BackgroundA requisite for ethical human subjects research is that participation should be informed and voluntary. Participation during the informed consent process by way of asking questions is an indicator of the extent to which consent is informed.AimsThe aims of this study were to assess the extent to which parents providing consent for children's participation in an observational tuberculosis (TB) research study in India actively participated during the informed consent discussion, and to identify correlates of that participation.MethodsIn an observational cohort study (...) of tuberculosis in infants in South India, field supervisors who were responsible for obtaining informed consent noted down questions asked during the informed consent discussions for 4,382 infants who were enrolled in the study. These questions were post-coded by topic. Bivariate and multivariate analysis was conducted to examine factors associated with asking at least one question during the informed consent process.ResultsIn total, 590 out of 4,382 (13.4%) parents/guardians asked any question during the informed consent process. We found that the likelihood of parents asking questions during the informed consent process was significantly associated with education level of either parent both parents being present, and location.ConclusionsThe findings have implications for planning the informed consent process in a largely rural setting with low levels of literacy. Greater effort needs to be directed towards developing simple participatory communication materials for the informed consent process. Furthermore, including both parents in a discussion about a child's participation in a research study may increase the extent to which consent is truly informed. Finally, continuing efforts need to be made to improve the communication skills of research workers with regard to explaining research processes and putting potential research participants at ease. (shrink)

Two of the most creditable responses in the spate of pro-globalization literature are Why Globalization Works, by the financial journalist Martin Wolf, and In Defense of Globalization, by the economist Jagdish Bhagwati. This article is a review of these two books.

This essay examines the controversy over the attempt to establish rules governing global capital flows in the Multilateral Agreement on Investment (MAI), which became a target of “antiglobalization” activism. Making sense of the activists' concerns about the MAI requires understanding how the emergence of transnational standards in contemporary globalization constitutes an exercise in power. I develop the concept of “network power” to explain the way in which the rise of a single coordinating standard for global activity can be experienced as (...) coercive, as it eclipses alternative standards and abrogates the genuinely free choice among different conventions. Using a network‐power analysis, I reinterpret the controversy over the MAI as a concern about the processes by which neoliberal globalization is being brought about. (shrink)

Conflict is an important consideration in the intensive care unit. In this setting, conflict most commonly occurs over the ‘best interests’ of the incapacitated adult patient; for instance, when families seek aggressive life-sustaining treatments, which are thought by the medical team to be potentially inappropriate. Indeed, indecision on futility of treatment and the initiation of end-of-life discussions are recognised to be among the greatest challenges of working in the ICU, leading to emotional and psychological ‘burnout’in ICU teams. When these disagreements (...) occur, they may be within the clinical team or among those close to the patient, or between the clinical team and those close to the patient. It is, therefore, crucial to have a theoretical understanding of decision-making itself, as unpicking misalignments in the family’s and clinical team’s decision-making processes may offer strategies to resolve conflict. Here, we relate Kahneman and Tversky’s work on cognitive biases and behavioural economics to the ICU environment, arguing that these biases could partly explain disparities in the decision-making processes for the two conflicting parties. We suggest that through the establishment of common ground, challenging of cognitive biases and formulation of mutually agreeable solutions, mediation may offer a pragmatic and cost-effective solution to conflict resolution. The litigation process is intrinsically adversarial and strains the doctor–patient–relative relationship. Thus an alternative external party should be considered, however mediation is not frequently used and more research is needed into its effectiveness in resolving conflicts in the ICU. (shrink)

Résumé Lorsque James Holmes, le tueur d’Aurora, affirme au moment de son arrestation « Je suis le Joker », en référence au dernier film mettant en scène Batman, il illustre l’une des actualisations possibles du virtuel qui peuple nos espaces médiatiques. On restera démuni face de tels passages à l’acte, de même que face aux médias eux-mêmes, tant qu’on ne comprendra pas mieux quelle est la nature de ce virtuel qu’ils font advenir à l’être.

The law often calls on the concept of public interest for assistance. Privacy law makes use of this concept in several ways, including to justify consent waivers for secondary research on health information. Because the law sees information privacy as a means for individuals to control their personal information, consent can only be set aside in special circumstances. Ballantyne and Schaefer argue that only public interest, and only a broad conception of public interest, can do the special ‘normative justificatory work’ (...) to override consent requirements. Other, similar-sounding concepts, such as public benefit, public good and social value, also provide useful services. But none more so than public interest. In fact, they argue, public interest is the superior concept precisely because it can capture those concepts as well as a range of other interests. Our response focuses on this claim. We argue their strategy is not as promising as it might first seem. Ballantyne and Schaefer construe the important role that public interest plays in this context as their endpoint. They claim that unless the concept is open and content-rich, it will lose some of its importance. But by refusing to place limits around it, their inquiry leads us back to a catch-all concept that lacks clear focus or meaning. In reply, we argue that, for practically minded theorists, a narrow conception of public interest is more useful. Further, the narrowing of public interest in this context can be achieved by first analysing it in its legal, rather than ethical, sense. (shrink)

Many scholars and activists have argued that the International Criminal Court holds potential for advancing the rights of women and girls, leading to extensive feminist engagement with and investment in the Court. As the ICC enters its second decade of existence, this article offers a reflection on both the possibilities and the challenges facing feminists. Can the international criminal law really offer a site for enhancing the rights of women? And if so, how? To explore these questions I focus on (...) the interaction between feminist activism and international criminal law institutions in relation to crimes of sexual and gender-based violence. I argue that some of the feminist strategies deployed to get sexual violence onto the international agenda have resulted in perverse outcomes. This should lead us to greater critical reflection regarding how international law conceives of sexual violence and direct our future engagements with international legal institutions. In particular feminist activists and scholars need to move away from focusing on the number of prosecutions towards challenging the international criminal law to characterise the nature of the harm in accordance with a recognition of sexual rights. (shrink)

As part of the Securities and Exchange Commission’s revision of Regulation S–K, which lays out reporting requirements for publicly-listed companies, many investors proposed the mandatory disclosure of sustainability information in the form of environmental, social and governance data. However, progress is contingent on collecting evidence regarding which sustainability disclosures are financially material. To inform this issue, we examine materiality standards developed by the Sustainability Accounting Standards Board. Firms voluntarily disclosing more SASB-identified sustainability information exhibit greater price informativeness, while the disclosure (...) of non-SASB information does not relate to informativeness. The results are robust to a changes analysis and a difference-in-differences analysis that exploits the staggered release of SASB standards across different industries over time. We also document stronger results for firms with higher exposure to sustainability issues, poorer sustainability ratings, greater institutional and socially responsible investment fund ownership, and coverage from analysts with lower portfolio complexity. (shrink)

The COVID-19 pandemic is putting the NHS under unprecedented pressure, requiring clinicians to make uncomfortable decisions they would not ordinarily face. These decisions revolve primarily around intensive care and whether a patient should undergo invasive ventilation. Certain vulnerable populations have featured in the media as falling victim to an increasingly utilitarian response to the pandemic—primarily those of advanced years or with serious existing health conditions. Another vulnerable population potentially at risk is those who lack the capacity to make their own (...) care decisions. Owing to the pandemic, there are increased practical and normative challenges to following the requirements of the Mental Capacity Act 2005. Both capacity assessments and best interests decisions may prove more difficult in the current situation. This may create a more paternalistic situation in decisions about the care of the cognitively impaired which is at risk of taking on a utilitarian focus. We look to these issues and consider whether there is a risk of patients who lack capacity to make their own care decisions being short-changed. (shrink)

We compared two digital humanities methods in the analysis of a contested scientific term. “Epigenetics” is as enigmatic as it is popular. Some authors argue that its meaning has diluted over time as this term has come to describe a widening range of entities and mechanisms (Haig, International Journal of Epidemiology 41:13–16, 2012). Others propose both a Waddingtonian “broad sense” and a mechanistic “narrow sense” definition to capture its various scientific uses (Stotz and Griffiths, History and Philosophy of the Life (...) Sciences 38:22, 2016). We evaluated these proposals by first replicating a recent analysis by (Linquist and Fullerton, Theoretical Medicine and Bioethics 42:137–154, 2021). We analyzed the 1100 most frequently cited abstracts on epigenetics across four disciplines: proximal biology, biomedicine, general biology, and evolution. Each abstract was coded for its heritability commitments (if any) and functional interpretation. A second study applied LDA topic modelling to the same corpus, thus providing a useful methodological comparison. The two methods converged on a discipline-relative ambiguity. Within such disciplines as biomedicine or molecular biology that focus on proximate mechanisms, “epigenetic(s)” refers to a range of molecular structures while specifying nothing in particular about their heritability. This proximal conception was primarily associated with the functions of gene regulation and disease. In contrast, a second relatively uncommon sense of “epigenetic(s)” is restricted to a small proportion of evolutionary abstracts. It refers to many of the same molecular structures, but regards them as trans-generationally inherited and associated with adaptive phenotypic plasticity. This finding underscores the benefit of digital tools in complementing traditional conceptual analysis. Philosophers should be cautious not to conflate the relatively uncommon evolutionary sense of epigenetics with the more widely used proximal conception. (shrink)

Thinking of Death places Plato's Euthydemus among the dialogues that surround the trial and death of Socrates. A premonition of philosophy's fate arrives in the form of Socrates' encounter with the two-headed sophist pair, Euthydemus and Dionysodorus, who appear as if they are the ghost of the Socrates of Aristophanes' Thinkery. The pair vacillate between choral ode and rhapsody, as Plato vacillates between referring to them in the dual and plural number in Greek. Gwenda-lin Grewal's close reading explores how (...) the structure of the dialogue and the pair's back-and-forth arguments bear a striking resemblance to thinking itself: in its immersive remove from reality, thinking simulates death even as it cannot conceive of its possibility. Euthydemus and Dionysodorus take this to an extreme, and so emerge as the philosophical dream and sophistic nightmare of being disembodied from substance. The Euthydemus is haunted by philosophy's tenuous relationship to political life. This is played out in the narration through Crito's implied criticism of Socrates-the phantom image of the Athenian laws-and in the drama itself, which appears to take place in Hades. Thinking of death thus brings with it a lurid parody of the death of thinking: the farce of perfect philosophy that bears the gravity of the city's sophistry. Grewal also provides a new translation of the Euthydemus that pays careful attention to grammatical ambiguities, nuances, and wit in ways that substantially expand the reader's access to the dialogue's mysteries. (shrink)

This book examines the entire range of sacred literature produced between the sixteenth- and nineteenth century to give a comprehensive account of Sikhism. Dealing with the historical evolution of the Sikh tradition, it discuss issues like self-image, identity, and ideology.

In mammalian cells, a complex network of signaling pathways tightly regulates a variety of cellular processes, such as proliferation and differentiation. New insights from one of the most‐important signaling cascades involved in oncogenesis, the Ras–Raf–MAPK pathway, suggest that the subcellular localisation and assembly of signaling modules of this pathway is crucial to control the biological response. This commonly requires membrane targeting events that are mediated by adaptor/scaffold proteins. Of particular interest is the translocation and complex formation of GTPase‐activating proteins (GAPs), (...) such as p120GAP, at the plasma membrane to inactivate Ras. Recent studies indicate that one member of the annexin family, annexin A6 acts as a targeting protein for p120GAP. This review discusses how annexin A6 modulates the involvement of negative regulators of the Ras–Raf–MAPK pathway contributing to Ras inactivation. BioEssays 28: 1211–1220, 2006. © 2006 Wiley Periodicals, Inc. (shrink)

Widespread recognition that economic inequality has been growing for forty years in most of the developed world, and in fact has tended to grow across most of the history of modern economies, shows that the period 1945-1973, when inequality of wealth and income shrank, was a marked anomaly in historical experience. At the time, however, the anomalous period of equality seemed to vindicate a long history of optimism about economic life:that growth would overcome meaningful scarcity and usher in an egalitarian (...) and humanistic period that could almost qualify as post-economic. This has not been the experience of the last four decades. In this intellectual history of the anomalous period, we trace the main lines of that optimism and its undoing. (shrink)

The shift towards "empirical bioethics" was largely triggered by a recognition that stakeholders' views and experiences are vital in ethical analysis where one hopes to produce practicable recommendations. Such perspectives can provide a rich resource in bioethics scholarship, perhaps challenging the researcher's perspective. However, overreliance on a picture painted by a group of research participants—or on pre‐existing literature in that field—can lead to a biased view of a given context, as the subjectivity of data generated in these ways cannot (and (...) should not wholly) be escaped. In response, we propose the implementation of a complementary approach of ethno‐immersion in bioethics research. By positioning oneself in the context being researched, the researcher can better understand the realities of that context. The researcher's understanding will, naturally, be subjective too. However, it will act as a better developed and more informed outsider view, when considering the picture painted by participants and previous studies, thus enabling the researcher to introduce more nuance when analysing data. We introduce this approach after examining what we call the context detachment problem, whereby some bioethics scholarship—empirical or otherwise—fails to reflect the reality of the healthcare setting it concerns. Our proposed ethno‐immersion (which differs from formal ethnography) is then explored as a response, highlighting its benefits, and answering the question of timing within a research project. Finally, we reflect on the applicability of our proposal to non‐empirical bioethics scholarship, concluding that it remains important but may require some adjustments. (shrink)

Both philosophy and linguistics have emphasized the importance of language as a means of dialogue. Despite the fact that Wittgenstein added a new layer of complication to this point of view, the Sapir-Whorf theory, proposed by Edward Sapir and his colleague Benjamin Lee Whorf, helped the impact of language on the mind acquire notoriety. With this idea, language not only continued to be a means of communication but also received recognition in the social science curriculum as a crucial element in (...) the development of personal identities and the process of knowledge assimilation. The effect of language on morality and ethics was the most significant element that philosophers and linguists overlooked in their extensive study. For instance, little is known about how the terms we choose can influence how we understand morality and ethics. The sole subject of this article will be how language influences the moral and ethical decisions we make. To put it another way, how we make choices is greatly influenced by the language or beliefs we use in both public and private life. This means that in order to understand a country’s law or socially accepted norms, it is crucial to closely examine the language that country uses. The options or goals that are publicly acceptable are also closely related to the language, metaphors, and discourses used by a specific society. The contemporary world does not analyze these incidents from a linguistic perspective, but language has contributed to the creation of accepted legal and social standards. (shrink)

Este artigo apresenta uma noção do embate velado entre a Igreja Católica e o Estado brasileiro para dominar a sociedade civil na transição império – república, um para não perder sua influência secular, o catolicismo, e outro, o Estado, para não se deixar influenciar pela ideologia antagonista ao projeto positivista-liberal a ser implementado naquele contexto onde o slogan fala por si "ordem e progresso".

Bioethics, Volume 36, Issue 4, Page 423-433, May 2022.

O Concílio Vaticano II foi um dos eventos mais importantes da história da Igreja do século XX. Partindo de sua história e dos documentos aprovados pelos bispos conciliares, o pós-concílio caracteriza-se, nesses seus 40 anos, por um debate acalorado e por luta identitária sobre como ele deve ser recepcionado pela Igreja universal e pelas igrejas particulares. Dessa forma, o presente artigo tem como objetivo apresentar as principais linhas hermenêuticas do Vaticano II, apontando alguns autores e obras sobre a discussão.