It is generally assumed that allocation problems in a socialized health care system result from limited resources and too much demand. Attempts at solutions have therefore centered in increasing efficiency, using evidence-based decision-making and on developing ways of balancing competing demands within the existing resource limitation. This article suggests that some of the difficulties in macro-allocation decision-making may result from the use of conflicting ethical perspectives by decision-makers. It presents evidence from a preliminary Canadian study to this effect.

Background Institutional review board (IRB) expertise is necessarily limited by maintaining a manageable board size. IRBs are therefore permitted by regulation to rely on outside experts for review. However, little is known about whether, when, why, and how IRBs use outside experts.Methods We conducted a national survey of U.S. IRBs to characterize utilization of outside experts. Our study uses a descriptive, cross-sectional design to understand how IRBs engage with such experts and to identify areas where outside expertise is most frequently (...) requested.Results The survey response rate was 18.4%, with 55.4% of respondents reporting their institution’s IRB uses outside experts. Nearly all respondents who reported using outside experts indicated they do so less than once a month, but occasionally each year (95%). The most common method of identifying an outside expert was securing a previously known subject matter expert (83.3%). Most frequently, respondents sought consultation for scientific expertise not held by current members (69.6%). Almost all respondents whose IRBs had used outside experts reported an overall positive impact on the IRB review process (91.5%).Conclusions Just over half of the IRBs in our sample report use of outside experts; among them, outside experts were described as helpful, but their use was infrequent overall. Many IRBs report not relying on outside experts at all. This raises important questions about what type of engagement with outside experts should be viewed as optimal to promote the highest quality review. For example, few respondents sought assistance from a Community Advisory Board, which could address expertise gaps in community perspectives. Further exploration is needed to understand how to optimize IRB use of outside experts, including how to recognize when expertise is lacking, what barriers IRBs face in using outside experts, and perspectives on how outside expert review impacts IRB decision-making and review quality. (shrink)

Pfeiffer, Kimberley We've heard it happening more than once. A couple uses IVF to fall pregnant then later down the track they conceive naturally. Confusing, right? Aren't they supposed to be infertile? Isn't that why people request this invasive and expensive procedure in the first place? Well, a recent study shows that more than 40% of women aged between 28 and 36 years that report having a history of infertility achieved subsequent births without using any form of reproductive assistance1. (...) Which raises the question, what does it mean to be infertile? (shrink)

Pezdek and Lam [Pezdek, K. & Lam, S. . What research paradigms have cognitive psychologists used to study “False memory,” and what are the implications of these choices? Consciousness and Cognition] claim that the majority of research into false memories has been misguided. Specifically, they charge that false memory scientists have been misusing the term “false memory,” relying on the wrong methodologies to study false memories, and misapplying false memory research to real world situations. We review each of these claims (...) and highlight the problems with them. We conclude that several types of false memory research have advanced our knowledge of autobiographical and recovered memories, and that future research will continue to make significant contributions to how we understand memory and memory errors. (shrink)

The quality of a research study application sends a distinct signal to the institutional review board (IRB) about the skills, capacities, preparation, communication, experience, and resources of its authors. However, efforts to research and define IRB application quality have been insufficient. Inattention to the quality of an IRB application is consequential because the application precedes IRB review, and perceptions of quality between the two may be interrelated and interdependent. Without a clear understanding of quality, IRBs do not know how to (...) define quality and researchers do not know how to achieve quality. This position has not been systematically studied to date, and future research could provide much-needed empirical validation. This paper lays the conceptual groundwork for future investigation into what constitutes quality in an IRB application. It includes a landscape review of multidisciplinary research on quality, as well as a discussion of quality frameworks analogous to research with human participants that exist in the published literature. It also examines the background and significance of federal research regulations, regulatory burdens, researchers’ regulatory literacy, and the roles and responsibilities of IRB professionals within this ecosystem. (shrink)

Debates about our moral relation to the law typically focus on the moral force of law. Often, the question asked is: Do we have a moral duty to follow the law? Recently, that question has been given a virtue-ethical formulation: Is there a virtue in abiding by the law? This paper considers our moral relation to the law in terms of virtue but focuses on a different question from the traditional ones. The question here is: Can the law model virtue (...) in beneficial ways that enable us to cultivate virtue? This paper shows that the law can do this by setting a moral example that we have good reason to emulate. This is significant given the distinctive influence the law has over our lives. The paper begins by examining the nature of a model, comparing different models of virtue, and then questions the possibility of a complete model of virtue such as the so-called Virtuous Person. The paper then articulates several ways in which the law can model virtue for us and responds to three objections: 1) the embodiment problem, 2) the poisoning problem, and 3) the emulation problem. (shrink)

Pfeiffer, Kimberley Review of: Conflicts of Conscience in Health Care: An Institutional Compromise, by Holly Fernandez-Lynch, Massachusetts Institute of Technology Press, 2008.

Cornish suggests that, because they were in the same class at school, Wittgenstein was the specific target of Hitler's bile in Mein Kampf, and that Hitler's beliefs about Jews came from the experience of meeting Wittgenstein at this time.

This pioneering collection of original essays aims to remedy the neglect of social needs and rights in human rights theory and practice by exploring the social dimensions of the human-rights minimum.

This collection gives George Yancy's transformative work in social and political philosophy and the philosophy of race the critical attention it has long deserved. Contributors apply perspectives from disciplines including philosophy, sociology, education, communication, peace and conflict studies, religion, and psychology.

This study steps beyond the traditional arguments of feminism and examines homebirth from a libertarian perspective. It addresses the debate over homebirth and midwifery, which includes the use of direct-entry midwives as well as the philosophical implications of individual autonomy expressed through consumer choice. Furthermore, this paper demonstrates that the medical establishment gains economic and political control primarily through medical licensing, and uses the state to undermine personal freedom as it advances a government-enforced monopoly on birth. At the same time, (...) empirical studies have established a substantial record of high safety and low medical complication rates for homebirth as compared to hospital births. Ultimately, the state’s restriction on medical choices is incompatible with the nonaggression principle and voluntarism, and therefore, with libertarianism. (shrink)

Arendt's innovation is to recognize that this countenancing of others is an aesthetic experience that creates the political world.Curtis plumbs the relevance of ...

A parallel may be drawn between the communicative aspect of civil disobedience and the communicative aspect of lawful punishment by the state. In punishing an offender, the state seeks to communicate both its condemnation of the crime committed and its desire for repentance and reformation on the part of the offender. Similarly, in civilly disobeying the law, a disobedient seeks to convey both her condemnation of a certain law or policy and her desire for recognition that a lasting change in (...) policy is required. When disobedients and authorities target each other, their confrontation allows for a direct comparison of the respective justifiability of their conduct. Their confrontation is explored in this paper with an eye to analysing how civil disobedients and authorities should engage with each other. (shrink)

This article shows that associative freedom is not what we tend to think it is. Contrary to standard liberal thinking, it is neither a general moral permission to choose the society most acceptable to us nor a content-insensitive claim-right akin to the other personal freedoms with which it is usually lumped such as freedom of expression and freedom of religion. It is at most (i) a highly restricted moral permission to associate subject to constraints of consent, necessity and burdensomeness; (ii) (...) a conditional moral permission not to associate provided our associative contributions are not required; and (iii) a highly constrained, content sensitive moral claim-right that protects only those wrongful associations that honour other legitimate concerns such as consent, need, harm and respect. This article also shows that associative freedom is not as valuable as we tend to think it is. It is secondary to positive associative claim-rights that protect our fundamental social needs and are pre-conditions for any associative control worth the name. (shrink)

Cornish suggests that, because they were in the same class at school, Wittgenstein was the specific target of Hitler's bile in Mein Kampf, and that Hitler's beliefs about Jews came from the experience of meeting Wittgenstein at this time.

In 2014, Ray Yeo published a modified account of the Spirit’s indwelling in “Towards a Model of the Indwelling: A Conversation with Jonathan Edwards and William Alston.” Yeo utilizes a conglomerate of Two-Minds Christology and Spirit Christology to provide a metaphysical framework for his model which he believes offers a viable alternative to more traditional merger accounts like those of Edwards and Alston. After providing an overview of Yeo’s objections to the merger accounts of Alston and Edwards, I will summarize (...) Yeo’s modified model. I will argue Yeo’s emphasis on the humanity of Christ in lieu of a literal, internal, and direct union of the Holy Spirit and the human person cannot alleviate the core metaphysical concerns which surface in all accounts of union between the divine and human. Yeo’s misunderstanding of Two-Minds Christology leads him to deny the full humanity of Christ; a humanity upon which his entire account of the indwelling relies. Yeo’s modified model will be shown unsuccessful as an account of the indwelling of the Holy Spirit even if one accepts both his conception of Two-Minds Christology and his conditions for indwelling. (shrink)

This collection gives George Yancy’s transformative work in social and political philosophy and the philosophy of race the critical attention it has long deserved. Contributors apply perspectives from disciplines including philosophy, sociology, education, communication, peace and conflict studies, religion, and psychology.

Values -- Tolerance -- Tolerant people -- Being tolerant of family -- Being tolerant of friends -- Being tolerant of neighbours -- Ways to be tolerant -- Being aware of others -- Respecting different kinds of families -- Accepting other cultures -- Including others -- Learning from others -- Being patient -- Personal set of values.

Oxford Legal Philosophy publishes the best new work in philosophically-oriented legal theory. It commissions and solicits monographs in all branches of the subject, including works on philosophical issues in all areas of public and private law, and in the national, transnational, and international realms; studies of the nature of law, legal institutions, and legal reasoning; treatments of problems in political morality as they bear on law; and explorations in the nature and development of legal philosophy itself. The series represents diverse (...) traditions of thought but always with an emphasis on rigour and originality. It sets the standard in contemporary jurisprudence.This book shows that civil disobedience is generally more defensible than private conscientious objection.Part I explores the morality of conviction and conscience. Each of these concepts informs a distinct argument for civil disobedience. The conviction argument begins with the communicative principle of conscientiousness. According to the CPC, having a conscientious moral conviction means not just acting consistently with our beliefs and judging ourselves and others by a common moral standard. It also means not seeking to evade the consequences of our beliefs and being willing to communicate them to others. The conviction argument shows that, as a constrained, communicative practice, civil disobedience has a better claim than private objection does to the protections that liberal societies give to conscientious dissent. This view reverses the standard liberal picture which sees private 'conscientious' objection as a modest act of personal belief and civil disobedience as a strategic, undemocratic act whose costs are only sometimes worth bearing.The conscience argument is narrower and shows that genuinely morally responsive civil disobedience honours the best of our moral responsibilities and is protected by a duty-based moral right of conscience.Part II translates the conviction argument and conscience argument into two legal defences. The first is a demands-of-conviction defence. The second is a necessity defence. Both of these defences apply more readily to civil disobedience than to private disobedience. Part II also examines lawful punishment, showing that, even when punishment is justifiable, civil disobedients have a moral right not to be punished. (shrink)

Brownlee rethinks human rights theory to reflect the fact that we are deeply social creatures. Our core social needs, for meaningful social inclusion, are more important than, and essential to, our civil, political, and economic needs. This grounds a right against social deprivation and a right to the resources to sustain other people.

In 1974, the United States Congress asked a question prompting a national conversation about ethics: which ethical principles should govern research involving human participants? To embark on an answer, Congress passed the National Research Act, and charged this task to the newly established National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. The Commission’s mandate was modest however, the results were anything but. The outcome was The Belmont Report: a trio of principles - respect for persons, (...) beneficence, and justice - serving as an ethical compass for scientists, researchers, and institutional review boards (IRBs). Almost 50 years later, the utility, legacy, and ingenuity of The Belmont Report continues to be both admired and challenged. Critics argue that Belmont is not fit for the 21st century, while supporters praise Belmont for its enduring wisdom. The goal of this paper is to equip IRB practitioners with the tools necessary to maximally interpret The Belmont Report and meaningfully engage in ethical analysis that reconsiders outmoded legacy thinking and fixed decision-making. Through historical and contextual reflection, this paper describes how IRB practitioners can contemporize review of ethical human research using their moral imagination – a skill found at the intersection of creativity, deliberation, and empathy. (shrink)

Human–wildlife interactions have existed for thousands of years, however as human populations increase and human impact on natural ecosystems becomes more intensive, both parties are increasingly being forced to compete for resources vital to both. Humans can value wildlife in many contexts promoting coexistence, while in other situations, such as crop-raiding, wildlife conflicts with the interests of people. As our closest phylogenetic relatives, chimpanzees in particular occupy a special importance in terms of their complex social and cultural relationship with humans. (...) A case study is presented that focuses on the Bossou chimpanzees’ perspective of their habitat in the Republic of Guinea, West Africa, by highlighting the risks and opportunities presented by a human-dominated landscape, and detailing their day-to-day coexistence with humans. Understanding how rural people perceive chimpanzees and how chimpanzees adapt to living in anthropogenic environments will enhance our understanding of how people-wildlife interactions develop into situations of conflict and therefore can generate sustainable solutions to prevent or mitigate situations of conflict. (shrink)

Human rights debates neglect social rights. This paper defends one fundamentally important, but largely unacknowledged social human right. The right is both a condition for and a constitutive part of a minimally decent human life. Indeed, protection of this right is necessary to secure many less controversial human rights. The right in question is the human right against social deprivation. In this context, ‘social deprivation’ refers not to poverty, but to genuine, interpersonal, social deprivation as a persisting lack of minimally (...) adequate opportunities for decent human contact and social inclusion. Such deprivation is endured not only in arenas of institutional segregation by prisoners and patients held in long-term solitary confinement and quarantine, but also by persons who suffer less organised forms of persistent social deprivation. The human right against social deprivation can be fleshed out both as a civil and political right and as a socio-economic right. The defence for it faces objections familiar to human rights theory such as undue burdensomeness, unclaimability, and infeasibility, as well as some less familiar objections such as illiberality, intolerability, and ideals of the family. All of these objections can be answered. (shrink)

Introduction ADAM CURETON AND KIMBERLEY BROWNLEE Disability and disadvantage are interrelated topics that raise important and sometimes overlooked issues in ...