Background: Clinical genomic implementation studies pose challenges for informed consent. Consent forms often include complex language and concepts, which can be a barrier to diverse enrollment, and these studies often blur traditional research-clinical boundaries. There is a move toward self-directed, web-based research enrollment, but more evidence is needed about how these enrollment approaches work in practice. In this study, we developed and evaluated a literacy-focused, web-based consent approach to support enrollment of diverse participants in an ongoing clinical genomic implementation study. (...) Methods: As part of the Cancer Health Assessments Reaching Many (CHARM) study, we developed a web-based consent approach that featured plain language, multimedia, and separate descriptions of clinical care and research activities. CHARM offered clinical exome sequencing to individuals at high risk of hereditary cancer. We interviewed CHARM participants about their reactions to the consent approach. We audio recorded, transcribed, and coded interviews using a deductively and inductively derived codebook. We reviewed coded excerpts as a team to identify overarching themes. Results: We conducted 32 interviews, including 12 (38%) in Spanish. Most (69%) enrolled without assistance from study staff, usually on a mobile phone. Those who completed enrollment in one day spent an average of 12 minutes on the consent portion. Interviewees found the information simple to read but comprehensive, were neutral to positive about the multimedia support, and identified increased access to testing in the study as the key difference from clinical care. Conclusions: This study showed that interviewees found our literacy-focused, web-based consent approach acceptable; did not distinguish the consent materials from other online study processes; and valued getting access to testing in the study. Overall, conducting empirical bioethics research in an ongoing clinical trial was useful to demonstrate the acceptability of our novel consent approach but posed practical challenges. (shrink)

In the process of conversion, one of the greatest challenges faced by Arab Muslims who choose to follow a Christian faith is determining how to relate to their birth communities, especially their immediate families. They continue to identify with their family and desire to function within its communal system and expectations, but also desire to be true to their new faith. For most converts in the Middle East, ceasing to adhere to the Islamic creed per se is not an act (...) of apostasy, but declaring that one has left Islam and chosen another faith is, and is seen as an act of rebellion by the community. The process of self-disclosure, or ‘coming out’, is complex, and many converts consider their decision about how to do this to be very important. There are various approaches converts may take, and various ways their families may respond, but one implicitly shared understanding between many converts and their families may be labelled ‘don’t ask, don’t tell’, whereby converts speak openly about their changed beliefs without explicitly declaring they have converted, and their families respond in kind, deliberately not asking if they have converted, in order to maintain a strong relationship with their loved ones. (shrink)

Millum and Bromwich provide a thorough and thoughtful analysis of what is required for sufficient informed consent, offering distinct conceptualizations of the ethical requirements of disclo...

Volume 20, Issue 5, June 2020, Page 31-33.

Attentional control has grown in importance within theoretical and predictive models of psychopathology over past decades. The Attentional Style Questionnaire is a novel measure of internal a...

Putnam's argument that we are not brains in a VAT has recently seen a resurgence in interest. Although objections to it are legion, an emerging consensus seems to be that even if it successfully refutes one version of the brain in a VAT scenario, lifelong envatment, it is powerless against a different one, recent envatment. Although initially appealing, I argue in this paper that this response-merely replacing lifelong envatment by recent envatment-is a bad response to Putnam's argument. Yet there is (...) a different version of the brain in a VAT scenario, recent memory-altering envatment, that Putnam's argument does not refute and is also sufficiently radical. The crucial issue turns out to be which epistemic sources sceptical scenarios may attack. I argue that there's no convincing reason for exempting memory from the sceptical attack: Sceptical scenarios must target memory to be sufficiently radical and they can do so without violating any constraint on sceptical scenarios. In the end Putnam's argument doesn't fail because of some 'deep' philosophical mistake, but because it overlooks how flexible and adjustable sceptical scenarios are. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Buddhist-Christian Studies 21.1 (2001) 155-157 [Access article in PDF] Book Review Buddhist Peacework: Creating Cultures of Peace Buddhist Peacework: Creating Cultures of Peace. Edited by David W. Chappell. Somerville, Massachusetts: Wisdom Publications, 1999. 253 pp. This earnest book demonstrates the continuing vitality of Buddhism in many parts of the world. The contributing authors are the leading figures of contemporary engaged Buddhism, and they write from firsthand experience. The Dalai (...) Lama outlines methods for promoting harmony among different religious traditions. Thich Nhat Hanh shows how the principle of nonviolence was tested in the rescue ofVietnamese boat people during the 1970s. A.T. Ariyaratne presents the work of the influential Sarvodaya movement in Sri Lanka. Shih Cheng-yen, sometimes called "the Mother Theresa of Asia," describes the relief work ofTzu Chi, the largest charitable organization in Taiwan. Dhammachari Lokamitra documents the impact of an adopted Buddhism among former "untouchables" in India. Robert Aitken surveys engaged Buddhist activity in North America, including hospice work, prison reform, and sustainable farming. Many of the writers have personally suffered the deprivations of war and oppression; in some cases they continue their work amid threats of violence or arrest.An aim ofBuddhist Peacework is to offer a Buddhist response to a declaration that emerged from a 1994 meeting of world religious leaders organized by UNESCO. This document, "Declaration of the Role of Religion in the Promotion of a Culture of Peace," is included as an appendix. Two of the book's contributors, the Dalai Lama and the senior Cambodian monk Maha Ghosananda, participated in the UNESCO meeting. Indeed, some of the declaration's language has an engaged Buddhist ring: "We must be at peace with ourselves; we strive to achieve inner peace through personal reflection and spiritual growth, and to cultivate a spirituality which manifests itself in action."One of Buddhism's distinctive teachings on the subject of peace is the practice of "internal disarmament," the term used by the Dalai Lama in his essay. Unless individuals are able to tame the forces of greed, anger, and delusion in their own minds, the prospects for peace between communities and between nations are slim. For an engaged Buddhist, there must be alignment between "inner" and "outer" disarmament. One cannot work for peace--or any other worthy social goal--in an agitated, antagonistic way. In this collection, peacework is something one does as spiritual practice.Shakyamuni Buddha approached the existential problem of suffering by analyzing the causes of suffering. In a similar spirit, engaged Buddhists have embarked on a Buddhistic analysis of the causes of war and peace. Contributor José Ignacio Cabezón writes: "Peace cannot arise simply by wishing it into existence, but only by the cultivation of its causes.Viewing peace in this way has the salutary effect of shifting the emphasis of peacework from result to causes." Somewhere in that mix of causes we [End Page 155] eventually encounter ourselves. If the world is truly interdependent, we share responsibility for violence and atrocities occurring "elsewhere."Thich Nhat Hanh, in his essay, declares: "If we look deeply, we will observe that the roots of war are in the unmindful ways we have been living. We have not sown enough seeds of peace and understanding in ourselves and others, therefore we are co-responsible: 'Because I have been like this, they are like that.'" The notion of sowing "seeds of peace" is reinforced in the image on the book's cover: two hands tenderly plant a seedling in receptive soil.But internal disarmament is not enough. As editor David Chappell asserts, "Today there is a new urgency for that [inner] peacework to be manifest socially, ecologically, and materially."Witness the plight of several Buddhist (and formerly Buddhist) nations in Asia. "Recently, Buddhist countries have become notorious arenas of genocide and brutality," writes Karma Lekshe Tsomo. Citing Burma, Cambodia, China, Sri Lanka, and Tibet, Tsomo asks, "What went wrong?" Peacework also has new meanings in an age of ecocrisis. For Stephanie Kaza, "a first step in keeping peace with nature calls for contact with ecological suffering." Kaza highlights four ways to... (shrink)

Jochen Briesen: Skeptische Paradoxa. Die philosophische Skepsis, kognitive Projekte und der epistemische Konsequentialismus. Mentis Verlag, Paderborn 2012, 341 S.

How Doctors Think defines the nature and importance of clinical judgment. Although physicians make use of science, this book argues that medicine is not itself a science but rather an interpretive practice that relies on clinical reasoning. A physician looks at the patient's history along with the presenting physical signs and symptoms and juxtaposes these with clinical experience and empirical studies to construct a tentative account of the illness. How Doctors Think is divided into four parts. Part one introduces the (...) concept of medicine as a practice rather than a science; part two discusses the idea of causation; part three delves into the process of forming clinical judgment; and part four considers clinical judgment within the uncertain nature of medicine itself. In How Doctors Think, Montgomery contends that assuming medicine is strictly a science can have adverse side effects, and suggests reducing these by recognizing the vital role of clinical judgment. (shrink)

In this monograph, I offer feminist reasons to develop a multidimensional account of forgiveness as a moral, and therefore at least partially deliberative, action or set of actions, which functions as a remedy in responding to blame or condemnation, releasing offenders from the fullness of their blameworthiness, in relational contexts which therefore require considerations of power between relata. I rely on feminist philosophical account of the relational self in order to contextualise these power relations. I provide accounts of forgiveness as (...) a performative utterance, third-party forgiveness, and self-forgiveness based upon this feminist and multidimensional model of forgiveness. (shrink)

The United States considers educating all students to a threshold of adequate outcomes to be a central goal of educational justice. The No Child Left Behind Act introduced evidence-based policy and accountability protocols to ensure that all students receive an education that enables them to meet adequacy standards. Unfortunately, evidence-based policy has been less effective than expected. This article pinpoints under-examined methodological problems and suggests a more effective way to incorporate educational research findings into local evidence-based policy decisions. It identifies (...) some things educators need to know and do to determine whether available interventions can play the right casual role in their setting to produce desired effects. It examines the value and limits of educational research, especially randomized controlled trials, for this task. (shrink)

While acknowledging Hannah Arendt's keen philosophical and political insights, Kathryn T. Gines claims that there are some problematic assertions and oversights regarding Arendt’s treatment of the "Negro question." Gines focuses on Arendt's reaction to the desegregation of Little Rock schools, to laws making mixed marriages illegal, and to the growing civil rights movement in the south. Reading them alongside Arendt's writings on revolution, the human condition, violence, and responses to the Eichmann war crimes trial, Gines provides a systematic analysis (...) of anti-black racism in Arendt’s work. (shrink)

With the growth of precision medicine research on health data and biospecimens, research institutions will need to build and maintain long-term, trusting relationships with patient-participants. While trust is important for all research relationships, the longitudinal nature of precision medicine research raises particular challenges for facilitating trust when the specifics of future studies are unknown. Based on focus groups with racially and ethnically diverse patients, we describe several factors that influence patient trust and potential institutional approaches to building trustworthiness. Drawing on (...) these findings, we suggest several considerations for research institutions seeking to cultivate long-term, trusting relationships with patients: Address the role of history and experience on trust, engage concerns about potential group harm, address cultural values and communication barriers, and integrate patient values and expectations into oversight and governance structures. (shrink)

The ethical principle of ‘respect for persons’ in clinical research has traditionally focused on protecting individuals’ autonomy rights, but respect for participants also includes broader, although less well understood, ethical obligations to regard individuals’ rights, needs, interests and feelings. However, there is little empirical evidence about how to effectively convey respect to potential and current participants. To fill this gap, we conducted exploratory, qualitative interviews with participants in a clinical genomics implementation study. We interviewed 40 participants in English or Spanish (...) about their experiences with respect in the study and perceptions of how researchers in a hypothetical observational study could convey respect or a lack thereof. Most interviewees were female, identified as Hispanic/Latino or non-Hispanic white, reported annual household income under US$60 000 and did not have a Bachelor’s degree ; 30% had limited health literacy. We identified four key domains for demonstrating respect: personal study team interactions, with an emphasis on empathy, appreciation and non-judgment; study communication processes, including following up and sharing results with participants; inclusion, particularly ensuring materials are understandable and procedures are accessible; and consent and authorisation, including providing a neutral informed consent and keeping promises regarding privacy protections. While the experience of respect is inherently subjective, these findings highlight four key domains that may meaningfully demonstrate respect to potential and current research participants. Further empirical and normative work is needed to substantiate these domains and evaluate how best to incorporate them into the practice of research. (shrink)

In Moral Passages, Kathryn Pyne Addelson presents an original moral theory suited for contemporary life and its moral problems. Her basic principle is that knowledge and morality are generated in collective action, and she develops it through a critical examination of theories in philosophy, sociology and women's studies, most of which hide the collective nature and as a result hide the lives and knowledge of many people. At issue are the questions of what morality is, and how moral theories (...) (whether traditional or feminist) are implemented. Addelson takes up a large number of historical cases and contemporary social problems, including teen pregnancy, contraception and abortion, and gay rights. These cases allow her to see how the knowledge and lives of some people are declared deviant or immoral, while those of others appear to show the public consensus. One case she uses throughout the book is Margaret Sanger's early work on birth control with the anarcho-syndicalist movement--a revisionist history that reveals rather than hides the collective nature of morality and knowledge. Addelson shows how the usual individualist philosophies promote theories which hide the authority of the professionals who make them. A collectivist approach, she argues, must show the part professionals play in collective action. Her aim is to allow professional knowledge makers to be morally and intellectually responsible. Based on Addelson's twenty years of work in feminist philosophy and interactionist sociology as well as her long-standing involvement in women's community organization, Moral Passages investigates how morality and knowledge are collectively enacted in today's world. (shrink)

Christians share a common concern for the earth. Evangelicals emphasize creation care; mainline Protestants embrace the green movement; the Catholic Church lists "10 deadly environmental sins;" and the Eastern Orthodox Patriarch has declared climate change an urgent issue of social and economic justice. This textbook examines seven contemporary environmental challenges through the lens of classical Christian virtues. Authors Kathryn Blanchard and Kevin O'Brien use these classical Christian virtues to seek a "golden mean" between extreme positions by pairing each virtue (...) with a pernicious environmental problem. Students are thus led past political pitfalls and encouraged to care for other creatures prudently, to develop new energy sources courageously, to choose our food temperately, to manage toxic pollution justly, to respond to climate change faithfully, to consider humanity's future hopefully, and to engage lovingly in advocacy for God's earth. Readers will emerge from this text with a deeper understanding of contemporary environmental problems and the fundamentals of Christian virtue ethics. (shrink)

This paper correlates community service goals from 82 business firms with various organizational characteristics, including goals, niches, structure, context, and performance. The results demonstrate that community-service goals are positively correlated with prestige goals, assets goals, superior-design niche, net assets size, and performance on income to net assets. Community-service goals, however, were not significantly correlated with profit goals, low-price niche, multiplicity of outputs, workflow continuity, qualifications, or centralization, as expected.

Der Wiener Kreis war Ausgangspunkt fA1/4r eine internationale philosophische Bewegung, die eine Erneuerung und Reformierung der Philosophie des 20. Jahrhunderts zur Folge hatte. Der Neopositivismus dieser Gruppe ist die wohl wichtigste philosophische Erscheinung der Zwischenkriegszeit. Da gerade im deutschsprachigen Raum diese Philosophie Ablehnung erfahren hat, ihre ReprAsentanten von den faschistischen Machthabern verfolgt und vertrieben wurden, ist die Bedeutung dieser Gesamtdarstellung A1/4ber den Wiener Kreis von Victor Kraft, die erstmals 1946 publiziert wurde, kaum zu ermessen. Kraft, selbst GrA1/4ndungsmitglied des (...) Zirkels, geht nicht nur auf die Positionen seiner verschiedenen Vertreter ein, sondern erarbeitet ausfA1/4hrlich den metaphysikkritischen Ansatz des logischen Empirismus, die Wechselwirkungen und VerAnderungen, die dieses Denken durch den EinfluA Wittgensteins und spAter dann durch die Kritik Poppers erhalten hat. (shrink)

The paper identifies the phenomenal rise of increasingly invasive forms of elective cosmetic surgery targeted primarily at women and explores its significance in the context of contemporary biotechnology. A Foucauldian analysis of the significance of the normalization of technologized women's bodies is argued for. Three "Paradoxes of Choice" affecting women who "elect" cosmetic surgery are examined. Finally, two utopian feminist political responses are discussed: a Response of Refusal and a Response of Appropriation.

"Change is not merely necessary to life--it is life." That's Alvin Toffler, characteristically stating the profound in a profoundly direct way. And yes, even when we see change coming--as we're about to graduate from school, take a new job, get married--it's still not so easy to accept. And when we don't see it coming--oof, we have an even harder time. Here to help us embrace change and defuse its unsettling power is Change Happens, a full-color illustrated gift book to consult, (...) to share, to give, and to keep on a night table. Curated by Kathryn and Ross Petras, the ultimate connoisseurs of quotes whose books and calendars have over 4.5 million copies in print, these words of wisdom inspire us to be open to change and remind us that nothing positive in life ever happens without it. Arranged alphabetically by subject--including Adapting, Curveballs, Faith, Letting Go, Regrets, Second Chances, Vulnerability--it's a book to turn to in moments of need, when offering advice to a friend or loved one, when urging a child to find the courage to take a step, when marking an important occasion. (shrink)

There is conflicting experimental evidence about whether the “stakes” or importance of being wrong affect judgments about whether a subject knows a proposition. To date, judgments about stakes effects on knowledge have been investigated using binary paradigms: responses to “low” stakes cases are compared with responses to “high stakes” cases. However, stakes or importance are not binary properties—they are scalar: whether a situation is “high” or “low” stakes is a matter of degree. So far, no experimental work has investigated the (...) scalar nature of stakes effects on knowledge: do stakes effects increase as the stakes get higher? Do stakes effects only appear once a certain threshold of stakes has been crossed? Does the effect plateau at a certain point? To address these questions, we conducted experiments that probe for the scalarity of stakes effects using several experimental approaches. We found evidence of scalar stakes effects using an “evidence seeking” experimental design, but no evidence of scalar effects using a traditional “evidence-fixed” experimental design. In addition, using the evidence-seeking design, we uncovered a large, but previously unnoticed framing effect on whether participants are skeptical about whether someone can know something, no matter how much evidence they have. The rate of skeptical responses and the rate at which participants were willing to attribute “lazy knowledge”—that someone can know something without having to check—were themselves subject to a stakes effect: participants were more skeptical when the stakes were higher, and more prone to attribute lazy knowledge when the stakes were lower. We argue that the novel skeptical stakes effect provides resources to respond to criticisms of the evidence-seeking approach that argue that it does not target knowledge. (shrink)

Open Access: What if it doesn’t get better? Against more hopeful and optimistic views that it is not just ideal but possible to put an end to what John Rawls calls “the great evils of human history,” I aver that when it comes to evils caused by human beings, the situation is hopeless. We are better off with the heavy knowledge that evils recur than we are with idealizations of progress, perfection, and completeness; an appropriate ethic for living with such (...) heavy knowledge, which I call an ‘Imperfectionist Ethic,’ could include resisting evils, improving the lives of victims, and even enjoying ourselves. Better conceptions of the objects of hope, and the good life, inform a praxis-centered, nonideal ethic, supportive of sustained moral motivation, resilience, and even cheer. I connect elements of stoic and pessimistic philosophy in order to outline some normative recommendations for living with evils. A praxis-centered ethic would helpfully adjust our expectations from changing an uncontrollable future, to developing better skills for living in a world that exceeds our control. (shrink)

This paper provides an argument for a more socially relevant philosophy of science (SRPOS). Our aims in this paper are to characterize this body of work in philosophy of science, to argue for its importance, and to demonstrate that there are significant opportunities for philosophy of science to engage with and support this type of research. The impetus of this project was a keen sense of missed opportunities for philosophy of science to have a broader social impact. We illustrate various (...) ways in which SRPOS can provide social benefits, as well as benefits to scientific practice and philosophy itself. Also, SRPOS is consistent with some historical and contemporary goals of philosophy of science. We’re calling for an expansion of philosophy of science to include more of this type of work. In order to support this expansion, we characterize philosophy of science as an epistemic community and examine the culture and practices of philosophy of science that can help or hinder research in this area. (shrink)

The authors examine the nature of the relationship between social science and philosophy and address the sort of work social science should do, and the role and sorts of claims that an accompanying philosophy should engage in. In particular, the authors reintroduce the question of ontology, an area long overlooked by philosophers of social science, and present a cricital engagement with the work of Roy Bhaskar. The book argues against the excesses of philosophising and commits itself to a philosophical approach (...) more deeply grounded in the social sciences. (shrink)

This paper imagines what the liberatory possibilities of (full) ectogenesis are, insofar as it separates woman from female reproductive function. Even before use with human infants, ectogenesis productively disrupts the biological paradigm underlying current gender categories and divisions of labour. I begin by presenting a theory of women’s oppression drawn from the radical feminisms of the 1960s, which sees oppression as deeply rooted in biology. On this view, oppressive social meanings are overlaid upon biology and body, as artefacts of culture (...) and history. I then argue that ectogenesis should be pursued to replace two modes of assisted gestation that can be seen as outgrowths of oppressive assumptions about women's function, ectogenesis should be pursued to replace two modes of assisted gestation. These are gestational surrogacy and uterine transplant, which arise partly from gendered, pronatalist, and geneticist norms. These practices are supported by assumptions about women’s identity and value. Pursuing technologies such as ectogenesis, which weaken the presumed link between biology and gender, is beneficial to (trans-inclusionary radical) feminist aims, as part of a broad project of challenging dominant power relations resting on and maintaining gender categories. By allowing the conceptual separation of female reproductive function from ‘woman’, ectogenesis raises questions about how we determine who counts in this gender identity, and also how we value those who claim the identity ‘woman’. I conclude that ectogenesis has the potential to challenge traditional patriarchal family structures, and thence all other male-dominated structures (of work, education, cultural production), allowing a reimagining of the family and society in more radical ways than we have yet achieved. (shrink)