The increasing use of cluster randomised trials in low-resource settings raises unique ethical issues. The Ottawa Statement on the Ethical Design and Conduct of Cluster Randomised Trials is the first international ethical guidance document specific to cluster trials, but it is unknown if it adequately addresses issues in low-resource settings. In this paper, we seek to identify any gaps in the Ottawa Statement relevant to cluster trials conducted in low-resource settings. Our method is to analyse a prototypical cluster trial conducted (...) in a low-resource setting with the Ottawa Statement; to identify ethical issues in the design or conduct of the trial not captured adequately and to make recommendations for issues needing attention in forthcoming revisions to the Ottawa Statement. Our analysis identified six ethical aspects of cluster randomised trials in low-resource settings that require further guidance. The forthcoming revision of the Ottawa Statement should provide additional guidance on these issues: streamlining research ethics committee review for collaborating investigators who are affiliated with other institutions; the classification of lay health workers who deliver study interventions as health providers or research participants; the dilemma experienced by investigators when national standards seem to prohibit waivers of consent; the timing of gatekeeper engagement, particularly when researchers face funding constraints; providing ancillary care in health services or implementation trials when a routine care control arm is known to fall below national standards and defining vulnerable participants needing protection in low-resource settings. (shrink)

Martin E. Rosenberg -/- The Gift of Silence: Towards an Anthropology of Jazz Improvisation as Neuro-Resistance. -/- ABSTRACT: -/- This essay addresses how the complex processes that occur during jazz improvisation enact behaviors that resemble the logic of gift exchange first described by Marcel Mauss. It is possible to bring to bear structural, sociological, political economical, deconstructive or even ethical approaches to what constitutes gift exchange during the performance of jazz. Yet, I would like to shift from focusing this (...) analysis of jazz improvisation with reference to the language of music as symbolic action (which all of these approaches require), to grounding improvisation in embodied and distributed cognition, the performance of which begins with a ritual gift of silence. By silence, I refer to the embodied, yet shared pure duration as felt synchrony within an individual performer, that extends to the members of an ensemble. Thus, I refer to both aesthetic and micro-political implications of embodied, yet also distributed musical cognition in real time. -/- For jazz musicians, embodied silence becomes the initial condition for processes of cognitive bifurcation. For it is bifurcation that attracts us to jazz in the first place. Here I expand my previous work establishing similarities in the behavior of bifurcating systems in physical and cognitive sciences to the unfolding of ambiguity in real time during improvisation with respect to polyphony, polytonality and polyrhythms in the history of jazz from Charlie Parker to Ornette Coleman. We can therefore re-conceptualize jazz improvisation as a subversive antidote for processes of determination identified in a sub-discipline of cultural studies called “cognitive capitalism.” By examining silence from this anthropological perspective, we can conceive of jazz performance as a ritualized resistance to top-down cognitive control immanent with social and digital networks. The ritual enactment that is jazz improvisation points towards an aesthetics of bifurcation that is simultaneously a micro-politics of neuro-resistance. In other words, I argue that freedom of thought requires freedom from thought as an initial condition. -/- Yet, I emphasize the empirical rather than mystical grounds to this gift of silence. The valorization of silence by jazz musicians is not simply etiquette, an ethics of reciprocity for performers exchanging “riffs,” but an initial condition that jazz performers (and, I would argue, listeners) experience in their bodies, thus linking embodied cognition to a collective field of cultural production that emerges from each embodied individual, and yet also pervades the ensemble in ways reminiscent of feedback loops in complex systems. The recent and remarkable research on music and the brain has demonstrated that it is now possible to describe jazz improvisation as possessing both embodied and distributed cognitive properties. The emergent neuronal ensemble behavior within the individual that is visible in jazz improvisors, discovered by the neuroscientists at Johns Hopkins led by Charles Limb, bears striking resemblance to the interactive behaviors of the jazz ensemble itself. Thus, it is by recourse to recent research by myself and others into the cognitive neuroscience of music generally, and jazz improvisation specifically, that the empirical grounds for an anthropology of neuro-resistance become visible. (shrink)

Larmore aims to recover three forms of moral complexity that have often been neglected by moral and political philosophers. First, he argues that virtue is not simply the conscientious adherence to principle. Rather, the exercise of virtue apply. He argues - and this is the second pattern of complexity - that recognizing the value of constitutive ties with shared forms of life does not undermine the liberal ideal of political neutrality toward differing ideals of the good life. Finally Larmore agrues (...) for what he calls the heterogeneity of morality. Moral thinking need not be exclusively deontological or consequentialist, and we should recognize that the ultimate sources of moral value are diverse. The arguments presented here do not attack the possibility of moral theory. But in addressing some of the central issues of moral and political thinking today thay attempt to restore to that thinking greater flexibility and a necessary sensitivity to our common experience. (shrink)

A new understanding of political philosophy from one of its leading thinkers What is political philosophy? What are its fundamental problems? And how should it be distinguished from moral philosophy? In this book, Charles Larmore redefines the distinctive aims of political philosophy, reformulating in this light the basis of a liberal understanding of politics. Because political life is characterized by deep and enduring conflict between rival interests and differing moral ideals, the core problems of political philosophy are the regulation (...) of conflict and the conditions under which the members of society may thus be made subject to political authority. We cannot assume that reason will lead to unanimity about these matters because individuals hold different moral convictions. Larmore therefore analyzes the concept of reasonable disagreement and investigates the ways we can adjudicate conflicts among people who reasonably disagree about the nature of the human good and the proper basis of political society. Challenging both the classical liberalism of Locke, Kant, and Mill, and more recent theories of political realism proposed by Bernard Williams and others, Larmore argues for a version of political liberalism that is centered on political legitimacy rather than on social justice, and that aims to be well suited to our times rather than universally valid. Forceful and thorough yet concise, What Is Political Philosophy? proposes a new definition of political philosophy and demonstrates the profound implications of that definition. The result is a compelling and distinctive intervention from a major political philosopher. (shrink)

The essays collected in this volume all explore the problem of the relation between moral philosophy and modernity. Charles Larmore addresses this problem by attempting to define the way distinctive forms of modern experience should orientate our moral thinking. Charles Larmore wonders whether the dominant forms of modern philosophy have not become blind to important dimensions of the moral life. The book argues against recent attempts to return to the virtue-centered perspective of ancient Greek ethics. As well as (...) exploring the differences between ancient and modern ethics, the author examines such topics as the roles of reason and history in our moral understanding, the inadequacy of philsophical naturalism, and the foundations of modern liberalism. There are also extended discussions of a number of leading contemporary philosophers: Rawls, Habermas, Williams and Rorty. (shrink)

In The Autonomy of Morality Charles Larmore challenges two ideas that have shaped the modern mind. The world, he argues, is not a realm of value-neutral fact, nor does human freedom consist in imposing principles of our own devising on an alien reality. Rather, reason consists in being responsive to reasons for thought and action that arise from the world itself. Larmore shows that the moral good has an authority that speaks for itself. Only in this light does the (...) true basis of a liberal political order come into view, as well as the role of unexpected goods in the makeup of a life lived well. (shrink)

Charles Rosenberg’s latest book is a collection of ten essays spanning twelve years’ work on the history of American medicine, and seeks to provide both the historian and the practicing physician with an understanding of the framework that lies beneath our modern medical system. He states his cause explicitly in the opening chapter: “Insofar as I have a personal agenda, it is a desire to underline the need...for physicians to think and act on an understanding of [their] unique (...) social and moral identity. It means thinking critically about...the world that informs and constrains clinical choices” (p. 11). (shrink)

An examination of split-brain syndrome, and whether split-brain patients have two minds.

This article analyzes six ethical principles at work in the Pastoral Letter of the Roman Catholic Bishops on the United States economy. The first three principles derive from the Thomistic tradition with its attempt to avoid the extremes of collectivism and individualism. Human beings are by nature social and called to live in political society. The principle of subsidiarity guides the role of the state. Distributive and social justice furnish the criteria for a just distribution of human goods. The fourth (...) ethical principle which is a later development in the Catholic tradition recognizes human rights including economic rights. In keeping with recent emphases in Catholic teaching the fifth principle insists that the goods of creation exist to serve all and stresses the social aspect of property. The sixth principle enunciates a preferential option for the poor and has come to the fore in the light of recent liberation theology. (shrink)

This book intends to introduce readers to the work of Charles E. Butterworth, and thereby to introduce students to Medieval islamic political philosophy, of which Butterworth is one of the world's most prominent scholars. In a wider sense, the Festschrift introduces its readers to the current debates on Medieval islamic political philosophy, related as they are to the questions of the relationship between islam and Christianity, the Medieval to the Modern world, and reason and revelation. Butterworth's scholarship spans six (...) decades, primarily translating, editing, and interpreting the works of the Muslim political philosopher Alfarabi (d. 950) and Averroes (Ibn Rushd, d. 1198). He began his studies of Muslim political philosophy at a time when the Middle East and islam did not have the political salience they have acquired in more recent years. instead, Butterworth's reason for engaging with islam was rooted in the question of the relationship between reason and revelation. While one possible answer was pursued in the Christian, latin West, the islamic borderlands of Greek, Roman, and Muslim civilization offered another. By exploring Averroes, who provides the possibility of an Aristotelian-Islamic political philosophy, and Alfarabi, who pursues a Platonic-islamic political philosophy, Butterworth showed how islamic civilization provided a viable alternative to the theologico-political question reason v revelation, as well as serving as an inspiration to the latin West. (shrink)

This chapter discusses the opening to the world in the Vatican II document Gaudium et Spes, the Pastoral Constitution on the Church in the Modern World. The approach of Gaudium et Spes differs from the earlier method of Catholic social teaching, which employed primarily a natural law approach. Gaudium et Spes introduces a more biblical, faith-centered, Christological approach to life in the world. In discussing the document itself, some of the problems in the document are also mentioned, especially its overly (...) optimistic approach and its somewhat one-sided anthropological outlook. The discussion also points out the many subsequent developments building on Gaudium et Spes that occurred later, including the greater emphasis on the particular as illustrated in liberation and feminist theologies, the preferential option for the poor, and the importance of historical consciousness and the resultant pluralism in Catholic approaches to life in the world. The chapter develops by considering three significant methodological issues—a more theological approach to life in the world, a more personalist approach, and a more inductive approach. (shrink)

One of the major intellectual figures of the twentieth century, Paul Ricoeur has influenced a generation of thinkers.

During the past few decades, engineering ethics has been oriented towards protecting the public from professional misconduct by engineers and from the harmful effects of technology. This “preventive ethics” project has been accomplished primarily by means of the promulgation of negative rules. However, some aspects of engineering professionalism, such as (1) sensitivity to risk (2) awareness of the social context of technology, (3) respect for nature, and (4) commitment to the public good, cannot be adequately accounted for in terms of (...) rules, certainly not negative rules. Virtue ethics is a more appropriate vehicle for expressing these aspects of engineering professionalism. Some of the unique features of virtue ethics are the greater place it gives for discretion and judgment and also for inner motivation and commitment. Four of the many professional virtues that are important for engineers correspond to the four aspects of engineering professionalism listed above. Finally, the importance of the humanities and social sciences in promoting these virtues suggests that these disciplines are crucial in the professional education of engineers. (shrink)

"... stimulating and insightful... a thoroughly researched and timely contribution to the secondary literature of ethics... " —Library Journal "His important new work establishes Scott... as one of the foremost interpreters of the Continental philosophical tradition of the US.... Necessary for anyone working in ethics or the Continental tradition." —Choice "... a provocative discourse on the consequences of the ethical in the thought of Nietzsche, Foucault, and Heidegger." —The Journal of Religion Charles E. Scott's challenging book advances the broad (...) claim that ethics as a way of judging and thinking has come into question as philosophers have confronted suffering and conflicts that arise from our traditional systems of value. (shrink)

In this book, Charles Larmore develops an account of morality, freedom, and reason that rejects the naturalistic metaphysics shaping much of modern thought. Reason, Larmore argues, is responsiveness to reasons, and reasons themselves are essentially normative in character, consisting in the way that physical and psychological facts - facts about the world of nature - count in favor of possibilities of thought and action that we can take up. Moral judgments are true or false in virtue of the moral (...) reasons there are. We need therefore a more comprehensive metaphysics that recognizes a normative dimension to reality as well. Though taking its point of departure in the analysis of moral judgment, this book branches widely into related topics such as freedom and the causal order of the world, textual interpretation, the nature of the self, self-knowledge, and the concept of duties to ourselves. (shrink)