Many global health issues, almost by definition, do not recognize state borders and therefore require bi-lateral, or more often multi-lateral international solutions. These latter solutions are articulated in international instruments (declarations, conventions, treaties, constitutions of international bodies, etc). However, the gap between formal adoption of such instruments by signatory states and substantive implementation of the articulated solutions can be very wide. This paper surveys a selection of international legal instruments, including those where the sought after positive outcomes have been achieved, (...) and those that have been ineffective, with little or no real progress being made. The paper looks for commonalities, both in the nature of the problems and the forms of the international legal instruments, to seek answers as to why some instruments ultimately succeeded where others failed. It also provides some guidance to law/ treaty makers to help ensure that they frame future instruments in such a way as to maximize the probability that those instruments will have a substantive positive impact on global health and health rights. (shrink)

In this paper we review selected international legal instruments, the effect, if any, that they have had on global health, and how these instruments might have contributed to the realization of health rights. We consider a number of instruments from the international health law field as well as two from the field of international environmental law.1 The latter two, in addition to the considerable link between health and climate/environment, are considered with the purpose of drawing more generalized lessons about what (...) contributes to the success or failure of an international legal instrument; the lessons are then applied to our analysis of the health law instruments that are the primary focus of our paper. (shrink)

Background Genetic databases are becoming increasingly common as a means of determining the relationship between lifestyle, environmental exposures and genetic diseases. These databases rely on large numbers of research subjects contributing their genetic material to successfully explore the genetic basis of disease. However, as all possible research questions that can be posed of the data are unknown, an unresolved ethical issue is the status of informed consent for future research uses of genetic material. Discussion In this paper, we discuss the (...) difficulties of an informed consent model for future ineffable uses of genetic data. We argue that variations on consent, such as presumed consent, blanket consent or constructed consent fail to meet the standards required by current informed consent doctrine and are distortions of the original concept. In this paper, we propose the concept of an authorization model whereby participants in genetic data banks are able to exercise a certain amount of control over future uses of genetic data. We argue this preserves the autonomy of individuals at the same time as allowing them to give permission and discretion to researchers for certain types of research. Summary The authorization model represents a step forward in the debate about informed consent in genetic databases. The move towards an authorization model would require changes in the regulatory and legislative environments. Additionally, empirical support of the utility and acceptability of authorization is required. (shrink)

Human reproductive cloning has become the most palpable example of the globalization of science. Throughout the world, events and conjectures in the media, such as the birth and death in the United Kingdom of the cloned sheep Dolly and projects to clone human beings by Korean scientists, by members of the Canadian-based Raelian cult, and by the Italian physician Antinori in an undisclosed country, have galvanized the political will of individual countries to ban human reproductive cloning.Yet, international attempts to harmonize (...) policies in the area of biomedical ethics and human research, such as the 1997 Council of Europe’s Convention on Human Rights and Biomedicine, and most recently, the United Nations’ efforts to adopt an international convention against human reproductive cloning, have been insufficient to trigger a substantial global policy design process on issues relating to these new technologies. (shrink)

The severe shortage of organs for transplantation and the continual reluctance of the public to voluntarily donate has prompted consideration of alternative strategies for organ procurement. This paper explores the development of market approaches for procuring human organs for transplantation and considers the social and moral implications of organ donation as both a gift of life and a commodity exchange. The problematic and paradoxical articulation of individual autonomy in relation to property rights and marketing human body parts is addressed. We (...) argue that beliefs about proprietorship over human body parts and the capacity to provide consent for organ donation are culturally constructed. We contend that the political and economic framework of biomedicine, in western and non-western nations, influences access to transplantation technology and shapes the form and development of specific market approaches. Finally, we suggest that marketing approaches for organ procurement are and will be negotiated within cultural parameters constrained by several factors: beliefs about the physical body and personhood, religious traditions, economic conditions, and the availability of technological resources. (shrink)

The international context of the last fifty years of modern bioethics have been significant in establishing health-care ethics or bioethics as a common parlance - an ideology of our times, achieving near universal acceptance, with little dissent. Most international health organizations have developed important declarations that have become the credo of their daily practice and long-term commitments. However, in the last decade in particular, bioethicists and other health-care practitioners and scholars have worried about the persistence of health-care inequities and the (...) inadequate realization of bioethics, particularly in low-to-middle income countries. Global bioethics, now well into the new millennium, has entered a regulatory crisis: it needs to confront not just global bioethical commitments around major scientific revolutions such as genomics, but further, a regulatory crisis about the persisting national public law silences and health inequities, especially in low-to-middle income countries. (shrink)

The international context of the last fifty years of modern bioethics have been significant in establishing health-care ethics or bioethics as a common parlance - an ideology of our times, achieving near universal acceptance, with little dissent. Most international health organizations have developed important declarations that have become the credo of their daily practice and long-term commitments. However, in the last decade in particular, bioethicists and other health-care practitioners and scholars have worried about the persistence of health-care inequities and the (...) inadequate realization of bioethics, particularly in low-to-middle income countries. Global bioethics, now well into the new millennium, has entered a regulatory crisis: it needs to confront not just global bioethical commitments around major scientific revolutions such as genomics, but further, a regulatory crisis about the persisting national public law silences and health inequities, especially in low-to-middle income countries. (shrink)

This series of responses was commissioned to accompany the article by Singer et al, which can be found at http://www.biomedcentral.com/1472-6939/2/1. If you would like to comment on the article by Singer et al or any of the responses, please email us on [email protected].

In this paper, we argue for the importance of incorporating a gendered perspective for the effective development of sustainable agricultural biotechnology systems in sub-Saharan Africa. Priority setting for agricultural policy and project development requires attention to gender issues specific to the demands of agricultural biotechnology. This is essential for successfully addressing food security and poverty reduction in sub-Saharan Africa (SSA). There has been a great deal of debate and literature on the implications of gender in agricultural development and policy. However, (...) the implications of gender in agricultural biotechnology and have received relatively less attention, especially in SSA. Based on interviews with key stakeholders in agricultural biotechnology across SSA, review of pertinent literature and field observations, we have found that incorporating a gendered perspective is critical for the sustainable development of agricultural biotechnology and requires attention in five areas: the inclusion of women, particularly women farmers, in decision-making around biotech/genetically modified (GM) crop and trait selection; equal representation of women as men in education for agricultural science and in agricultural biotechnology research and development professions; greater involvement of women in extension services and farmers’ associations for successful delivery of information about biotech crops equality between men and women in access to resources for biotech/GM crop cultivation; and increased control for women farmers over biotech/GM crop management and income generation. We explain the consequences of failing to include such gender-responsive considerations into priority setting for agricultural biotechnology development and policy in SSA and provide recommendations for how policy makers and project partners of development initiatives can avoid such oversights. (shrink)

At a time when there is increasing need to offer psychotherapeutic approaches which accommodate clients' religious and spiritual beliefs, and acknowledge the potential for healing and growth offered by religious frameworks, this book explores psychology from an Islamic paradigm and demonstrates how Islamic understandings of human nature, the self, and the soul can inform an Islamic psychotherapy. Drawing on a qualitative, grounded theory analysis of interviews with Islamic scholars and clinicians, this unique volume distils complex religious concepts to reconcile Islamic (...) theology with contemporary notions of psychology. Chapters offer nuanced explanations of relevant Islamic tradition and theological sources, consider how this relates to Western notions of psychotherapy and common misconceptions, and draw uniquely on first-hand data to develop a new theory of Islamic psychology. This in turn, informs an innovative and empirically driven model of practice which translates Islamic understandings of human psychology into a clinical framework for Islamic psychotherapy. An outstanding scholarly contribution to the modern and emerging discipline of Islamic psychology, this book makes a pioneering contribution to the integration of the Islamic sciences and clinical mental health practice. It will be a key resource for scholars, researchers, and practicing clinicians with an interest in Islamic psychology and Muslim mental health, as well as religion, spirituality and psychology more broadly. (shrink)

Consanguineous marriage is traditionally common throughout the Eastern Mediterranean region, especially in the mainly Muslim countries. To date, there is little information on consanguinity in Yemen. The aim of this study was to ascertain the rate of consanguineous marriage and average coefficient of inbreeding in Sanaa City by means of a multi-stage random sampling technique. A total of 1050 wives and husbands were interviewed on consanguinity in their households. The total incidence of consanguinity was 44·7% (95% CI 41·7–47·7%) with first-cousin (...) marriages constituting 71·6% of the total consanguineous marriages and 32% of all marriages. Paternal parallel first cousins (Type I) accounted for 49% of first-cousin marriages. The average coefficient of inbreeding (F) was 0·02442. The incidence of consanguinity is relatively high in Yemen with predominantly first-cousin marriage. This might be related to the deeply rooted social and cultural beliefs in the country. (shrink)

ObjectivesDepression and anxiety persist in cancer patients, creating an additional burden during treatment and making it more challenging in terms of management and control. Studies on the prevalence of depression and anxiety among cancer patients in the Middle East are limited and include many limitations such as their small sample sizes and restriction to a specific type of cancer in specific clinical settings. This study aimed to describe the prevalence and risk factors of depression and anxiety among cancer patients in (...) the inpatient and outpatient settings.Materials and MethodsA total of 1,011 patients formed the study sample. Patients’ psychological status was assessed using the Hospital Anxiety and Depression Scale, the Patient Health Questionnaire, and the Generalized Anxiety Disorder 7-item scale. The prevalence rate of depressive and anxious symptomatology was estimated by dividing the number of patients who exceeded the borderline score: 10 or more for each subscale of the HADS scale, 15 or more for the GAD-7 scale, and 15 or more in the PHQ-9 by the total number of the patients. Risk factors were identified using logistic regression.ResultsThe prevalence of depressive and anxious symptomatology among all patients was 23.4% and 19.1–19.9%, respectively. Depressive symptomatology was more prevalent across patients who were hospitalized compared with patients in the outpatient setting. Similarly, anxious symptomatology was more prevalent in the inpatient setting. In the inpatient setting, depressive symptomatology was more prevalent among patients with bladder cancer, while severe anxious symptomatology was more prevalent across patients with lung cancer. In the outpatient setting, depressive and anxious symptomatology was more prevalent among breast and prostate cancer patients, respectively. Despite that, around 42.7% and 24.8% of the patients, respectively, reported that they feel anxious and depressed, and only 15.5% of them were using medications to manage their conditions.ConclusionOur study findings demonstrated a higher prevalence of depressive and anxious symptomatology in the inpatient setting and advanced disease stages. In addition, the underutilization of antidepressant therapy was observed. There is a need to consider mental disorders as part of the treatment protocol for cancer patients. Enhanced clinical monitoring and treatment of depression and anxiety of cancer patients are required. (shrink)

This is the first study to examine the relationship between sustainability and soundness in banking as part of an integrated reporting approach. We consider 12 major European banks over the period 2006–2016. To test the relationship, two indexes were constructed, the sustainable performance index, which attempts to measure sustainability, and the banking soundness index, which measures bank soundness. The results show a bidirectional causality between sustainability and banking soundness. More specifically, soundness encourages banks to engage in sustainable development activities, while (...) the implementation of a sustainable development approach has a negative effect on banking soundness. Our research contributes to the literature on this topic in two ways. First, we propose a new method for measuring banking soundness based on a Bayesian approach. This approach allows us to study a large number of criteria and allows us to determine proactively the importance and the contribution of different determinants in achieving soundness. In addition, to the best of our knowledge, this is the first study that attempts to study the relationship between bank soundness and sustainability. (shrink)

The role of software architecture in large-scale Agile development is important because several teams need to work together to release a single software product while helping to maximise teams’ autonomy. Governing and aligning Agile architecture across autonomous squads, when using the Spotify model, is a challenge because the Spotify model lacks practices for addressing Agile architecture governance. To explore how software architecture can be governed and aligned by scaling the Spotify model, we conducted a longitudinal embedded case study in a (...) multinational FinTech organisation. Then, we developed and evaluated an approach for architectural governance by conducting an embedded case study. The collected data was analysed using Thematic Analysis and informed by selected Grounded Theory techniques such as memoing, open coding, constant comparison, and sorting. Our approach for architectural governance comprises an organisational structure change and an architecture change management process. The benefits reported by the practitioners include devolving architectural decision-making to the operational level, enhancing architectural knowledge sharing among squads, minimising wasted effort in architectural refactoring, and other benefits. The practitioners in our case study realised an improved squad autonomy by the ability to govern and align architectural decisions. We provide two key contributions in this paper. First, we present the characteristics of our proposed architectural governance approach, its evaluation, benefits, and challenges. Second, we present how the novel Heterogeneous Tailoring model was enhanced to accommodate our architectural governance approach. (shrink)

This article explores the possibility that there is a parental duty to use preimplantation genetic diagnosis (PGD) for the medical benefit of future children. Using one genetic disorder as a paradigmatic example, we find that such a duty can be supported in some situations on both ethical and legal grounds. Our analysis shows that an ethical case in favor of this position can be made when potential parents are aware that a possible future child is at substantial risk of inheriting (...) a serious genetic condition. We further argue that a legal case for a duty to use PGD for medical benefit can be made in situations in which potential parents have chosen to conceive through in vitro fertilization and know that any children conceived are at substantial risk of having a serious genetic condition. (shrink)

Hastings Center Report, Volume 51, Issue 5, Page 30-41, September‐October 2021.

L’objet de cet article est d’éclairer les rapports qu’entretiennent le droit naturel et l’économie dans la pensée de F. Bastiat. On montre que le statut de la raison humaine occupe une place centrale dans cette articulation. On met également en évidence les tensions entre le mécanisme de répartition des droits de propriété soumis à une procédure de concurrence et le respect de la loi naturelle. A cet égard, F. Bastiat définit la liberté comme la capacité à utiliser la raison.The aim (...) of this paper is to throw a new light on the close relations between natural rights and economics in F. Bastiat’s thought. We show that the human reason status holds a central place in this articulation. We also underscore the problematic compatibility between the natural rights allocation mechanism based on a competition process and the natural law. We explain how F. Bastiat comes to grips with this tension. He proposes to define the notion of liberty as the faculty of using human reason. (shrink)

This paper focuses on innovation in the context of business–non‐governmental organization (NGO) partnerships for corporate social responsibility (CSR). While different aspects of business–NGO partnerships have been studied, the role of innovation and its potential implications for partnership outcomes have so far not been systematically explored. The paper defines innovation in simple and concrete terms and synthesizes from the literature what can be considered as critical ingredients to foster social alliance innovation. The paper posits in turn that these ingredients correspond closely (...) to the conception of social capital and offers a consolidated framework that helps in probing around these ingredients and social capital in accounting for innovative partnership outcomes. The empirical part consists of a comparative analysis of six case studies of business–NGO collaboration in the context of CSR in the United Kingdom. The evidence presented makes it clear that strategic partnerships are more readily capable of innovation and that social capital as an umbrella concept is very promising in explaining the differential success and performance of social alliances and central to understanding the dynamics of social alliance innovation and value creation. (shrink)

_A provocative examination of how unequal access to reproductive technology replays the sins of the eugenics movement_ Eugenics, the effort to improve the human species by inhibiting reproduction of “inferior” genetic strains, ultimately came to be regarded as the great shame of the Progressive movement. Judith Daar, a prominent expert on the intersection of law and medicine, argues that current attitudes toward the potential users of modern assisted reproductive technologies threaten to replicate eugenics’ same discriminatory practices. In this book, (...) Daar asserts how barriers that block certain people’s access to reproductive technologies are often founded on biases rooted in notions of class, race, and marital status. As a result, poor, minority, unmarried, disabled, and LGBT individuals are denied technologies available to well-off nonminority heterosexual applicants. An original argument on a highly emotional and important issue, this work offers a surprising departure from more familiar arguments on the issue as it warns physicians, government agencies, and the general public against repeating the mistakes of the past. (shrink)

This paper focuses on innovation in the context of business–non-governmental organization (NGO) partnerships for corporate social responsibility (CSR). While different aspects of business–NGO partnerships have been studied, the role of innovation and its potential implications for partnership outcomes have so far not been systematically explored. The paper defines innovation in simple and concrete terms and synthesizes from the literature what can be considered as critical ingredients to foster social alliance innovation. The paper posits in turn that these ingredients correspond closely (...) to the conception of social capital and offers a consolidated framework that helps in probing around these ingredients and social capital in accounting for innovative partnership outcomes. The empirical part consists of a comparative analysis of six case studies of business–NGO collaboration in the context of CSR in the United Kingdom. The evidence presented makes it clear that strategic partnerships are more readily capable of innovation and that social capital as an umbrella concept is very promising in explaining the differential success and performance of social alliances and central to understanding the dynamics of social alliance innovation and value creation. (shrink)

This article explores the impact of Dobbs on access to assisted reproductive technologies. Clinical aspects of IVF, including embryo discard and cryopreservation, preimplantation genetic testing, and selective reduction of multiple pregnancy are potentially jeopardized by a new legal landscape that protects embryos over the interest of infertility patients.

Enactment of mandated pre-procedure disclosures in abortion and assisted reproductive technology services has swelled in recent years. Calls to equally regard these mandates as neutral tools in furtherance of patient protection fail to acknowledge key substantive and structural differences in these reproduction-affecting mandates. While ART mandates permit physicians to use their medical judgment to protect presumptively vulnerable egg donors and gestational carriers, abortion disclosures impart scientifically suspect messaging aimed at dissuading women from pursuing pregnancy termination. These and other distinctions counsel (...) in favor of regarding and analyzing abortion and ART mandated disclosures as separate and distinguishable informed consent tools. (shrink)

Causal sets are a particular class of partially ordered sets, which are proposed as basic models of discrete space-time, specially in the field of quantum gravity. In this context, we show the existence of temporal foliations for any causal set, or more generally, for a causal space. Moreover, we show that automorphisms of a large class of infinite causal sets fall into two classes 1) Automorphisms of spacelike hypersurfaces in some given foliation, or 2) Translations in time. More generally, we (...) show that for any automorphism \ of a generic causal set \, there exists a partition of \ into finitely many subcausets, on each of which or above hold. These subcausets can be assumed connected if, in addition, there are enough distinct orbits under \. (shrink)

L’objet de cet article est d’éclairer les rapports qu’entretiennent le droit naturel et l’économie dans la pensée de F. Bastiat. On montre que le statut de la raison humaine occupe une place centrale dans cette articulation. On met également en évidence les tensions entre le mécanisme de répartition des droits de propriété soumis à une procédure de concurrence et le respect de la loi naturelle. A cet égard, F. Bastiat définit la liberté comme la capacité à utiliser la raison.The aim (...) of this paper is to throw a new light on the close relations between natural rights and economics in F. Bastiat’s thought. We show that the human reason status holds a central place in this articulation. We also underscore the problematic compatibility between the natural rights allocation mechanism based on a competition process and the natural law. We explain how F. Bastiat comes to grips with this tension. He proposes to define the notion of liberty as the faculty of using human reason. (shrink)

In recent years, courts have increasingly found them-selves arbiters of disputes in the emotionally charged area of assisted reproductive technologies. Legal disputes are hardly surprising in the world of infertility medicine, where millions of patients spend billions of dollars in efforts to have a child. Increasingly, these efforts produce embryos that are frozen for later use, at once maximizing a couple's chances for success and minimizing the medical intrusiveness that necessarily accompanies most forms of assisted reproductive technologies. But with over (...) 100,000 embryos in frozen storage in the United States and a divorce rate of 40 to 50 percent, it is not surprising that disputes over the disposition of these embryos are arising, causing the legal landscape surrounding these technologies to continue to expand. (shrink)

Telling the truth is one of the most respected virtues in medical history and one of the most emphasized in the code of medical ethics. Health care providers are frequently confronted with the dilemma as to whether or not to tell the truth. This dilemma deepens when both choices are critically vicious: The choice is no longer between “right and right” or “right and wrong,” it is between “wrong and wrong.” In the case presented and discussed in this paper, a (...) research team in Saudi Arabia unintentionally uncovered information regarding misattributed paternity. In such a situation and in the context of a tribal cultural system, what should the team do with this information? This case analysis demonstrates the joint application of ethical resources originating from within and outside the Saudi Arabian context. The article analyses the case based on the moral problems involved, relevant medical application, and the impact of such information in the Saudi tribal and Islamic domains. The most pertinent relevant values and secular debates on similar matters are discussed. Finally, the article aims to provide an Islamic dimension of family, fatherhood, and adultery. (shrink)