Genomic research results and incidental findings with health implications for a research participant are of potential interest not only to the participant, but also to the participant's family. Yet investigators lack guidance on return of results to relatives, including after the participant's death. In this paper, a national working group offers consensus analysis and recommendations, including an ethical framework to guide investigators in managing this challenging issue, before and after the participant's death.

This article discusses how the Gawad Kalinga movement in the Philippines has operationalized good governance among its communities. This movement has not only provided opportunities for collaboration and cooperation between and among the three major governance actors, governments, business, and civil society, but more important, provided a framework for active citizen engagement in the process of improving their quality of life. Citizen participation is central not only in the theory of social quality but also in good governance. The paper argues (...) argues that in order for reforms to be successful and sustainable, institutional reforms and active citizen engagement are necessary. These reforms are key to addressing some basic problems facing nations today, an alarming decline in trust in institutions and corruption. This paper is divided into three parts. The first part discusses good governance approaches and reform of public administration in relation to social quality theory. The second part discusses the tenets of citizenship and civil organization leadership within the context of good governance. The third part focuses on an emerging citizens’ movement in the Philippines—the Gawad Kalinga movement, which highlights the aspects of citizen engagement. The last part contains some concluding remarks drawn from the Gawad Kalinga experience as applied governance reform, and its implications for enhancing social quality. (shrink)

Returning genomic research results to family members raises complex questions. Genomic research on life-limiting conditions such as cancer, and research involving storage and reanalysis of data and specimens long into the future, makes these questions pressing. This author group, funded by an NIH grant, published consensus recommendations presenting a framework. This follow-up paper offers concrete guidance and tools for implementation. The group collected and analyzed relevant documents and guidance, including tools from the Clinical Sequencing Exploratory Research Consortium. The authors then (...) negotiated a consensus toolkit of processes and documents. That toolkit offers sample consent and notification documents plus decision flow-charts to address return of results to family of living and deceased participants, in adult and pediatric research. Core concerns are eliciting participant preferences on sharing results with family and on choice of a representative to make decisions about sharing after participant death. (shrink)

The topology of DNA duplexes changes during replication and also after deproteinization in vitro. Here we describe these changes and then discuss for the first time how the distribution of superhelical stress affects the DNA topology of replication intermediates, taking into account the progression of replication forks. The high processivity of Topo IV to relax the left‐handed (+) supercoiling that transiently accumulates ahead of the forks is not essential, since DNA gyrase and swiveling of the forks cooperate with Topo IV (...) to accomplish this task in vivo. We conclude that despite Topo IV has a lower processivity to unlink the right‐handed (+) crossings of pre‐catenanes and fully replicated catenanes, this is indeed its main role in vivo. This would explain why in the absence of Topo IV replication goes‐on, but fully replicated sister duplexes remain heavily catenated. (shrink)

This discussion is grounded in Aristotelian–Thomistic realism and takes the position that nursing is a practical science. As an exposition of the title statement, distinctions are made between opinion and truth, and the speculative, productive and practical sciences. Sources of opinion and truth are described and a discussion follows that truth can be achieved through knowing principles and causes of the natural kind behind phenomena. It is proposed that humans are the natural kind behind nursing phenomena. Thus, human nature provides (...) proper principles (the truth) of nursing practice. (shrink)

A careful reading of Aristotle's Nicomachean Ethics focusing on his treatment of politics reveals a multifaceted discipline with political science, legislation, practice and ethics. These aspects of the discipline bear clear resemblance to the multiple conceptions of nursing. The potential that nursing is a multifaceted discipline, with nursing science as just one facet challenges the author's own conception of nursing as a practical science. Aristotle's discussion would seem to argue that nursing science is nursing, but nursing is more. Nursing is (...) also ethical practice, or art, and legislative for health. The multifaceted discipline of politics is united by the end, the common good, a just community that makes human happiness possible. Reasoning in this way, nursing is unified by its end, health of individuals and communities. Since nursing is not unique in having health as its end, this discussion ends with the question of where its uniqueness lies, i.e. within the activities or the personal presence of its practitioners. This discussion also contains some of the contemporary ethical and legislative challenges with which nursing is confronted. (shrink)

This philosophical enquiry considers the impact of a global world view and technology on the meaning of being human. The global vision increases our awareness of the common bond between all humans, while technology tends to separate us from an understanding of ourselves as human persons. We review some advances in connecting as community within our world, and many examples of technological changes. This review is not exhaustive. The focus is to understand enough changes to think through the possibility of (...) healthcare professionals becoming cyborgs, human–machine units that are subsequently neither human and nor machine. It is seen that human technology interfaces are a different way of interacting but do not change what it is to be human in our rational capacities of providing meaningful speech and freely chosen actions. In the highly technical environment of the ICU, expert nurses work in harmony with both the technical equipment and the patient. We used Heidegger to consider the nature of equipment, and Descartes to explore unique human capacities. Aristotle, Wallace, Sokolowski, and Clarke provide a summary of humanity as substantial and relational. (shrink)

Preparing to lecture on Aristotle's contribution to Nursing at the International Philosophy of Nursing Conference August 22, 2016, in Quebec City, Quebec, Canada, I came upon the recently published article by my IPONS colleague, Allmark (2016), “Aristotle for Nursing.” Allmark (2016) provides a comprehensive and understandable overview of Aristotle's philosophical system including the substantial nature of being and the four causes of change. Nurses using Aristotle to support practice and theoretical research will benefit from a careful reading of Allmark to (...) enrich their use of the realist understanding of knowledge of nature (epistemology) and the matter–form causal relationships within natural being (ontology and teleology). Allmark carefully displays the distinction between good health and flourishing; a distinction sometimes hard to grasp. Nurses are concerned with the end of health, but cannot achieve for others, the fullness of living which is flourishing.We will limit ourselves to expanding three areas that seem important, first, that nursing is much more than a productive science or craft, second, that Aristotle does provide an important note on the persistence of the soul, and, third, while Aristotle does not address the possibility of a personal creative highest being as Allmark says, his references to the divine are worth considering. (shrink)

The Aristotelian‐Thomist philosopher holds that human intellectual knowledge is possible because of the order in the world and natural human capacities. It is the position of this paper that there is a shared human form or nature that unites all humanity as members of the same kind. Moral treatment is due to every human being because they are human, and is not based upon expression of abilities. Humans have substantial dynamic existence in the world, an existence which overflows in expressive (...) relationships. As both patient and health professional are human, human nature forms the natural foundation of health care. This paper looks towards human nature for moral guidance. The therapeutic relationship is seen as a part of the interpersonal moral space formed by human relationality, which tends towards community – in this case, the healthcare system. The therapeutic relationship is also a source of moral responsibility, as illness makes the patient vulnerable, while knowledge and nursing capacities generate in the nurse a duty to care. Nursing theory serves to connect philosophical reflection and nursing practice. Imogene King's conceptual system and theory of Goal Attainment is the theory that follows from the perspective of human person being presented. This synthesis of philosophy and theory is developed with the goal of shedding light on healthcare decisions in palliative care. The article concludes with the acknowledgement that the complexity of contextualized individual decisions requires the insight and discipline of the moral practitioner, and provides some thoughts on how education, development, and refinement transform an individual into a nurse. (shrink)

This discussion is grounded in Aristotelian–Thomistic realism and takes the position that nursing is a practical science. As an exposition of the title statement, distinctions are made between opinion and truth, and the speculative, productive and practical sciences. Sources of opinion and truth are described and a discussion follows that truth can be achieved through knowing principles and causes of the natural kind behind phenomena. It is proposed that humans are the natural kind behind nursing phenomena. Thus, human nature provides (...) proper principles (the truth) of nursing practice. (shrink)

This paper discusses a classic Aristotelian understanding of science, nature, and methods of inquiry and proof. It then discusses nursing as a practical science and provides some demonstrations through the application of classical methods. In the Aristotelian tradition an individual substance is a unity of form and matter: form being the intelligible universal that becomes the concept, while matter is the principle of individuation. Science is mediate intellectual causal knowledge. Inquiry uses hypothetical argument, and proof that is from valid syllogistic (...) reasoning with true premises provides necessity and certitude. This proof requires knowledge of the natural kind that gives origin to the attributes under investigation. The variability of nature is overcome by reasoning on the supposition of the end.Within the classical understanding of speculative and practical science, nursing is a practical science. As a science, nursing investigates the principles and causes of its subject, be that human beings, health or nursing behaviours as knowable nursing operations. The goal is knowledge of practice for the sake of practice, but nursing as a science is not operable. Nursing practice, that is nursing art or technologies, must complete the science. Reasoning on the supposition of the end, for example of cardiac compensation, allows one to identify necessary activities and physical states. Three causal demonstrations about decubiti show that demonstrations are possible. Classical science would teach us that the practical science of nursing studies human nature in order to identify principles and causes of health and principles and causes of nursing operations themselves. It also requires that the science ends in practical operation. Thus, proper decisions and individual actions in particular patient situations must complete nursing science. (shrink)

This book derives from a 1993 National Endowment for the Humanities Summer Institute on Knowledge, Teaching, and Wisdom. The Institute took place at the University of California, Berkeley, and was co-directed by Keith Lehrer and Nicholas D. Smith. The aims of the Institute were several: we sought to reintroduce wisdom as a topic of discussion among contemporary philosophers, to undertake an historical investigation of how and when and why it was that wisdom faded from philosophical view, and to ask how (...) contemporary epistemological theories might apply to the obviously related subjects of teaching and wisdom. In recruiting participants, Lehrer and Smith put the greatest emphasis on those with professional interests in epistemology and the history of philosophy, of the ancient Greeks especially ancient Greek philosophy (because in the writings all three subjects of the Institute were explicitly related and discussed). But in addition to these two groups, some effort was made also to include others, with academic specializations in a variety of fields other than epistemology and the history of philosophy, to ensure that a broad perspective could be achieved in our discussions. To an obvious extent, the papers in this book reflect the recruitment emphases and variety. They also testify to the extent that the Institute managed to bring life to our subjects, and to raise very old questions in a contemporary context. (shrink)

Mayhew wants to rescue Aristotle from charges of misogynic ideology. Although there are residues of traditional Greek assumptions in the biological works, Mayhew holds Aristotle was not rationalizing from these ideas. Rationalization involves self-deception, evasion of truth, and the “desire to support some outlook, agenda, or position”. Mayhew will argue that Aristotle generalized from insufficient and flawed evidence, but that it was an honest attempt at scientific reasoning and not an attempt to show that women are inferior.

This paper examines the characteristics of infectious diseases that raise special medical and social ethical issues, and explores ways of integrating both current bioethical and classical public health ethics concerns. Many of the ethical issues raised by infectious diseases are related to these diseases’ powerful ability to engender fear in individuals and panic in populations. We address the association of some infectious diseases with high morbidity and mortality rates, the sense that infectious diseases are caused by invasion or attack on (...) humans by foreign micro‐organisms, the acute onset and rapid course of many infectious diseases, and, in particular, the communicability of infectious diseases. The individual fear and community panic associated with infectious diseases often leads to rapid, emotionally driven decision making about public health policies needed to protect the community that may be in conflict with current bioethical principles regarding the care of individual patients. The discussion includes recent examples where dialogue between public health practitioners and medical‐ethicists has helped resolve ethical issues that require us to consider the infected patient as both a victim with individual needs and rights and as a potential vector of disease that is of concern to the community. (shrink)

This essay explores some concerns about the quality of informed consent in patients whose autonomy is diminished by fatal illness. It argues that patients with diminished autonomy cannot give free and voluntary consent, and that recruitment of such patients as subjects in human experimentation exploits their vulnerability in a morally objectionable way. Two options are given to overcome this objection: (i) recruit only those patients who desire to contribute to medical knowledge, rather than gain access to experimental treatment, or (ii) (...) provide prospective subjects the choice to participate in standard doubleblind study or receive the experimental treatment. Either option would guarantee that patients in desperate conditions are given a more meaningful choice and a richer freedom, and thus a higher quality of informed consent, than under standard randomized trials. (shrink)

La Filosofía para Niños y Niñas de M. Lipman, promueve una praxis de la vida que considera la libertad como el auténtico proyecto de realización individual y social, que debe ser asumido desde la infancia. Propiciar una experiencia investigativa y dialógica que le permita a los niños y las niñas problematizar filosóficamente la realidad, es decir, indagar acerca del sentido de cualquier acción, acto, praxis tiene su punto de origen en un interrogar-se por la libertad como experiencia que hace posible (...) el desarrollo de la sensibilidad y la racionalidad. La conciencia de ser y estar libres, depende de la autonomía de una voluntad para decidir y del deseo para elegir el sentido que debe orientar la vida en su presente y proyección futura. Niños y niñas estimulados con experiencias de este tipo, podrán llegar a ser ciudadanos y ciudadanas capaces de lograr la transformación de la sociedad desde una justicia, bien, equidad y paz, compartida por todos. (shrink)

El objetivo del trabajo es plantear una revisión de los clásicos de la filosofía para ampliar nuestro conocimiento histórico y, a la vez, abrir la puerta a nuevas posibles conceptualizaciones de lo político. Concretamente, defendemos que puede haber relevantes pensadoras entre las mujeres religiosas del Renacimiento (y probablemente antes), cuyos escritos son difíciles de analizar desde la perspectiva empleada para estudiar los textos prototípicos del género discursivo. Para solventar esta dificultad, partimos de dos premisas: a) la configuración de los universos (...) discursivos en que se les permite tomar parte no tiene por qué coincidir con la de los discursos prototípicamente masculinos; y b) no se puede comprender el buen gobierno del convento, entendido como una particular civitas (filosofía política), sin la experiencia religiosa femenina como medio para legitimar un poder que no les es reconocido por medios humanos (mística política). A modo de ejemplo, analizamos desde esta distinción entre filosofía política y mística política dos tratados de la carmelita descalza María de san José Salazar, _Consejos que da una priora_ (1590) y _Maestra de novicias_ (1602), en los que se proponen recomendaciones para el virtuoso gobierno conventual femenino basadas en una incuestionable experiencia de gestión. (shrink)

Although entrepreneurial intention has been widely studied using cognitive models, we still lack entrepreneurial vocation and, therefore, lack disruptive innovations. Entrepreneurship scholars have some understanding of the reasons underlying this weakness, although there is much room for improvement in our learning concerning how to promote entrepreneurship among university students, especially in the transformed context of digital technologies. This paper focuses on the early stages of start-up, and in particular seeks to evaluate what role social and psychological factors play in the (...) development of entrepreneurial intentions. Drawing on network theory, we consider the impact of social networks on entrepreneurial intention. Specifically, we analyze the influence of two types of social networks: face-to-face and online social networks, with the latter proving especially important in digital transformations. In addition, based on affective congruency theory, we relate affect with entrepreneurial intention. Particularly, we evaluate the influence of positive and negative dispositional affectivity on the formation of entrepreneurial intentions. Finally, since affect and emotions can also be related with social relationships, we analyze whether dispositional affectivities influence entrepreneurial intention through the mediation effect of social networks. Using structural equation modeling, we confirm the impact of both online and face-to-face social networks, as well as positive dispositional affectivity on entrepreneurial intention for 589 higher education students in Spain. However, negative dispositional affectivity is not seen to influence entrepreneurial intention. Furthermore, both face-to-face and online social networks are influenced by positive dispositional affectivity. Moreover, these two types of networks can even partially mediate the relationship between positive dispositional affectivity and entrepreneurial intention. Positive dispositional affectivity can thus influence entrepreneurial intention in two different ways: directly and indirectly through both face-to-face and online social networks. This study provides further insights and adds to the literature on affect, social networks, and entrepreneurial intention. From a broader perspective, we also contribute to the literature on disruptive innovations by explaining how the development of entrepreneurial intentions would have positive consequences for university students vis-à-vis achieving these disruptive innovations. (shrink)

Background Respect is essential to providing high quality healthcare, particularly for groups that are historically marginalized and stigmatized. While ethical principles taught to health professionals focus on patient autonomy as the object of respect for persons, limited studies explore patients’ views of respect. The purpose of this study was to explore the perspectives of a multiculturally diverse group of low-income women living with HIV (WLH) regarding their experience of respect from their medical physicians. Methods We analyzed 57 semi-structured interviews conducted (...) at HIV case management sites in South Florida as part of a larger qualitative study that explored practices facilitating retention and adherence in care. Women were eligible to participate if they identified as African American (n = 28), Hispanic/Latina (n = 22), or Haitian (n = 7). They were asked to describe instances when they were treated with respect by their medical physicians. Interviews were conducted by a fluent research interviewer in either English, Spanish, or Haitian Creole, depending on participant’s language preference. Transcripts were translated, back-translated and reviewed in entirety for any statements or comments about “respect.” After independent coding by 3 investigators, we used a consensual thematic analysis approach to determine themes. Results Results from this study grouped into two overarching classifications: respect manifested in physicians’ orientation towards the patient (i.e., interpersonal behaviors in interactions) and respect in medical professionalism (i.e., clinic procedures and practices). Four main themes emerged regarding respect in provider’s orientation towards the patient: being treated as a person, treated as an equal, treated without blame or prejudice, and treated with concern/emotional support. Two main themes emerged regarding respect as evidenced in medical professionalism: physician availability and considerations of privacy. Conclusions Findings suggest a more robust conception of what ‘respect for persons’ entails in medical ethics for a diverse group of low-income women living with HIV. Findings have implications for broadening areas of focus of future bioethics education, training, and research to include components of interpersonal relationship development, communication, and clinic procedures. We suggest these areas of training may increase respectful medical care experiences and potentially serve to influence persistent and known social and structural determinants of health through provider interactions and health care delivery. (shrink)

In this article, we present results from a literature review of intrinsic, instrumental, and relational values of nature conducted for the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services, as part of the Methodological Assessment of the Diverse Values and Valuations of Nature. We identify the most frequently recurring meanings in the heterogeneous use of different value types and their association with worldviews and other key concepts. From frequent uses, we determine a core meaning for each value type, which is (...) sufficiently inclusive to serve as an umbrella over different understandings in the literature and specific enough to help highlight its difference from the other types of values. Finally, we discuss convergences, overlapping areas, and fuzzy boundaries between different value types to facilitate dialogue, reduce misunderstandings, and improve the methods for valuation of nature's contributions to people, including ecosystem services, to inform policy and direct future research. © 2023 The Author(s). Published by Oxford University Press on behalf of the American Institute of Biological Sciences. (shrink)

Las prácticas éticas, particularmente las cívicas o ciudadanas, están demostrando con toda propiedad que el desarrollo económico y político del Estado debería ir a la par con el cumplimiento de principios o normas de moralidad pública. En una sociedad cada vez más globalizada por el dominio de la razón técnica, es necesario orientar éticamente la racionalidad de nuestras acciones humanas hacia fines sociales mucho más justos, equitativos y democráticos. El ideal griego de la “res publica” todavía compromete al Estado moderno (...) con la práctica de valores éticos. Sin éstos, la gobernabilidad de la sociedad se hace mucho más conflictiva, en vez de tolerante y consensuada. La inclusión de normas éticas y principios morales en las políticas públicas del estado social, es cada vez más legítima si se quiere que el Estado cumpla cabalmente su rol de integración social. (shrink)

In this essay transdisciplinarity is approached from a Complexity perspective, emphasizing the philosophical supposition that leads to think transdisciplinarity from a much more holistic and contingent epistemic relation between the “congnitive subject and the cognitive object”, allowing us to und..

This paper examines the characteristics of infectious diseases that raise special medical and social ethical issues, and explores ways of integrating both current bioethical and classical public health ethics concerns. Many of the ethical issues raised by infectious diseases are related to these diseases' powerful ability to engender fear in individuals and panic in populations. We address the association of some infectious diseases with high morbidity and mortality rates, the sense that infectious diseases are caused by invasion or attack on (...) humans by foreign micro-organisms, the acute onset and rapid course of many infectious diseases, and, in particular, the communicability of infectious diseases. The individual fear and community panic associated with infectious diseases often leads to rapid, emotionally driven decision making about public health policies needed to protect the community that may be in conflict with current bioethical principles regarding the care of individual patients. The discussion includes recent examples where dialogue between public health practitioners and medical-ethicists has helped resolve ethical issues that require us to consider the infected patient as both a victim with individual needs and rights and as a potential vector of disease that is of concern to the community. (shrink)

Numerous recommendations and guidelines aim to improve the quality, timeliness and transparency of medical publications. However, these guidelines use ambiguous language that can be challenging to interpret, particularly for speakers of English as a second language. Cultural expectations within the Asia-Pacific region raise additional challenges and several studies have suggested that awareness and application of ethical publication practices in the Asia-Pacific region is relatively low compared with other regions. However, guidance on applying ethical publication practice guidelines in the Asia-Pacific region (...) is lacking. This commentary aims to improve publication practices in the Asia-Pacific region by providing guidance on applying the 10 principles of the Good Publication Practice 3 (GPP3) guidelines and the International Committee of Medical Journal Editors (ICMJE) criteria for authorship. Recommendations are provided for encore presentations, applying the ICMJE authorship criteria in the context of regional cultural expectations, and the role of study sponsors and professional medical writers. Ongoing barriers to compliance with guidelines are also highlighted, and additional guidance is provided to support authors submitting manuscripts for publication. The roles of regional journals, regulatory authorities and professional bodies in improving practices are also discussed. (shrink)

Congenital amusia in its most common form is a disorder characterized by a musical pitch processing deficit. Although pitch is involved in conveying emotion in music, the implications for pitch deficits on musical emotion judgements is still under debate. Relatedly, both limited and spared musical emotion recognition was reported in amusia in conditions where emotion cues were not determined by musical mode or dissonance. Additionally, assumed links between musical abilities and visuo-spatial attention processes need further investigation in congenital amusics. Hence, (...) we here test to what extent musical emotions can influence attentional performance. Fifteen congenital amusic adults and fifteen healthy controls matched for age and education were assessed in three attentional conditions: executive control, alerting, and orienting while music expressing either joy, tenderness, sadness, or tension was presented. Visual target detection was in the normal range for both accuracy and response times in the amusic relative to the control participants. Moreover, in both groups, music exposure produced facilitating effects on selective attention that appeared to be driven by the arousal dimension of musical emotional content, with faster correct target detection during joyful compared to sad music. These findings corroborate the idea that pitch processing deficits related to congenital amusia do not impede other cognitive domains, particularly visual attention. Furthermore, our study uncovers an intact influence of music and its emotional content on the attentional abilities of amusic individuals. The results highlight the domain-selectivity of the pitch disorder in congenital amusia, which largely spares the development of visual attention and affective systems. (shrink)