This paper examines pain and pain relief in the Caribbean, where pain is widely perceived as an unavoidable part of life, and where unnecessary suffering results from untreated and under treated pain. Barriers to pain relief in the Caribbean include patient and family attitudes, inadequate knowledge among health professionals and unduly restrictive regulations on the medical use of opioids. Similar barriers exist all over the world. This paper urges medical, nursing and public health professionals, and educators to examine attitudes towards (...) pain and pain relief and to work towards making effective pain relief and palliation more accessible. It recommends that i) health professionals and officials be better educated about pain, palliation and opioids, ii) regulatory restrictions be updated in light of clinical and scientific evidence, iii) opioid procurement policies be adjusted to facilitate increased medical use, iv) medical charts and records be modified to routinely elicit and document patients levels of pain, and v) educational campaigns be developed to inform the public that moderate and severe pain can be safely relieved at the end of life and other stages of life. The professional, respectful, and beneficent response to patients in pain is to provide rapid and aggressive pain relief or to urgently consult a pain or palliative specialist. When a health system hinders such efforts the ethical response is to identify, facilitate and advocate for overcoming barriers to improvement. (shrink)

This paper examines pain and pain relief in the Caribbean, where pain is widely perceived as an unavoidable part of life, and where unnecessary suffering results from untreated and under treated pain. Barriers to pain relief in the Caribbean include patient and family attitudes, inadequate knowledge among health professionals and unduly restrictive regulations on the medical use of opioids. Similar barriers exist all over the world. This paper urges medical, nursing and public health professionals, and educators to examine attitudes towards (...) pain and pain relief and to work towards making effective pain relief and palliation more accessible. It recommends that i) health professionals and officials be better educated about pain, palliation and opioids, ii) regulatory restrictions be updated in light of clinical and scientific evidence, iii) opioid procurement policies be adjusted to facilitate increased medical use, iv) medical charts and records be modified to routinely elicit and document patients levels of pain, and v) educational campaigns be developed to inform the public that moderate and severe pain can be safely relieved at the end of life and other stages of life. The professional, respectful, and beneficent response to patients in pain is to provide rapid and aggressive pain relief or to urgently consult a pain or palliative specialist. When a health system hinders such efforts the ethical response is to identify, facilitate and advocate for overcoming barriers to improvement. (shrink)

To the Editor: Conflicts of interest pervade medicine with sometimes profound repercussions. The unethical recruitment of oocyte donors, for example, reported by Aaron Levine in “Self-Regulation, Compensation, and the Ethical Recruitment of Oocyte Donors” (Mar–Apr 2010) threatens medical professionalism, societal trust in medicine, and possibly the health of young women. Levine shows that in violation of fertility industry standards, donors with high SAT scores are often paid more than those with lower scores. Such payments are deceptive and ethically problematic because (...) neither intelligence nor SAT score is proven to be genetically transmitted. Moreover, some question the value of aptitude and intelligence tests .. (shrink)

An unlinked seroprevalence study of HIV and other viruses was conducted on pregnant women on the Caribbean island of Grenada in 1994. Investigators were from both the developed world and the Grenadian Ministry of Health . There was then no board on Grenada to protect research subjects or review ethical aspects of studies. Nurses from the MOH were asked to verbally inform their patients about the study, and request that patients become subjects of the study and give blood for screening. (...) If consent was given nurses took blood and administered a survey about each subjects' knowledge of HIV transmission routes. Nurses shared a spoken dialect and cultural heritage with prospective subjects and were probably more effective than foreign researchers at informing subjects. Informed consent was obtained with a simplified consent form supplemented by conversation with each prospective research subject. Facilitating discussion between people with common cultural backgrounds helps apply the Western approach to informed consent to communities in the developing world. Researchers must disclose all information to nurses or other mediators, and ensure that nurses disclose as much information as possible to prospective subjects. So modified, informed consent maintains respect for persons and becomes applicable and relevant to various cultures. (shrink)

Various forms of research are essential in emergency, disaster and disease outbreak situations, but challenges exist including the long length of time it takes to get research proposals approved. Consequently, it would be very advantageous to have an acceptable model for efficient coordination and communication between and among research ethics committees/IRBs and ministries of health, and templates for expediting ethical review of research proposals in emergency and epidemic situations to be used across the Caribbean and in other low and middle (...) income countries. This project involved a literature search and the interviewing of ministry of health officials, public health practitioners, and research ethics committee/IRB members in Jamaica and St. Lucia, to obtain suggestions for the best model for efficient coordination and communication between research ethics committees, and developed a template for expediting review of research protocols in epidemic and emergency conditions. (shrink)

Jecker et al. (2024) offer seven principles with which to guide conference organizers and assess how ethically a conference is organized. While focused on bioethics, these principles are relevant t...

Stakeholder consultation is part of the democratic process, embraces respect for persons, and is necessary for upholding the principle of justice. People are more likely to uphold standards they have participated in setting, so stakeholder consultation encourages adherence to societal and institutional standards as these evolve. Stakeholder consultation is also responsive to the call to “resocialize” ethics by contextualizing dilemmas and involving the destitute in choices about their healthcare. In resource-poor settings, such consultation promotes local “ownership” of, and leadership within, (...) development programs, which enhances effectiveness and sustainability. Stakeholder consultation is, therefore, a form of capacity building. To succeed, it must be responsive to regional, national, and individual constraints, including socioeconomic, cultural, and political ones. Several such constraints impact on the demand for, and availability of, palliative healthcare in the Caribbean. (shrink)

There is international recognition of the need for sustainable research ethics committees to provide ethical review of human subjects research in developing countries, but many developing countries do not have such committees . Theoretical and practical uncertainties encountered by an IRB on the Caribbean island of Grenada offer insight into ethical review of research in developing countries. Theoretical uncertainties include questions about whether means of ensuring confidentiality and obtaining informed consent will be effective in local settings, and whether deviations from (...) Western norms are justifiable. International guidelines are helpful in addressing these concerns, but are subject to interpretation. Guidelines are less helpful in practical areas like selecting members or chairs. They do not address what sort of procedures and paperwork will work in a developing country, or IRBs’ relationships to governments that have no mandate for them. Experiences presented here show that IRBs in developing countries can sustainably adhere to international standards. Sustainability requires knowledge, personal commitment, and an official mandate to uphold international standards. Capacity building must therefore focus on educational programs to make developing country leaders knowledgeable about the value of international guidelines to their nations. Such knowledge is needed before people will become motivated to promote, implement, and uphold the guidelines. People in developing countries must help design bridges to help their nations put international standards into practice. The structure of such bridges may, of necessity, vary in different settings. (shrink)

Guideline 20 of the updated International Ethics Guidelines for Health‐related Research Involving Humans (2016) by the Council for International Organizations of Medical Sciences (CIOMS) provides guidance on research in disasters and disease outbreaks against the background of the need to generate knowledge quickly, overcome practical impediments to implementing such research, and the need to maintain public trust. The guideline recommends that research ethics committees could pre‐screen study protocols to expedite ethical reviews in a situation of crisis, that pre‐arrangements be made (...) regarding data sharing and biomedical sample sharing, and that sponsors and research ethics committees seek to minimize risk to researchers conducting research during a disaster. This paper critiques these recommendations against the background of the findings of a survey of public health officials and chairs of research ethics committees in the Caribbean during 2016, which sought to determine the best template for the expeditious ethical review of research proposals in emergency and epidemic situations in the Caribbean, and whose findings can serve as a model for other low‐ and middle‐income countries. (shrink)

Health promotion involves social and environmental interventions designed to benefit and protect health. It often harmfully impacts the environment through air and water pollution, medical waste, g...

Climate change harms health and damages and diminishes environmental resources. Gradually it will cause health systems to reduce services, standards of care, and opportunities to express patient autonomy. Prominent public health organizations are responding with preparedness, mitigation, and educational programs. The design and effectiveness of these programs, and of similar programs in other sectors, would be enhanced by greater understanding of the values and tradeoffs associated with activities and public policies that drive climate change. Bioethics could generate such understanding by (...) exposing the harms and benefits in different cultural, socioeconomic, and geographic contexts, and through interdisciplinary risk assessments. Climate change is a bioethics problem because it harms everyone and involves health, values, and responsibilities. This article initiates dialog about the responsibility of bioethics to promote transparency and understanding of the social values and conflicts associated with climate change, and the actions and public policies that allow climate change to worsen. (shrink)

Drug Safety Communications are used by the Food and Drug Administration to inform health care providers, patients, caregivers, and the general public about safety issues related to FDA-approved drugs. To assess patient knowledge of the messaging contained in DSCs related to the sleep aids zolpidem and eszopiclone, we conducted a large, cross-sectional patient survey of 1,982 commercially insured patients selected by stratified random sampling from the Optum Research Database who had filled at least two prescriptions for either zolpidem or eszopiclone (...) between July 1, 2012 and June 30, 2013. Among the 594 respondents, two-thirds reported hearing generally about drug safety information prior to starting a new drug, with the remaining one-third “rarely” or “never” hearing such information. Providers and pharmacists were primary sources of drug safety information. Two-thirds of zolpidem users and half of eszopiclone users reported having heard about the related DSC messages, ability to accurately identify the major factual messages was limited. Respondents reacted to new drug safety information about their sleep aids by reporting that they would want to learn about alternative ways to help them sleep and seek out more information about the safety of their specific sleeping pill. Opportunities may exist for the FDA to work with providers and pharmacies to help ensure the DSC information is more widely received and is more fully understood by those taking the affected medications. (shrink)

ABSTRACT:Planet Earth and its growing human population are challenged by the health impacts of industrial policies that drive global emissions production and cause climate change. The health-care industry has capacity and responsibility to adopt environmentally sustainable policies and practices. Bioethicists have a responsibility to support environmental sustainability through their clinical, research, educational, and policy work. They communicate complex ideas to diverse stakeholders and can communicate similarly to improve understanding about emissions and the value of environmentally sustainable policy. A growing bioethics (...) literature addresses climate change in collaboration with human and veterinary medicine and other disciplines. Pursuing environmental sustainability with the vigor that made autonomy a norm would help to reduce global emissions production in health care and make it a role model for other industries. Making environmental sustainability a health-care norm would be as significant an accomplishment as doing so for individual autonomy. (shrink)

A google scholar search for “global bioethics” returns citations situating ethical analyses within the evolving social and physical features of the global environment. Such work is consistent with...

One manifestation of climate change is the increasingly severe extreme weather that causes injury, illness and death through heat stress, air pollution, infectious disease and other means. Leading health organisations around the world are responding to the related water and food shortages and volatility of energy and agriculture prices that threaten health and health economics. Environmental and climate ethics highlight the associated challenges to human rights and distributive justice but rarely address health or encompass bioethical methods or analyses. Public health (...) ethics and its broader umbrella, bioethics, remain relatively silent on climate change. Meanwhile global population growth creates more people who aspire to Western lifestyles and unrestrained socioeconomic growth. Fulfilling these aspirations generates more emissions; worsens climate change; and undermines virtues and values that engender appreciation of, and protections for, natural resources. Greater understanding of how virtues and values are evolving in different contexts, and the associated consequences, might nudge the individual and collective priorities that inform public policy toward embracing stewardship and responsibility for environmental resources necessary to health. Instead of neglecting climate change and related policy, public health ethics and bioethics should explore these issues; bring transparency to the tradeoffs that permit emissions to continue at current rates; and offer deeper understanding about what is at stake and what it means to live a good life in today's world. (shrink)

Parsa-Parsi et al bring attention to the World Medical Association (WMA) and transparency to its International Code of Medical Ethics (ICoME) revisions.1 We value their report and the revised ICoME but explain here that the ICoME cannot reflect consensus among all WMA members, or the wider medical profession, given structural and epistemic injustices that restrain low-income and middle-income country (LMIC) physicians from participating in activities such as WMA revisions. Such injustices overlook experiences and contributions of those from LMICs and marginalised (...) groups, hindering their access to and influence within medicine.2 They also undermine access to information about, and from, the WMA. Recruiting new members from, and better engaging members in, LMICs would strengthen the WMA and its influence across the medical profession, and better elevate environmental sustainability as a biomedical and bioethical concern. This would be beneficial because there is controversy among physicians, bioethicists and other stakeholders about the relevance of environmental sustainability to medicine.3 4 That its addition to the ICoME was ‘uncontentious’ hints at structural and epistemic injustices in the revision process and homogeneity of those most involved in the revisions. Based on our observations as medical educators, it appears that few medical students and physicians at our institution, and few across the Caribbean and …. (shrink)

In the Caribbean as in many other areas costly biomedical resources and personnel are limited, and more and more people are turning to alternative medicine and folk practitioners for health care. To meet the goal of providing health care for all, research on nonbiomedical therapies is needed, along with legal recognition of folk practitioners to establish standards of practice.

Professions typically formulate codes of ethics. Medical students are exposed to various codes and often are expected to recite some.

Guidelines for Institutional Review Boards (IRBs) or research ethics committees exist at national and international levels. These guidelines are based on ethical principles and establish an internationally acceptable standard for the review and conduct of medical research. Having attained a multinational consensus about what these fundamental guidelines should be, IRBs are left to interpret the guidelines and devise their own means of implementing them. Individual and community values bear on the interpretation of the guidelines so different IRBs attain different levels (...) of effectiveness. In the Caribbean and Pan American regions there are few IRBs. Obstacles to the establishment and function of IRBs are exacerbated in developing regions like these by differences in language, literacy, and local value systems; education, administrative expertise, facilities, and access to information are also limited. A regional IRB network might facilitate more uniform ethical review in developing countries, and simplify IRB procedures. (shrink)

Climate change has substantial impacts on public health and safety, disease risks and the provision of health care, with the poor being particularly disadvantaged. Management of the associated health risks and changing health service requirements requires adequate responses at local levels. Health-care providers are central to these responses. While climate change raises ethical questions about its causes, impacts and social justice, medicine and bioethics typically focus on individual patients and research participants rather than these broader issues. We broaden this focus (...) by examining awareness among health-care providers in the Caribbean region, where geographic and socioeconomic features pose particular vulnerabilities to climate change. In focus groups, Caribbean providers described rises in mosquito-borne, flood-related, heat-related, respiratory and mental illnesses, and attributed these to local impacts of climate change. Their discussions showed that the significance of these impacts differs in different Caribbean nations, raising policy and social justice questions. Bioethics and public health ethics are situated to frame, inform and initiate public and policy dialog about values and scientific evidence associated with climate change. We urge readers to initiate such dialog within their own institutions about the context-dependent nature of the burdens of climate change, and values and policies that permit it to worsen. (shrink)

There is international recognition of the need for sustainable research ethics committees to provide ethical review of human subjects.

This article outlines challenges to benefitting developing countries that are hosts of international research. In the context of existing guidance and frameworks for benefit‐sharing, it aims to provoke dialog about socioeconomic factors and other background conditions that influence what constitute benefits in a given host setting, and about the proportionality between benefits to hosts and benefits to sponsors and researchers. It argues that capacity‐building for critical thinking and negotiation in many developing country governments, institutions, and communities is a benefit because (...) it can help to overcome background conditions that impinge on equitable international research negotiations, partnerships, and benefits. Enhancing the capacity for both critical thinking and negotiation can, like other targets of capacity‐building, nurture respectful and trusting partnerships that benefit all stakeholders in international research. (shrink)

CIOMS has been criticised for not adequately consulting stakeholders about its revised ethical guidelines regarding medical research.

Changes in earth's atmosphere, oceans, soil, weather patterns, and ecosystems are well documented by countless scientific disciplines. These manifestations of climate change harm public health. Given their goals and social responsibilities, influential health organizations recognize health impacts compounded by geography, social values, social determinants of health, health behaviors, and relationships between humans and environments primarily described in feminist ethics and environmental ethics. Health impacts are relevant to, but seldom addressed in bioethics, global health, public policy, or health or environmental policy. (...) This book is the first to describe cultural, geographic, and socioeconomic factors that influence the regional significance of these impacts and frame them for bioethics and policy analyses. (shrink)

This article presents empirical data on the limited availability of hospice and palliative care to the 6 million people of the English-speaking Caribbean. Ten of the 13 nations therein responded to a survey and reported employing a total of 6 hospice or palliative specialists, and having a total of 15 related facilities. The evolving socioeconomic and cultural context in these nations bears on the availability of such care, and on the willingness to report, assess, and prioritize pain, and to prescribe (...) opiates for pain. Socioeconomics and culture also impinge on what medications and modalities of care are routinely available for pain or other conditions and can challenge professionalism, empathy, and responsiveness to patients’ unrelieved pain. Although all respondents report having a protocol for pain management, hospice, or end-of-life care, their annual medical use of opiates is well below the global mean. The International Narcotics Control Board , which monitors such use, encourages Caribbean and other low- and middle-income countries to increase their use of opiates to treat pain, and to overcome both unfounded fears of addiction and overly restrictive interpretation of related laws and regulations. Contextual considerations like those described here are important to the success of policies and capacity-building programs aiming to increase access to hospice and palliation, and perhaps to improving other aspects of health and healthcare. Exploring and responding to the realities of socioeconomic and cultural conditions will enhance public and policy dialogue and improve the design of interventions to increase access to palliative and hospice care. Improving access to palliative and hospice care in the Caribbean demonstrates beneficence and helps to fulfill human rights conventions. (shrink)

An unlinked seroprevalence study of HIV and other viruses was conducted on pregnant women on the Caribbean island of Grenada in 1994. Investigators were from both the developed world and the Grenadian Ministry of Health . There was then no board on Grenada to protect research subjects or review ethical aspects of studies. Nurses from the MOH were asked to verbally inform their patients about the study, and request that patients become subjects of the study and give blood for screening. (...) If consent was given nurses took blood and administered a survey about each subjects' knowledge of HIV transmission routes. Nurses shared a spoken dialect and cultural heritage with prospective subjects and were probably more effective than foreign researchers at informing subjects. Informed consent was obtained with a simplified consent form supplemented by conversation with each prospective research subject. Facilitating discussion between people with common cultural backgrounds helps apply the Western approach to informed consent to communities in the developing world. Researchers must disclose all information to nurses or other mediators, and ensure that nurses disclose as much information as possible to prospective subjects. So modified, informed consent maintains respect for persons and becomes applicable and relevant to various cultures. (shrink)

Professionalism is demonstrated through attitudes and behaviors. Medical education is concerned with teaching and evaluating it among students. It is often bioethicists who teach professionalism to medical students. Most bioethics curricula use lectures and group discussions to introduce principles and theories, but there is variation in number of credit and contact hours, placement in the curriculum and alongside which courses bioethics is placed), the extent of individual mentoring, and the emphasis placed on any particular philosophical approach. Bioethics curricula also vary (...) in whether and how explicitly and extensively they address topics, including professionalism, cultural competence, medical humanities, spirituality, death and dying, and community service, and in the number and topics of vignettes, controversies, assignments, and course activities. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Peirce on Realism and Idealism by Robert LaneAaron B. WilsonPeirce on Realism and Idealism Robert Lane. Cambridge UP, 2018.Robert Lane's Peirce on Realism and Idealism is the ultimate secondary source for those who wish to engage the forms of realism and idealism that Peirce develops over the course of his writings. Lane could not have given his monograph a more concise and descriptive title. He never strays from (...) the topics of realism and idealism, and it is remarkably complete. It includes extensive discussion on Peirce's basic realism (Lane's term) as well as his extreme scholastic realism (Peirce's term), his basic idealism (Lane's term), and his objective idealism (Peirce's term). It might not be the best resource for those interested in the historical influences on Peirce's forms of realism and idealism. For instance, if one is interested mainly in Peirce's extreme scholastic realism and its roots in scholastic philosophy, Mayorga (2007)1 might still be a more useful resource. Also, Lane leaves much to be said about the epistemological underpinnings of Peirce's forms of realism and idealism. Peirce's theory of perception and his critical common-sensism do not get much attention. Also, there is much in Peirce's later semeiotic writings that could have been brought to bear on the issues.However, I do not see any of these omissions as failures of Lane's work. As I read it, the book's central aims are to determine the following: (1) what metaphysical views did Peirce hold, (2) when did he hold them, (3) are they consistent with one another, and (4) what is the textual evidence that he held them as such. With respect to these aims, Peirce on Realism and Idealism exhibits the gold standard of Peirce scholarship: it is remarkably sensitive to dates, different writings, and contexts of writings, and the reader gets a strong impression that Lane has not left any stone unturned—that he had at least skimmed every word in every lecture, published writing, letter, and unpublished manuscript that Peirce produced.Although the book contains some interpretations about which I have some reservations, which I describe further on, I agree with most of its central claims. This includes the claim that, despite various developments, Peirce had always subscribed to "basic realism": the thesis that there are things independent of what anyone thinks about them. A whole chapter is dedicated to showing that Peirce's 1868–1869 "anti-Cartesian" papers are consistent with basic realism, and I found that chapter very helpful. Another thesis that Lane defends, and that I strongly agree with, is that Peirce held a representationalist view of truth. Truth as "correspondence" with reality is one of two [End Page 107] key aspects of Peirce's account of truth (the other being, as Lane calls it, an "investigative aspect"). After works by Christopher Hookway, Cheryl Misak, and others that attempt to de-emphasize or obscure Peirce's representationalism, perhaps to make him more appealing to contemporary analytic "neopragmatists," it is absolutely refreshing to read a book that embraces Peirce's representationalism without apology.However, in the remainder of this review, I will focus on parts that I found troubling. Some of this trouble is probably due more to Peirce himself than to Lane's interpretation of Peirce. But some of it directly concerns Lane's interpretation. In particular, the parts of chapter 6 concerning Peirce's modal realism, while stimulating and enlightening, are also problematic. Further, I do not think that Lane's account of Peirce's idealism appropriately recognizes its similarity to Hegelian or Absolute idealism.To begin with Peirce's modal realism, Lane's discussion of it sets out by addressing the fact that, as Peirce recognizes, the conditionals comprising "pragmatic clarifications," or what result from applying the "pragmatic maxim" to a concept, must be in the hypothetical or subjunctive mood. This is in order to make sense of the truth of even indicative non-conditional propositions such as, to use Peirce's and Lane's example, "the diamond is hard." If the conditionals into which a concept is pragmatically clarified are in the indicative mood... (shrink)

In a prior issue of Developing World Bioethics, Cheryl Macpherson and Ruth Macklin critically engaged with an article of mine, where I articulated a moral theory grounded on indigenous values salient in the sub-Saharan region, and then applied it to four major issues in bioethics, comparing and contrasting its implications with those of the dominant Western moral theories, utilitarianism and Kantianism. In response to my essay, Macpherson and Macklin have posed questions about: whether philosophical justifications are something (...) with which bioethicists ought to be concerned; why something counts as ‘African’; how medicine is a moral enterprise; whether an individual right to informed consent is consistent with sub-Saharan values; and when thought experiments help to establish firm conclusions about moral status. These are important issues for the field, and I use this reply to take discussion of them a step or two farther, defending my initial article from Macpherson's and Macklin's critical questions and objections. (shrink)

Two articles published in Bioethics recently have explored the ways that bioethics can contribute to the climate change debate. Cheryl Cox Macpherson argues that bioethicists can play an important role in the climate change debate by helping the public to better understand the values at stake and the trade-offs that must be made in individual and social choices, and Sean Valles claims that bioethicists can contribute to the debate by framing the issues in terms of the public health (...) impacts of climate change. While Macpherson and Valles make valid points concerning a potential role for bioethics in the climate change debate, it is important to recognize that much more than ethical analysis and reflection will be needed to significantly impact public attitudes and government policies. (shrink)

Cheryl Cox MacPherson recently argued, in an article for this journal, that ‘Climate Change is a Bioethics Problem’. This article elaborates on that position, particularly highlighting bioethicists' potential ability to help reframe the current climate change discourse to give more attention to its health risks. This reframing process is especially important because of the looming problem of climate change skepticism. Recent empirical evidence from science framing experiments indicates that the public reacts especially positively to climate change messages framed (...) in public health terms, and bioethicists are particularly well positioned to contribute their expertise to the process of carefully developing and communicating such messages. Additionally, as climate framing research and practice continue, it will be important for bioethicists to contribute to the creation of that project's nascent ethical standards. The discourse surrounding antibiotic resistance is posited as an example that can lend insight into how communicating a public health-framed message, including the participation of bioethicists, can help to override public skepticism about the findings of politically contentious scientific fields. (shrink)

In dialogue with Kristin Ross and Fred Moten, as well as recent theorizations of destituent power, this article aims to trace the practical logic that governs place-based politics in our anarchic epoch, including the construction of collective formations that defend them.

This article provides a thematic overview of the work of contemporary French philosopher Grégoire Chamayou. It suggests that the notion of violent capture serves as a guiding theme linking Chamayou's work, linking it to his early study of experimental medicine, his genealogy of manhunting and predatory power, as well as his recent study of contemporary predatory or "cynegetic" warfare use of drones.

In Sons of Anarchy, the male members of the MC are only one part of the story, as the Charming women play equally pivotal roles in the action. This chapter takes a look at the women to see how they wield their power, what they do with it, and how it is limited by the world in which they operate. The stories told on Sons of Anarchy are familiar to us. The character's lives ebb and flow with hopes and fears, (...) gains and losses, friendship and enmity, love and resentments, and regrets and triumphs that we can identify with. We ride alongside the characters as they strive for the ideals that make life worth living, such as friendship, love, and happiness, though none of the characters seems to have achieved these ideals perfectly in their lives. (shrink)

From the very first scene of The Good Place, monumental duplicity is at work. Everything is contrived and everyone is lying, both to themselves and to one another. The Good Place raises the issue of how to determine whether a person is ethical or not. Both Eleanor and Tahani struggle with significant feelings of inadequacy, compelling them to commit ethical infractions to land them in “The Good Place”. Although Tahani and Eleanor come from divergent social stations, they share a common (...) legacy of familial abuse that deeply affected their sense of self‐worth, causing them to relentlessly exploit and abuse others in their attempts to gain a positive self‐image. The Good Place reminds that in our lives we are constantly confronted by ethical dilemmas that challenge us to make choices, and all we have for guidance are flawed, often conflicting ideals that we pick up along the way. (shrink)

A new translation of two essential works on Deleuze, written by one of his contemporaries. From the publication of Deleuze: A Philosophy of the Event to his untimely death in 2006, Francois Zourabichvili was regarded as one of the most important new voices of contemporary philosophy in France. His work continues to make an essential contribution to Deleuze scholarship today. This edition makes two of Zourabichvili's most important writings on the philosophy of Gilles Deleuze available in a single volume. A (...) Philosophy of the Event is an exposition of Deleuze's philosophy as a whole, while the complementary Deleuze's Vocabulary approaches Deleuze's work through an analysis of key concepts in a dictionary form. This new translation is set to become an event within Deleuze Studies for many years to come. Key Features: Distinguishes Deleuze's notion of the event from the phenomenological, ontological and voluntarist conceptions that continue to lay claim to it today; With an introduction by Gregg Lambert and Daniel W. Smith, two of the world's leading commentators on Deleuze, explaining the key themes and arguments of Zourabichvili's work. (shrink)

This study investigates professional tax practitioners' ethical judgments and behavioral intentions in cases involving client pressure to adopt aggressive reporting positions, an issue that has been identified as the most difficult ethical/moral problem facing public accounting practitioners. The multidimensional ethics scale (MES) was used to measure the extent to which a hypothetical behavior was consistent with five ethical philosophies (moral equity, contractualism, utilitarianism, relativism, and egoism). Responses from a sample of 67 tax professionals supported the existence of all dimensions of (...) the MES other than egoism. Regressions of ethical judgments and behavioral intentions on the MES dimensions indicate that ethical decision making is most heavily influenced by the moral equity dimension, followed by the contractualism dimension. In contrast, the utilitarianism and relativism dimensions were only related to ethical judgments and behavioral intentions in isolated instances. (shrink)