The pipeline framework for identifying ethical issues in machine learning healthcare applications outlined by Char et al. is a very useful starting point for the systematic consideration...

There is a strong need to connect agricultural research to social movements and community-based food system reform efforts. Participatory research methods are a powerful tool, increasingly used to give voice to communities overlooked by academia or marginalized in the broader food system. Plant breeding, as a field of research and practice, is uniquely well-suited to participatory project designs, since the basic process of observing and selecting plants for desirable traits is accessible to participants without formal plant breeding training. The challenge (...) for plant breeders engaged in participatory research is to consider not only how their work incorporates farmer input in developing new varieties, but also how it interacts with broader questions of food sovereignty, food justice, diversity and democratization in the food system. This article examines these issues in the context of the Seed to Kitchen Collaborative, a participatory variety evaluation and breeding project at the University of Wisconsin-Madison. (shrink)

We are printing in its entirety the discussion document which sets out a code of professional conduct for nurses published by the Royal College of Nursing in November 1976 together with commentaries by the Assistant Secretary of the British Medical Association, a professor of nursing studies, student nurses and a lawyer. The image of the nurse is still that of one of Florence Nightingale's young ladies or of a member of a religious order who is wholly dedicated to caring for (...) the sick. Today, as this document and the comments upon it show, 'dedication' is still part of the motive which leads a man or woman to become a nurse but in addition, and this is where the public may be ignorant or choose to be ignorant, nursing offers a career where intellectual achievement and the satisfaction of a demanding job bring their proper financial reward and place in the professional community. We are grateful to the Royal College of Nursing for permission to publish this document. (shrink)

There is a strong need to connect agricultural research to social movements and community-based food system reform efforts. Participatory research methods are a powerful tool, increasingly used to give voice to communities overlooked by academia or marginalized in the broader food system. Plant breeding, as a field of research and practice, is uniquely well-suited to participatory project designs, since the basic process of observing and selecting plants for desirable traits is accessible to participants without formal plant breeding training. The challenge (...) for plant breeders engaged in participatory research is to consider not only how their work incorporates farmer input in developing new varieties, but also how it interacts with broader questions of food sovereignty, food justice, diversity and democratization in the food system. This article examines these issues in the context of the Seed to Kitchen Collaborative, a participatory variety evaluation and breeding project at the University of Wisconsin-Madison. (shrink)

This paper describes COMET, the first 'expert' computer system to incorporate a comprehensive set of the rules of law and medical ethics relating to consent to medical treatment.

Objectives To conduct an independent evaluation of the first phase of the Health Foundation’s Safer Patients Initiative (SPI), and to identify the net additional effect of SPI and any differences in changes in participating and non-participating NHS hospitals. Design Mixed method evaluation involving five substudies, before and after design. Setting NHS hospitals in the United Kingdom. Participants Four hospitals (one in each country in the UK) participating in the first phase of the SPI (SPI1); 18 control hospitals. Intervention The SPI1 (...) was a compound (multi-component) organisational intervention delivered over 18 months that focused on improving the reliability of specific frontline care processes in designated clinical specialties and promoting organisational and cultural change. Results Senior staff members were knowledgeable and enthusiastic about SPI1. There was a small (0.08 points on a 5 point scale) but significant (P<0.01) effect in favour of the SPI1 hospitals in one of 11 dimensions of the staff questionnaire (organisational climate). Qualitative evidence showed only modest penetration of SPI1 at medical ward level. Although SPI1 was designed to engage staff from the bottom up, it did not usually feel like this to those working on the wards, and questions about legitimacy of some aspects of SPI1 were raised. Of the five components to identify patients at risk of deterioration—monitoring of vital signs (14 items); routine tests (three items); evidence based standards specific to certain diseases (three items); prescribing errors (multiple items from the British National Formulary); and medical history taking (11 items)—there was little net difference between control and SPI1 hospitals, except in relation to quality of monitoring of acute medical patients, which improved on average over time across all hospitals. Recording of respiratory rate increased to a greater degree in SPI1 than in control hospitals; in the second six hours after admission recording increased from 40% (93) to 69% (165) in control hospitals and from 37% (141) to 78% (296) in SPI1 hospitals (odds ratio for “difference in difference” 2.1, 99% confidence interval 1.0 to 4.3; P=0.008). Use of a formal scoring system for patients with pneumonia also increased over time (from 2% (102) to 23% (111) in control hospitals and from 2% (170) to 9% (189) in SPI1 hospitals), which favoured controls and was not significant (0.3, 0.02 to 3.4; P=0.173). There were no improvements in the proportion of prescription errors and no effects that could be attributed to SPI1 in non-targeted generic areas (such as enhanced safety culture). On some measures, the lack of effect could be because compliance was already high at baseline (such as use of steroids in over 85% of cases where indicated), but even when there was more room for improvement (such as in quality of medical history taking), there was no significant additional net effect of SPI1. There were no changes over time or between control and SPI1 hospitals in errors or rates of adverse events in patients in medical wards. Mortality increased from 11% (27) to 16% (39) among controls and decreased from 17% (63) to 13% (49) among SPI1 hospitals, but the risk adjusted difference was not significant (0.5, 0.2 to 1.4; P=0.085). Poor care was a contributing factor in four of the 178 deaths identified by review of case notes. The survey of patients showed no significant differences apart from an increase in perception of cleanliness in favour of SPI1 hospitals. Conclusions The introduction of SPI1 was associated with improvements in one of the types of clinical process studied (monitoring of vital signs) and one measure of staff perceptions of organisational climate. There was no additional effect of SPI1 on other targeted issues nor on other measures of generic organisational strengthening. (shrink)

ABSTRACT In the present study, we examined how the perceived attainability and relatability of moral exemplars predicted moral elevation and pleasantness among both adult and college student participants. Data collected from two experiments were analyzed with Bayesian multilevel modeling to explore which factors significantly predicted outcome variables at the story level. The analysis results demonstrated that the main effect of perceived relatability and the interaction effect between attainability and relatability shall be included in the best prediction model, and thus, were (...) deemed to predict the outcome variables significantly. The main effect of relatability as well as its interaction with attainability positively predicted elevation and pleasantness. We discussed educational implications of the findings in terms of how relatability may be the first point of emphasis for moral educators to focus on and attainability can then bolster the effectiveness. These relatable and attainable moral exemplars can be sources for moral elevation and pleasantness, which promote motivation to emulate moral behavior presented by the exemplars. (shrink)

Recent policy in relation to clinical research proposals in the UK has distinguished between two types of review: scientific and ethical. This distinction has been formally enshrined in the recent changes to research ethics committee structure and operating procedures, introduced as the UK response to the EU Directive on clinical trials. Recent reviews and recommendations have confirmed the place of the distinction and the separate review processes. However, serious reservations can be mounted about the science/ethics distinction and the policy of (...) separate review that has been built upon it. We argue here that, first, the science/ethics distinction is incoherent, and, second, that RECs should not only be permitted to consider a study’s science, but that they have anobligation do so. (shrink)

The Report of the Ad Hoc Adivisory Group on the Operation of NHS Research Ethics Committees has resulted in a strange mixture of the timid, the revolutionary, and the bizarre.The Report of the Ad Hoc Advisory Group on the Operation of NHS Research Ethics Committees is a curious document.1 The remit of the review was focused on the workings and effectiveness of NHS research ethics committees and the multicentre committees ). The Group was primarily set up in response to a (...) series of complaints from medical researchers about the new research governance regime in the UK as a result of the Clinical Trials Directive2 and the Governance Arrangements for NHS Research Ethics Committees.3 The opportunity was also taken to consider the role of research ethics committees in a wider context, and take account of recent developments in relation to the ethics review of social care research,4 student projects,5 as well as recent legislation such as the Human Tissue Act,6 and the Mental Capacity Act.7 However, the resulting report is a strange mixture of the timid, the revolutionary, and the bizarre.A good example of the report’s timidity is its reluctance to propose fundamental change to the process of review or seriously limit the type of research that requires REC review. To its credit AHAG does suggest that some research ‘especially surveys and many studies on NHS staff, could normally be conducted safely without a requirement for REC review’ .1 This is, of course, to be welcomed. However, the report ultimately seems dismissive of the general complaint from researchers that the current process is inappropriately uniform. For example, in section 3.2, it is argued that the ‘common perception that the NHS REC system is dominated …. (shrink)

This paper argues that qualitative research is both useful and necessary, as it provides an essential means of gaining a richer understanding of patients' perceptions, social processes and meanings. In their paper in this edition of Clinical Ethics, Hallowell and Lawton raise many issues relating to the way that qualitative research is treated by RECs in the UK. In this paper I discuss just three key topics stimulated by their paper: the way that methodology relates to ethics, the experience and (...) character of the researcher, and the normative/descriptive distinction. I strongly support Hallowell and Lawton's appeal for greater communication between qualitative researchers and RECs. In other respects, I would argue that they do not go far enough. The recent review of research ethics structures and the review process provides an opportunity to move away from the present 'one size fits all' approach to ethical review. I would argue that this change could only benefit qualitative research and researchers. (shrink)

We examined the relationship between moral foundations, empathic traits, and moral identity using an online survey via Mechanical Turk. In order to determine how moral foundations contribute to empathic traits and moral identity, we performed classical correlation analysis as well as Bayesian correlation analysis, Bayesian ANCOVA, and Bayesian regression analysis. Results showed that individualizing foundations (harm/care, fairness/reciprocity) and binding foundations (ingroup/loyalty, authority/respect, purity/sanctity) had various different relationships with empathic traits. In addition, the individualizing versus binding foundations showed somewhat reverse relationships (...) with internalization and symbolization of moral identity. This suggests that moral foundations can contribute to further understanding of empathic traits and moral identity and how they relate to moral behavior in reality. We discuss the implications of these results for moral educators when starting to teach students about moral issues. (shrink)

Do those of us living in the present have an obligation to rectify injustices committed by others in the distant past? This article is an attempt to revisit the problem of historical injustice by bringing together recent work on structural injustice in relation to the problem of wrongful benefit. The problem of benefitting from injustice, I argue, provides firmer grounds of obligation in forward-looking accounts of responsibility for historical injustice specifically. I argue (1) that if the negative effects of historical (...) injustice endure into the present, and (2) if we participate in structures that allow for its reproduction, then (3) our moral responsibility to set matters straight increases to the extent that we derive a benefit from the perpetuation of an unjust _status quo_. Finally, (4) a general moral obligation to make the world less unjust generates a motive for individuals to learn more about their place in a structure that reproduces the negative effects of historical injustice. (shrink)

During the WHO-GloPID COVID-19 Global Research and Innovation Forum meeting held in Geneva on the 11th and 12th of February 2020 a number of different ethical concepts were used. This paper briefly states what a number of these concepts mean and how they might be applied to discussions about research during the COVID-19 pandemic and related outbreaks. This paper does not seek to be exhaustive and other ethical concepts are, of course, relevant and important.

We explored the relationship between 24 character strengths measured by the Global Assessment of Character Strengths (GACS), which was revised from the original VIA instrument, and moral functioning comprising postconventional moral reasoning, empathic traits and moral identity. Bayesian Model Averaging (BMA) was employed to explore the best models, which were more parsimonious than full regression models estimated through frequentist regression, predicting moral functioning indicators with the 24 candidate character strength predictors. Our exploration was conducted with a dataset collected from 666 (...) college students at a public university in the Southern United States. Results showed that character strengths as measured by GACS partially predicted relevant moral functioning indicators. Performance evaluation results demonstrated that the best models identified by BMA performed significantly better than the full models estimated by frequentist regression in terms of AIC, BIC, and cross-validation accuracy. We discuss theoretical and methodological implications of the findings for future studies addressing character strengths and moral functioning. (shrink)

Although some previous studies have investigated the relationship between moral foundations and moral judgment development, the methods used have not been able to fully explore the relationship. In the present study, we used Bayesian Model Averaging (BMA) in order to address the limitations in traditional regression methods that have been used previously. Results showed consistency with previous findings that binding foundations are negatively correlated with post-conventional moral reasoning and positively correlated with maintaining norms and personal interest schemas. In addition to (...) previous studies, our results showed a positive correlation for individualizing foundations and post-conventional moral reasoning. Implications are discussed as well as a detailed explanation of the novel BMA method in order to allow others in the field of moral education to be able to use it in their own studies. (shrink)

We report on the deliberations of an interdisciplinary group of experts in science, law, and philosophy who convened to discuss novel ethical and policy challenges in stem cell research. In this report we discuss the ethical and policy implications of safety concerns in the transition from basic laboratory research to clinical applications of cell-based therapies derived from stem cells. Although many features of this transition from lab to clinic are common to other therapies, three aspects of stem cell biology pose (...) unique challenges. First, tension regarding the use of human embryos may complicate the scientific development of safe and effective cell lines. Second, because human stem cells were not developed in the laboratory until 1998, few safety questions relating to human applications have been addressed in animal research. Third, preclinical and clinical testing of biologic agents, particularly those as inherently complex as mammalian cells, present formidable challenges, such as the need to develop suitable standardized assays and the difficulty of selecting appropriate patient populations for early phase trials. We recommend that scientists, policy makers, and the public discuss these issues responsibly, and further, that a national advisory committee to oversee human trials of cell therapies be established. **NB we did not reccommend a NAC, we think it might be appropriate**. (shrink)

We developed and tested a behavioral version of the Defining Issues Test-1 revised (DIT-1r), which is a measure of the development of moral judgment. We conducted a behavioral experiment using the behavioral Defining Issues Test (bDIT) to examine the relationship between participants’ moral developmental status, moral competence, and reaction time when making moral judgments. We found that when the judgments were made based on the preferred moral schema, the reaction time for moral judgments was significantly moderated by the moral developmental (...) status. In addition, as a participant becomes more confident with moral judgment, the participant differentiates the preferred versus other schemas better particularly when the participant’s abilities for moral judgment are more developed. (shrink)

The process of dehumanization, or thinking of others as less than human, is a phenomenon with significant societal implications. According to Haslam's model, two concepts of humanness derive from comparing humans with either animals or machines: individuals may be dehumanized by likening them to either animals or machines, or humanized by emphasizing differences from animals or machines. Recent work in cognitive neuroscience emphasizes understanding cognitive processes in terms of interactions between distributed cortical networks. It has been found that reasoning about (...) internal mental states is associated with activation of the default mode network and deactivation of the task positive network ; whereas reasoning about mechanical processes produces the opposite pattern. We conducted two neuroimaging studies. The first examined the neural bases of dehumanization and its relation to these two brain networks, using images and voice-over social narratives which either implicitly contrasted or implicitly likened humans to either animals or machines. The second study addressed a discrepancy between findings from the first study and prior work on the neural correlates of dehumanization: using a design similar to prior work we examined neural responses to pictures of humans, animals and machines, presented without any social context. In both studies, human and humanizing conditions were associated with relatively high activity in the DMN and relatively low activity in the TPN. However, the non-human and dehumanizing conditions deviated in different ways: they demonstrated more marked changes either in the DMN or in the TPN. Notably, differences between the animal dehumanizing and humanizing conditions were most evident in regions associated with mechanistic reasoning, not in the mentalizing network. Conjunction analysis of contrasts from both paradigms revealed that only one region was consistently more active when participants saw human, a medial parietal region regarded as the central hub of the DMN. These findings provide a neural basis for Haslam's distinction between two types of dehumanization, and suggest that the DMN and TPN play opposing roles in creating a sense of moral concern. (shrink)

Background: Moral Growth Mindset (MGM) is a belief about whether one can become a morally better person through efforts. Prior research showed that MGM is positively associated with promotion of moral motivation among adolescents and young adults. We developed and tested the English version of the MGM measure in this study with data collected from college student participants. Methods: In Study 1, we tested the reliability and validity of the MGM measure with two-wave data (N = 212, Age mean = (...) 24.18 years, SD = 7.82 years). In Study 2, we retested the construct validity of the MGM measure once again and its association with other moral and positive psychological indicators to test its convergent and discriminant validity (N = 275, Age mean = 22.02 years, SD = 6.34 years). Results: We found that the MGM measure was reliable and valid from Study 1. In Study 2, the results indicated that the MGM was well correlated with other moral and positive psychological indicators as expected. Conclusions: We developed and validated the English version of the MGM measure in the present study. The results from studies 1 and 2 supported the reliability and validity of the MGM measure. Given this, we found that the English version of the MGM measure can measure one’s MGM as we intended. (shrink)

The generation of evidence is integral to the work of public health and health service providers. Traditionally, ethics has been addressed differently in research projects, compared with other forms of evidence generation, such as quality improvement, program evaluation, and surveillance, with review of non-research activities falling outside the purview of the research ethics board. However, the boundaries between research and these other evaluative activities are not distinct. Efforts to delineate a boundary – whether on grounds of primary purpose, temporality, underlying (...) legal authority, departure from usual practice, or direct benefits to participants – have been unsatisfactory. (shrink)

If stem cell-based therapies are developed, we will likely confront a difficult problem of justice: for biological reasons alone, the new therapies might benefit only a limited range of patients. In fact, they might benefit primarily white Americans, thereby exacerbating long-standing differences in health and health care.

Médecins Sans Frontières is one of the world’s leading humanitarian medical organizations. The increased emphasis in MSF on research led to the creation of an ethics review board in 2001. The ERB has encouraged innovation in the review of proposals and the interaction between the ERB and the organization. This has led to some of the advances in ethics governance described in this paper.