This commentary tests a methodology proposed by Munk et al. (2022) for using failed predictions in machine learning as a method to identify ambiguous and rich cases for qualitative analysis. Using a dataset describing actions performed by fictional characters interacting with machine vision technologies in 500 artworks, movies, novels and videogames, I trained a simple machine learning algorithm (using the kNN algorithm in R) to predict whether or not an action was active or passive using only information about the fictional (...) characters. Predictable actions were generally unemotional and unambiguous activities where machine vision technologies were treated as simple tools. Unpredictable actions, that is, actions that the algorithm could not correctly predict, were more ambivalent and emotionally loaded, with more complex power relationships between characters and technologies. The results thus support Munk et al.'s theory that failed predictions can be productively used to identify rich cases for qualitative analysis. This test goes beyond simply replicating Munk et al.'s results by demonstrating that the method can be applied to a broader humanities domain, and that it does not require complex neural networks but can also work with a simpler machine learning algorithm. Further research is needed to develop an understanding of what kinds of data the method is useful for and which kinds of machine learning are most generative. To support this, the R code required to produce the results is included so the test can be replicated. The code can also be reused or adapted to test the method on other datasets. (shrink)

This article empirically examines how healthy volunteers evaluate and make sense of the risks of phase I clinical drug trials. This is an ethically important topic because healthy volunteers are exposed to risk but can gain no medical benefit from their trial participation. Based on in-depth qualitative interviews with 178 healthy volunteers enrolled in various clinical trials, we found that participants focus on myriad characteristics of clinical trials when assessing risk and making enrolment decisions. These factors include the short-term and (...) long-term effects; required medical procedures; the type of trial, including its design, therapeutic area of investigation, and dosage of the drug; the amount of compensation; and trust in the research clinic. In making determinations about the study risks, participants rely on information provided during the consent process, their own and others’ experiences in clinical trials, and comparisons among studies. Our findings indicate that the informed consent process succeeds in communicating well about certain types of risk information while simultaneously creating lacunae that are problematically filled by participants through their collective experiences and assumptions about risk. We discuss the ethical implications of these findings and make recommendations for improving the consent process in healthy volunteer trials. (shrink)

This article empirically examines how healthy volunteers evaluate and make sense of the risks of phase I clinical drug trials. This is an ethically important topic because healthy volunteers are exposed to risk but can gain no medical benefit from their trial participation. Based on in-depth qualitative interviews with 178 healthy volunteers enrolled in various clinical trials, we found that participants focus on myriad characteristics of clinical trials when assessing risk and making enrolment decisions. These factors include the short-term and (...) long-term effects; required medical procedures; the type of trial, including its design, therapeutic area of investigation, and dosage of the drug; the amount of compensation; and trust in the research clinic. In making determinations about the study risks, participants rely on information provided during the consent process, their own and others’ experiences in clinical trials, and comparisons among studies. Our findings indicate that the informed consent process succeeds in communicating well about certain types of risk information while simultaneously creating lacunae that are problematically filled by participants through their collective experiences and assumptions about risk. We discuss the ethical implications of these findings and make recommendations for improving the consent process in healthy volunteer trials. (shrink)

This article empirically examines how healthy volunteers evaluate and make sense of the risks of phase I clinical drug trials. This is an ethically important topic because healthy volunteers are exposed to risk but can gain no medical benefit from their trial participation. Based on in-depth qualitative interviews with 178 healthy volunteers enrolled in various clinical trials, we found that participants focus on myriad characteristics of clinical trials when assessing risk and making enrolment decisions. These factors include the short-term and (...) long-term effects; required medical procedures; the type of trial, including its design, therapeutic area of investigation, and dosage of the drug; the amount of compensation; and trust in the research clinic. In making determinations about the study risks, participants rely on information provided during the consent process, their own and others’ experiences in clinical trials, and comparisons among studies. Our findings indicate that the informed consent process succeeds in communicating well about certain types of risk information while simultaneously creating lacunae that are problematically filled by participants through their collective experiences and assumptions about risk. We discuss the ethical implications of these findings and make recommendations for improving the consent process in healthy volunteer trials. (shrink)

This article empirically examines how healthy volunteers evaluate and make sense of the risks of phase I clinical drug trials. This is an ethically important topic because healthy volunteers are exposed to risk but can gain no medical benefit from their trial participation. Based on in-depth qualitative interviews with 178 healthy volunteers enrolled in various clinical trials, we found that participants focus on myriad characteristics of clinical trials when assessing risk and making enrolment decisions. These factors include the short-term and (...) long-term effects; required medical procedures; the type of trial, including its design, therapeutic area of investigation, and dosage of the drug; the amount of compensation; and trust in the research clinic. In making determinations about the study risks, participants rely on information provided during the consent process, their own and others’ experiences in clinical trials, and comparisons among studies. Our findings indicate that the informed consent process succeeds in communicating well about certain types of risk information while simultaneously creating lacunae that are problematically filled by participants through their collective experiences and assumptions about risk. We discuss the ethical implications of these findings and make recommendations for improving the consent process in healthy volunteer trials. (shrink)

The article "Picking and Choosing Among Phase I Trials", written by Jill A. Fisher, Torin Monahan and Rebecca L. Walker, was originally published Online First without Open Access. After publication in volume 16, issue 4, page 535-549 the author decided to opt for Open Choice and to make the article an Open Access publication.

Phase 1 healthy volunteer clinical trials—which financially compensate subjects in tests of drug toxicity levels and side effects—appear to place pressure on each joint of the moral framework justifying research. In this article, we review concerns about phase 1 trials as they have been framed in the bioethics literature, including undue inducement and coercion, unjust exploitation, and worries about compromised data validity. We then revisit these concerns in light of the lived experiences of serial participants who are income-dependent on phase (...) 1 trials. We show how participant experiences shift attention from discrete exchanges, behaviors, and events in the research enterprise to the ongoing and dynamic patterns of serial participation in which individual decision-making is embedded in collective social and economic conditions and shaped by institutional policies. We argue in particular for the ethical significance of structurally diminished voluntariness, routine powerlessness in setting the terms of exchange, and incentive structures that may promote pharmaceutical interests but encourage phase 1 healthy volunteers to skirt important rules. (shrink)

In phase I clinical trials, healthy volunteers are dosed with investigational drugs and subjected to blood draws and other bodily monitoring procedures. In exchange, they are paid. Healthy volunteers are, in a very direct sense, selling access to their bodies for pharmaceutical companies and their associates to run drugs through. In his ethnographic study of socalled professional guinea pigs, Roberto Abadie writes, "Paid volunteers are well aware of the demand for an idealized, perfectly healthy volunteer. They also realize that their (...) body is a valued commodity in clinical trials research". It is perhaps surprising, then, that commodification is little discussed in the bioethics literature on phase I... (shrink)

Background The ethical use both of human and non-human animals in research is predicated on the assumption that it is of a high quality and its projected benefits are more significant than the risks and harms imposed on subjects. Yet questions remain about whether and how IRBs and IACUCs should consider the scientific value of proposed research studies.Methods We draw upon 45 interviews with IRB and IACUC members and researchers with oversight experience about their perceptions of their own roles in (...) reviewing the quality and value of scientific protocols. Interview transcripts were memoed to highlight specific findings, which were then used to identify key themes through an iterative process.Results IRB and IACUC members expressed broad trust in the need for and value of research, and they often assumed that protocols had social value or that prior review, especially when associated with funding, affirmed both the rigor and merit of those protocols. Some oversight members also took an explicit stance against scientific review by stating that such review is not within the regulatory mandates governing their parts in the oversight system. Yet other interviewees expressed uneasiness about the current paradigm for evaluating the quality and overall value of science, suggesting that IRB and IACUC members perceive gaps in the oversight systems.Conclusions These findings reveal many similarities in how IRB and IACUC members understand the roles and limitations of their respective oversight committees. We conclude with a discussion of how the lack of a clear mandate regarding scientific review within US federal regulations may undermine ethical engagement of whether human and animal research is scientifically justified, resulting in a “mission lapse” wherein no organizational body is clearly responsible for ensuring that the research being conducted has the potential to advance science and benefit society. (shrink)

The body is a rich object for aesthetic inquiry. We aesthetically assess both our own bodies and those of others, and our felt bodily experiences have aesthetic qualities. The body features centrally in aesthetic experiences of visual art, theatre, dance and sports. It is also deeply intertwined with one's identity and sense of self. Artistic and media representations shape how we see and engage with bodies, with consequences both personal and political. This volume contains sixteen original essays by contributors in (...) philosophy, sociology, dance, disability theory, critical race studies, feminist theory, medicine, and law. They explore bodily beauty, sexual attractiveness, the role of images in power relations, the distinct aesthetics of disabled bodies, the construction of national identity, the creation of compassion through bodily presence, the role of bodily style in moral comportment, and the somatic aesthetics of racialized police violence. -/- Contents: Maria del Guadalupe Davidson, "Black Silhouettes on White Walls: Kara Walker’s Magic Lantern"; A. W. Eaton, "Taste in Bodies and Fat Oppression"; C. Winter Han, "From 'Little Brown Brothers' to 'Queer Asian Wives': Constructing the Asian Male Body"; Deborah L. Rhode, "Appearance as a Feminist Issue"; Shirley Anne Tate, "A Tale of Two Olympians—Beauty, 'Race,' Nation"; Glenn Parsons, "The Merrickites"; Stephen Davies, "And Everything Nice"; Tobin Siebers, "In/Visible: Disability on the Stage"; Jill Sigman, "Live, Body-Based Performance: An Account from the Field"; Barbara Gail Montero, "Aesthetic Effortlessness"; Peg Brand Weiser and Edward B. Weiser, "Misleading Aesthetic Norms of Beauty: Perceptual Sexism in Elite Women's Sports"; Yuriko Saito, "Body Aesthetics and the Cultivation of Moral Virtues"; George Yancy, "White Embodied Gazing, the Black Body as Disgust, and the Aesthetics of Un-Suturing"; Richard Shusterman, "Somaesthetics and the Fine Art of Eating"; Ann J. Cahill, "Sexual Desire, Inequality, and the Possibility of Transformation"; Sheila Lintott and Sherri Irvin, "Sex Objects and Sexy Subjects: A Feminist Reclamation of Sexiness" -/- . (shrink)

The essays in this volume explore those aspects of Kant’s writings which concern issues in the philosophy of mind. These issues are central to any understanding of Kant’s critical philosophy and they bear upon contemporary discussions in the philosophy of mind. Fourteen specially written essays address such questions as: What role does mental processing play in Kant’s account of intuition? What kinds of empirical models can be given of these operations? In what sense, and in what ways, are intuitions object-dependent? (...) How should we understand the nature of the imagination? What is inner sense, and what does it mean to say that time is the form of inner sense? Can we cognize ourselves through inner sense? How do we self-ascribe our beliefs and what role does self-consciousness play in our judgments? Is the will involved in judging? What kind of knowledge can we have of the self ? And what kind of knowledge of the self does Kant proscribe? These essays showcase the depth of Kant’s writings in the philosophy of mind, and the centrality of those writings to his wider philosophical project. Moreover, they show the continued relevance of Kant’s writings to contemporary debates about the nature of mind and self. Contents: 0. Introduction Anil Gomes and Andrew Stephenson 1. Kant, The Philosophy Of Mind, And Twentieth Century Analytic Philosophy Anil Gomes 2. Synthesis And Binding Lucy Allais 3. Understanding Non-Conceptual Representation Of Objects: Empirical Models Of Sensibility’s Operation Katherine Dunlop 4. Are Kantian Intuitions Object-Dependent? Stefanie Grüne 5. Intuition And Presence Colin McLear 6. Imagination And Inner Intuition Andrew Stephenson 7. Inner Sense And Time Ralf M. Bader 8. Can’t Kant Cognize Himself? Or, A Problem For (Almost) Every Interpretation Of The Refutation Of Idealism Andrew Chignell 9. A Kantian Critique Of Transparency Patricia Kitcher 10. Judging For Reasons: On Kant And The Modalities Of Judgment Jessica Leech 11. Kant On Judging And The Will Jill Vance Buroker 12. Self and Selves Ralph C. S. Walker 13. Subjects Of Kant’s First Paralogism Tobias Rosefeldt 14. The Lessons Of Kant’s Paralogisms Paul Snowdon. (shrink)

One of the main purposes of feminist jurisprudence is to create or find better ways of being and living for women through the analysis, critique, and use of law. Rich work has emerged, and continues to emerge, from feminist theorists exploring conceptions of the self, personhood, identity and subjectivity that could be used to form a basic unit in law and politics. In this article, it is argued that a strong sense of human subjectivity needs to be retained to enable (...) the human potentiality of women and men to flourish. This can be done in a way which is not essentialist, yet does not dissolve the subject out of existence, issues pertinent to feminist jurisprudence in recent years. (shrink)

Biological dysfunction is regarded, in many accounts, as necessary and perhaps sufficient for disease. But although disease is conceptualized as all-or-nothing, biological functions often differ by degree. A tension is created by attempting to use a continuous variable as the basis for a categorical definition, raising questions about how we are to pinpoint the boundary between health and disease. This is the line-drawing problem. In this paper, we show how the line-drawing problem arises within “dysfunction-requiring” accounts of disease, such as (...) those of Christopher Boorse and Jerome Wakefield. We then provide several detailed examples to establish that biological dysfunction cannot provide a boundary. We examine potential ways of resolving the line-drawing problem, either by dropping one of the claims that generates it, or by appealing to additional criteria. We argue that two of these options are plausible, and that each of these can be applied with regard to different diseases. (shrink)

William Tait is one of the most distinguished philosophers of mathematics of the last fifty years. This volume collects his most important published philosophical papers from the 1980's to the present. The articles cover a wide range of issues in the foundations and philosophy of mathematics, including some on historical figures ranging from Plato to Gdel.

Plato of Athens, who laid the foundations of the Western philosophical tradition and in range and depth ranks among its greatest practitioners, was born to a prosperous and politically active family circa 427 BC. In early life an admirer of Socrates, Plato later founded the first institution of higher learning in the West, the Academy, among whose many notable alumni was Aristotle. Traditionally ascribed to Plato are thirty-five dialogues developing Socrates' dialectic method and composed with great stylistic virtuosity, together with (...) the Apology and thirteen letters. The four works in this volume recount the circumstances of Socrates' trial and execution in 399 BC. In Euthyphro, set in the weeks before the trial, Socrates and Euthyphro attempt to define holiness. In Apology, Socrates answers his accusers at trial and unapologetically defends his philosophical career. In Crito, a discussion of justice and injustice explains Socrates' refusal of Crito's offer to finance his escape from prison. And in Phaedo, Socrates discusses the concept of an afterlife and offers arguments for the immortality of the soul. This edition, which replaces the original Loeb edition by Harold North Fowler, offers text, translation, and annotation that are fully current with modern scholarship." -- Publisher's description. (shrink)

Poor working conditions remain a serious problem in supplier facilities in developing countries. While previous research has explored this from the developed buyers’ side, we examine this phenomenon from the perspective of developing countries’ suppliers and subcontractors. Utilizing qualitative data from a major knitwear exporting cluster in India and a stakeholder management lens, we develop a framework that shows how the assumptions of conventional, buyer-driven voluntary governance break down in the dilution of buyer power and in the web of factors (...) rooted in suppliers’ traditions, beliefs, local demands and resource dependency. We reveal out how success in governing collaborative global supply chains often falls short within the subcontracting stage, where a stakeholder management mindset is elusive to most participants. We suggest that success in governing collaborative global supply chains is dependent on concepts of stakeholder utility and the presence of shared value that is often at odds with the realities of power, information asymmetry and compliance/reward systems inherent in the non-market coordination of global supply chains. Our findings offer important insights for delineating the concepts of value creation from CSR concepts and practices, and for modifying the basic assumptions of conventional supply chain governance. (shrink)

Multinational corporations dominate the global business arena, but new expectations for MNC boards call to question how they might effectively manage global stakeholder relationships in this new era of accountability. Uniting political behavior theory, which describes a board’s international political orientation, and global operating governance systems outlining a set of board behaviors, we develop a typology of four types of boards. We then provide recommendations for the development of an integrative governance structure, taking into account the mechanisms, structure, endorsements, and (...) codes of conduct that MNCs can use to promote ethical behavior across MNC horizons. (shrink)

This article argues that hope is of value in clinical ethics and that it can be important for clinicians to be sensitive to both the risks of false hope and the importance of retaining hope. However, this sensitivity requires an understanding of the complexity of hope and how it bears on different aspects of a well-functioning doctor-patient relationship. We discuss hopefulness and distinguish it from three different kinds of hope, or ‘hopes for’, and then relate these distinctions back to differing (...) accounts of autonomy. This analysis matters because it shows how an overly narrow view of the ethical obligations of a clinician to their patient, and autonomy, might lead to scenarios where patients regret the choices they make. (shrink)

Infectious disease outbreaks in residential care are complex to manage and difficult to control. Research in this setting that includes individuals who lack capacity must conform to national legislation. We report here on our study that is investigating outbreaks of scabies, an itchy skin infection, in the residential care setting in the southeast of England. There appears to be a gap in legislative advice regarding the inclusion of people who lack capacity in research that takes place during time-limited acute scenarios (...) such as outbreaks. We received inconsistent advice from experts regarding, in particular, the role of nominated consultees. There is a potential inequality for vulnerable populations who cannot themselves provide informed consent in terms of their access to participation in a range of health-related research. (shrink)

Collaboration between the arts and health sectors is gaining momentum. Artists are contributing significantly to public health efforts such as vaccine confidence campaigns. Artists and the arts are well positioned to contribute to the social conditions needed to build trust in the health sector. Health professionals, organizations, and institutions should recognize not only the power that can be derived from the insights, artefacts, and expertise of artists and the arts to create the conditions that make trust possible. The health sector (...) must also recognize that, while it can gain much from partnership with artists, artists risk much—namely, the public's trust—when they are in such partnerships. This essay unpacks these claims and considers the care and ethical considerations that must be brought to these partnerships to yield constructive pathways for ethical collaboration as well as for both establishing public trust and continuing to hold the health care profession accountable for becoming more trustworthy. (shrink)

Medicine seeks to overcome one of the most fundamental fragilities of being human, the fragility of good health. No matter how robust our current state of health, we are inevitably susceptible to future illness and disease, while current disease serves to remind us of various frailties inherent in the human condition. This article examines the relationship between fragility and uncertainty with regard to health, and argues that there are reasons to accept rather than deny at least some forms of uncertainty. (...) In situations of current ill health, both patients and doctors seek to manage this fragility through diagnoses that explain suffering and provide some certainty about prognosis as well as treatment. However, both diagnosis and prognosis are inevitably uncertain to some degree, leading to questions about how much uncertainty health professionals should disclose, and how to manage when diagnosis is elusive, leaving patients in uncertainty. We argue that patients can benefit when they are able to acknowledge, and appropriately accept, some uncertainty. Healthy people may seek to protect the fragility of their good health by undertaking preventative measures including various tests and screenings. However, these attempts to secure oneself against the onset of biological fragility can cause harm by creating rather than eliminating uncertainty. Finally, we argue that there are good reasons for accepting the fragility of health, along with the associated uncertainties. (shrink)

Negative words or integrated negations: Nothingness, the completely Other, Nothing, the Infinite, the Unknowable, the Subconscious all have a certain poetic overtone. But we must be careful of linguistic sleight-of-hand taken for an idea.

In this article, we offer a perspective into howCanadian doctoral nursing students’ writing capacity is mentored and, as a result, we argue is disciplined. We do this by sharing our own disciplinary and interdisciplinary experiences of writing with, for and about nurses. We locate our experiences within a broader discourse that suggests doctoral (nursing) students be prepared as stewards of the (nursing) discipline. We draw attention to tensions and effects of writing within (nursing) disciplinary boundaries. We argue that traditional approaches (...) to developing nurses’ writing capacity in doctoral programs both shepherds and excludes emerging scholarly voices, and we present some examples to illustrate this dual role. We ask our nurse colleagues to consider for whom nurses write, offering an argument that nurses’ writing must ultimately improve patient care and thus would benefit from multiple voices in writing. (shrink)

As rationing decisions become more of an immediate reality for healthcare practitioners it is important to design mechanisms that facilitate carefully deliberated outcomes. No individual can be expected to be able to cover wide debate on their own, so an exercise has been designed that helps generate consensus decisions from diverse opinions. The exercise was piloted with two groups, an undergraduate medical class and the members of a general practice. Though the aims were different for each group, the tool was (...) useful to both for producing the desired outcomes. Expert and non-expert knowledge were drawn upon and rationing prioritisation lists regarding funding of infertility treatment were generated. A description of the exercise and the results produced by the two groups are provided, as well as the theoretical placement for the significance of forming consensus from diversity. (shrink)

Here we present and develop the hypothesis that the derepression of endogenous retrotransposable elements (RTEs) – “genomic parasites” – is an important and hitherto under‐unexplored molecular aging process that can potentially occur in most tissues. We further envision that the activation and continued presence of retrotransposition contribute to age‐associated tissue degeneration and pathology. Chromatin is a complex and dynamic structure that needs to be maintained in a functional state throughout our lifetime. Studies of diverse species have revealed that chromatin undergoes (...) extensive rearrangements during aging. Cellular senescence, an important component of mammalian aging, has recently been associated with decreased heterochromatinization of normally silenced regions of the genome. These changes lead to the expression of RTEs, culminating in their transposition. RTEs are common in all kingdoms of life, and comprise close to 50% of mammalian genomes. They are tightly controlled, as their activity is highly destabilizing and mutagenic to their resident genomes. (shrink)

Mental health legislation that requires patients to accept ‘care’ has come under increasing scrutiny, prompted primarily by a human rights ethic. Epistemic issues in mental health have received some attention, however, less attention has been paid to the possible epistemic problems of mental health legislation existing. In this manuscript, we examine the epistemic problems that arise from the presence of such legislation, both for patients without a prior experience of being detained under such legislation and for those with this experience. (...) We also examine how the doctor is legally obligated to compound the epistemic problems by the knowledge they prioritise and the failure to generate new knowledge. Specifically, we describe the problems of testimonial epistemic injustice, epistemic silencing, and epistemic smothering, and address the possible justification provided by epistemic paternalism. We suggest that there is no reasonable epistemic justification for mental health legislation that creates an environment that fundamentally unbalances the doctor–patient relationship. Significant positive reasons to counterbalance this are needed to justify the continuation of such legislation. (shrink)

Nursing knowledge development and application are influenced by numerous factors within the context of science and practice. The prevailing culture of science along with an evolving context of increasingly technological environments and rationalization within health care impacts both the generation of nursing knowledge and the practice of nursing. The effects of the culture of science and the context of nursing practice may negatively impact the structure and application of nursing knowledge, how nurses practice, and how nurses understand the patients and (...) families for whom they care. Specifically, the nature of critical care and its highly technical environment make critical care nursing especially vulnerable to these potentially negative influences. The influences of the culture of science and the increasingly technical practice context may result in an overreliance on the natural sciences to guide critical care nursing actions and an associated marginalization of the caring relationship in critical care nursing practice. Within this environment, nursing philosophy may not be foundational to nursing actions; rather, the dominant culture of science and the rationalization of health care may be informing nursing practice. As such, the ideology and goals of nursing may not be central to the practice of critical care nursing. The purpose of this paper is to explore the influence of the culture of science on the development of nursing knowledge and theory. Further, we aim to describe the value of using conceptual frameworks, such as Roy's Adaptation Model, as a nursing philosophy to influence the development of person‐centred nursing knowledge and theory to inform critical care nursing practice as it related to the care of patients and families. In doing so, nursing philosophy is situated as foundational for nursing actions. (shrink)

Evidence‐based interventions have been developed and used to prevent HIV infections among black men who have sex with men (MSM) in Canada and the United States; however, the degree to which interventions address racism and other interlocking oppressions that influence HIV vulnerability is not well known. We utilize integrative antiracism to guide a review of HIV prevention intervention studies with black MSM and to determine how racism and religious oppression are addressed in the current intervention evidence base. We searched CINAHL, (...) PsychInfo, MEDLINE and the CDC compendium of evidence‐based HIV prevention interventions and identified seventeen interventions. Three interventions targeted black MSM, yet only one intervention addressed racism, religious oppression, cultural assets and religious assets. Most interventions' samples included low numbers of black MSM. More research is needed on interventions that address racism and religious oppression on HIV vulnerability among black MSM. Future research should focus on explicating mechanisms by which multiple oppressions impact HIV vulnerability. We recommend the development and integration of social justice tools for nursing practice that aid in addressing the impacts of racism and other oppressions on HIV vulnerability of black MSM. (shrink)