The concept of regulatory ‘checkpoints’ in the eukaryotic cycle has proved to be a fruitful one. Here, its applicability to the bacterial cell cycle is examined. A primitive DNA damage checkpoint operates in E. coli such that, after exposure to ultraviolet light, while excision repair occurs, chromosome replication continues very slowly with the production of discontinuous daughter strands. The slower the rate of excision of photoproducts, the greater the delay before the normal rate of DNA replication is restored, the additional (...) time for repair ensuring that normal survival is maintained. A model is proposed in which replication rate is controlled by the ratio of RecAcoated to uncoated single stranded regions of DNA in the replication fork. There are also two cell division inhibitors SulA (=SfiA) and SfiC under the control of the SOS system and sensitive to DNA damage, but they are irrelevant to the survival of wild‐type bacteria under normal conditions. In strains where SulA and SfiC do not operate, inhibition is not influenced by the rate of excision repair and so fails one of the criteria for a DNA damage checkpoint, namely the monitoring of the DNA for the level of residual damage. (shrink)

There is growing evidence that mutations can arise in non‐dividing cells (both bacterial and mammalian) in the absence of chromosomal replication. The processes that are involved are still largely unknown but may include two separate mechanisms. In the first, DNA lesions resulting from the action of endogenous mutagens may give rise to RNA transcripts with miscoded bases. If these confer the ability to initiate DNA replication, the DNA lesions may have an opportunity to miscode during replication and thus could give (...) rise to apparently ‘adaptive’ mutations. A second mechanism is suggested by recent work in starved bacteria, showing that there is much more turnover of chromosomal DNA than has been previously thought. This could permit polymerase errors to lead to mutations in non‐dividing cells. Such cryptic DNA synthesis, which may essentially replace existing DNA rather than duplicating it, could, in principle, act as an additional source of variability on which selection may act, initially in the absence of cell division. In mammals such processes would undoubtedly have implications for germ cell mutagenesis and carcinogenesis. (shrink)

This article explores how researchers in a scientific research lab co-operate with each other and value these co-operations, using a case study of a life sciences lab as an illustrative example. It explores how researchers within the lab co-operate in three main ways: through their ideas, methods and resources. A core contention of this article is that the values researchers attach to these different ways of co-operating can be assessed on two dimensions: goals and ways of understanding. The goals dimension (...) moves from group goals, manifested in the vision of the lab defined by its principal investigator, to the goals of individual researchers within the lab, often achieved through work on individual projects. Individual goals were more highly valued by researchers in this case study. The ways of understanding dimension moves from theory-based and theory-building research activities, to craft-based activities related to the research lab’s experiments. Theoretical ways of understanding are more highly valued by researchers in this case study. Combined, these two dimensions mean that researchers will value co-operations that support individual goals and theoretical ways of understanding more highly. Idea-based collaborations, individualistic and theoretical in nature, were the most highly valued. Collaborations based on resources, communal and craft-centered, were the least valued in this case study. (shrink)

Developing novices’ proficiency in skilful activities is central to the reproduction of human societies. The interactional practices through which instruction is accomplished have provided a rich focus for ethnomethodological and conversation analytic studies examining classroom settings, and, more recently, non-classroom environments of instruction in practical and manual skills. This paper examines the work of instruction in basketball training and in particular the correction of player performances, which are a ubiquitous and central feature of instruction in basketball training sessions. A central (...) part of this instructional action relies on the coach observing training activities to determine players’ competencies and to extract relevant correctables from the players’ embodied displays, which are in turn embedded within complex arrangements of rapidly moving bodies situated in material environments. In this paper we examine the visual-analytic work involved in both organizing and observing a basketball training activity, demonstrating the sequential layering of multiple membership categorization devices drawn upon in producing and recognizing actions in this setting. We argue that the coach deploys spatial orientations which function analogously to membership categorization devices, with players’ bodily positions relative to one another and the material structure of the surround generating category-like sets of rights, responsibilities, and sequential relevancies. As we demonstrate, these orientations provide crucial resources for the identification of players’ errors and thereby for the organization of instruction in interaction in this setting. (shrink)

While there has been significant discussion in the health sciences and ethics literatures about problems associated with publication practices (e.g., ghost- and gift-authorship, conflicts of interest), there has been relatively little practical guidance developed to help researchers determine how they should fairly allocate credit for multi-authored publications. Fair allocation of credit requires that participating authors be acknowledged for their contribution and responsibilities, but it is not obvious what contributions should warrant authorship, nor who should be responsible for the quality and (...) content of the scientific research findings presented in a publication. In this paper, we review arguments presented in the ethics and health science literatures, and the policies or guidelines proposed by learned societies and journals, in order to explore the link between author contribution and responsibility in multi-author multidisciplinary health science publications. We then critically examine the various procedures used in the field to help researchers fairly allocate authorship. (shrink)

When patients are not able to speak for themselves, surrogate decision makers are asked to guide treatment decisions and formulate a plan of care in accordance with what the patients would have wanted. This necessitates an exploration into the patients’ views about life and how it should be lived, how the patients constructed their identity or life story, and their attitudes towards sickness and suffering. When an individual appoints a surrogate, such as a healthcare power of attorney, a common presumption (...) is that this designation evinces merit. This obscures the possibility of multiple other considerations that influence individual choice. This article presents a clinical case in which the claim to know someone best created a controversy that brought treatment decisions to a standstill. Further, it illuminates how the question, “Given the current medical condition, what would this person want?” risks presuming that a singular, unambiguous preference exists and that one person can provide the answer. Clinical ethicists can play a vital role in situations when there is a dispute among a designated surrogate and family members over a patient’s preference. By embracing the complexity of the desire to synthesize seemingly irreconcilable perspectives about identity, uncovering the reasons that underlie disagreement, and guiding inquiry in such a way that allows stakeholders to move beyond the conflict, clinical ethicists can facilitate decision making that honors the patient and may mitigate moral distress. (shrink)

Why did Bernhard Riemann, arguably the most original mathematician of his generation, spend the last year of life investigating the mechanism of hearing? Fighting tuberculosis and the hostility of eminent scientists such as Hermann Helmholtz, he appeared to forsake mathematics to prosecute a case close to his heart. Only sketchy pages from his last paper remain, but here we assemble some significant clues and triangulate from them to build a broad picture of what he might have been driving at. Our (...) interpretation is that Riemann was a committed idealist and from this philosophical standpoint saw that the scientific enterprise was lame without the “poetry of hypothesis”. He believed that human thought was fundamentally the dynamics of “mind-masses” and that the human mind interpenetrated, and became part of, the microscopic physical domain of the cochlea. Therefore, a full description of hearing must necessarily include the perceptual dimensions of what he saw as a single manifold. The manifold contains all the psychophysical aspects of hearing, including the logarithmic transformations that arise from Fechner’s law, faithfully preserving all the subtle perceptual qualities of sound. For Riemann, hearing was a unitary physical and mental event, and parallels with modern ideas about consciousness and quantum biology are made. A unifying quantum mechanical model for an atom of consciousness—drawing on Riemann’s mind-masses and the similar “psychons” proposed by Eccles—is put forward. (shrink)

In their article, Pavarani and colleagues offer a vision of evolutionary bioethics that focuses on innovation and empirical research as a means to enrich the field of bioethics. Empirical bi...

Scientific authorship serves to identify and acknowledge individuals who “contribute significantly” to published research. However, specific authorship norms and practices often differ within and across disciplines, labs, and cultures. As a consequence, authorship disagreements are commonplace in team research. This study aims to better understand the prevalence of authorship disagreements, those factors that may lead to disagreements, as well as the extent and nature of resulting misbehavior. Methods include an international online survey of researchers who had published from 2011 to (...) 2015. Of the 6673 who completed the main questions pertaining to authorship disagreement and misbehavior, nearly half reported disagreements regarding authorship naming; and discipline, rank, and gender had significant effects on disagreement rates. Paradoxically, researchers in multidisciplinary teams that typically reflect a range of norms and values, were less likely to have faced disagreements regarding authorship. Respondents reported having witnessed a wide range of misbehavior including: instances of hostility, undermining of a colleague’s work during meetings/talks, cutting corners on research, sabotaging a colleague’s research, or producing fraudulent work to be more competitive. These findings suggest that authorship disputes may contribute to an unhealthy competitive dynamic that can undermine researchers’ wellbeing, team cohesion, and scientific integrity. (shrink)

A current advance within the agricultural industry is the use of genetic engineering to produce novel crops for food production. This technology raises questions about how societies should position themselves with respect to genetically modified (GM) crop development and implementation; namely, how should the potentials and risks of this technology be evaluated? We argue that current methods to evaluate the risks and benefits of GM crops are inadequate and not conducive to the strategic development of this technology, where a way (...) to ameliorate technology assessments for GM crops is to include farmers in the research process of evaluating these crops prior to their commercialization. However, particularities concerning the ethical status of such research require special consideration and vigilance. For example, in such technology assessment initiatives, farmers would occupy both the roles of research participant and research investigator. Other particularities surface due to factors related to the nature of GM crops. These particularities are examined with reference to concepts drawn from the field of research ethics, namely informed consent, compensatory decisions, and issues of participant inclusion/exclusion. (shrink)

Labelling schemes are practical arrangements aimed at making 'ethical' products widely available and visible. They are crucial to expanded development of ethical markets and hence to the addition of moral dimensions to the normally amoral behaviour linking consumers and retail and production businesses. The study reported here attempts to assess the contribution of UK ethical, social and environmental certification and labelling initiatives to 'sustainable' consumption and production. The research sought to assess the overall potential of initiatives to inject human values (...) into the supply-distribution chains, through a qualitative survey of 15 of the 26 main UK initiatives: in social justice, animal welfare and environmental sustainability from the agriculture, food processing, timber, aquaculture, textiles and personal care sectors. By analysing the basic characteristics and concepts of these labels and investigating the emergence of labelling initiatives, we assess whether labels help add an ethical dimension, or whether, in some respects, they also reduce such missions to the technical management of adding only another 'utility' to a product. The analysis assesses whether the gradual 'mainstreaming' of ethical initiatives such as 'Fairtrade' risks subsuming ethical goals within business participants' competitive and profit-oriented logics. However, the contrasting perspectives revealed between rival labelling initiatives show that the scope and functions of labelling projects go beyond the manifest ones of information communication between consumers and producer and actually introduce elements of socio-political regulation. These are essential for more sustainable and ethical business practices and are an integral part of any humanisation of business involvement. (shrink)

Efforts to develop democratic schools have moved along particular rules and standards of ‘reasoning’ even when expressed through different ideological and paradigmatic lines. From attempts to make a democratic education to critical pedagogy, different approaches overlap in their historical construction of the reason of schooling: designing society by designing the child. These approaches to democracy make inequality into the premise of equality, assuming a consensual partition of the world and the need for specific agents to monitor partitioned boundaries, thus reinserting (...) differences as the basis of practice. Democracy, however, according to Jacques Rancière, only becomes visible when its partitioning is challenged under the opinion of equality. Yet, undoing the epistemological dogma of planning embodied in the notions of ‘critical’ and deliberative democracy might also involve confronting the comparative style of thought which provides the epistemological ‘rules’ that insert inequality as equality. Deleuze and Guattari's rhizome and Derrida's justice help extend Rancière's democracy and equality into unfamiliar terrain. What implications might this have for thinking about educational policy and curriculum? The argument, ironically, maintains Enlightenment attitudes about reason and rationality, but while ‘trying’ different epistemological rules and recognizing how the epistemological and ontological fold into one another it provides an alternative understanding of education and democracy. (shrink)

ABSTRACTBuilding on Google's efforts to scan millions of books, this article introduces methodology using a database of annual word frequencies of the 40,000 most frequently occurring words in the American literature between 1800 and 2009. The current paper uses this methodology to replicate and identify terror management processes in historical context. Variation in frequencies of word usage of constructs relevant to terror management theory are investigated over a time period of 209 years. Study 1 corroborated previous TMT findings and demonstrated (...) that word use of constructs related to death and of constructs related to patriotism and romantic relationships significantly co-vary over time. Study 2 showed that the use of the word “death” most strongly co-varies over time with the use of medical constructs, but also co-varies with the use of constructs related to violence, relationships, religion, positive sentiment, and negative sentiment. Study 3 foun... (shrink)

Military physicians are often perceived to be in a position of ‘dual loyalty’ because they have responsibilities towards their patients but also towards their employer, the military institution. Further, they have to ascribe to and are bound by two distinct codes of ethics, each with its own set of values and duties, that could at first glance be considered to be very different or even incompatible. How, then, can military physicians reconcile these two codes of ethics and their distinct professional/institutional (...) values, and assume their responsibilities towards both their patients and the military institution? To clarify this situation, and to show how such a reconciliation might be possible, we compared the history and content of two national professional codes of ethics: the Defence Ethics of the Canadian Armed Forces and the Code of Ethics of the Canadian Medical Association. Interestingly, even if the medical code is more focused on duties and responsibility while the military code is more focused on core values and is supported by a comprehensive ethical training program, they also have many elements in common. Further, both are based on the same core values of loyalty and integrity, and they are broad in scope but are relatively flexible in application. While there are still important sources of tension between and limits within these two codes of ethics, there are fewer differences than may appear at first glance because the core values and principles of military and medical ethics are not so different. (shrink)

Authorship is commonly used as the basis for the measurement of research productivity. It influences career progression and rewards, making it a valued commodity in a competitive scientific environment. To better understand authorship practices amongst collaborative teams, this study surveyed authors on collaborative journal articles published between 2011 and 2015. Of the 8364 respondents, 1408 responded to the final open-ended question, which solicited additional comments or remarks regarding the fair distribution of authorship in research teams. This paper presents the analysis (...) of these comments, categorized into four main themes: disagreements, questionable behavior, external influences regarding authorship, and values promoted by researchers. Results suggest that some respondents find ways to effectively manage disagreements in a collegial fashion. Conversely, others explain how distribution of authorship can become a “blood sport” or a “horror story” which can negatively affect researchers’ wellbeing, scientific productivity and integrity. Researchers fear authorship discussions and often try to avoid openly discussing the situation which can strain team interactions. Unethical conduct is more likely to result from deceit, favoritism, and questionable mentorship and may become more egregious when there is constant bullying and discrimination. Although values of collegiality, transparency and fairness were promoted by researchers, rank and need for success often overpowered ethical decision-making. This research provides new insight into contextual specificities related to fair authorship distribution that can be instrumental in developing applicable training tools to identify, prevent, and mitigate authorship disagreement. (shrink)

Lee (2017) calls for greater attention to the shared epistemological and normative grounds of both public health ethics and environmental ethics, and to Potter’s original conception of bioethics, which, as she rightly observes, has been largely disregarded in contemporary North American bioethics scholarship and practice. In a previous publication we also argued in favor of reviving the Potterian approach to bioethics; we built a case grounded in “the relatively new field of molecular epigenetics [that] provides novel information that should serve (...) as additional justification for expanding the scope of bioethics to include environmental and public health concerns.”. (shrink)

This article concerns the ways in which authors from various fields conceptualise the ethical issues arising in the conduct of research. We reviewed critically and systematically the literature concerning the ethics of conducting research in order to engage in a reflection about the vocabulary and conceptual categories used in the publications reviewed. To understand better how the ethical issues involved in conducting research are conceptualised in the publications reviewed, we 1) established an inventory of the conceptualisations reviewed, and 2) we (...) critically assessed them. We found that the publications reviewed mostly showed examples of descriptive ethics, in that most authors describe ethical issues without reflecting much on them, which could be explained both by 1) a lack of ethical education in research contexts, and 2) by the fact that we do not know what researchers know (or do not) about ethical issues. Additionally, the definitions identified in the publications are scarce and at times imprecise, but this seems more to point out the ethical vocabulary’s difficulties in certain contexts. Further, very few authors offer proper conceptualisations of the ethical issues arising in conducting research. When dealing with vast arrays of ethical issues to conceptualise, perhaps one ought to remember that some typologies already exist that could guide further reflection and help understand other realities for which the current ethical vocabulary may be lacking. We believe that combining the reviewed typologies, both with other well-developed typologies and critical reflection, could help support better ethical practice in conducting research. (shrink)

This paper addresses responses to news about the imposing of a local lockdown in a UK city. The opposition to the measure shows it to be controversial as does the associated rejection of the grounds for taking action against covid more generally, which comes alongside the devaluing of expertise, resistance to public health responses, a proliferation of conspiracy theories and misinformation and the harm that can be caused by focussing on non-adherence to covid measure. The research question for this analysis (...) is therefore: how are arguments about the local lockdown discursively formulated in online discussions? Discursive analysis of online discussions following four newspaper articles identified six arguments used that range from scepticism to conspiratorial: scepticism over (1) the prevalence and; (2) severity of covid; (3) lockdowns generally do not work and (4) the specific city lockdown will not work; (5) lockdowns are overly risk averse; and (6) there are hidden political motives for lockdowns. The discussion shows how both the ‘conspiratorial’ and non-conspiratorial arguments are potentially harmful from a public health perspective. (shrink)

Genetic testing in the workplace is a technology both full of promise and fraught with ethical peril. Though not yet common, it is likely to become increasingly so. We survey the key arguments in favour of such testing, along with the most significant ethical worries. We further propose a set of pragmatic criteria, which, if met, would make it permissible for employers to offer (but not to require) workplace genetic testing.

There is a widely acknowledged shortage of and an increasing demand for transplantable human organs and tissues (e.g., kidney, heart, lung, liver, cornea) in developed and developing countries around the world. In response to this need, Lott and Savulescu (2007) propose the creation of a human embryonic stem (hESC) bank to facilitate the equitable and efficient dissemination of human leukocyte anti- gen (HLA) matched tissues and organs to patients in need of replacement. Although not an unreasonable proposal, the authors go (...) on to make a much stronger claim. They argue that hESCs are such important tools for addressing the massive unmet global need for organs that it is ethically justified to require mandatory banking of spare embryos, and they argue for the use of financial (or other) inducements to procure embryos for the derivation of hESCs. (shrink)

Both law and medicine rely on self-regulation and codes of professionalism to ensure duties are performed in a competent, ethical manner. Unlike physicians, however, judges are lawyers themselves, so judicial oversight is also self-regulation. As previous literature has highlighted, the hesitation to report a cognitively-compromised judge has resulted in an “opensecret” amongst lawyers who face numerous conflicts of interest.Through a case study involving a senior judge with severe cognitive impairment, this article considers the unique ethical dilemmas that cognitive specialists may (...) encounter when navigating duties to patient, society, and the medical profession, without clear legal guidance.Systemic self-regulatory inadequacies in the legal profession are addressed, as well as challenges that arise when trying to preserve the trust and dignity of an incapacitated patient who must fulfill special duties to society.Ultimately, because of their unique neurological expertise and impartial assessments, we submit that allowing cognitive specialists to submit their assessments to an internal judiciary board may act as an additional check and balance to ensure the fair and competent administration of justice. (shrink)

Nanotechnology research is beginning to see widespread coverage in the media and popular science literatures, but discussions of hopes and fears about nanotechnology have already become polarised into utopian and dystopian visions. More moderate discussions focus on the near-term applications of nanotechnologies, and on potential benefits and harms. However, in exploring the social and ethical implications of nanotechnology, important lessons should be learned from experiences in other fields. In particular, studies of the ethical, legal, and social issues of genetics research (...) have successfully mapped out many of the issues that arise when new technologies are deployed. It is our contention that, for the most part, the ethical and social issues arising in nanomedicine are not altogether new, and thus do not require novel ethical principles or frameworks, nor a massive investment in ‘NELSI’ research. Instead, what is needed is support for the development of a culture of ethics amongst scientists and clinicians, basic scientific and medical knowledge for bioethicists, and a social competency for citizens to participate actively in debates about the implications of new technologies in general. (shrink)

The case study presented by Winch and Sinnott (2011) shows not only how difficult it is for clinicians and researchers to identify conflicts of interest (COI), but also how damaging it can be when there are unin- formed and uncoordinated policy responses by senior administrators.

This chapter contains sections titled: Opening Scene or the Progressive Utopia Critical Pedagogy and Notions of Democracy The Pedagogy of the What If … Policing as the Negation of Politics The Question of Democratic Education 8 Confronting the Entanglement of Schooling—Planning—Comparing Democracy and Justice Concluding Thoughts Notes References.

The paper’s authors are composers operating within the field of experimental music. Their music is created from the use of limited materials placed into repetitive structures involving cyclic pitch patterns and sustained tone textures. This reductive approach to composition provides a fertile area for discussions of temporality, as the music functions outside of standard teleological narrative structures thereby prompting more varied subjective temporal experiences for listeners. The paper will take as its starting point the experience of the listener, rather than (...) the musical score, enhancing discussions from Thomas Clifton’s Music as Heard.1 This angle is particularly relevant when discussing minimal works, as the score does not give an indication to what the auditory experience will be, it simply acts as what pianist Philip Thomas describes as a ‘prescription for action’ for the performers.2 Drawing particularly upon work on the temporal experience by Merleau-Ponty, the paper discusses how phenomenological approaches can provide effective insight into the experience of sustained tone and repetitive music. By discussing notions of retention and protention, the two composers will explore how this permeates their compositional approach, particularly in relation to the use of repetition, examining the different types of musical materials used by the composers and how this affects the temporalities experienced upon performance. Points of similarity and variance between the two outlooks are explored in detail, providing an in-depth discussion as to how attitudes towards temporality can result in nuanced differences in output. Fundamental essences are clarified and discussed in relation to other composers’ work, and in particular American composer James Tenney’s work in applying a phenomenological model upon the listening experience is considered alongside the central discussion. The results of this investigation provide both clear artistic statements on the role of phenomenological thought in the creative process, and also tentative starting points for further discussion on experiential temporalities in minimal and experimental musics. (shrink)

In seeking to clarify the concept of conflict of interest (COI) in debates about physician–industry relationships, Howard Brody (2011) highlights the extent to which the prob- lem turns on a common pejorative understanding of COI. Whether it is the academic or public policy “pharmapologists” or “pharmascolds” talking about COI, there is often a straightforward and overly simplistic correlation made: that is, a conflict of interest—by definition—leads to fraudulent or corrupt behavior. The same type of reasoning is com- monly found in (...) discussions about COI outside the health sciences, most notably in news stories about the awarding of government contracts or the behaviour of corporate executives. The problem is that in focusing on dramatic failures to manage COI (e.g., around Vioxx), there is a tendency to strongly associate COI with extreme forms of financial and even criminal misconduct, leaving the public, policymakers, academics, and professionals with a skewed and limited understanding of the concept. (shrink)

In the United Kingdom, there are moves to extend formal ethical review of research involving human subjects beyond the traditional oversight by NHS local or multi-centre research ethics committees of medical or clinical research, to also encompass all ‘non-clinical’ research involving human subjects. This paper describes and analyses the development and implementation of a model for ethical review within the university sector. At Cardiff University, a devolved or two-tiered system of ethics review has been created in which a top-level university (...) research ethics committee provides policy advice to and oversight of school-based research ethics committees that engage in formal ethics review of research conducted in their respective schools. We describe the system and reflect on the challenges and benefits of implementing such a coordinated and comprehensive university-wide system of ethics review. (shrink)

Research on research ethics—regarding both the governance and practice of the ethical review of human subjects research—has a tumultuous history in North America and Europe. Much of the academic literature focuses on issues to do with regulating the conduct and quality of ethics review of research protocols by ethics committees (research ethics boards (REBs) in Canada and institutional review boards (IRBs) in the United States). In addition, some of the literature attends to issues particular to the review of qualitative research, (...) and still other literature addresses the challenges posed by and the need for research on REBs/IRBs. It is this third group of literature within which our article is situated. (shrink)

: Decisions about funding health services are crucial to controlling costs in health care insurance plans, yet they encounter serious challenges from intellectual property protection—e.g., patents—of health care services. Using Myriad Genetics' commercial genetic susceptibility test for hereditary breast cancer (BRCA testing) in the context of the Canadian health insurance system as a case study, this paper applies concepts from social contract theory to help develop more just and rational approaches to health care decision making. Specifically, Daniels's and Sabin's "accountability (...) for reasonableness" is compared to broader notions of public consultation, demonstrating that expert assessments in specific decisions must be transparent and accountable and supplemented by public consultation. (shrink)

The introduction of pre-exposure prophylaxis (PrEP) for HIV has triggered critical analysis within the social sciences. For example, some have signalled how PrEP may lead to a renewed medicalisation of gay and other homosexually-active men’s sexuality. This chapter challenges some of those accounts. Adopting a public health ethics perspective, it argues that gay men should be understood as agentic in their use of PrEP, as opposed to being the passive victims of medicalisation, and that greater attention should be paid to (...) questions of pleasure in PrEP use. Applying a reproductive justice framework, the chapter argues that the worldwide inaccessibility of PrEP constitutes a more serious ethical issue than the potential problem of the medicalisation of gay men’s sexuality. (shrink)

Objective Our study sought to (1) describe the practices and preferences of Colombian adolescents in accessing sexual and reproductive health services: accompanied versus alone; (2) compare actual practices with stated preferences; and (3) determine age and gender differences regarding the practice and these stated preferences. -/- Methods 812 participants aged 11–24 years old answered a survey in two Profamilia clinics in the cities of Medellin and Cali in Colombia. A cross-sectional analysis was performed to compare participants’ answers based on the (...) variables of gender and age. -/- Results A quarter of participants visited the clinic alone (25.4%). Females were more likely to go alone in comparison to males (26.3% vs 14.1%; p = 0.031), and older participants went alone more often than younger participants (p < 0.001). Most participants – 72.7% (95 %CI: 69.3–75.9) – expressed a preference in being accompanied to the clinic, and more than 90% had their preferences met. The preferences of older participants were, however, less likely to be met than those of younger participants (p < 0.001), notably, because they predominantly wanted to be accompanied. -/- Conclusion Contemporary public health and bioethics literature advocates in favor of developing health services that better meet the preferences of adolescents. The present research highlights an apparent blind spot related to the role that others (e.g., parents, friends, partners) can or should play in accompanying adolescent patients when they access sexual and reproductive health services. Respecting adolescents’ preferences, and hence their autonomy, is not simply a matter of ensuring freedom from constraints (e.g., their right and ability to go alone). Rather, it should also consider the liberty to choose whether to be accompanied when accessing SHRS and by whom. (shrink)

Dans notre société de plus en plus digitalisée, avons-nous vraiment le choix d’adopter ou non les technologies? Comment cette digitalisation impacte-t-elle les personnes âgées en particulier et son écosystème? Quels sont les enjeux éthiques soulevés par cette digitalisation? Ce texte vise à amener des éléments de réflexions en lien avec ces enjeux selon le point de vue de divers experts des domaines de la technologie, du vieillissement et de la bioéthique. Ces experts se sont rencontrés lors d’un symposium ayant eu (...) lieu à Angers, France, en octobre 2019. Le texte est un compte-rendu des échanges et points de vue de ces experts, ainsi que des discussions ouvertes qu’ils ont eues avec l’assistance, portant sur les principaux enjeux soulevés par cette digitalisation selon la perspective des personnes âgées, des proches-aidants, des soignants, de la société et de la recherche. (shrink)

Public discussions of ethical issues related to the biotechnology industry tend to treat "biotechnology" as a single, undifferentiated technology. Similarly, the pros and cons associated with this entire sector tend to get lumped together, such that individuals and groups often situate themselves as either "pro-" or "anti-" biotechnology as a whole. But different biotechnologies and their particular application context pose very different challenges for ethical corporate decision-making. Even within a single product category, different specialty products can pose strikingly different ethical (...) challenges. In this paper, we focus on the single over-arching category of "genetic testing" and compare tests for disease susceptibility and drug response. We highlight the diversity of ethical challenges - grouped under the broad categories of "truth in advertising" and "protecting intellectual property" - raised by the commercialization and marketing of these technologies. By examining social and technical differences between genetic tests, and the associated corporate ethics challenges posed by their commercialization, our intent is to contribute to the nascent business ethics literature examining issues raised by the development and marketing of genetic tests. (shrink)

Background There has been debate on whether a global or unified field of bioethics exists. If bioethics is a unified global field, or at the very least a closely shared way of thinking, then we should expect bioethicists to behave the same way in their academic activities anywhere in the world. This paper investigates whether there is a 'global bioethics' in the sense of a unified academic community. Methods To address this question, we study the web-linking patterns of bioethics institutions, (...) the citation patterns of bioethics papers and the buying patterns of bioethics books. Results All three analyses indicate that there are geographical and institutional differences in the academic behavior of bioethicists and bioethics institutions. Conclusion These exploratory studies support the position that there is no unified global field of bioethics. This is a problem if the only reason is parochialism. But these regional differences are probably of less concern if one notices that bioethics comes in many not always mutually understandable dialects. (shrink)