Backround Education in ethics and professionalism should reflect the realities medical students encounter in the hospital and clinic. Method We performed content analyses on Case Observation and Assessments (COAs) written by third-year medical students about ethical and professional issues encountered during their internal medicine and paediatrics clinical clerkships. Results A cohort of 141 third-year medical students wrote 272 COAs. Content analyses identified 35 subcategories of ethical and professional issues within 7 major domains: decisions regarding treatment (31.4%), communication (21.4%), professional duties (...) (18.4%), justice (9.8%), student-specific issues (5.4%), quality of care (3.8%), and miscellaneous (9.8%). Conclusions Students encountered a wide variety of ethical and professional issues that can be used to guide pre-clinical and clinical education. Comparison of our findings with results from similar studies suggests that the wording of an assignment (specifying “ethical” issues, “professional” issues, or both) may influence the kinds of issues students identify in their experience-based clinical narratives. (shrink)

This book is the result of a three-year study undertaken by a multidisciplinary working party of the Institute of Medical Ethic (UK). The group was chaired by a moral theologian, and its members included biological and ethological scientists, toxicologists, physicians, veterinary surgeons, an expert in alternatives to animal use, officers of animal welfare organizations, a Home Office Inspector, philosophers, and a lawyer. Coming from these different backgrounds, and holding a diversity of moral views, the members produced the agreed report as (...) a result of detailed and rigorous discussions. The book sets out facts about animal experiments and about animal abilities to experience pain, distress and anxiety. There is a detailed examination of the moral claims related to the benefits likely to accrue from animal research, and of strategies for weighing these benefits against the harm caused to animals, in order to decide whether particular research projects ought or ought not to proceed. This leads to consideration of the statutory and non-statutory controls which safeguard standards in such research. The final section explores a variety of philosophical arguments about the use of animals in research, and offers a philosophical justification for the Working Party's more practical conclusions. Written in clear, nontechnical language, this book is accessible to lay people as well as to scientists. It is the first such document to emerge from a meeting of people with such widely differing views on this highly controversial subject, and represents a major contribution towards informing and raising the quality of contemporary debate. The book is unique in drawing together material and ideas never before found in one volume. It will interest a broad spectrum of readers, from ethicists and animal rights advocates to scientific researchers and laboratory administrators, along with general readers concerned about this compelling issue. (shrink)

Eduard Pernkopf’s Atlas of Topographical and Applied Human Anatomy is a four-volume anatomical atlas published between 1937 and 1963, and it is generally believed to be the most comprehensive, detailed, and accurate anatomy textbook ever created. However, a 1997 investigation into “Pernkopf’s Atlas,” raised troubling questions regarding the author’s connection to the Nazi regime and the still unresolved issue of whether its illustrations relied on Jewish or other political prisoners, including those executed in Nazi concentration camps. Following this investigation, the (...) book was removed from both anatomy classrooms and library bookshelves. A debate has ensued over the book’s continued use, and justification for its use has focused on two issues: there is no definitive proof the book includes illustrations of concentration camp prisoners or Jewish individuals in particular, and there is no contemporary equivalent to this text. However, both points fail to address the central importance of the book, not simply as part of anatomy instruction, but also as a comprehensive historical narrative with important ethical implications. Having encountered a first edition copy, these authors were given a unique opportunity to engage with the text through the respective humanities lenses of history, ethics, and narrative. In doing so, an instructive and profound irony has surfaced: Nazis, including Pernkopf, viewed specific groups of people as less than human, giving rise to unthinkable atrocities perpetuated against them. However, these same individuals became the sources for the creation of the Atlas, which served as the model for primary instruction on the human form for more than half of the twentieth century. In this article, we recount the difficult and somewhat opaque provenance of this book, engage the ethical questions surrounding both its creation and its use, and ultimately propose a pedagogical methodology for its continued use in medical education. (shrink)

I begin my comments with a first-person narrative. I know Octavio, Erotildes, and Nuria from the time I worked at the Institute of Psychiatry and was very close to the field of mental health. They are people whose work I admire and appreciate. I comment on this text from the point of view of someone who has never worked directly in mental health assistance and whose knowledge about severe mental illness therapy has occurred mostly from a third-person perspective. My comments (...) are based on parallels with situations and experiences that I have been studying lately.First of all, I want to say that I fully agree with the authors’ argument that “experiences and narratives about illness, treatment, and recovery are... (shrink)

Jane Grant's book explores the need to redefine the social compact in twenty-first century America. It proposes a new compact that would honor the expansion of civil, political, and social rights in America, and would integrate these rights within a new civic procedural ethos, clarifying our obligations to each other, future generations, other nations, and other species.

After retirement, older people often find themselves far from their children and grandchildren, and many spend their last years isolated and alone. As traditional concepts of family and social institutions fragment, social networks weaken, leading to an epidemic of loneliness, and substance abuse and suicide in developed countries. In fact, life expectancy in the US has dropped for the past few years, in large part due to a dramatic increase in suicide and drug overdose. None of these social problems is (...) likely to be solved by metformin. They point to a crisis of identity and meaning, an existential crisis. In this context, one might wonder if we are already seeing the effects of tinkering with our lifespan. There are many more conclusions one could draw about the implications of longevity, many of which have been elegantly described in Beyond Therapy: Biotechnology and the Pursuit of Happiness, published by the President’s Council on Bioethics, which I used as a reference for this talk. I hope I have been successful in providing a 10,000-foot view of the questions of efforts to extend human longevity and its implications that will provoke thought and discussion. I would like to end these reflections by turning back to my favorite transhumans. The reason we love superheroes is not for their superior strength or intelligence, but their characters. They use their powers to protect and serve humanity rather than dominate or annihilate it. It is not their gadgetry that makes them great, but how they use it to save the vulnerable. Even as a small child I knew that if everyone acted the way they did, the world would be a better place. The moral of every story was that the “enhancement” humanity needed would not come as the fruit of technology, but of virtue. (shrink)

The recently revised Common Rule requires that donors of biospecimens for research be informed if their specimens might be used for commercial profit. The Common Rule, however, does not apply to sharing or selling de-identified biospecimens that are “leftover” from clinical uses. As a result, many medical researchers remain uncertain of their legal and ethical obligations when a commercial entity expresses interest in these specimens.

Synthetic biology is an increasingly high‐profile area of research that can be understood as encompassing three broad approaches towards the synthesis of living systems: DNA‐based device construction, genome‐driven cell engineering and protocell creation. Each approach is characterized by different aims, methods and constructs, in addition to a range of positions on intellectual property and regulatory regimes. We identify subtle but important differences between the schools in relation to their treatments of genetic determinism, cellular context and complexity. These distinctions tie into (...) two broader issues that define synthetic biology: the relationships between biology and engineering, and between synthesis and analysis. These themes also illuminate synthetic biology's connections to genetic and other forms of biological engineering, as well as to systems biology. We suggest that all these knowledge‐making distinctions in synthetic biology raise fundamental questions about the nature of biological investigation and its relationship to the construction of biological components and systems. BioEssays 30:57–65, 2008. © 2007 Wiley Periodicals, Inc. (shrink)

A paradigm for peace discovered in the cosmopolitan neighborhoods of poor urban immigrants.

The dictionary shows philosophers at their best (and their worst), at their most perverse and their most elegant. Organised by philosopher, and indexed by thought, concept and phrase, it enables readers to discover who said what, and what was said by whom. Over 300 philosophers are represented, from Aristotle to Zeno, including Einstein, Aquinas, Sartre and De Beauvoir, and the quotations range from short cryptic phrases to longer statements. This Dictionary of Philosophical Quotations d will not change your life. It (...) will change your mind. (shrink)

Calls for the “translation” of research from bench to bedside are increasingly demanding. What is translation, and why does it matter? We sketch the recent history of outcome-oriented translational research in the United States, with a particular focus on the Roadmap Initiative of the National Institutes of Health (Bethesda, MD). Our main example of contemporary translational research is stem cell research, which has superseded genomics as the translational object of choice. We explore the nature of and obstacles to translational research (...) and assess the ethical and biomedical challenges of embracing a translational ethos. (shrink)

Is the societal-level of analysis sufficient today to understand the values of those in the global workforce? Or are individual-level analyses more appropriate for assessing the influence of values on ethical behaviors across country workforces? Using multi-level analyses for a 48-society sample, we test the utility of both the societal-level and individual-level dimensions of collectivism and individualism values for predicting ethical behaviors of business professionals. Our values-based behavioral analysis indicates that values at the individual-level make a more significant contribution to (...) explaining variance in ethical behaviors than do values at the societal-level. Implicitly, our findings question the soundness of using societal-level values measures. Implications for international business research are discussed. (shrink)

What are the primary characteristics that define what it means to be human? And what happens to those characteristics in the face of technology past, present, and future? The three essays in Image, by leading philosophers of religion Mark Taylor, Mary-Jane Rubenstein, and Thomas Carlson, play at this intersection of the human and the technological, building out from Heidegger's notion that humans master the world by picturing or representing the real.Taylor's essay traces a history of capitalism, dwelling on the (...) lack of humility, particularly in the face of our own mortality, that is the persistent failure of humans, before turning to art as a possible way to bring us back to earth and recover humility before it is too late. Rubenstein zeroes in on the delusions of imaginative conquest associated with space travel. Through a genealogy of the modern "view from space" from the iconic Earth rise photo of 1968 up to the new privatized American space race, Rubenstein provides an analysis of the perils of the one-world and the false unity it projects. In his essay, Carlson takes as his starting point the surveillance capitalism of facial recognition technology. He dives deep into Heidegger to meditate on the elimination of individuals through totalizing gestures and the relationship between such elimination and our encounters with mortality. Each of these essays, in its own way, reflects on the nature of imagination, the character of technological vision in contemporary culture, and the implications of these for the kinds of sociality and love that condition our human experience. (shrink)

This article identifies several critical problems with the last 30 years of research into hostile communication on the internet and offers suggestions about how scholars might address these problems and better respond to an emergent and increasingly dominant form of online discourse which I call ‘e-bile’. Although e-bile is new in terms of its prevalence, rhetorical noxiousness, and stark misogyny, prototypes of this discourse—most commonly referred to as ‘flaming’—have always circulated on the internet, and, as such, have been discussed by (...) scholars from a range of disciplines. Nevertheless, my review of this vast body of literature reveals that online hostility has historically posed a number of conceptual, methodological, and epistemological challenges due to which scholars have typically underplayed, overlooked, ignored, or otherwise marginalised its prevalence and serious ethical and material ramifications. Fortunately, lessons learned from my analysis suggests promising approaches for future research into this challenging form of new media discourse. (shrink)

This article provides current Schwartz Values Survey (SVS) data from samples of business managers and professionals across 50 societies that are culturally and socioeconomically diverse. We report the society scores for SVS values dimensions for both individual- and societal-level analyses. At the individual-level, we report on the ten circumplex values sub-dimensions and two sets of values dimensions (collectivism and individualism; openness to change, conservation, self-enhancement, and self-transcendence). At the societal-level, we report on the values dimensions of embeddedness, hierarchy, mastery, affective (...) autonomy, intellectual autonomy, egalitarianism, and harmony. For each society, we report the Cronbach’s α statistics for each values dimension scale to assess their internal consistency (reliability) as well as report interrater agreement (IRA) analyses to assess the acceptability of using aggregated individual level values scores to represent country values. We also examined whether societal development level is related to systematic variation in the measurement and importance of values. Thus, the contributions of our evaluation of the SVS values dimensions are two-fold. First, we identify the SVS dimensions that have cross-culturally internally reliable structures and within-society agreement for business professionals. Second, we report the society cultural values scores developed from the twenty-first century data that can be used as macro-level predictors in multilevel and single-level international business research. (shrink)

An unlikely-and entirely unforgettable-tale of a most unusual friendship between Flora, an elephant calf stolen from her African home, and David, the circus impresario and magician, who adopts, trains, and ultimately liberates her in a tale freely inspired by actual events.

Truly transforming the healthcare delivery and payment system turns on the ability to engage in the interoperable electronic exchange of patient health information across and beyond the care continuum. Achieving transformation requires a legal framework that supports information sharing with appropriate privacy and security protections and a trusted governance structure.

BackgroundHIV cure research involving cell and gene therapy has intensified in recent years. There is a growing need to identify ethical standards and safeguards to ensure cell and gene therapy (CGT) HIV cure research remains valued and acceptable to as many stakeholders as possible as it advances on a global scale.MethodsTo elicit preliminary ethical and practical considerations to guide CGT HIV cure research, we implemented a qualitative, in-depth interview study with three key stakeholder groups in the United States: (1) biomedical (...) HIV cure researchers, (2) bioethicists, and (3) community stakeholders. Interviews permitted evaluation of informants’ perspectives on how CGT HIV cure research should ethically occur, and were transcribed verbatim. We applied conventional content analysis focused on inductive reasoning to analyze the rich qualitative data and derive key ethical and practical considerations related to CGT towards an HIV cure.ResultsWe interviewed 13 biomedical researchers, 5 community members, and 1 bioethicist. Informants generated considerations related to: perceived benefits of CGT towards an HIV cure, perceived risks, considerations necessary to ensure an acceptable benefit/risk balance, CGT strategies considered unacceptable, additional ethical considerations, and considerations for first-in-human CGT HIV cure trials. Informants also proposed important safeguards to developing CGT approaches towards an HIV cure, such as the importance of mitigating off-target effects, mitigating risks associated with long-term duration of CGT interventions, and mitigating risks of immune overreactions.ConclusionOur study identified preliminary considerations for CGT-based HIV cure across three key stakeholder groups. Respondents identified an ideal cure strategy as one which would durably control HIV infection, protect the individual from re-acquisition, and eliminate transmission to others. Known and unknown risks should be anticipated and perceived as learning opportunities to preserve and honor the altruism of participants. Preclinical studies should support these considerations and be transparently reviewed by regulatory experts and peers prior to first-in-human studies. To protect the public trust in CGT HIV cure research, ethical and practical considerations should be periodically revisited and updated as the science continues to evolve. Additional ethics studies are required to expand stakeholder participation to include traditionally marginalized groups and clinical care providers. (shrink)

In this volume we will focus on how educators in high schools (grades 9-12) can incorporate the teaching of ethics effectively across all disciplines.

Volume 19, Issue 6, June 2019, Page 28-29.