Engagement with genomic medicine and research has increased globally during the past few decades, including rapid developments in Sri Lanka. Genomic research is carried out in Sri Lanka on a variety of scales and with different aims and perspectives. However, there are concerns about participants' understanding of genomic research, including the validity of informed consent. This article reports a qualitative study aiming to explore the understanding, knowledge, and attitudes of the Sri Lankan public towards genomic medicine and to inform the (...) development of an effective and appropriate process for informed consent in that setting. Purposive sampling was employed. Participants were recruited from a sub-group of the public in Colombo, Sri Lanka who had either consented or refused to donate genetic material for a biobank. Data were collected using face-to-face semi-structured interviews. Interview data were transcribed verbatim and translated into English. Conventional content analysis was used. The analysis developed three key themes: a) ‘Scientific literacy’ describes an apparent lack of scientific knowledge that seems to affect a participant’s ability to understand the research, b) ‘Motivation’ describes narratives about why participants chose (not) to take part in the research, despite not understanding it, and c) ‘Trust’ describes how trust served to mitigate the apparent ethical deficit created by not being fully informed. In this article, we argue that informed trust is likely an acceptable basis for consent, particularly in settings where scientific literacy might be low. However, researchers must work to be worthy of that trust and ensure that misconceptions are actively addressed. (shrink)

An increasing number of non-governmental organisations provide humanitarian assistance, including healthcare. Some faith-based NGOs combine proselytising work with humanitarian aid. This can result in ethical dilemmas that are rarely discussed in the literature. The article explores several ethical issues, using four generic activities of faith-based NGOs: It is discriminatory to deny aid to a needy community because it provides less opportunity for proselytising work. Allocating aid to a community with fewer health needs but potential for proselytising work is unjust, since (...) it neither maximises welfare nor assists the most needy . Faith-based-NGOs may state that proselytising work combined with humanitarian assistance improves spiritual wellbeing and overall benefit. However, proselytising work creates religious doubts, which could transiently decrease wellbeing. Proselytising work is unlikely to be a perceived need of the population and, if carried out without consent, breaches the principle of autonomy. Such work also exploits the vulnerability of disaster victims. Governments that decline the assistance of a faith-based NGO involved in proselytising work may deprive the needy of aid. Three strategies are proposed: Increase knowledge to empower communities, individuals and governments; information on NGOs could be provided through an accessible register that discloses objectives, funding sources and intended spiritual activities. Clearly demarcate between humanitarian aid from proselytising work, by setting explicit guidelines for humanitarian assistance. Strengthen self-regulation by modifying the Code of Conduct of the Red Cross to state criteria for selecting communities for assistance and procedures for proselytising work. (shrink)

Sri Lanka, once a colony of Britain, gained independence in 1948. However, especially the health sector continues to use English as its main medium of communication. Such language bias leads to marginalization of those less fluent in English, and hinders achieving a higher level of health literacy. Discrimination of people or social groups based on their language is termed linguicism. Tackling linguicism requires an understanding of its historic roots and an exploration of potential links to colonial racial prejudices. Published literature (...) presents evidence that traces linguicism to language policies of the British colonial government. Though an exhaustive survey of historical records is not presented, there is reasonable evidence to suggest a close link. British colonial rule derived its justification from supremacist and racist ideology. As a result, English became the medium in all forms of official communications, a situation that persisted after independence. A similar situation exists in many parts of the worlds. We should recognize language-based discrimination and linguicism as public health issues. They are detrimental to health of vulnerable groups and have the potential to worsen health disparities. (shrink)

Prior work shows limited success in retail firms’ efforts to create socially responsible supply chains by enforcing suppliers’ compliance with labor standards, partly due to conflicting sourcing demands exerted on the supplier by siloed functional units within the retail firm. To ensure the substantive adoption of labor standards throughout its supply chain, we argue that the retail firm must improve their degree of “supply chain labor compliance integration” by minimizing cross-functional tensions in human capital, identities, processes and goals. We define (...) supply chain labor compliance integration, identify its determinant organizational practices that reduce cross-functional tensions, and explain the mechanisms by which it improves the retail firm’s supply chain labor standards performance. This work offers theoretical and practical insights on the retail firm’s capacity for managing socially responsible supply chains, and more broadly, on how systematically minimizing intra-organizational tensions arising in the pursuit of competing organizational priorities is a prerequisite for their simultaneous execution in inter-organizational business exchanges. (shrink)

Fragile states and developing countries increasingly contract out health services to non-state providers (NSPs) (such as non-governmental organisations, voluntary sector and private sector). The paper identifies ethical issues when contracts involve devolution of health services to NSPs and proposes procedures to prevent or resolve these ethical dilemmas. Ethical issues were identified by examining processes of contracting out. Health needs could be used to select areas to be contracted out and to identify service needs. Health needs comprise “disease-burden-related needs”, “health-service needs”, (...) and “urgency of health-service needs”. The mix of services should include an analysis of cost-effectiveness. NSPs should be selected fairly, without bias, and conflicts of interest during their work must be avoided. The population’s views must be respected and accountability structures established. Devolved health services should ensure equity of access to healthcare. The services ought to be sustainable and evaluated objectively. Of these issues, conflicts of interest among NSPs and sustainability of health services have not attracted attention in the literature on ethics of health policy. Fair procedures could address these ethical issues—for example, public consultation on issues; decisions based on the public consultation and made on evidence; principles of decisions stated and reasonable; decisions given adequate publicity; a mechanism established to challenge decisions; assurance that mechanisms meet the above conditions; and regular review of the policies. These procedures are complemented by improving self-governance of NSPs, countries’ development of guidelines for devolving health services, and measures to educate the public of the client countries on these issues. (shrink)

Racial bias and language discrimination are recognized in the health sector in countries such as Sri Lanka. This may extend to images used in health communication and educational literature. We analyzed the racial and ethnic representation in a sample of newspapers and websites related to health obtained over a period. Most of the human figures in health-related messages in newspapers had an overrepresentation of Caucasians. This trend was absent in websites where 73% of the images of Sri Lankans. The reasons (...) for this pattern could be due to the availability of image-quality photographs and exposure to a norm that is racially biased. For example, a majority of images in medical textbooks and prestigious journals are of white Caucasians. A predominance of such images could have two impacts. At an individual level, it would affect acquiring skills of visual diagnoses. At a societal level, it may reinforce a view that most forms of health-related knowledge are created in the West and could add to existing discrimination based on skin color (i.e., colorism). The latter is a known psychosocial stressor that contributes to psychological distress among socially disadvantaged populations and promotes behaviors adverse to health and residential segregation. These may contribute to poorer physical, mental, and infant health outcomes in dark-skinned individuals compared to lighter-skinned in the USA and Canada. Such discrimination within the health system would compromise basic human dignity, disempower patients, and violate the principle of autonomy. Sri Lankan media, the healthcare profession, and educationists need to recognize the relevance and importance of using images that appropriately reflect the realities of their own environment, its people, and patients. (shrink)

Chronic stroke survivors with severe contralesional arm paresis face numerous challenges to performing activities of daily living, which largely rely on the use of the less-affected ipsilesional arm. While use of the ipsilesional arm is often encouraged as a compensatory strategy in rehabilitation, substantial evidence indicates that motor control deficits in this arm can be functionally limiting, suggesting a role for remediation of this arm. Previous research has indicated that the nature of ipsilesional motor control deficits vary with hemisphere of (...) damage and with the severity of contralesional paresis. Thus, in order to design rehabilitation that accounts for these deficits in promoting function, it is critical to understand the relative contributions of both ipsilesional and contralesional arm motor deficits to functional independence in stroke survivors with severe contralesional paresis. We now examine motor deficits in each arm of severely paretic chronic stroke survivors with unilateral damage to determine whether hemisphere-dependent deficits are correlated with functional independence. Clinical evaluation of contralesional, paretic arm impairment was conducted with the upper extremity portion of the Fugl-Meyer assessment. Ipsilesional arm motor performance was evaluated using the Jebsen-Taylor Hand Function Test, grip strength, and ipsilesional high-resolution kinematic analysis during a visually targeted reaching task. Functional independence was measured with the Barthel Index. Functional independence was better correlated with ipsilesional than contralesional arm motor performance in the left hemisphere damage group [JTHFT: [r = −0.73, p = 0.017]; grip strength: [r = 0.64, p = 0.047]], and by contralesional arm impairment in the right hemisphere damage group [UEFM: [r = 0.66, p = 0.040]]. Ipsilesional arm kinematics were correlated with functional independence in the left hemisphere damage group only. Examination of hemisphere-dependent motor correlates of functional independence showed that ipsilesional arm deficits were important in determining functional outcomes in individuals with left hemisphere damage only, suggesting that functional independence in right hemisphere damaged participants was affected by other factors. (shrink)

Sponsorship of medical conferences by the pharmaceutical industry has led to many ethical issues, especially in resource-poor developing countries. The core issue in these instances is to reduce or avoid conflicts of interests. COI is a set of circumstances that creates a risk that professional judgment or actions regarding a primary interest will be unduly influenced by secondary interests. Disruption of social trust should also be considered. This deontological approach should be complemented by a consequentialist approach. Towards this, the concept (...) ofdistal interests is introduced. DI lies beyond the immediately visible COIs and the consequences of immediate decisions. They are ‘distal’ in time or place: ‘DI in time’ means consequence of the decision in future scenarios, while ‘DI in space’ means those that impinge on other institutions or bodies. In judging the consequences, it is also necessary to consider the reality of the existing relationship between the pharmaceutical industry and organisers of conferences. In more developed countries, these relationships are governed by stricter regulations, adherence to codes of conduct by both parties and stronger institutional oversights. In contrast, developing countries such as Sri Lanka the regulatory environment is lax and the demarcation of interests between the pharmaceutical industry and the medical profession is considerably blurred. Therefore, establishing clear rules of engagement between the stakeholders should be considered as an attempt to clear the muddy waters. The paper proposes a set of guidelines to capture these approaches. (shrink)

Festschrift volume to K. Ramakrishna Rao, Indian psychologist, philosopher and educationist; contributed articles.

Study of rationalism in Urdu literature.

Constitutional and judicial law-making is increasingly beginning to find its reflection not only in the Anglo-Saxon, but also in the Romano-Germanic legal family. However, the prerequisites for the use of this legal instrument are different, which determines the relevance of conducting a comparative analysis regarding the provision of such a mechanism in the USA and Kazakhstan. The purpose of the research is to identify common and distinctive features in the process of implementation of constitutional and judicial law-making in countries belonging (...) to different legal systems. The article uses the methods of analysis, synthesis, comparison, deduction and generalization. As a result, the specificity of ensuring the mechanism of constitutional law-making in the USA was expressed, taking into account various forms of law-making activity. It has been established that the development of constitutional provisions in the United States takes place with the help of the constitutional doctrines of the Supreme Court of the United States, which provide for the introduction of amendments to constitutional provisions without a formal procedure. As a result of the study of the experience of Kazakhstan, it was established that special priority was given to the role of precedent, in particular, the decision of the Supreme Court of the Republic of Kazakhstan. This is explained by the integrative nature of the Romano-Germanic legal system, which allows effective development of national legislation as a whole and its provisions. The obtained results can be used during the professional training of judges in the Republic of Kazakhstan. (shrink)

K. Satchidananda Murty (1924-2011) was a vociferous writer and an iconoclast. This volume is a collection of his unpublished writings. It includes Murty's views on the Veda, its meaning, relevance, and study, and shows the significance of the Vedāntic vision to the modern world. Murty elucidates the basic tenets of Advaita Vedānta and expounds the Advaitic doctrine of the relationships between Brahman and God, Brahman and the individual self, as well as between God and the world. In his writings, Murty (...) contrasts empirical knowledge with transcendental wisdom and surveys the history of Indian science and scientific views in ancient times. The book also includes Murty's musings on the scholar Śankara's philosophy, authorship and religious life. An important contribution to Indian philosophy, the volume will be of great interest to scholars, teachers and students of Hindu philosophy, Vedāntic philosophy, Advaita Vedanta, comparative philosophy, religious studies, and South Asian studies. (shrink)

This chapter provides an introduction to higher-order metaphysics as well as to the contributions to this volume. We discuss five topics, corresponding to the five parts of this volume, and summarize the contributions to each part. First, we motivate the usefulness of higher-order quantification in metaphysics using a number of examples, and discuss the question of how such quantifiers should be interpreted. We provide a brief introduction to the most common forms of higher-order logics used in metaphysics, and indicate a (...) number of questions which can be raised in such systems using logical vocabulary alone. Using a further example, we return to applications of higher-order logics in metaphysics. We also mention key developments in the history of higher-order logic as it pertains to metaphysics. Finally, we mention certain arguments which have been raised against the use of higher-order logic, and some ways of responding to them. (shrink)

This monograph aims to mathematically codify the notion of "moral systems" and define a sensible distance between them. It consists of three parts, aimed at an audience with varying interests and mathematical backgrounds. The first part steers philosophical, formally defining moral systems and several related concepts. The second part studies black box algorithms, including questions of inference and metric construction. The third part explores the technical construction of metrics amongst conditional probability distributions.

It is advisable to treat some sorts of discourse about fiction with the aid of an intensional operator "in such-And-Such fiction...." the operator may appear either explicitly or tacitly. It may be analyzed in terms of similarity of worlds, As follows: "in the fiction f, A" means that a is true in those of the worlds where f is told as known fact rather than fiction that differ least from our world, Or from the belief worlds of the community in (...) which the fiction originated. (shrink)

PART The Early Wittgenstein Half of what I say is meaningless. I say it so that the other half may reach you. Kahlil Gibran My work consists of two parts ...

Principles of justice, David Estlund argues, cannot be falsified by people’s unwillingness to satisfy them. In his Utopophobia, Estlund rejects the view that justice must bend to human motivation to deliver practical implications for how institutions ought to function. In this paper, I argue that a substantive argument against such bending of justice principles must challenge the reasons for making these principles sensitive to motivational limitations. Estlund, however, provides no such challenge. His dispute with benders of justice is therefore a (...) verbal one over the true meaning of justice, which need not worry those with the intuition that justice should perform a function that requires bending. By focusing on John Rawls’s reasons for bending his justice principles, I point towards a substantive critique of bent justice. (shrink)

What is interest and how has it been conceptualized and studied? -- What explains the power of interest? : Why are students who have an interest for content more likely to continue to reengage and develop more conceptual sophistication? -- What is known about assessing existing interest? How do new interests develop? How can the phase of a person's interest be identified and measured? -- What is the relation between the development of interest and other motivational variables? -- Is it (...) a paradox that interest declines as subject matter gets more developed? What is "interest driven learning"? Does it matter if interests are taken up in rather than out of school? How different is an interest in one versus another subject matter, or domain? -- What we can now say about interest, its generation and development? What are the implications of knowing that interest can be developed? What could further research help us to understand? (shrink)

I examine two challenges that collaborative research raises for science. First, collaborative research threatens the motivation of scientists. As a result, I argue, collaborative research may have adverse effects on what sorts of things scientists can effectively investigate. Second, collaborative research makes it more difficult to hold scientists accountable. I argue that the authors of multi-authored articles are aptly described as plural subjects, corporate bodies that are more than the sum of the individuals involved. Though journal editors do not currently (...) conceive of the authors of multi-authored articles this way, this conception provides us with the conceptual resources to make sense of how collaborating scientists behave.Keywords: Collaborative research; Authorship; Multi-authored articles; Responsibility; Reward system; Plural subject. (shrink)

Recent research in the cognitive science of religion suggests that humans intuitively believe that others survive death. In response to this finding, three cognitive theories have been offered to explain this: the simulation constraint theory (Bering, Citation2002); the imaginative obstacle theory (Nichols, Citation2007); and terror management theory (Pyszczynski, Rothschild, & Abdollahi, 2008). First, I provide a critical analysis of each of these theories. Second, I argue that these theories, while perhaps explaining why one would believe in his own personal immortality, (...) leave an explanatory gap in that they do not explain why one would intuitively attribute survival of death to others. To fill in the gap, I offer a cognitive theory based on offline social reasoning and social embodiment which provides for the belief in an eternal social realm in which the deceased survive—the afterlife. (shrink)