In emergency research, obtaining informed consent can be problematic. Research to develop and improve treatments for patients admitted to hospital with life-threatening and debilitating conditions is much needed yet the issue of research without consent (RWC) raises concerns about unethical practices and the loss of individual autonomy. Consistent with the policy and practice turn towards greater patient and public involvement in health care decisions, in the US, Canada and EU, guidelines and legislation implemented to protect patients and facilitate acute research (...) with adults who are unable to give consent have been developed with little involvement of the lay public. This paper reviews research examining public opinion regarding RWC for research in emergency situations, and whether the rules and regulations permitting research of this kind are in accordance with the views of those who ultimately may be the most affected. (shrink)

In this paper the current legislative landscape and the challenges researchers face in obtaining informed consent in acute situations are explored. In such situations, some current guidelines can be difficult or impossible to apply. Capacity should be formally assessed before consent is sought to ensure that vulnerable persons are neither inappropriately recruited to a study nor denied the opportunity to participate. However, there is little guidance in current legislation as to how this should be achieved. When the patient is considered (...) to be unable to provide prospective informed consent, other forms are sometimes permissible, although all have specific drawbacks. First, it is argued that a brief instrument, suitable for the acute situation, is needed to determine whether patients have the capacity to consent to clinical trials. Secondly, it is argued that there are areas of the informed consent process that require review, and ways that improvements could be made are suggested. (shrink)

The ability to reason ethically is an extraordinarily important aspect of professionalism in any field. Indeed, the greatest challenge in ethical professional practice involves resolving the conflict that arises when the professional is required to choose between two competing ethical principles. Ethical Reasoning in the Mental Health Professions explores how to develop the ability to reason ethically in difficult situations. Other books merely present ethical and legal issues one at a time, along with case examples involving "right" and "wrong" answers. (...) In dramatic contrast, Ethical Reasoning in the Mental Health Professions provides you with the needed background in methods of ethical reasoning and introduces an innovative nine-step model of ethical decision-making for resolving ethical dilemmas. Ethical Reasoning in the Mental Health Profession discusses the ethical codes of both psychology and counseling. This interdisciplinary approach promotes a better understanding of the similarities and differences in the points of emphasis in the two codes, which, in turn, enriches your understanding of the range of ethical considerations relevant to the practice of the mental health professions. (shrink)

Mainstream economics evaluates capitalism primarily from the perspective of efficiency. Social philosophy typically applies other or additional normative criteria, such as equality, democracy, and community. This essay examines the implications of these contrasting sets of criteria in the evaluation of capitalism. Its first two sections consider the criteria themselves, assuming that a trade-off exists between them. The last three sections question whether such a trade-off necessarily occurs, and explore the claim that improvements in nonefficiency dimensions of capitalist society may enhance, (...) rather than conflict with, efficiency. (shrink)

Details the intellectual development of George Herbert Mead as a thinker of great originality and as a practitioner of social reform.

Background Making the right decisions, while simultaneously showing respect for patient autonomy, represents a great challenge to nursing home staff in the issues of life-prolonging treatment, hydration, nutrition and hospitalisation to dying patents in end-of-life. Objectives To study how physicians and nurses protect nursing home patients' autonomy in end-of-life decisions, and how they justify their practice. Design A qualitative descriptive design with analysis of the content of transcribed in-depth interviews with physicians and nurses. Participants Nine physicians and ten nurses in (...) 10 nursing homes in Norway. Results and interpretations Assessment of the patient's competence to consent to treatment is almost absent. The physicians build their practice on the principles of beneficence and nonmaleficence. Nurses tend to trust the patients' rejection of life support, even when the patients have difficulty speaking or suffer from dementia. Relatives were, according to the health personnel, included in decision-making processes to a very limited extent. However, futile life support is sometimes provided contrary to the physicians' judgement of what constitutes the patient's best interest on occasions when they are pressurised by next of kin. Conclusions The study reveals a need to improve decision-making routines according to ethical ideals and legislation. Conflicts between relatives and healthcare professionals in the decision-making process deflect the focus from searching for the best possible treatment for the terminal patient. Further discussion is required as to whether the concept of autonomy is applicable in situations in which the patient is impaired and dying. (shrink)

What is sin? Is it simply wrongdoing? Why do its effects linger over time? In this sensitive, imaginative, and original work, Gary Anderson shows how changing conceptions of sin and forgiveness lay at the very heart of the biblical tradition. Spanning nearly two thousand years, the book brilliantly demonstrates how sin, once conceived of as a physical burden, becomes, over time, eclipsed by economic metaphors. Transformed from a weight that an individual carried, sin becomes a debt that must be (...) repaid in order to be redeemed in God's eyes. Anderson shows how this ancient Jewish revolution in thought shaped the way the Christian church understood the death and resurrection of Jesus and eventually led to the development of various penitential disciplines, deeds of charity, and even papal indulgences. In so doing it reveals how these changing notions of sin provided a spur for the Protestant Reformation. Broad in scope while still exceptionally attentive to detail, this ambitious and profound book unveils one of the most seismic shifts that occurred in religious belief and practice, deepening our understanding of one of the most fundamental aspects of human experience. (shrink)

Ancient Hebrew Periodization and the Language of the Book of Jeremiah: The Case for a Sixth-Century Date of Composition. By Aaron D. Hornkohl. Studies in Semitic Languages and Linguistics, vol. 74. Leiden: Brill, 2014. Pp. viii + 517. $210.

This book offers a close reading of Adorno’s more explicitly political writings and his work on fascist and anti-Semitic propaganda, and argues for the continuing relevance of these works for contemporary political practice. Adorno’s criticism of political violence and mass movements has, surprisingly, yet to be brought to bear upon contemporary developments in critical theory in the vein of Slavoj Žižek and Alan Badiou. Since a significant portion of this book is dedicated to offering an Adornian response to Žižek, it (...) situates Adorno in the contemporary discussion on strategies for resistance to global capitalism. (shrink)

The authors conducted this interview with Luce Irigaray in her home in Paris in May, 1994.

This article treats the Jewish Babylonian Aramaic 3rd person singular pronoun נוולא nawla, attested four times in the vast rabbinic corpus: three times in the Babylonian Talmud and one time in Tractate Sofrim. First, it is shown that the form is epicene, as it can have both masculine and feminine antecedents. Second, the four attestations reveal a specialized meaning for the form, to wit, ‘this-one’ or ‘that-one’ when there are specifically two items under discussion. Which is to say, the form (...) נוולא nawla is not used for simple ‘he’ or ‘she’ or ‘this’ or ‘that’, for which JBA and other Aramaic dialects have familiar and widely attested forms. Third, the article proposes that the form is borrowed from the Hurro-Urartian family, well known for its epicene pronouns. See, for example, Hurrian anni=lla, ani=lla, etc., Urartian i=ne=lə, ina=ne=lə, etc. Even though these forms are plural forms, while נוולא nawla is a singular form, comparative evidence demonstrates that when pronouns are borrowed from one language to another, they at times may jump person and number. (shrink)

The authors conducted this interview with Luce Irigaray in her home in Paris in May, 1994.

How Old Is the Hebrew Bible? By Ronald Hendel and Jan Joosten. The Anchor Yale Bible Reference Library. New Haven: Yale University Press, 2019. Pp. xvi + 221. $45.

Federal guidelines require that informed consent be obtained from participants when they are enrolled in a research study. When conducting research with children, the guidelines utilize the term permission to describe parents' agreement to enroll their children in a study. The basic components of consent and permission are well described and identical, with the exception of the person for whom the decision to participate is being made. Beyond permission, when enrolling minor participants in research, affirmative agreement to participate in research (...) or assent must be obtained from the child participants themselves. The concept of children's assent to research, however, is poorly defined, resulting in inconsistency in its pursuit and, consequently, in its utility. The interface between cognitive development, emotional, and social development must be examined as it pertains to this special situation of decision making. For this process to meaningfully protect minors, the assent process must be clarified, decisions regarding parental veto power must be more convincingly justified, and researchers must be better educated and held accountable for the valid execution of this process. Strategies for implementing the assent process more effectively are presented. (shrink)