Research to improve the health of pregnant and fetal patients presents ethical challenges to clinical investigators, institutional review boards, funding agencies, and data safety and monitoring boards. The Common Rule sets out requirements that such research must satisfy but no ethical framework to guide their application. We provide such an ethical framework, based on the ethical concept of the fetus as a patient. We offer criteria for innovation and for Phase I and II and then for Phase III clinical trials (...) to improve the health of pregnant patients and of fetal patients and also criteria to responsibly manage the transition from investigation to clinical practice. Basing ethical criteria for research involving pregnant women on the ethical concept of the fetus as a patient insulates the proposed ethical framework and therefore research on pregnant women from the divisive and politicized concepts and discourses of personhood, fetal rights, and unborn child. (shrink)

Emotions have been the subject of social science research for many decades. Predominantly, this research has been orientated around research on emotion. While this genre of research focuses on emotion as a topic of inquiry, I propose that research with emotion can contribute to different ways of understanding social experience. Due to a different epistemological foundation, different methodological approaches are required with different ethical implications. This article will define research with and on emotion, before providing examples of the former. Based (...) on these examples, this article explores ethical implications. The article concludes with a brief reflection on the benefits of sociological research with emotion, against which the many challenges should be assessed. (shrink)

Yarkoni highlights patterns of overgeneralization in psychology research. In this comment, we note that such challenges also pertain to applied psychological and organizational research and practice. We use two examples – cross-cultural generalizability and implicit bias training – to illustrate common practices of overgeneralization from narrow research samples to broader operational populations. We conclude with recommendations for research and practice.

This book offers a critical introduction to the work of American philosopher D. G. Leahy (1937-2014). Leahy's fundamental thinking can be characterized as an absolute creativity in which all creating is 'live' -- a happening occurring now that manifests a supersaturated polyontological actuality that is essentially created by the logic that characterizes it. Leahy leaves behind the categorial presuppositions of modern thought, eclipsing both Cartesian and Hegelian subjectivities and introducing instead an essentially new form of thinking founded in a nondual (...) logic of creation. The new thinking delineates the absolute unicity of existence as a creative interactivity beyond all traditional dichotomies (such as one vs. many, unity vs. plurality, identity vs. change): a fully "digitized" actuality that is nothing but newness, which inherently implies nothing but change. Through this new form of thinking, change itself is revealed to be the very essence of reality and mind. Any reader looking for a quantum leap beyond the thrall of modern and postmodern fixations is invited to hear and apprehend this new thinking that refuses to be conditioned by paradigms, categories, species, genera, walls, bridges, boundaries, or abstractions: an essentially free thinking that embodies creative novelty itself. (shrink)

Certification schemes and labels such as the Forest Stewardship Council, Fairtrade, and Rainforest Alliance are market-based mechanisms designed to harness consumer power in economically developed countries to influence companies to improve the economic, social and environmental welfare of producers, workers and communities in economically developing countries. However, consumers are largely not convinced that certification schemes are acting in the interests of developing countries, because consumers have different understandings of the ethics of global trade. Drawing on the results of six semi-structured (...) focus groups comprising 58 consumers and an online panel-based survey of 1014 respondents, this study tests the central assumption underlying these schemes that consumers are motivated to hold companies responsible for unethical behaviour. Most consumers hold sceptical, and at times, conflicting views in terms of how they perceive the root causes of the problems, possible solutions and ethical trade beneficiaries. This study contributes to the nascent literature on political consumerism, by highlighting an under-theorised and contradictory challenge for certification schemes. Political consumers are required to recognise the complexities of ethical trade while believing that the simple act of purchasing their labelled products is effective. Consumers also envisage a role for government regulation. (shrink)

Cross-sector partnerships (CSP) are increasingly recognized as essential for addressing our world’s mounting sustainability challenges. However, place is often considered merely as a contextual backdrop for these partnerships in CSP research. In this study, we focus on the ways in which place, including the natural, built, and cultural dimensions of geographic locations, is actively leveraged to facilitate cross-sector collaboration. Employing a qualitative and engaged research approach, we helped organize and studied two workshops held in small communities on the east coast (...) of Canada whose goal was to build a cross-sector network of community leaders focused on revitalizing communities suffering from the collapse of their primary industry, the cod fishery. We show how the staging of place fostered deeper connections among participants by reducing barriers to participation, intensifying contact with others, and enabling participants to share local knowledge. In turn, connecting through place prompted participants to recognize a shared purpose and sense of belonging, two key elements for building cross-sector collaboration. (shrink)

This study examined academic and instructional effects of history fair participation on English Language Learners (ELLs). The exhibition preparation process included inquiry-based pedagogy to increase bilingual students’ social studies knowledge. The Bilingual History Fair required recent immigrant, 4th–12th grade students to explore community and immigration through oral history research projects. The mixed-methods data collection process involved a survey of 37 teacher participants, two teacher focus group interviews, and pre- and post-data collected from 149 student participants. Student involvement in the history (...) project expanded student learning and understanding of historical concepts. Through this initiative, teachers validated the students’ languages, cultures, and life experiences of their families. The student-to-teacher interactions and the employed targeted instructional strategies were “key methods to moving ELLs toward a stage of historical thinking that will have a measurable impact on student progress in the social studies” ( Salinas, Franquiz, & Guberman 2006, p. 207 ). The findings demonstrate that “teaching social studies that matters to ELLs is an achievable goal” ( Cruz & Thornton, 2009, p. 274 ). The process enhanced the self-concept and efficacy of the students and their sense of place in their schools and communities. (shrink)

Reality and contradiction -- The paradox of desire -- God and the world -- Necessity and obedience -- Grace and decreation -- Conclusion : Weil's theological coherence.

Albert Jonsen in The Birth of Bioethics notes that his career in bioethics began with a phone call to him from soon-to-be colleagues at the University of California at San Francisco Medical Center. Bioethics didn't begin with a bang but as an accident in the root sense—something that happened, not by necessity, but rather by chance. Indeed, the opening chapters of Jonsen's book chronicle a series of accidents that helped to create the field of bioethics. Principal among these was the (...) fact that physicians and biomedical scientists who became puzzled about the moral dimensions of their work and began to think about these puzzles sought help in doing so from moral theologians and philosophers. These physicians and scientists, for the most part, were university people. They thought broadly, not just deeply, about their work, but they just as well could have defined themselves by their academic discipline and departments and not reached beyond these familiar and comfortable intellectual confines to the “culture” of the humanities disciplines and departments. The theologians and philosophers whom these physicians and scientists sought out were also university people who also happened to have generous views of the intellectual life in their disciplines—atypical of the time, especially in philosophy. If C. P. Snow had been altogether right and if ungenerous self-understanding of their work by physicians, scientists, philosophers, and theologians had prevailed, bioethics might not have happened at all. (shrink)

D. G. Leahy’s highly original philosophical thinking is a bid to transform all the categories of modern thought, eliminating the central notion of self and effecting a historic metanoia that ends modernity and inaugurates an absolute actuality characterized by simultaneous newness of the world and newness of mind. This chapter introduces Leahy’s ideas to the uninitiated reader.

The philosopher and religious thinker Simone Weil is one of the most radical theological thinkers of the mid-twentieth century. Weil’s thinking of God is radical at core because her conception of the act of creation dissents from every established Christian tradition: Weil posits that God must contract God’s power for something to exist as other than God. God cannot therefore create out of infinite power, but only by electing powerlessness, relinquishing power, becoming Dieu impuissant. This chapter revises her legacy and (...) places her thought within the radical theological tradition. (shrink)

Research to improve the health of pregnant and fetal patients presents ethical challenges to clinical investigators, institutional review boards, funding agencies, and data safety and monitoring boards. The Common Rule sets out requirements that such research must satisfy but no ethical framework to guide their application. We provide such an ethical framework, based on the ethical concept of the fetus as a patient. We offer criteria for innovation and for Phase I and II and then for Phase III clinical trials (...) to improve the health of pregnant patients and of fetal patients and also criteria to responsibly manage the transition from investigation to clinical practice. Basing ethical criteria for research involving pregnant women on the ethical concept of the fetus as a patient insulates the proposed ethical framework and therefore research on pregnant women from the divisive and politicized concepts and discourses of personhood, fetal rights, and unborn child. (shrink)

Moral distress is one of the core topics of clinical ethics. Although there is a large and growing empirical literature on the psychological aspects of moral distress, scholars, and empirical investigators of moral distress have recently called for greater conceptual clarity. To meet this recognized need, we provide a philosophical taxonomy of the categories of what we call ethically significant moral distress: the judgment that one is not able, to differing degrees, to act on one’s moral knowledge about what one (...) ought to do. We begin by unpacking the philosophical components of Andrew Jameton’s original formulation from his landmark 1984 work and identify two key respects in which that formulation remains unclear: the origins of moral knowledge and impediments to acting on that moral knowledge. We then selectively review subsequent literature that shows that there is more than one concept of moral distress and that explores the origin of the values implicated in moral distress and impediments to acting on those values. This review sets the stage for identifying the elements of a philosophical taxonomy of ethically significant moral distress. The taxonomy uses these elements to create six categories of ethically significant moral distress: challenges to, threats to, and violations of professional integrity; and challenges to, threats to, and violations of individual integrity. We close with suggestions about how the proposed philosophical taxonomy of ethically significant moral distress sheds light on the concepts of moral residue and crescendo effect of moral distress and how the proposed taxonomy might usefully guide prevention of and future qualitative and quantitative empirical research on ethically significant moral distress. (shrink)

Physicians make some medical decisions without disclosure to their patients. Nondisclosure is possible because these are silent decisions to refrain from screening, diagnostic or therapeutic interventions. Nondisclosure is ethically permissible when the usual presumption that the patient should be involved in decisions is defeated by considerations of clinical utility or patient emotional and physical well-being. Some silent decisions - not all - are ethically justified by this standard. Justified silent decisions are typically dependent on the physician's professional judgment, experience and (...) knowledge, and are not likely to be changed by patient preferences. We condemn the inappropriate exclusion of the patient from the decision-making process. However, if a test or treatment is unlikely to yield a net benefit, disclosure and discussion are at times unnecessary. Appropriate silent decisions are ethically justified by such considerations as patient benefit or economy of time. (shrink)

Zygon®, Volume 57, Issue 2, Page 322-343, June 2022.

American Academy of Pediatrics (AAP) and American College of Medical Genetics (ACMG) recently provided two recommendations about predictive genetic testing of children. The Clinical Sequencing Exploratory Research Consortium's Pediatrics Working Group compared these recommendations, focusing on operational and ethical issues specific to decision making for children. Content analysis of the statements addresses two issues: (1) how these recommendations characterize and analyze locus of decision making, as well as the risks and benefits of testing, and (2) whether the guidelines conflict or (...) come to different but compatible conclusions because they consider different testing scenarios. These statements differ in ethically significant ways. AAP/ACMG analyzes risks and benefits using best interests of the child and recommends that, absent ameliorative interventions available during childhood, clinicians should generally decline to order testing. Parents authorize focused tests. ACMG analyzes risks and benefits using the interests of the child and other family members and recommends that sequencing results be examined for additional variants that can lead to ameliorative interventions, regardless of age, which laboratories should report to clinicians who should contextualize the results. Parents must accept additional analysis. The ethical arguments in these statements appear to be in tension with each other. (shrink)

Philosophy textbooks typically treat bioethics as a form of "applied ethics"-i.e., an attempt to apply a moral theory, like utilitarianism, to controversial ethical issues in biology and medicine. Historians, however, can find virtually no cases in which applied philosophical moral theory influenced ethical practice in biology or medicine. In light of the absence of historical evidence, the authors of this paper advance an alternative model of the historical relationship between philosophical ethics and medical ethics, the appropriation model. They offer two (...) historical case studies to illustrate the ways in which physicians have "appropriated" concepts and theory fragments from philosophers, and demonstrate how appropriated moral philosophy profoundly influenced the way medical morality was conceived and practiced. (shrink)

The Cambridge World History of Medical Ethics is the first comprehensive scholarly account of the global history of medical ethics. Offering original interpretations of the field by leading bioethicists and historians of medicine, it will serve as the essential point of departure for future scholarship in the field. The volumes reconceptualize the history of medical ethics through the creation of new categories, including the life cycle; discourses of religion, philosophy, and bioethics; and the relationship between medical ethics and the state, (...) which includes a historical reexamination of the ethics of apartheid, colonialism, communism, health policy, imperialism, militarism, Nazi medicine, Nazi "medical ethics," and research ethics. Also included are the first global chronology of persons and texts; the first concise biographies of major figures in medical ethics; and the first comprehensive bibliography of the history of medical ethics. An extensive index guides readers to topics, texts, and proper names. (shrink)

David McCullough never expected that his commencement speech in 2012 would go viral and be talked about all over the world. Now he gives insights to that speech, school, family, and life in general in a witty and poignant way that is good for parents and teens.

The return of genetic research results after death in the pediatric setting comes with unique complexities. Researchers must determine which results and through which processes results are returned. This paper discusses the experience over 15 years in pediatric cancer genetics research of returning research results after the death of a child and proposes a preventive ethics approach to protocol development in order to improve the quality of return of results in pediatric genomic settings.

In this issue of Perspectives in Biology and Medicine, Schneiderman and colleagues critique a recent multi-society policy statement—developed by the American Thoracic Society and endorsed by four other organizations—entitled “Responding to Requests for Potentially Inappropriate Treatment in Intensive Care Units”. The focus of Schneiderman’s critique is the Multiorganization Policy Statement’s choice of the term “potentially inappropriate” to describe a class of interventions that clinicians should resist providing for patients near the end of life, even when patients or their families request (...) or demand them.1 Schneiderman and colleagues argue that the term... (shrink)

This volume reprints in a scholar's edition the first English-language texts on bioethics, John Gregory's (1724-1773) Observations on the Duties and Offices of a Physician and on the Method of Prosecuting Enquiries in Philosophy (London, 1770) and Lectures on the Duties and Qualifications of a Physician (London, 1772). Five previously unpublished manuscripts of Gregory's lectures are also included. An introduction places Gregory's medical ethics and philosophy of medicine in their eighteenth-century contexts of Scottish Enlightenment history and culture, Baconian science and (...) philosophy of medicine, medical practice, the feminine and feminist philosophy of the Bluestocking Circle, and moral sense philosophy, particularly David Hume's concept of sympathy, and provides a bibliography of primary and secondary sources as an aid to teaching and future scholarship. The book's index provides access to Gregory's texts, by using both historical terms and current terminology of bioethics. A volume in the subseries Classics of Medical Ethics. (shrink)

During the COVID-19 pandemic, ethics centers were forced to reimagine program delivery. In a tumultuous time with rampant social isolation, the need for ethics education and dialogue was also critical. The authors, members of the directorship team of the Kegley Institute of Ethics, discuss how KIE met these challenges through organizing over fifty online events during the pandemic, including webinars, pedagogy workshops, ethics bowls, intercollegiate student conversations, colloquia, film viewings, and podcasts. The article describes both the opportunities and challenges that (...) different types of virtual events present and argues that innovation in online programming can help ethics centers show ethical leadership in their communities. As one example, we discuss how online events can both enhance and hinder accessibility for participants. We also describe how online programming presents both barriers and opportunities for community building and can prompt ethics centers to reflect on their identities and missions. (shrink)

Physicians make some medical decisions without disclosure to their patients. Nondisclosure is possible because these are silent decisions to refrain from screening, diagnostic or therapeutic interventions. Nondisclosure is ethically permissible when the usual presumption that the patient should be involved in decisions is defeated by considerations of clinical utility or patient emotional and physical well-being. Some silent decisions—not all—are ethically justified by this standard. Justified silent decisions are typically dependent on the physician's professional judgment, experience and knowledge, and are not (...) likely to be changed by patient preferences. We condemn the inappropriate exclusion of the patient from the decision-making process. However, if a test or treatment is unlikely to yield a net benefit, disclosure and discussion are at times unnecessary. Appropriate silent decisions are ethically justified by such considerations as patient benefit or economy of time. (shrink)

Minimizing the costs that others impose upon oneself and upon those in whom one has a fitness stake, such as kin and allies, is a key adaptive problem for many organisms. Our ancestors regularly faced such adaptive problems. One solution to this problem is to impose retaliatory costs on an aggressor so that the aggressor and other observers will lower their estimates of the net benefits to be gained from exploiting the retaliator in the future. We posit that humans have (...) an evolved cognitive system that implements this strategy which we conceptualize as a revenge system. The revenge system produces a second adaptive problem: losing downstream gains from the individual on whom retaliatory costs have been imposed. We posit, consequently, a subsidiary computational system designed to restore particular relationships after cost-imposing interactions by inhibiting revenge and motivating behaviors that signal benevolence for the harmdoer. The operation of these systems depends on estimating the risk of future exploitation by the harmdoer and the expected future value of the relationship with the harmdoer. We review empirical evidence regarding the operation of these systems, discuss the causes of cultural and individual differences in their outputs, and sketch their computational architecture. (shrink)

The best things in my Ufe have come to me by accident and this book results from one such accident: my having the opportunity, out of the blue, to go to work as H. Tristram Engelhardt, Jr. 's, research assistant at the Institute for the Medical Humanities in the University of Texas Medi cal Branch at Galveston, Texas, in 1974, on the recommendation of our teacher at the University of Texas at Austin, Irwin C. Lieb. During that summer Tris "lent" (...) me to Chester Bums, who has done important schol arly work over the years on the history of medical ethics. I was just finding out what bioethics was and Chester sent me to the rare book room of the Medical Branch Library to do some work on something called "medical deontology. " I discovered that this new field of bioethics had a history. This string of accidents continued, in 1975, when Warren Reich (who in 1979 made the excellent decisions to hire me to the faculty in bioethics at the Georgetown University School of Medicine and to persuade Andre Hellegers to appoint me to the Kennedy Institute of Ethics) took Tris Engelhardt's word for it that I could write on the history of modem medical ethics for Warren's major new project, the Encyclopedia of Bioethics. Warren then asked me to write on eighteenth-century British medical ethics. (shrink)