Scientific advances in health care have been disproportionately distributed across social strata. Disease burden is also disproportionately distributed, with marginalized groups having the highest risk of poor health outcomes. Social determinants are thought to influence health care delivery and the management of chronic diseases among marginalized groups, but the current conceptualization of social determinants lacks a critical focus on the experiences of people within their environment. The purpose of this article was to integrate the literature on marginalization and (...) situate the concept in the framework of social determinants of health. We demonstrate that social position links marginalization and social determinants of health. This perspective provides a critical lens to assess the societal power dynamics that influence the construction of the socio‐environmental factors affecting health. Linking marginalization with social determinants of health can improve our understanding of the inequities in health care delivery and the disparities in chronic disease burden among vulnerable groups. (shrink)

Autonomy is a vital principle in medical law and ethics. It occupies a prominent place in all medico-legal and ethical debate. But there is a dangerous presumption that it should have the only vote, or at least the casting vote. This book is an assault on that presumption, and an audit of autonomy's extraordinary status. This book surveys the main issues in medical law, noting in relation to each issue the power wielded by autonomy, asking whether that power can be (...) justified, and suggesting how other principles can and should contribute to the law. It concludes that autonomy's status cannot be intellectually or ethically justified, and that positive discrimination in favour of the other balancing principles is urgently needed in order to avoid some sinister results. 'This book is a sustained attack on the hegemony of the idea of autonomy in medical ethics and law. Charles Foster is no respecter of authority, whether of university professors or of law Lords. He grabs his readers by their lapels and shakes sense into them through a combination of no-nonsense rhetoric and subtle argument that is difficult to resist.' Tony Hope, Professor of Medical Ethics, Oxford University 'This book is unlikely to be in pristine state by the time you have finished reading it. Whether that is because you have thrown it in the air in celebration or thrown it across the room in frustration will depend on your perspective. But this book cannot leave you cold. It is a powerful polemic on the dominance of autonomy in medical law, which demands a reaction. Charles Foster sets out a powerful case that academic medical lawyers have elevated autonomy to a status it does not deserve in either ethical or legal terms. In a highly engaging, accessible account, he challenges many of the views which have become orthodox within the academic community. This will be a book which demands and will attract considerable debate.' Jonathan Herring, Exeter College, Oxford University 'This is a learned, lively and thought-provoking discussion of problems central to the courts' approach to ethical issues in medical law. What principles are involved? More significantly, which really underlie and inform the process of seeking justice in difficult cases? Charles Foster persuasively argues, and demonstrates, that respect for autonomy is but one of a number of ethical principles which interact and may conflict. He also addresses the sensitive issue of the extent to which thoughts and factors which go to influence legal decisions may not appear in the judgments.' Adrian Whitfield QC. 'Introducing the Jake La Motta of medical ethics. Foster is an academic street-fighter who has bloodied his hands in the court room. He provides a stinging, relentless, ground attack on the Goliath of medical ethics: the central place of autonomy in liberal medical ethics. This is now the first port of call for those who feel that medical ethics has become autonomized.' Julian Savulescu, Uehiro Chair in Practical Ethics, University of Oxford. "This important book offers a robust challenge to anyone, whether lawyer or 'ethicist', who sees respect for autonomy as the only game in town. It argues eloquently and effectively that, on the one hand, despite the reverence paid to it by judges, in practice the law, even in the context of consent, weaves together a number of moral threads of which autonomy is merely one, in the pursuit of a good decision. It argues on the other hand, that were the day-to-day practice of law to be guided primarily by respect for autonomy, this would be wrong. Foster concludes that whilst, 'any society that does not have laws robustly protecting autonomy is an unsafe and unhappy one', so too would be a society in which too much emphasis was placed on respect for autonomy at the expense of other important moral principles. This is essential reading for anyone interested in the role of autonomy and indeed of medical ethics, in the law." Michael Parker, Professor of Bioethics, University of Oxford. (shrink)

Using data obtained during a retrospective interview study of 30 women who had undergone genetic testing—BRCA1/2mutation searching—this paper describes how women, previously diagnosed with breast/ovarian cancer, perceive their role in generating genetic information about themselves and their families. It observes that when describing their motivations for undergoing DNA testing and their experiences of disclosing genetic information within the family these women provide care based ethical justifications for their actions. Finally, it argues that generating genetic information and disclosing this information (...) to kin raise different types of ethical issues. The implications of these findings for ethical debates about informed choice in the context of genetic testing are discussed. (shrink)

FOSTER J, CHIANG F, HILLARD RC, HALL P and HEATH A. Nursing Inquiry 2010; 17: 309–316 Team process in community‐based participatory research on maternity care in the Dominican RepublicA cross‐cultural team consisting of US trained academic midwife researchers, Dominican nurses, and Dominican community leaders have partnered in this international nursing and midwifery community‐based participatory research (CBPR) project in the Dominican Republic to understand the community experience with publicly funded maternity services. The purpose of the study was to understand (...) community perceptions of maternity services. This article highlights the activities that the research team carried out during each phase of the research process, and how they established team identity, team trust, and team efficacy. This research has created a platform for new avenues for health providers and community to partner to improve maternal‐newborn care. Community‐based participatory research is one way forward to address the past and present inequities constitutive of global health disparities. (shrink)

In reply to Dr Benians's article which suggests that social workers at times abuse their authority, three areas can be considered: the broader context of the social work task, the legal process itself, and the contribution made by child psychiatrists.

Echoing other articles in this special issue, this article re-evaluates a collection of feminist works that fell out of fashion as a consequence of academic feminism embracing poststructuralist and postmodernist trends. In line with fellow contributors, the article critically reflects upon the unsympathetic reading of feminisms considered to be essentialising and universalistic, in order to re-evaluate, in my case, ecofeminism. As an introduction, I reflect on my own perhaps unfair rejection of ecofeminism as a doctoral researcher and early career academic (...) who, in critiquing 1990s international environmental governance, sought to problematise the essentialist premise on which it appeared to be based. The article thereafter challenges this well-rehearsed critique by carefully revisiting a sample of ecofeminist work produced between the late 1970s and the early 1990s. In an effort to avoid wholesale abandonment of the wealth of feminist theory often labelled as second wave, or the rendering of feminisms of the past as redundant as feminist theory changes over time, this article re-reads the work of ecofeminists, such as Starhawk, Susan Griffin and Vandana Shiva, to demonstrate their contemporary relevance. In so doing, the article argues that a contemporary re-reading of ecofeminism offers insights allowing for a radical rethinking of contemporary environmental governance. (shrink)

Dementia is a topic of enormous human, medical, economic, legal and ethical importance. Its importance grows as more of us live longer. The legal and ethical problems it raises are complex, intertwined and under-discussed. This book brings together contributions from clinicians, lawyers and ethicists – all of them world leaders in the field of dementia – and is a comprehensive, scholarly yet accessible library of all the main (and many of the fringe) perspectives. It begins with the medical facts: what (...) is dementia? Who gets it? What are the current and future therapeutic and palliative options? What are the main challenges for medical and nursing care? The story is then taken up by the ethicists, who grapple with questions such as: is it legitimate to lie to dementia patients if that is a kind thing to do? Who is the person whose memory, preferences and personality have all been transformed by their disease? Should any constraints be placed on the sexual activity of patients? Are GPS tracking devices an unpardonable interference with the patient's freedom? These issues, and many more, are then examined through legal lenses. The book closes with accounts from dementia sufferers and their carers. It is the first and only book of its kind, and the authoritative text. (shrink)

The principle of informed consent is now well established within the National Health Service (NHS) in relation to any type of medical treatment. However, this ethical principle appears to be far less well established in relation to medical screening programmes such as Britain's national cervical screening programme. This article will critically examine the case for health care providers vigorously pursuing women to accept an invitation to be screened. It will discuss the type of information which women would need in (...) order to make an informed decision about whether or not to be screened. The lack of such information in current patient leaflets on the "smear test" will then be documented. Finally, the article will explore possible ways of maximising women's autonomy in relation to the cervical screening programme without sacrificing any of its main benefits. (shrink)

The physician-researcher conflict of interest has thus far eluded satisfactory solution. Most attempts to deal with it focus on improving informed consent. But those attempts are not successful and may even make things worse. Research subjects are already voluntarily undertaking the risks of research — we should not ask them to go it alone — to undergo medical “treatment” without medical “care.” The only effective solution is that in much clinical research, each research subject should have a doctor independent (...) from the research study. (shrink)

Despite advances in the treatment of heart failure, the physical symptoms and stress of the disease continue to negatively impact patients’ health outcomes. Technology now offers promising ways to integrate personalized support from health care professionals via a variety of platforms. Digital health technology solutions using mobile devices or those that allow remote patient monitoring are potentially more cost effective and may replace in-person interaction. Notably, digital health methods may not only improve clinical outcomes but may also improve the (...) psycho-social status of HF patients. Using digital health to address biopsychosocial variables, including elements of the person and their context is valuable when considering chronic illness and HF in particular, given the multiple, cross-level factors affecting chronic illness clinical management needed for HF self-care. (shrink)

Most discussions of the use of race and ethnicity in biomedical research and clinical care focus on broad national and transnational populations. Looking at the problem from the perspective of large populations, however, misses the rest of a continuum that runs from the global human population to local communities. If race and ethnicity are fundamental categories for biomedical analyses, they should be informative at all points along that continuum, much as the definition of a gene remains unchanged whether analyzed (...) in the context of an individual, a group, or the total human population. By examining the utility of racial and ethnic categories at a local community level, we can better evaluate whether those categories are indeed fundamental units for analysis. Alternatively, these categories may be analytic proxies useful primarily for approximating aggregate biological and social features of large populations at national and transnational levels of analysis. (shrink)

In positioning his laudandus Hagesias as the co-founder of Syracuse, Pindar considers the larger ideological implications of including a seer in a colonial foundation. The poet begins Olympian 6 by praising Hagesias as an athletic victor, seer, and sunoikistêr and therefore as a figure of enormous ritual power. This portrayal, however, introduces an element of competition into Hagesias' relationship with his patron Hieron, the founder of Aitna. In response, the ode's subsequent mythic portions circumscribe Hagesias' status so as to mitigate (...) any challenge the seer might present to Hieron's own political authority. An intertextual reading of Olympian 6's myth with the myth of Pelops in Olympian 1 highlights Pindar's careful negotiation of Hagesias' position in this colonial context. Despite the resulting need to affirm Hagesias' subordination to Hieron, Pindar joins together the seemingly incompatible roles of seer and co-founder because, as an intertextual reading of Nemean 1 helps to illustrate, Hagesias embodies and symbolically enacts in the ode Hieron's synoikism of Aitna. (shrink)

In 1997 the Royal Pharmaceutical Society of Great Britain published a report entitledFrom Compliance to Concordance: Achieving Shared Goals in Medicine Taking. This article applies this new model—of doctors and patients working together towards a shared goal—to the prescribing of hormonal forms of contraception. It begins by critically evaluating the current dominant model of contraceptive prescribing. It claims that this model tends to stereotype all women, but particularly young, poor and black women, as unreliable and ill-informed contraceptors who need to (...) be advised and even controlled by much more knowledgeable and socially responsible family planning experts. The article then suggests how a much more egalitarian model of contraceptive prescribing might be put into practice, whilst acknowledging the existence of many serious obstacles to such a radical shift within family planning services. In conclusion, the article suggests that until contraceptive prescribers begin to take women’s experiences of, and concerns about, hormonal contraceptives seriously they will fail to develop a potentially much more effective and liberating model of family planning. (shrink)

Tort claims have been studied for various reasons. Several studies have found that most tort claims are not related to negligent adverse events and most negligent adverse events do not result in tort claims. Several studies have examined the disposition of tort claims to understand the likelihood of payment once a claim has been made. Still others have proposed that tort-claims trend analysis may help administrators target their quality-improvement efforts and identify problems with quality that would not otherwise be captured.In (...) this article, we conduct a tort-claims analysis to explore areas for quality improvement, specifically for patient safety, in the Veterans Health Administration. Patient safety is an increasingly highlighted aspect of health-care delivery. Failure to assure patient safety can result in bad clinical outcomes, additional costs of care, and a negative organizational image. Filing a tort claim is one way for an individual to express concern about an organization. For our analysis, we draw from resolved tort claims in the Veterans Health Administration from fiscal years 1989 to 2000. (shrink)

Tort claims have been studied for various reasons. Several studies have found that most tort claims are not related to negligent adverse events and most negligent adverse events do not result in tort claims. Several studies have examined the disposition of tort claims to understand the likelihood of payment once a claim has been made. Still others have proposed that tort-claims trend analysis may help administrators target their quality-improvement efforts and identify problems with quality that would not otherwise be captured.In (...) this article, we conduct a tort-claims analysis to explore areas for quality improvement, specifically for patient safety, in the Veterans Health Administration. Patient safety is an increasingly highlighted aspect of health-care delivery. Failure to assure patient safety can result in bad clinical outcomes, additional costs of care, and a negative organizational image. Filing a tort claim is one way for an individual to express concern about an organization. For our analysis, we draw from resolved tort claims in the Veterans Health Administration from fiscal years 1989 to 2000. (shrink)

In 1997 the Royal Pharmaceutical Society of Great Britain published a report entitledFrom Compliance to Concordance: Achieving Shared Goals in Medicine Taking. This article applies this new model—of doctors and patients working together towards a shared goal—to the prescribing of hormonal forms of contraception. It begins by critically evaluating the current dominant model of contraceptive prescribing. It claims that this model tends to stereotype all women, but particularly young, poor and black women, as unreliable and ill-informed contraceptors who need to (...) be advised and even controlled by much more knowledgeable and socially responsible family planning experts. The article then suggests how a much more egalitarian model of contraceptive prescribing might be put into practice, whilst acknowledging the existence of many serious obstacles to such a radical shift within family planning services. In conclusion, the article suggests that until contraceptive prescribers begin to take women’s experiences of, and concerns about, hormonal contraceptives seriously they will fail to develop a potentially much more effective and liberating model of family planning. (shrink)

Traditional approaches to character education have been viewed by many educators as an attempt to establish self control within students to habituate them to prescribed behaviour and as nothing more than a ‘bits‐and‐pieces’ approach to moral education. While this is accurate for many character education programmes, integrated multi‐dimensional character education embraces both moral education and character formation. Students learn to identify and process social conventions within the core values of the school and community and have opportunities to learn practical reasoning (...) skills in schools where character education is integrated into all aspects of the schooling process. Reported in this article are several studies, including two large‐scale experimental investigations, that show integrated character education results in an improved school environment, student pro‐social and moral behaviour, and reading and maths test scores. Schools become more caring communities; student discipline referrals drop significantly, particularly in areas related to bullying behaviour; and test scores in moderately achieving schools increase nearly 50%. (shrink)

There are differences in caregivers’ literacy and health literacy levels that may affect their ability to consent to children participating in clinical research trials. This study aimed to explore the effectiveness, and caregivers’ understandings, of the process of informed consent that accompanied their child’s participation in a dental randomized control trial (RCT). Telephone interviews were conducted with a convenience sample of ten caregivers who each had a child participating in the RCT. Pre-tested closed and open-ended questions were used, and the (...) findings were produced from an inductive analysis of the latter and a descriptive analysis of the former. Participants had limited understanding of the purpose of the RCT and rated the readability of the consent form more highly than they rated their understanding of the research. All felt that informed consent was vital, but some caregivers had not read the consent documents. Some caregivers enrolled their child in the RCT because they trusted the researchers, and the majority wanted to improve dental care for children. The informed consent process was not always effective despite high readability of the informed consent documents. Researchers must consider the health literacy of the study group, and actively engaging with caregivers to achieve meaningful informed consent may be challenging. Future research could explore participants’ perspectives of informed consent in populations with low health literacy and assess whether an underlying expectation not to comprehend health-related information may be a barrier to informed consent. (shrink)

Newborn screening involves the collection of blood from the heel of a newborn baby and testing it for a list of rare and inheritable disorders. New biochemical screening technologies led to expansions of NBS programs in the first decade of the 21st century. It is expected that they will in time be replaced by genetic sequencing technologies. These developments have raised a lot of ethical debate. We reviewed the ethical literature on NBS, analyzed the issues and values that emerged, and (...) paid particular interest to the type of impacts authors think NBS should have on the lives of children and their families. Our review shows that most authors keep their ethical reflection confined to policy decisions, about for instance the purpose of the program, and its voluntary or mandatory nature. While some authors show appreciation of how NBS information empowers parents to care for their children, most authors consider these aspects to be ‘private’ and leave their evaluation up to parents themselves. While this division of moral labor fits with the liberal conviction to leave individuals free to decide how they want to live their private lives, it also silences the ethical debate about these issues. Given the present and future capacity of NBS to offer an abundance of health-related information, we argue that there is good reason to develop a more substantive perspective to whether and how NBS can contribute to parents’ good care for children. (shrink)

This article confronts the problems of establishing normative restrictive claims for delegitimizing conduct and attitudes of cultural appropriation. Using C. Thi Nguyen’s and Matthew Strhol’s intimacy account (IA) as a background, I offer an alternative of cultural adoption relying upon Alain Locke’s value theory and philosophical pluralism. The phenomenon of cultural adoption I propose develops some insights from Nguyen’s and Strohl’s IA, while critiquing their framework’s perceived limitations. By adding loyalty and intensity to the prerogatives of intimacy, the hope is (...) that a more nuanced approach to the ethical concerns of cultural adoption will be achieved. My contention is that Locke’s notions of a racial sense or kinship feeling provides stronger grounds for establishing an ethics of the passerby or what I will call non-intimate encounters. Next, I will argue that the interpersonal relations of groups cannot be interpreted as simple, but only as complex wholes. Instead of monoliths and exclusive binaries, we have to recognize variation within groups and learn to think in what Albert Murray calls “mulatto,” or a culture of novel hybrids. In the final section, I argue that Locke’s philosophy, broadly construed, operates as a contraceptive knowledge against the growing imperial apathy of populists and absolutists. We should work to abandon forms of political and epistemological violence by rejecting these forms of cultural abuse. It is my grand contention that human groups express in their differences a uniqueness that makes us distrust or admire and like each other. (shrink)

Children in foster care are considered a “vulnerable population” in clinical care and research, with good reason. These children face multiple medical, psychological, and social risks that obligate the child welfare and healthcare systems to protect them from further harms. An unintended consequence of the “vulnerable population” designation for children in foster care is that it may impose barriers on tracking and studying their health that creates gaps in knowledge that are key to their receipt (...) of medical care and good outcomes. These gaps in knowledge have implications for justice, beneficence, and maleficence and serve to undermine “protection” of this population. Here we review the challenges of research regarding children in foster care, particularly medically complex children, and offer specific recommendations to include children in foster care in medical research. (shrink)

: In this essay, Riggs demonstrates how heterosexism shapes foster-care assessment practices in Australia. Through an examination of lesbian and gay foster-care applicants' assessment reports and with a focus on the heteronormative assumptions contained within them, Riggs demonstrates that foster-care public policy and research on lesbian and gay parenting both promote the idea that lesbian and gay parents are always already "just like" heterosexual parents. To counter this idea of "sameness," Riggs proposes an approach (...) to both assessing and researching lesbian and gay parents that privileges the specific experiences of lesbians and gay men and resists the heterosexualization of lesbian and gay families by focusing on some potentially radical differences shaping lesbian and gay lives. (shrink)

In this essay, Riggs demonstrates how heterosexism shapes foster-care assessment practices in Australia. Through an examination of lesbian and gay foster-care applicants’ assessment reports and with a focus on the heteronormative assumptions contained within them, Riggs demonstrates that foster-care public policy and research on lesbian and gay parenting both promote the idea that lesbian and gay parents are always already “just like” heterosexual parents. To counter this idea of “sameness,” Riggs proposes an approach to (...) both assessing and researching lesbian and gay parents that privileges the specific experiences of lesbians and gay men and resists the heterosexualization of lesbian and gay families by focusing on some potentially radical differences shaping lesbian and gay lives. (shrink)

The program provides psycho-social support to foster adolescents during both their placement in foster families and in transitional period of leaving care, until they manage to cope with independent living. It is concieved as a direct answer to the needs of young people disturbed by the insecure patterns of attachment, who needed an opportunity to explore and modify negative experiences and acquire more successful models on how to build and maintain relationships, how to integrate the past, develop (...) self-esteem and successfully enter the world of adults. It is based on the principles of community psychology, the concept of the group as the transitional object and group dynamics. It was created through interaction with the beneficiaries, with emphasis on their participation and linking with all relevant players on the local level. Applied methods: self-support groups, psychological workshops, supportive activities in socialization and social integration, trainings, educational courses, counselling service, co-operation with foster parents, schools, local community and participation activities with focus on campaigning for development of aftercare services. The Manual, which resulted from the programme, is prompting professionals to develop new services entitled to children and youth and to involve users themselves in the reforms of the system. (shrink)

This paper outlines briefly care as a formal construct of a highly regulatory approach to being looked after in the setting of foster care. It then moves on to consider care and its expression within the interdependencies and everyday moral ?workings out? between people in caring relationships. These relationships are informed partly by exterior regulation, but also emerge predominantly from care as a social process and daily human activity in which the self exists through and (...) with others. Drawing from an in-depth qualitative study of 10 foster families supported by local authorities or independent agencies in Wales, the paper examines the meaning of care in what is often a nebulous mix of paid and unpaid fostering. The moral texture of the foster family is revealed in regard to three areas of everyday domestic life that are often taken for granted and rarely researched: the symbolism of food, issues of the body, and aspects of touch. The paper concludes with a brief reprise of foster care as relational, constitutive and contextual in contrast with care as a professional and regulatory discipline. (shrink)

Approximately one in 10 children in foster care are medically complex and require intensive medical supervision, frequent hospitalization, and difficult medical decision making. Some of these children are in foster care because their parents cannot care for their medical needs; other parents are responsible for their child’s medical needs due to abuse or neglect. In either case, there can be uncertainty about the role that a child’s biological parents should play in making serious medical decisions. (...) Here we highlight some of the ethical challenges inherent in making these decisions for children in foster care, as seen through the lenses of a child welfare provider, an inpatient care physician, and a primary care pediatrician. (shrink)

Respect for patient autonomy is paramount in resolving ethical tensions in end-of-life care. The concept of relational autonomy has contributed to this debate; however, scholars often use this concept in a fragmented manner. This leads to partial answers on ascertaining patients’ true wishes, meaningfully engaging patients’ significant others, balancing interests among patients and significant others, and determining clinicians’ obligations to change patients’ unconventional convictions to enhance patient autonomy. A satisfactory solution based on relational autonomy must incorporate patients’ competence (apart (...) from decisional capacity), authenticity (their true desires or beliefs) and the involvement level of their significant others. To that end, we argue that John Christman’s procedural approach to relational autonomy provides critical insights, such as the diachronic or socio-historical personhood, sustained critical reflection and his recent explication of the nature of asymmetrical relationships and helpful interlocutors. This study reviews Christman’s account, proposes minor modifications and advocates for an integrated three-dimensional model for medical decision-making. Clarifying the relationship among the three elements promotes an ethical framework with a coherent understanding of relational autonomy. This model not only provides a descriptive and normative framework for end-of-life care practice but also reconsiders the nature of the clinician–patient relationship and its normative implications. We further present a case study to illustrate the merits of our proposed model. Altogether, our proposal will help navigate complex medical decision-making, foster trust and negotiate shared values between patients and their significant others, particularly in end-of-life care. (shrink)

This article adopts Husserl’s transcendental phenomenology to explore the complex relationship between patients and physicians. It delves into the coexistence of two distinct voices in the realm of medicine and health: the “voice of medicine” and the “voice of life-world.” Divided into three sections, the article emphasizes the importance of shifting from a scientific-medical attitude to a more personalistic approach in physician–patient interactions. This shift aims to prevent depersonalization and desubjectification. Additionally, it highlights the equal and irreducible nature of patients (...) while acknowledging the vital role physicians hold in the realm of illness. The article stresses the need for a balanced and equitable relationship between both parties, rooted in the shared life-world. Moreover, empathy is underscored as a crucial element in fostering meaningful dialogue, wherein understanding diverse perspectives and attitudes towards illness is paramount. The article argues that differences between patients and physicians are necessary for empathy, while shared similarities form its foundation. Ultimately, a harmonious relationship facilitates empathy and enables the constitution of a new sense of life for both patients and physicians. (shrink)

Concern for and interest in research integrity has increased significantly during recent decades, both in academic and in policy discourse. Both in terms of diagnostics and in terms of therapy, the tendency in integrity discourse has been to focus on strategies of individualisation (detecting and punishing individual deviance). Other contributions to the integrity debate, however, focus more explicitly on environmental factors, e.g. on the quality and resilience of research ecosystems, on institutional rather than individual responsibilities, and on the quality of (...) the research culture. One example of this is the Bonn PRINTEGER Statement. This editorial to the LSSP thematic series (article collection) entitled Addressing integrity challenges in research: the institutional dimension invites authors to contribute to the research integrity debate. Notably, we are interested in submissions addressing issues such as institutional responsibilities, changes in the research climate, duties of research managers and research performing or research funding organisations (RPOs and RFOs) as well as new approaches to integrity education. (shrink)

Concern for and interest in research integrity has increased significantly during recent decades, both in academic and in policy discourse. Both in terms of diagnostics and in terms of therapy, the tendency in integrity discourse has been to focus on strategies of individualisation. Other contributions to the integrity debate, however, focus more explicitly on environmental factors, e.g. on the quality and resilience of research ecosystems, on institutional rather than individual responsibilities, and on the quality of the research culture. One example (...) of this is the Bonn PRINTEGER Statement. This editorial to the LSSP thematic series entitled Addressing integrity challenges in research: the institutional dimension invites authors to contribute to the research integrity debate. Notably, we are interested in submissions addressing issues such as institutional responsibilities, changes in the research climate, duties of research managers and research performing or research funding organisations as well as new approaches to integrity education. (shrink)

In this case, an adolescent with a life-threatening immune disease experiences increased social complexity, child welfare involvement, and placement into foster care, which could disrupt a medical...