, and thereby finding freedom. In an age of machine learning, this book celebrates the student who develops more than mastery, cultivating curiosity, judgment, creativity, and an ability to keep learning beyond formal schooling. Roth shows how the student throughout history has been someone who interacts dynamically with the world, absorbing its lessons and creatively responding to them. (shrink)

Scientists have the ability to influence policy in important ways through how they present their results. Surprisingly, existing codes of scientific ethics have little to say about such choices. I propose that we can arrive at a set of ethical guidelines to govern scientists’ presentation of information to policymakers by looking to bioethics: roughly, just as a clinician should aim to promote informed decision-making by patients, a scientist should aim to promote informed decision-making by policymakers. Though this may sound like (...) a natural proposal, I show it offers guidance that conflicts with standard scientific practices. I conclude by considering one cost of the proposal: that it would prevent scientists from acting as advocates in a way that is currently common in certain fields. I accept that the proposal would restrict scientists’ political advocacy rights, but argue that the benefits of adopting it — promoting democratic governance — justify the restriction. (shrink)

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

Since international trade leads to prosperity, most economics are in favor of globalization. This basic conviction is shared in this paper. Several standard arguments brought forward by critics of globalization - e.g. the claims that globalization increases poverty, destroys jobs, undermines the welfare state, enables international corporations to seize power and leads to environmental degradation and uniform culture - are shown to be invalid. Nevertheless, compared to orthodox economists, a more critical view of globalization is proposed in this paper, and (...) several shortcomings of globalization are discussed. These shortcomings are the unidirectional trade liberalization at the expense of developing countries, international organizations, like the IMF of World Bank, representing narrow economic interests and, above all, the lack of 'global governance'. Therefore, the implementation of functional overlapping competing jurisdiction is put forward. It is argued that the alternative proposition of a world government is dangerous, and global solidarity ineffective. (shrink)

As these opening quotes acknowledge, the Prisoner’s Dilemma (PD) represents a core puzzle within the formal mathematics of game theory.3 Its rise in conspicuity is evident figure 2.1 above demonstrating a relatively steady rise in incidences of the phrase’s usage between 1960 to 1995, with a stable presence persisting into the twenty first century. This famous two-person “game,” with a stock narrative cast in terms of two prisoners who each independently must choose whether to remain silent or speak, each advancing (...) self-interest at the expense of the other and thereby achieving a mutually suboptimal outcome, mires any social interaction it is applied to into perplexity. The logic of this game proves the inverse of Adam Smith’s invisible hand: individuals acting on self interest will achieve a mutually suboptimal outcome. However, as this chapter illuminates, the assumptions underlying game theory drive this conclusion. (shrink)

A multitude of legislation impacts the use of samples and data for research in South Africa. With the coming into effect of the Protection of Personal Information Act No. 4 of 2013 in July 2021, recent attention has been given to safeguarding research participants’ personal information. The protection of participants’ privacy in research is essential, but it is not the only risk at stake in the use and sharing of personal information. Other rights and interests that must also be considered (...) and safeguarded include the right to non-discrimination, the right to dignity, and the right to enjoy the benefits of scientific progress. This can be achieved by ensuring that the ethical values and universal principles that underpin the research landscape, namely equity, reciprocity, justice and solidarity, are embedded in the regulatory framework for the management and use of personal information. This paper advocates an integrated bioethics approach to the use of personal information for research in SA. A key feature in embedding such an approach is a Data Transfer Agreement that appropriately integrates the safeguards and protections set out by our regulatory framework with bioethical rules and procedures when personal information is used and shared for research purposes. This paper thus calls for the development of a national DTA that is guided by key ethical principles when data are shared for research purposes. This paper will be followed by a webinar on 23 June 2022 hosted by the Department of Science and Innovation and the SA Medical Research Council, where the recommendations and suggestions set out herein will be unpacked, discussed and debated by relevant stakeholders. (shrink)

Philosophers of science are increasingly arguing for and addressing the need to do work that is socially and scientifically engaged. However, we currently lack well-developed frameworks for thinking about how we should engage other expert communities and what the epistemic benefits are of doing so. In this paper, I draw on Collins and Evans' concept of ‘interactional expertise’ – the ability to speak the language of a discipline in the absence of an ability to practice – to consider the epistemic (...) benefits that can arise when philosophers engage scientific communities. As Collins and Evans argue, becoming an interactional expert requires that one ‘hang out’ with members of the relevant expert community in order to learn crucial tacit knowledge needed to speak the language. Building on this work, I argue that acquiring interactional expertise not only leads to linguistic fluency, but it also confers several ‘socio-epistemic’ benefits such as the opportunity to cultivate trust with scientific communities. These benefits can improve philosophical work and facilitate the broader uptake of philosophers' ideas, enabling philosophers to meet a variety of epistemic goals. As a result, having at least some philosophers of science acquire interactional expertise via engagement will likely enhance the diversity of epistemic capacities for philosophy of science as a whole. For some philosophers of science, moreover, the socio-epistemic benefits identified here may be more important than the ability to speak the language of a discipline, suggesting the need for a broader analysis of interactional expertise, which this paper also advances. (shrink)

Over the last 20+ years, multinational corporations have been confronted with accusations of abuse of market power and unfair and unethical business conduct especially as it relates to their overseas operations and supply chain management. These accusations include, among others, worker exploitation in terms of unfairly low wages, excessive work hours, and unsafe work environment; pollution and contamination of air, ground water and land resources; and, undermining the ability of natural government to protect the well-being of their citizens. MNCs have (...) responded to these accusations by creating voluntary codes of conduct which commit them to specific standards for addressing these issues. These codes are created at both the industry-wide and the individual company level. Unfortunately, these codes have generated little credibility and public trust because their compliance claims cannot be independently verified, and they lack transparency and full public disclosure. In this article, we present a case study of the voluntary code of conduct by Mattel, Inc., the world’s largest toy company. The code, called the Global Manufacturing Principles, confronts the general criticism leveled against voluntary codes of conduct by creating detailed standards of compliance, independent external monitoring of the company’s compliance with its code of conduct, and making full, and uncensored public disclosure of the audit findings and company’s response in terms of remedial action. We present a detailed account of how Mattel’s voluntary code of conduct was created, implemented, and ultimately abandoned over 9 years. We provide an evaluative analysis of the company’s GMP compliance throughout its life span, which suggests a bell-shaped curve, where early top management commitments were met with pockets of resistance from operational groups, who were concerned about balancing GMP compliance efforts with traditional performance criteria. The early stage response from Mattel’s top management was quick and supported with the requisite resources. As a result, the compliance process accelerated, becoming increasingly more robust and effective. The success of code compliance and increased transparency in public disclosure energized field managers with a sense of professional satisfaction and publicly recognized accomplishments. The decline in GMP compliance was equally steep. When all the easily attainable targets had been reached at the company-operated plants, addressing vendor plants’ compliance presented a new set of challenges, which taxed corporate resources and management commitment. It would seem that value-based and ethics-oriented considerations, i.e., doing the right thing for the right reason, were no longer the driving force for Mattel’s management. Mattel did not see any economic benefit from its proactive stance, when competitors did not seem to suffer adverse consequences for not following suit. The final contributing factor to the code’s abandonment was a widely publicized series of product recalls which absorbed top management’s attention. (shrink)

The “fair benefits” approach to international research is designed to produce results that all can agree are fair without taking a stand on divisive questions of justice. But its appealing veneer of collaboration masks ambiguities at both a conceptual and an operational level. An attempt to put it into practice would look a lot like an auction, leaving little reason to think the outcomes will satisfy even minimal conditions of fairness.

Questions of patient autonomy have formed an important part of ethical debate in medicine from at least the post-war period onwards. Although initially important as a counterweight to widespread medical paternalism, recent years have seen a reaction against a widely perceived ‘triumph of autonomy’. In particular, competent patients' refusal of life-saving or clearly beneficial treatment presents complex dilemmas for both healthcare professionals and ethicists. Discussion of the mechanism provided by the Israel Patient's Rights Act of 1996 for ethics committees to (...) override refusal of treatment by such patients has provided several examples in which it seems an obligation to benefit the patient can outweigh concerns regarding respect for their autonomy. However, such analyses as have been undertaken so far may be seen to omit important elements of the moral decision-making process that takes place even when the latter appears to ‘win out’. In addition to helping better prepare clinicians to meet such challenges in the future, a fuller appreciation of those elements that are present in justified cases of coercive treatment may enable them to arrive at a better understanding of what autonomy itself can mean in a medical context. (shrink)

This paper summarizes the longstanding debate over psychology's fragmentation by illustrating two principal impediments to the fostering of consensus and unity. The paper then discusses the important benefits of past dialogue concerning these issues, suggesting that some progress has been made in dealing with problems of disunity and fragmentation, particularly at the metatheoretical and philosophical levels. This general discussion then forms the backdrop for the following articles, which together form a single argument in favor of a hermeneutic approach to the (...) problem of fragmentation. (shrink)

In this article, we analyse content from two recent reports to examine how a public health framework to cognitive enhancement is emerging. We find that, in several areas, these reports provide population-level arguments both for and against the use of cognitive enhancers. In discussing these arguments, we look at how these reports are indicative of potentially innovative frameworks—epidemiological, risk/benefit and socio-historical—by which to explore the public health impact of cognitive enhancement. Finally, we argue that these reports are suggestive of (...) both tensions between the bioethical and public health approaches and are also indicative of how these two frameworks can, in part, be seen as complementary. (shrink)

Growing data on the socioeconomic determinants of health pose a challenge to analysis and application of fairness in health. In Just health: meeting health needs fairly, Norman Daniels argues for a change in the population end of our thinking about just health. What about clinical care? Given our knowledge of the importance of wealth, education or social status to health, is fairness in medicine served better by continuing to avoid considering our patients’ social status in setting clinical priorities, or by (...) attempting to equalise existing health inequalities by giving priority to the socioeconomically disadvantaged at the point of care? In this article, I argue that doctors should not attempt the latter. Granted, giving priority to low status would go some way towards compensating unjust health inequalities and the impression of being left aside in other social spaces. It would represent reverse discrimination, but could still be justified inasmuch as disadvantaged groups could be identifiable, and as long as the intent was compensation rather than retribution. However, under current circumstances such priority would risk being attributed arbitrarily, would represent a form of medical proselytising, risk leaving the worst-off with less by alienating the powerful, and require teaching doctors to act in strongly counter-cultural ways—possibly at great cost. Crucially, however, we protect both equal health and equal regard by treating all alike: priority to low status would promote the first somewhat, but at the expense of sacrificing the second. (shrink)

The rule of rescue describes the powerful human proclivity to rescue identified endangered lives, regardless of cost or risk. Deciding whether or not to perform a decompressive craniectomy as a life-saving or ‘rescue’ procedure for a young person with a severe traumatic brain injury provides a good example of the ethical tensions that occur in these situations. Unfortunately, there comes a point when the primary brain injury is so severe that if the patient survives they are likely to remain severely (...) disabled and fully dependent. The health resource implications of this outcome are significant. By using a web-based outcome prediction model this study compares the long-term outcome and designation of two groups of patients. One group had a very severe injury as adjudged by the model and the other group a less severe injury. At 18 month follow-up there were significant differences in outcome and healthcare requirements. This raises important ethical issues when considering life-saving but non-restorative surgical intervention. The discussion about realistic outcome cannot be dichotomised into simply life or death so that the outcome for the patient must enter the equation. As in other ‘rescue situations’, the utility of the procedure cannot be rationalised on a mere cost–benefit analysis. A compromise has to be reached to determine at what point either the likely outcome would be unacceptable to the person on whom the procedure is being performed or the social utility gained from the rule of rescue intervention fails to justify the utilitarian value and justice of equitable resource allocation. (shrink)

Background: Despite potential benefits of the return of research results to research participants, the TriCouncil Policy Statement , which reflects Canadian regulatory ethical requirements, does not require this. The policies of Canadian research ethics boards are unknown.Objectives: To examine the policies of Canadian university based REBs regarding returning results to research participants, and to ascertain if the presence/absence of a policy may be influenced by REB member composition.Design: Email survey of the coordinators of Canadian university based REBs to determine the (...) presence/absence of a policy on return of research results to research participants both during an ongoing study and at conclusion. REB coordinators were asked to return a copy of the policy or guidelines and to describe the member composition of their REB.Findings: Of 50 REBs that were contacted 34 responded and 22 met the inclusion criteria. Two had a policy that governed the return of research results while on a study, and seven following the completion of a study. Presence of an ethicist or a lawyer on the REB did not influence the presence/absence of such policies. No REBs had specific guidelines describing how participants should be informed of results.Conclusions: Most REBs did not require researchers to disclose study results to research participants either during or following a study. Thus this study identifies an ethical shortcoming in the conduct of human research in Canada. It has also demonstrated that there are no clear recommendations by REBs to facilitate the return of results to participants following research projects. (shrink)

Open Access: This paper will connect literature on epistemic injustice with literature on victims and perpetrators, to argue that in addition to considering the credibility deficit suffered by many victims, we should also consider the credibility excess accorded to many perpetrators. Epistemic injustice, as discussed by Miranda Fricker, considers ways in which someone might be wronged in their capacity as a knower. Testimonial injustice occurs when there is a credibility deficit as a result of identity-prejudicial stereotypes. However, criticisms of Fricker (...) have pointed out that credibility is part of a more complex system that includes both deficits and excesses. I will use these points to argue that we should look closer at sources of credibility excess in cases of sexual assault. This means that in addition to considering sources of victim blaming by looking at ways in which “ideal” victims are constructed, we also need to consider ways in which “ideal” perpetrators are constructed. (shrink)

This article examines the variety of men's responses to feminism in late nineteenthand early twentieth-century United States through texts that addressed the claims raised by the turn-of-the-century women's movements. Antifeminist texts relied on traditional arguments, as well as Social Darwinist and natural law notions, to reassert the patriarchal family and to oppose women's suffrage and participation in the public sphere. Masculinist texts sought to combat the purported feminization of American manhood by proposing islands of masculinity, untainted by feminizing forces; proscribed (...) homosociality was also cast as an effective antidote to homosexuality. Profeminist texts openly embraced women's claims for changes in public participation and private and family life, both out of a sense of justice and the conviction that such changes would benefit men and challenge the emerging industrial capitalist order. Parallels to contemporary men's responses to the women's movement are suggested. (shrink)

This paper gives an ethical argument for temporarily waiving intellectual property protections for COVID-19 vaccines. It examines two proposals under discussion at the World Trade Organization : the India/South Africa proposal and the WTO Director General proposal. Section I explains the background leading up to the WTO debate. Section II rebuts ethical arguments for retaining current IP protections, which appeal to benefiting society by spurring innovation and protecting rightful ownership. It sets forth positive ethical arguments for a temporary waiver that (...) appeal to standing in solidarity and holding companies accountable. After examining built-in exceptions to existing agreements and finding them inadequate, the paper replies to objections to a temporary waiver and concludes, in section III, that the ethical argument for temporarily waiving IP protection for COVID-19 vaccines is strong. There are no data in this work. (shrink)

The aim of the present study is to explore pre-service elementary teachers’ evaluations of the evidence and models and their positions on a socio-scientific topic, namely genetically modified organisms, after evaluating them through Model Evidence Link diagrams. The findings of this study show that the participants mostly constructed accurate evidence-model links. However, they mostly generated inaccurate relationships between the model and the evidence when the evidence had nothing to do with the model. The results also show that the participants mostly (...) evaluated the model-evidence relationships at the descriptive and relational levels. The participants were able to construct accurate links; however, they could not critically evaluate the model-evidence links. Finally, although the participants read supportive, opposing and irrelevant evidence about the benefits of GMOs, and discussed them with their group mates, most of them still thought that GMOs are not beneficial to society. Furthermore, none of them stated the belief that GMOs are beneficial to society. (shrink)

Stem cell research is a newly emerging technology that promises a wide variety of benefits for humanity. It has, however, also caused much ethical, legal, and theological debate. While some forms of its application were prohibited in the beginning, they have now started to be used in many countries. This fact obliges us to discuss the regulation of stem cell research at national and international level. It is obvious that in order to make regulations and to draw up legislation at (...) national or international levels it helps to know the perspectives of different cultures and faith traditions. In this article the issue is explored from an Islamic perspective. Firstly, some basic information is given about Islam to explain how laws are drawn up and regulations made in this tradition. Secondly, the principles on which the laws and regulations are based are applied to stem cell research, and finally the permitted and prohibited methods of stem cell research are described. The discussions throughout the paper demonstrate that while some ethicists argue that stem cell research is unethical in the Islamic tradition, tradition permits it as long as such research is aimed at improving human health. (shrink)

Monetary intelligence theory asserts that individuals apply their money attitude to frame critical concerns in the context and strategically select certain options to achieve financial goals and ultimate happiness. This study explores the dark side of monetary Intelligence and behavioral economics—dishonesty. Dishonesty, a risky prospect, involves cost–benefit analysis of self-interest. We frame good or bad barrels in the environmental context as a proxy of high or low probability of getting caught for dishonesty, respectively. We theorize: The magnitude and intensity (...) of the relationship between love of money and dishonest prospect may reveal how individuals frame dishonesty in the context of two levels of subjective norm—perceived corporate ethical values at the micro-level and Corruption Perceptions Index at the macro-level, collected from multiple sources. Based on 6382 managers in 31 geopolitical entities across six continents, our cross-level three-way interaction effect illustrates: As expected, managers in good barrels, mixed barrels, and bad barrels display low, medium, and high magnitude of dishonesty, respectively. With high CEV, the intensity is the same across cultures. With low CEV, the intensity of dishonesty is the highest in high CPI entities —the Enron Effect, but the lowest in low CPI entities. CPI has a strong impact on the magnitude of dishonesty, whereas CEV has a strong impact on the intensity of dishonesty. We demonstrate dishonesty in light of monetary values and two frames of social norm, revealing critical implications to the field of behavioral economics and business ethics. (shrink)

[Sir Stephen Gaselee, who died in June 1943, was, as is widely known, a devoted student of Petronius. He read the book first in 1901 when he was still at Eton; two years later he already possessed nearly a hundred Petroniana and was distributing to booksellers a short bibliography which he had compiled in order that they might help to fill the gaps in his collection. Petronius was the subject of the Fellowship dissertation which he submitted unsuccessfully at King's in (...) 1908. It comprised a copy of Buecheler's editio minor interleaved with foolscap sheets on which was written a critical and epexegetical commentary, and a substantial volume of typescript entitled Some Materials for an Edition of Petronius and dealing with the personality of the author, the place of his book in Classical literature, its literary history, the manuscripts, and the printed editions. The last section was presently expanded into a long paper which, with a handlist, was presented to the Bibliographical Society in 1909. In the following year appeared a large and expensive reprint of the earliest English translation of Petronius for which Gaselee supplied an introduction and a Latin text. In 1915 he published at his own cost a collotype facsimile of that part of the Codex Traguriensis which contains the Cena Trimalchionis, adding a preface and an annotated transcript of the facsimile. In 1916 Gaselee went to the Foreign Office and, except for a brief interval in 1919, worked there until his death. He continued to collect Petroniana and to note in his interleaved text parallel passages and suggestions of other scholars, but the leisure necessary for the preparation of his own edition was never at his disposal. Thenceforward his contributions to the subject are both few and slight. (shrink)

The possibility of generating incidental findings — in both research and clinical contexts — has long been regarded as a risk of these enterprises. Should incidental findings in research also be regarded as potential benefits? At first glance, it would seem they ought to be. After all, in particular circumstances or given a particular set of values, any piece of information can be beneficial. Therefore, it may seem incoherent or unduly paternalistic to regard IFs only as risks. Moreover, developments in (...) science and technology increasingly transform what was once of uncertain meaning and dubious value into information that is likely to have clear meaning and potential personal value, if not obvious clinical utility. For these reasons, it would seem that in the future, IFs should be treated as potential benefits in the design and regulation of research. (shrink)

Nurses and midwives are part of health care in all the stages of our lives from preconception to death. Recent scientific advances have introduced new techniques of screening and diagnosis linked to stem cell isolation and therapies. These could affect us at any age and therefore nurses will be involved as carers and patients advocates for these techniques. In this article stem cell techniques and therapies are outlined, as well as some of the ethical challenges faced by various nursing groups, (...) whether in adult, learning difficulties, mental health, paediatric, primary care, public health or health visiting areas. Nurses have to understand the ethical issues and the rights of all parties (donor, recipient and families), which may conflict with each other, to be able to weigh up the benefits and costs to each group involved. Answers have to be found on a case-by-case basis within local moral frameworks and law. Nurses represent all parties in these therapies and act as advocates for every patient group. They need to act in an interprofessional environment to promote the best interests of all their clients, both clinically and ethically. (shrink)

Human infection challenge studies have been proposed as a means to accelerate SARS-CoV2 vaccine development and thereby help to mitigate a prolonged global public health crisis. A key criterion for the ethical acceptability of SARS-CoV2 HCS is that potential benefits outweigh risks. Although the assessment of risks and benefits is meant to be a standard part of research ethics review, systematic comparisons are particularly important in the context of SARS-CoV2 HCS in light of the significant potential benefits and harms at (...) stake as well as the need to preserve public trust in research and vaccines. In this paper we explore several considerations that should inform systematic assessment of SARS-CoV-2 HCS. First, we detail key potential benefits of SARS-CoV-2 HCS including, but not limited to, those related to the acceleration of vaccine development. Second, we identify where modelling is needed to inform risk-benefit assessments. Modelling will be particularly useful in comparing potential benefits and risks of HCS with those of vaccine field trials under different epidemiological conditions and estimating marginal risks to HCS participants in light of the background probabilities of infection in their local community. We highlight interactions between public health policy and research priorities, including situations in which research ethics assessments may need to strike a balance between competing considerations. (shrink)

1. First person authority: the received explanation Over a wide range of psychological attributes, a mature speaker seems to enjoy a defeasible form of authority on how things are with him. The received explanation of this is epistemic, and rests upon a cognitive assumption. The speaker’s word is a authoritative because when things are thus-and-so with him, then normally he knows that they are. This is held to be because the speaker has direct and privileged access to the contents of (...) his consciousness by means of introspection, conceived as a faculty of inner sense. Like perceptual knowledge, introspective knowledge is held to be direct and non-evidential. Accordingly, the first-person utterances ‘I have a pain’, ‘I believe that p’, ‘I intend to V’ are taken to be descriptions of what is evident to inner sense. Many classical thinkers held such subjective knowledge to be not only immediate, but also infallible and indubitable. The challenge to the received conceptions came from Wittgenstein. He denied the cognitive assumption, arguing that it cannot be said of me at all (except perhaps as a joke) that I know that I am in pain. For what is that supposed to mean — except perhaps that I am in pain?1 If it makes no sense to say that one knows that one is in pain, then the epistemic explanation is a non-starter, since it explains the special authoritative status of a person’s avowal of pain by reference to the putative fact that the subject of pain knows, normally knows, or cannot but know, that he is in pain when he is. It is important to note that Wittgenstein did not mechanically generalize the case of pain across the whole domain of firstperson utterances. The case of pain constitutes only one pole of a range of such utterances. Avowals and averrals of belief and intention approximate the other pole, and require independent analysis and grammatical description. (shrink)

Introduction Financial conflicts of interest (fCOI) present well documented risks to the integrity of biomedical research. However, few studies differentiate among fCOI types in their analyses, and those that do tend to use preexisting taxonomies for fCOI identification. Research on fCOI would benefit from an empirically-derived taxonomy of self-reported fCOI and data on fCOI type and payor prevalence.Methods We conducted a content analysis of 6,165 individual self-reported relationships from COI statements distributed across 378 articles indexed with PubMed. Two coders (...) used an iterative coding process to identify and classify individual fCOI types and payors. Inter-rater reliability was κ = 0.935 for fCOI type and κ = 0.884 for payor identification.Results Our analysis identified 21 fCOI types, 9 of which occurred at prevalences greater than 1%. These included research funding (24.8%), speaking fees (20.8%), consulting fees (18.8%), advisory relationships (11%), industry employment (7.6%), unspecified fees (4.8%), travel fees (3.2%), stock holdings (3.1%), and patent ownership (1%). Reported fCOI were held with 1,077 unique payors, 22 of which were present in more than 1% of financial relationships. The ten most common payors included Pfizer (4%), Novartis (3.9%), MSD (3.8%), Bristol Myers Squibb (3.2%), AstraZeneca (3.1%), GSK (3%), Boehringer Ingelheim (2.9%), Roche (2.8%), Eli LIlly (2.5%), and AbbVie (2.4%).Conclusions These results provide novel multi-domain prevalence data on self-reported fCOI and payors in biomedical research. As such, they have the potential to catalyze future research that can assess the differential effects of various types of fCOI. Specifically, the data suggest that comparative analyses of the effects of different fCOI types are needed and that special attention should be paid to the diversity of payor types for research relationships. (shrink)

The purpose of this book is to further an understanding of religion -- not of the kind that might come from psychological or sociological enquiry -- but an understanding from the inside, so to speak, of the subject-matter of such explanatory enquiries. An understanding of the kind possessed by someone who, firmly believing in a religion, has thought about the nature of religion. The book aims to increase this kind of understanding where it already exists, and in its absence, at (...) bringing about some degree of it without presupposing in a reader any religious belief at all. (shrink)

The first longevity revolution began in the middle of the 19th century, accelerated through the first half of the 20th century, and led to the first and only quantum leap in human life expectancy.In the 20th century alone, life expectancy at birth in most developed nations rose by about 30 years. The first three quarters of the century were notable for gains made at younger and middle ages, and in the last quarter century, old age mortality declined. Nothing in history (...) has ever come close to the magnitude of this benefit to humanity. The rise in life expectancy occurred swiftly because the primary beneficiaries of advances in public health and... (shrink)

The issues of the ethics of germ line modification in general and of enhancement by germ line modification in particular have been the subject of hundreds of articles in the bioethical literature. Both because the techniques are far from perfected and because the potential long term side effects are unkown, there is a widespread consensus that germ line modification for enhancement is absolutely unethical and beyond the pale at the present time. The author considers a thought expperiment projecting into the (...) future in which perhaps the safety and reversibility of germ line modification have been clearly demonstrated. Under such circumstances it is contended that the dividing line between treatment and enhancement is difficult and indeed perhaps impossible to maintain. The Jewish tradition is examined and from the various sources cited it would seem that the benefits of certain kinds of genetic enhancements might well outweigh the objections to such manipulations. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Notes and Fragments RAILING AGAINST REALISM: PHILOSOPHY AND TO THE LIGHTHOUSE by S. P. ROSENBAUM The argument of Graheim Parkes's "Imagining Reality in To the Lighthouse" is described by its author as "a railing against the realist position" (p. 35) as he understands it primarily in my article "The Philosophical Reedism ofVirginia Woolf." ' Apart from the question of whemer railing is a useful way of conducting an inquiry (...) into literature and philosophy, Parkes's discussion raises several important issues about these connections. The way diey are raised, however, involves various mistedces and muddles that make a brief reply to his eurticle difficult. To begin with a small reveeding example, Parkes asserts that I miss the irony in Virginia Woolfs use of die letters P, Q, and R to describe Mr. Ramsay's problems of diought (p. 41). Here is what I wrote: "By representing Mr. Ramsay 's thinking as proceeding in die very genered form of conventional logical symbols, Virginia Woolf is wittily extending the standard letters used to symbolize die conditional type of argument, If P men Cf (p. 339, with italics added this time). Parkes's misreading of my text does not inspire confidence when he turns to Virginia Woolfs fiction or G. E. Moore's philosophy. On a more significant issue, Parkes complains that I boggle his mind by saying diat philosophically, Moore influenced Virginia Woolf more man anyone else, whereas Platonic ideas abound in her books (p. 35). Of course they do, but not very much in her epistemology, which was the subject of my eurticle.2 What Peirkes does not mention is that Plato was also a profound influence on Moore's philosophy. One of die reasons Moore's influence on Bloomsbury was so strong is that he reinterpreted Plato for them. In her images and ideas Virginia Woolf was influenced direcdy dirough her reading of Plato etnd also indirectly through the work of Plotinus and Moore. These influences are not easily sepeurated, which is why studies of Platonic emd Neoplatonic influences in her work that ignore Moore's significance are so incomplete. 89 90Philosophy and Literature Peirkes claims mat die evidence of Moore's influence on Virginia Woolf is slight (p. 34), and then he concerns himself with the putative influences of German philosophers for whom mere is no evidence at all. In the fifteen years since I wrote my article, the biographical evidence for Moore's influence has continued to accumulate as Virginia Woolfs letters, memoirs, emd dieiries were published. From her first novel, in which Principia Etnica is quoted emd briefly discussed, down to die recently discovered revised version of her last memoir, in which she reaffirms her deep respect for Moore,3 the indications of Moore's significance for Virginia Woolf ought to convince any disinterested reader. It cannot be dismissed with a sneer about "the voguish fascination of the Bloomsbury Group..." (p. 34), especially from someone proposing to study yet again the depth psychology of her fiction via Nietzsche and Heidegger (P- 44). Nothing I say here, of course, will persuade Parkes of the value of philosophical realism for understanding To the Lighthouse because diat philosophy, as he conceives of it in his article, consists of straw. To tedce just one exeimple, Peirkes appeeurs to believe Moore's epistemology etrgues "diat things and persons are what they are independently of human consciousness" (p. 37). There is no space here to explain philosophical realism again to Parkes, odier than to note that it is not inconsistent with the veirious concerns (to use Peurkes's terminology) about "transpersonal imagination" or "participation in phenomena" that he finds so interesting in the novel. But what about die novel? For readers indifferent to whether Moore or Russell, Nietzsche or Heidegger are to be found in To the Lighthouse, the relevant question is what such philosophical interpretations medce of it. To them I ceui only say, reread the novel and then ask yourselves if an account of it diat says nothing about die value of art and almost nodiing about the value oflove bears much resemblance to your reading experience. Parkes thinks the portrait of Mr. Ramsay is unsympathetic because he is criticized emd mocked... (shrink)

Two of the most important concepts in medicine are “curing” and “caring”. Patients should enter clinical trials with the understanding that they benefit from the treatment or that there may be some benefit to others. In many cancer trials, for example, the best that can be hoped for is a prolongation of life. Whether or not life is prolonged, we argue that there exists an obligation which can be termed a “bond of responsibility” to provide appropriate palliative care (...) within the patient’s own cultural context.The Declaration of Helsinki,1 the principal code governing the conduct of medical research, shows this “bond of responsibility” to be at its core. A number of statements stand out: “the health of my patient will be my first consideration”2 and “a physician shall only act in a patient’s best interest when providing medical care which might have the effect of weakening the physical and mental …. (shrink)

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

Generally, I find gatherings of the Association for the Scientific Study of Consciousness more interesting and congenial than the Tucson conferences. There are at least two reasons for this, the first one obvious: the former is smaller. Less crowds, more chances to participate in discussions . The second reason reflects my predispositions, and of course those of the ASSC: the talks, research, and speculation are closely data-driven. I find it highly refreshing to attend talks on consciousness which are reporting experiments (...) done by groups employing stringent quality controls, and to hear speculation which is carefully restrained to inferences that closely and clearly follow from consensually verified data. I find it hopeful that researchers have not abandoned lines of inquiry which have decades of experiments to back them up merely because they have not yet found answers to some particular questions. But hey, these are my own biases; I'm someone who thinks the Skeptical Inquirer is a valuable resource. (shrink)

Living organ donation in the UKThe prospect of new regulation is often met with reluctance and legitimate fears of additional bureaucracy for very little benefit. Changes to the approval procedure for living organ donation in the UK, however, appear to have made a real, and positive, difference to the practice. The Human Tissue Act 2004 abolished the Unrelated Live Transplants Regulatory Authority and handed responsibility for overseeing living donation to the newly established Human Tissue Authority. On paper, the new (...) system appeared to be a significant improvement on the old one. It removed the illogical disparity between related and unrelated donors. Previously only donations from unrelated individuals needed prior approval and evidence of a genetic link was a green light to proceed without further investigation, suggesting, erroneously, that donation within families was always voluntary and free from pressure and coercion. While the reasoning behind this distinction was obvious—coming as it did in the immediate aftermath of the uncovering of an international trade in human organs—the logic behind the distinction was lacking. Although the list of permitted relationships was broad, donation between spouses, long-term partners or friends was subject to the full and frequently drawn-out approval process designed to prevent surreptitious payment.Now all living organ donation needs prior approval but the system has been streamlined to avoid the long delays that became synonymous with the old system. Under the new regime: Applications are reviewed at a local level by a group of “independent assessors” who have been trained and accredited by the HTA.The independent assessor must be satisfied that the person consenting to the donation has been given and understood the necessary information and that there is no evidence of reward or coercion or evidence that the person has been subjected to pressure to consent. …. (shrink)