Authoritarian governments are characterised by political systems with concentrated and centralised power. Healthcare is a critical component of any state. Given the powers of an authoritarian regime, we consider the opportunities they possess to derive good health outcomes. The 2019 Varsity Medical Ethics Debate convened on the motion: ‘This house believes authoritarian government is the route to good health outcomes’ with Oxford as the Proposition and Cambridge as the Opposition. This article summarises and extends key arguments made during the 11th (...) annual debate between medical students from the Universities of Oxford and Cambridge. By contrasting the principles underlying authoritarianism and democracy, it enables a discussion into how they translate into healthcare provision and the outcomes derived. Based on the foundation of said principles, an exploration of select cases represents examples of applications and the results. We analyse the past, present and future implications on the basis of fundamental patient-centred care. (shrink)

Standpoint theorists have long been clear that marginalization does not make better understanding a given. They have been less clear, though, that social dominance does not make ignorance a given. Indeed, many standpoint theorists have implicitly committed themselves to what I call the strong epistemic disadvantage thesis. According to this thesis, there are strong, substantive limits on what the socially dominant can know about oppression that they do not personally experience. I argue that this thesis is not just implausible but (...) politically pernicious; it is an excuse for ignorance and silence that stifles our ability to address many injustices. Moreover, I argue that if we are to avoid lending support to the SEDT while working within a standpoint theory framework, we must hold that the socially dominant can achieve marginalized standpoints. So, we must hold that men can achieve feminist standpoints, that white women (and men) can achieve black feminist standpoints, and so on. (shrink)

There is an undeniable tendency to dismiss women’s sexual assault allegations out of hand. However, this tendency is not monolithic—allegations that black men have raped white women are often met with deadly seriousness. I argue that contemporary rape culture is characterized by the interplay between rape myths that minimize rape, and myths that catastrophize rape. Together, these two sets of rape myths distort the epistemic resources that people use when assessing rape allegations. These distortions result in the unjust exoneration of (...) people we cannot conceive of as monstrous, while making it too easy to believe that some marginalized people could be rapists. I also argue that rape myths enable a novel kind of epistemic injustice. This injustice concerns how our assessments of trustworthiness and our assessments of plausibility interact. I argue that rape myths can result in runaway credibility deflations that can explain both why people fail to believe most women, and also why people may unjustly believe false allegations that white women have been raped by black men. (shrink)

Experiments are commonly thought to have epistemic privilege over simulations. Two ideas underpin this belief: first, experiments generate greater inferential power than simulations, and second, simulations cannot surprise us the way experiments can. In this article I argue that neither of these claims is true of experiments versus simulations in general. We should give up the common practice of resting in-principle judgments about the epistemic value of cases of scientific inquiry on whether we classify those cases as experiments or simulations, (...) per se. To the extent that either methodology puts researchers in a privileged epistemic position, this is context sensitive. (shrink)

Deception sometimes results in nonconsensual sex. A recent body of literature diagnoses such violations as invalidating consent: the agreement is not morally transformative, which is why the sexual contact is a rights violation. We pursue a different explanation for the wrongs in question: there is valid consent, but it is not consent to the sex act that happened. Semantic conventions play a key role in distinguishing deceptions that result in nonconsensual sex (like stealth condom removal) from those that don’t (like (...) white lies). Our framework is also applicable to more controversial cases, like those implicated in so-called “gender fraud” complaints. (shrink)

Belief polarization occurs when subjects who disagree about some matter of fact are exposed to a mixed body of evidence that bears on that dispute. While we might expect mutual exposure to common evidence to mitigate disagreement, since the evidence available to subjects comes to consist increasingly of items they have in common, this is not what happens. The subjects’ initial disagreement becomes more pronounced because each person increases confidence in her antecedent belief. Kelly aims to identify the mechanisms that (...) underlie this phenomenon and assess whether these processes undermine the justification of polarized beliefs. He concludes that given evidentialism, justification is not undermined by the polarizing mechanisms. I take on board Kelly’s description of the polarizing mechanisms, but challenge his conclusion. I argue that on plausible versions of evidentialism, the beliefs that result from these routes to polarization are not justified. (shrink)

Are there epistemic duties to inquire? The idea enjoys intuitive support. However, prominent evidentialists argue that our only epistemic duty is to believe well (i.e., to have doxastically justified beliefs), and doing so does not require inquiry. Against this, I argue that evidentialists are plausibly committed to the idea that if we have epistemic duties to believe well, then we have epistemic duties to inquire. This is because on plausible evidentialist views of evidence possession (i.e., views that result in plausible (...) theories of evidentialist justification), inquiry is sometimes a necessary constitutive means of forming doxastically justified beliefs—beliefs that are proportioned to and based on one's evidence. So, either evidentialist views of evidence possession commit them to epistemic duties to inquire or they lead to independently implausible theories of evidentialist justification. My discussion also has important implications for the zetetic turn in epistemology, since I argue that evidentialists who are staunchly opposed to epistemic norms on inquiry have reason to reconsider. (shrink)

Madison Kilbride recently argued that insurance ) should cover in vitro fertilisation with preimplantation genetic testing services for couples at high risk of having a child affected with a genetic condition. She argues that IVF-PGT meets CMS’s definition of ‘medically necessary care’, where such care includes ‘services or supplies needed to diagnose or treat an illness, injury, condition, disease or its symptoms’. Kilbride argues that IVF-PGT satisfies this definition in two ways: as a diagnostic tool and as a treatment. Contradicting (...) Kilbride, however, I argue that IVF-PGT provides neither diagnosis nor treatment under CMS’s definition. Thus, as long as we accept CMS’s definition of medically necessary care—which Kilbride does, explicitly—it follows that IVF-PGT does not count as medically necessary care. Still, there may be other reasons to conclude that IVF-Preimplantation genetic testing should be covered, and so, it would be a mistake to reject Kilbride’s conclusion altogether. The problem is simply that Kilbride’s argument—that the procedure should be covered because it is medically necessary per CMS’s definition—is not sound. I conclude by discussing a number of other genetic services that are not currently being covered despite the fact that they do seem to satisfy CMS’s definition of ‘medically necessary diagnosis or treatment’. These services, I argue, should be provided under CMS before we consider expanding coverage to include elective procedures such as IVF-PGT. (shrink)

In this paper, I discuss the recent discovery of alleged arsenic bacteria in Mono Lake, California, and the ensuing debate in the scientific community about the validity and significance of these results. By situating this case in the broader context of projects that search for anomalous life forms, I examine the methodology and upshots of challenging biochemical constraints on living things. I distinguish between a narrower and a broader sense in which we might challenge or change our knowledge of life (...) as the result of such a project, and discuss two different kinds of projects that differ in their potential to overhaul our knowledge of life. I argue that the arsenic bacteria case, while potentially illuminating, is the kind of constraint-challenging project that could not—in spite of what was said when it was presented to the public—change our knowledge of life in the deeper sense. (shrink)

Francesco Redi’s seventeenth-century experiments on insect generation are regarded as a key contribution to the downfall of belief in spontaneous generation. Scholars praise Redi for his experiments demonstrating that meat does not generate insects, but condemn him for his claim elsewhere that trees can generate wasps and gallflies. He has been charged with rejecting spontaneous generation only to change his mind and accept it, and in the process, with failing as a rigorous experimental philosopher. In this paper I defend Redi (...) from both of these charges. In doing so, I draw some broader lessons for our understanding of spontaneous generation. ‘Spontaneous generation’ does not refer to a single theory, but rather a landscape of possible views. I analyze Redi’s theoretical commitments and situate them within this landscape, and argue that his error in the case of insects from plants is not as problematic as previous commentators have said it is. In his research on gall insects Redi was addressing a different question from that of his experiments on insect generation—the question was not “Can insects come from nonliving matter?,” but rather, “Can insects come from living organisms which are not their parents?” In the latter case, he gave an answer which we now know to be false, but this was not due to any failure in his rigor as an experimental philosopher. (shrink)

Concepts like testimonial injustice (Fricker, 2007) and testimonial violence (Dotson, 2011) articulate that marginalized epistemic agents are unjustly undermined as testifiers when dominant agents cannot or will not hear, understand, or believe their testimony. This paper turns attention away from these constraints on uptake, and towards pragmatic, social, and political constraints on how dominant audiences receive and react to testimony. I argue that these constraints can also be sources of testimonial injustice and epistemic violence. Specifically, I explore a kind of (...) injustice that I call testimonial withdrawal, which occurs when a would-be speaker chooses to remain silent because they know or reasonably expect that there is pragmatic risk associated with speaking, given their unjust marginalization. I argue that this unjustly undermines epistemic agency, and that expanding Fricker and Dotson’s umbrella concepts to accommodate this idea results in a better understanding of the moral and epistemic contours of both testimonial withdrawal and these broader categories. (shrink)

Fiscal equivalence in the public administration of justice requires local police and courts to be financed exclusively by the populations that benefit from their services. Within a polycentric framework, broad based taxation to achieve fiscal equivalence is a desirable principle of public finance because it conceptually allows for the provision of justice to be determined by constituent’s preferences, and increases the political accountability of service providers to constituents. However, the overproduction of justice services can readily occur when the benefits of (...) the justice system are not enjoyed equally. Paradoxically, the same properties that make fiscal equivalence desirable by imposing restraint and control between constituents and local government also create internal pressures for agents of the state to engage in predatory, revenue-generating behavior. (shrink)

Human microbiome research makes causal connections between entire microbial communities and a wide array of traits that range from physiological diseases to psychological states. To evaluate these causal claims, we first examine a well-known single-microbe causal explanation: of Helicobacter pylori causing ulcers. This apparently straightforward causal explanation is not so simple, however. It does not achieve a key explanatory standard in microbiology, of Koch’s postulates, which rely on manipulations of single-microorganism cultures to infer causal relationships to disease. When Koch’s postulates (...) are framed by an interventionist causal framework, it is clearer what the H. pylori explanation achieves and where its explanatory strengths lie. After assessing this ‘simple’, single-microbe case, we apply the interventionist framework to two key areas of microbiome research, in which obesity and mental health states are purportedly explained by microbiomes. Despite the experimental data available, interventionist criteria for explanation show that many of the causal claims generated by microbiome research are weak or misleading. We focus on the stability, specificity and proportionality of proposed microbiome causal explanations, and evaluate how effectively these dimensions of causal explanation are achieved in some promising avenues of research. We suggest some conceptual and explanatory strategies to improve how causal claims about microbiomes are made. (shrink)

A contemporary of William Shakespeare and Ben Jonson, Christopher Marlowe was one of the most influential early modern dramatists, whose life and mysterious death have long been the subject of critical and popular speculation. This collection sets Marlowe's plays and poems in their historical context, exploring his world and his wider cultural influence. Chapters by leading international scholars discuss both his major and lesser-known works. Divided into three sections, 'Marlowe's works', 'Marlowe's world', and 'Marlowe's reception', the book ranges from Marlowe's (...) relationship with his own audience through to adaptations of his plays for modern cinema. Other contexts for Marlowe include history and politics, religion and science. Discussions of Marlowe's critics and Marlowe's appeal today, in performance, literature and biography, show how and why his works continue to resonate; and a comprehensive further reading list provides helpful suggestions for those who want to find out more. (shrink)

Recently, some work in feminist epistemology has received more uptake from mainstream western analytic epistemology than it had in the past. There has been recognition of the importance of topics like epistemic injustice, standpoint epistemology, and epistemologies of ignorance, for instance. But these discussions are often seen as orthogonal to core epistemic theorizing - they have not received uptake as fundamental contestations of the ways we understand epistemic value, or core normative epistemic concepts. I suggest that one reasons for this (...) is the perception that insofar as feminist theorizing is responsive to moral and political concerns, it is not doing epistemology because it is not theorizing about epistemic value. This assumes a specific kind of epistemic value monism - a view whose popularity, I argue, derives at least partly from features of the methodologies that are popular in mainstream epistemology. I show that by using a different type of methodology - ameliorative inquiry - we see that there is a principled reason to doubt epistemic value monism. We can thus understand feminist theorizing in ways that are richer, more accurate, and that contribute to our understanding of the ways in which our practical, moral, and epistemic agency are intertwined. (shrink)

Human microbiome research makes causal connections between entire microbial communities and a wide array of traits that range from physiological diseases to psychological states. To evaluate these causal claims, we first examine a well-known single-microbe causal explanation: of Helicobacter pylori causing ulcers. This apparently straightforward causal explanation is not so simple, however. It does not achieve a key explanatory standard in microbiology, of Koch’s postulates, which rely on manipulations of single-microorganism cultures to infer causal relationships to disease. When Koch’s postulates (...) are framed by an interventionist causal framework, it is clearer what the H. pylori explanation achieves and where its explanatory strengths lie. After assessing this ‘simple’, single-microbe case, we apply the interventionist framework to two key areas of microbiome research, in which obesity and mental health states are purportedly explained by microbiomes. Despite the experimental data available, interventionist criteria for explanation show that many of the causal claims generated by microbiome research are weak or misleading. We focus on the stability, specificity and proportionality of proposed microbiome causal explanations, and evaluate how effectively these dimensions of causal explanation are achieved in some promising avenues of research. We suggest some conceptual and explanatory strategies to improve how causal claims about microbiomes are made. (shrink)

Human microbiome research makes causal connections between entire microbial communities and a wide array of traits that range from physiological diseases to psychological states. To evaluate these causal claims, we first examine a well-known single-microbe causal explanation: of Helicobacter pylori causing ulcers. This apparently straightforward causal explanation is not so simple, however. It does not achieve a key explanatory standard in microbiology, of Koch’s postulates, which rely on manipulations of single-microorganism cultures to infer causal relationships to disease. When Koch’s postulates (...) are framed by an interventionist causal framework, it is clearer what the H. pylori explanation achieves and where its explanatory strengths lie. After assessing this ‘simple’, single-microbe case, we apply the interventionist framework to two key areas of microbiome research, in which obesity and mental health states are purportedly explained by microbiomes. Despite the experimental data available, interventionist criteria for explanation show that many of the causal claims generated by microbiome research are weak or misleading. We focus on the stability, specificity and proportionality of proposed microbiome causal explanations, and evaluate how effectively these dimensions of causal explanation are achieved in some promising avenues of research. We suggest some conceptual and explanatory strategies to improve how causal claims about microbiomes are made. (shrink)

Koonin argues that CRISPR-Cas systems present the best-known case in point for Lamarckian evolution because they satisfy his proposed criteria for the specific inheritance of acquired adaptive characteristics. We see two interrelated issues with Koonin’s characterization of CRISPR-Cas systems as Lamarckian. First, at times he appears to confuse an account of the CRISPR-Cas system with an account of the mechanism it employs. We argue there is no evidence for the CRISPR-Cas system being “Lamarckian” in any sense. Second, it is unclear (...) whether the mechanism is more “Lamarckian” than many other forms of genetic change already well-characterized in Darwinian terms. We present three conceptually distinct senses in which the mechanism of IAC may be considered Lamarckian and argue that only the strongest sense of goal-directed IAC would be difficult to accommodate in a Darwinian account. As the CRISPR-Cas mechanism does not qualify as “Lamarckian” in this strong sense, we argue there is no conceptual value in calling it “Lamarckian”. Finally, we suggest that CRISPR-Cas systems do hold the potential for genuinely non-Darwinian, directed evolution in a way that Koonin did not discuss, involving their potential use as a human gene-editing tool. (shrink)

Adaptive phenotypic plasticity allows organisms to cope with environmental variability, and yet, despite its adaptive significance, phenotypic plasticity is neither ubiquitous nor infinite. In this review, we merge developmental and population genetic perspectives to explore costs and limits on the evolution of plasticity. Specifically, we focus on the role of modularity in developmental genetic networks as a mechanism underlying phenotypic plasticity, and apply to it lessons learned from population genetic theory on the interplay between relaxed selection and mutation accumulation. We (...) argue that the environmental specificity of gene expression and the associated reduction in pleiotropic constraints drive a fundamental tradeoff between the range of plasticity that can be accommodated and mutation accumulation in alternative developmental networks. This tradeoff has broad implications for understanding the origin and maintenance of plasticity and may contribute to a better understanding of the role of plasticity in the origin, diversification, and loss of phenotypic diversity. (shrink)

In The Infidel and the Professor: David Hume, Adam Smith, and the Friendship That Shaped Modern Thought, Dennis Rasmussen reminds us that ‘Hume believed that “the first Quality of an Historian is to be true & impartial; the next to be interesting”’ (p. 72). Rasmussen meets both criteria in his history of the friendship of Hume and Smith, two luminaries of the Scottish Enlightenment. The Infidel and the Professor lays out the facts carefully, showing both the depth of Hume and (...) Smith’s warmth and respect for each other as well as the extent of their shared intellectual interests and mutual influence. But while he is ‘true & impartial,’ just as Hume would want, Rasmussen also tells a lively and engrossing story. In a well-paced and beautifully written narrative, he demonstrates the same wit and genuine affection for his subjects that he proves characterized their relationship. (shrink)

Color coding is used to guide attention in computer displays for such critical tasks as baggage screening or air traffic control. It has been shown that a display object attracts more attention if its color is more similar to the color for which one is searching. However, what does similar precisely mean? Can we predict the amount of attention that a display color will receive during a search for a given target color? To tackle this question, two color‐search experiments measuring (...) the selectivity of saccadic eye movements and mapping out its underlying color space were conducted. A variety of mathematical models, predicting saccadic selectivity for given target and display colors, were devised and evaluated. The results suggest that applying a Gaussian function to a weighted Euclidean distance in a slightly modified HSI color space is the best predictor of saccadic selectivity in the chosen paradigm. Hue and intensity information by itself provides a basis for useful predictors, spanning a possibly spherical color space of saccadic selectivity. Although the current models cannot predict saccadic selectivity values for a wide variety of visual search tasks, they reveal some characteristics of color search that are of both theoretical and applied interest, such as for the design of human–computer interfaces. (shrink)

While the various therapeutic neurotechnologies currently in development—TMS, tDCS, and related treatment modalities—have the potential to greatly augment the treatment of a spectrum of diseases an...

The global pandemic needs to mark a turning point for the peoples of Aotearoa New Zealand. How can we make sure that our culturally diverse nation charts an equitable and sustainable path through and beyond this new world? In a less affluent future, how can we ensure that all New Zealanders have fair access to opportunities? One challenge is to preserve the sense of common purpose so critical to protecting each other in the face of Covid-19. How can we centre (...) what we have learnt about resilience within Māori and wider Pacific communities in our reforms? How can public understanding of Covid-19 science create a platform for the future social valuing of expertise? How can we ensure that the impact of Covid-19 in New Zealand results in a more sustainable, and inclusive workforce–for instance by expanding our perceptions of the value of our workers through promoting digital inclusion? To meet these challenges, we must reimagine our existing traditions of thought, breathing new life into perennial concepts and debates. Our paper indicates some of the ways that Philosophy is central to this collective reimagining, highlighting solutions to be found across our rich philosophical traditions. (shrink)

Institutional review boards have a dual goal: first, to protect the rights and welfare of human research subjects, and second, to support and facilitate the conduct of valuable research. In striving to achieve these goals, IRBs must often consider conflicting interests. In the discussion below, we characterize research oversight as having three elements: research regulations, which establish a minimum acceptable standard for research conduct; ethical principles, which help us identify and define relevant ethical issues; and virtue ethics, which guides the (...) prioritization of relevant issues. We describe specific ways in which the lessons of virtue ethics suggest revisions to the IRB structure and review process, the education and training of IRB members, and the appropriate limits of regulations in research ethics oversight. (shrink)

Microbial model systems have a long history of fruitful use in fields that include evolution and ecology. In order to develop further insight into modelling practice, we examine how the competitive exclusion and coexistence of competing species have been modelled mathematically and materially over the course of a long research history. In particular, we investigate how microbial models of these dynamics interact with mathematical or computational models of the same phenomena. Our cases illuminate the ways in which microbial systems and (...) equations work as models, and what happens when they generate inconsistent findings about shared targets. We reveal an iterative strategy of comparative modelling in different media, and suggest reasons why microbial models have a special degree of epistemic tractability in multimodel inquiry. (shrink)

In two studies, we explored the frequency and phenomenology of musical imagery. Study 1 used retrospective reports of musical imagery to assess the contribution of individual differences to imagery characteristics. Study 2 used an experience sampling design to assess the phenomenology of musical imagery over the course of one week in a sample of musicians and non-musicians. Both studies found episodes of musical imagery to be common and positive: people rarely wanted such experiences to end and often heard music that (...) was personally meaningful. Several variables predicted musical imagery, including personality, musical preferences, and positive mood. Musicians tended to hear musical imagery more often, but they reported less frequent episodes of deliberately-generated imagery. Taken together, the present research provides new insights into individual differences in musical imagery, and it supports the emerging view that such experiences are common, positive, and more voluntary than previously recognized. (shrink)

ABSTRACTThis research investigated whether precues engage proactive control to reduce emotional interference during speech production. A picture-word interference task required participants to name target pictures accompanied by taboo, negative, or neutral distractors. Proactive control was manipulated by presenting precues that signalled the type of distractor that would appear on the next trial. Experiment 1 included one block of trials with precues and one without, whereas Experiment 2 mixed precued and uncued trials. Consistent with previous research, picture naming was slowed in (...) both experiments when distractors were taboo or negative compared to neutral, with the greatest slowing effect when distractors were taboo. Evidence that precues engaged proactive control to reduce interference from taboo distractors was found in Experiment 1. In contrast, mixing precued trials in Experiment 2 resulted in no taboo cueing benefit. These results suggest that item-level proactive control can b... (shrink)

Background: Treatment of psychotic disorders in pregnancy is often ethically and clinically challenging, especially when psychotic symptoms impair decision-making capacity. There are several competing ethical obligations to consider: the ethical obligation to maternal autonomy, the maternal and fetal beneficence-based obligations to treat peripartum psychosis, and the fetal beneficence-based obligation to minimize teratogenic exposure. Objective: This article outlines an ethical framework for clinical decision-making for the management of chronic psychosis in pregnancy, with an emphasis on special considerations in the previable and (...) periviable period. Case Presentation: A 31-year-old gravida 2, para 1 with intrauterine pregnancy at 12 weeks and 4 days gestation was brought to the emergency department by her husband seven months after delivering her first child, due to sudden onset of behavioral changes that included self-isolation, not eating, and not taking care of her child. Her past medical history included hypothyroidism and inflammatory bowel disease, but no prior psychiatric illness. After being admitted to the psychiatric hospital, she continued to have poor oral intake and weight loss despite initial inpatient treatment with antipsychotics, levothyroxine, and discontinuation of corticosteroids. Her pregnancy was also complicated by the diagnosis of multiple fetal anomalies at 20 weeks gestation, when the fetus was periviable. Conclusions: For previable or periviable pregnancies, the patient and/or surrogate should decide whether to pursue prenatal genetic screening and invasive diagnostic testing, as well as whether to continue or terminate the pregnancy. When the choice is made to continue the pregnancy, initiation of long-term psychiatric treatment (including medications with potential adverse fetal effects) should be based on shared decision-making between the physician and the patient and/or surrogate. Although some pharmacologic interventions may have potential adverse effects on the developing fetus, the use of psychotropic medications can be ethically justified, even if the patient herself does not have the capacity to consent and requires a surrogate, when the goal is to restore maternal autonomy and minimize the risks of maternal and fetal harm from untreated psychiatric illness. (shrink)

AbstractIntegrity is considered an important corporate value. Yet recent global events have highlighted the challenges firms face at living up to their stated values, especially when extended supply chain partners are involved. The concept of Supply Chain Integrity (SCI) can help firms shift focus beyond internal corporate integrity, toward supply chain integrity. Researchers and managers will benefit from an understanding of the SCI concept toward implementing SCI to better align supply chain partners with stated corporate values. This research fully develops (...) and empirically grounds the firm-level, inter-firm-oriented SCI concept. The thematic analysis of six firms’ archival and website content elaborated empirical descriptions of SCI themes and enabled the development of a process model for SCI, presenting a novel view of the underlying process by which firms can assess, develop, and maintain SCI across their supply chains. We propose the SCI model as an evolutionary process to improve a firm’s supply chain sustainability, rather than a dichotomous end state where firms either “have” integrity or they don’t. The SCI model could be used as a tool to help leaders create necessary change to better align values and supporting statements with culture, while influencing and affecting stakeholders across the supply chain. This is particularly important in today’s world, where business leaders must consider all stakeholders and address important stakeholder-driven issues such as supply chain sustainability, resilience, and security, which are now at the forefront in the ever-changing environment. (shrink)

BackgroundWhen conducting research with Indigenous populations consent should be sought from both individual participants and the local community. We aimed to search and summarise the literature about methods for seeking consent for research with Indigenous populations.MethodsA systematic literature search was conducted for articles that describe or evaluate the process of seeking informed consent for research with Indigenous participants. Guidelines for ethical research and for seeking consent with Indigenous people are also included in our review.ResultsOf 1447 articles found 1391 were excluded (...) ; 56 were relevant and included. Articles were categorised into original research that evaluated the consent process or publications detailing the process of seeking consent and guidelines for ethical research. Guidelines were categorised into international ; national and state/regional/local guidelines. In five studies based in Australia, Canada and The United States of America the consent process with Indigenous people was objectively evaluated. In 13 other studies interpreters, voice recording, videos, pictures, flipcharts and “plain language” forms were used to assist in seeking consent but these processes were not evaluated. Some Indigenous organisations provide examples of community-designed resources for seeking consent and describe methods of community engagement, but none are evaluated. International, national and local ethical guidelines stress the importance of upholding Indigenous values but fail to specify methods for engaging communities or obtaining individual consent. In the ‘Grey literature’ concerns about the consent process are identified but no solutions are offered.ConclusionConsultation with Indigenous communities is needed to determine how consent should be sought from the community and the individual, and how to evaluate this process. (shrink)