The objective of this study—a substudy to a phase I bioequivalence study—was to compare the effect of standard and concise consent forms on research volunteers’ comprehension of and satisfaction with consent forms, as well as to assess the effect of select volunteer characteristics, such as financial motivations to participate in research, on their comprehension. A 36-item questionnaire measured volunteers’ comprehension, satisfaction, and motivations for participation. Volunteers were randomized to the standard Pfizer consent form or a concise, easier-to-read form. We approached (...) 139 volunteers to participate, and 138 completed the questionnaire . The cohorts did not differ in sociodemographic characteristics. We found that the average comprehension scores for the standard consent form cohort and the concise consent cohort were about the same, and that satisfaction with the consent form was high in both cohorts. Surprisingly, volunteers with a financial motivation had significantly greater comprehension of the study. (shrink)

Reappraisal is a widely investigated emotion regulation strategy, often impaired in those with acquired brain injury. Little is known, however, about the tools to measure this capacity in pat...

A number of recent papers have described the successful derivation of egg and sperm precursor cells from mouse embryonic stem cells—so-called “artificial” gametes. Although many scientific questions remain, this research suggests numerous new possibilities for stem cell research and assisted reproductive technology, if a similar breakthrough is achieved with human embryonic stem cells. The novel opportunities raised by artificial gametes also prompt new ethical questions, such as whether same-sex couples should be able to access this technology to have children who (...) are genetically related to them both.THE CREATION OF “ARTIFICIAL” GAMETESOver the past two years, a number of papers have been published detailing the first successful attempts at differentiating mouse embryonic stem cells into egg1 and sperm2 precursor cells. Previously, researchers had used embryonic stem cells to generate tissues such as brain, liver, and pancreatic cells, but not germ cells of any kind. Production of gamete precursor cells was achieved initially through allowing stem cell lines to differentiate more or less randomly, but recent research has focused on identifying the precise ways in which differentiation into gametes can be precipitated and controlled. These breakthroughs make it seem likely that ongoing research on human stem cells will yield similar possibilities,3 raising questions over the practicalities of what might be achieved with such “artificial” gametes. In turn, the novel opportunities presented by artificial gametes raise a number of ethical concerns.The initial breakthrough, namely the obtaining of egg cells from mouse stem cells, was achieved by means of relatively simple science. Rather than coaxing stem cells to develop into eggs using complicated cocktails of growth factors, researchers adopted standard cell culture conditions, but grew the cells at higher density than usual.3–6 Growing the cells in this way led to the formation of ovary-like cell aggregates, which (when separated and stimulated with …. (shrink)

This paper adopts the lens of environmental ethics to explore whether there is a disparity between the ethical approaches of a company in comparison to those expressed by stakeholders in relation to environmental issues, specifically those communicated through the corporate environmental report. Discourse analysis is adopted to explore the environmental section of the sustainability reports of the case study company as compared to the responses of a sample of the company’s stakeholders, using the lens of three branches of environmental ethics: (...) utilitarianism, deontology and virtue ethics. Results indicate that the ethical approaches expressed in the case study company’s environmental reports were grounded in utilitarianism and deontology, in contrast to a virtue ethics approach expressed by external stakeholders. The disparity widened as the relationship between the company and the stakeholder became less direct. This disparity signals a failure to meet one of the primary purposes for preparing sustainability reports: to engage with stakeholders. As such this research contributes to the literature by identifying a disparity in the how this information is communicated compared with how it is perceived by stakeholders. This has important implications for the success of current stakeholder engagement practices. (shrink)

For over four decades, knowledge that symptoms of some inherited diseases can be prevented or reduced via early detection and treatment in newborns has underpinned state-funded screening programs in most developed countries. Conditions for which newborn screening is now a recognized preventative public health initiative include phenylketonuria, congenital hypothyroidism, and, more recently, cystic fibrosis and sickle cell disorder. The use of tandem mass spectrometry to detect conditions such as amino-acidopathies and fatty-acid oxidation defects is also becoming increasingly prevalent. a.

This paper queries the absence of disabled voices in contemporary citizenship literature. It argues that the language and imagery of the citizen is imbued with hegemonic normalcy and as such excludes disability. Feminist perspectives, such as those which argue for a form of maternal citizenship, largely fail to acknowledge disability experiences. Exclusionary practices are charted and links are made between gender, race and disability in this process. A citizenship which acknowledges disability is fundamental to re-imaging local, national and international collectivities.

Few subjects provoke as much controversy or debate as that of medical care, and the law that governs such an emotive area finds itself with the near-impossible task of simultaneously trying to regulate the medical profession and healthcare provision whilst upholding the rights of the millions of people who use those services every year. Medical Law combines an accessible explanation of the complex and challenging legal rules of medical care in England and Wales with a stimulating examination of the social, (...) political and ethical arguments such care provokes. It examines a broad range of issues, from the structure and organisation of the NHS, through the rules of clinical negligence, as well as focussing on the legal and ethical concerns around such deeply contentious areas as surrogacy, organ donation, abortion and euthanasia. Written very much with newcomers to the area in mind, Leanne Bell lucidly outlines not just what the law is, but how it has developed over time and also provides insights as to how advances in medical technology and techniques may call for it to evolve in the future. (shrink)

The pandemic has been the most vivid agent of change that many of us have known. But it has not changed everything: plenty of the institutions, norms, and practices that sustain racial capitalism, settler colonialism, and cisheteropatriarchy have either weathered the storm of the crisis or been nourished by its effects. And yet enough has changed for us to see that the pandemic has profoundly recontextualised those structures and systems of violence, bringing us into a fresh negotiation with, for example, (...) the question of how we discuss and imagine freedom. Responding in part to this unexpected provocation, activist-scholars Robyn Maynard and Leanne Betasamosake Simpson forged a collaboration from the lockdown of 2020, corresponding by letter to create their forthcoming book, Rehearsals for Living, due to be published by Haymarket Books (US) and Knopf (Canada) in 2022. In this interview, we asked them to explain the epistolary form of the book and expand on the concept of “rehearsal”, before inviting them to reflect on a series of issues that animate our current crises: the politics of recognition; the notion of apocalypse; ways to disrupt linear temporalities; practises of reciprocity against proprietary logics; the gendered violence of state apparatuses; and worldbuilding as a method of resistance. In their expansive answers, Robyn and Leanne draw on their experiences as organisers and educators, commenting on anticolonial struggles, the Movement for Black Lives, and the rise of abolition discourse. Stressing the need to build a multiplicity of shared homespaces in the face of racial/colonial capitalism and organized abandonment, they challenge us to rethink the predicaments and possibilities of the present, enabling us to imagine futures liberated of extractivist, carceral governance – “planting more liberatory futures in the present”, as Robyn puts it. The task of sowing those seeds is a collective praxis of rewriting the narratives that constitute us, refusing to hear that nothing can change and insisting that everything must. (shrink)

This paper explores the difficulties of implementing international human rights standards in post conflict states, particularly in Islamic States, using Afghanistan as a case study. The paper will submit that imposing international human rights law with a ‘top down' approach is ineffective, using the example of the western-style Afghan constitution which contains many human rights protections, such as freedom of religion, that cannot be realized in contemporary Afghan society. It will be argued that a more transparent, consultative and long-term approach (...) to human rights implementation should be taken in post conflict situations, if ‘human rights' is to be more than a catch phrase for membership of the international community. (shrink)

Feminist scholarship on the relative importance of working-class institutional strength in the economy and in the state has led to two divergent conclusions. Radical feminists argue that working-class institutions dominated by men produce male-biased outcomes; socialist feminists hold that working-class institutions promote classwide interests that benefit women as well as men. This article addresses this debate by applying generic and gendered working-class strength models of the welfare state in an examination of women's public pension quality. Quality is measured as women's (...) average pension compared with that of men, relative to women's average earnings, and compared with the average wage in the society. The authors find support for the socialist feminist view. Working-class institutions, having historically organized and represented the interests of working men, benefit women by improving the security and adequacy of their retirement incomes, but it is women's access to working-class economic and political institutions that brings greater economic equality with men in old age. (shrink)

Investigation of “out-of-body experiences” has implications for understanding both normal bodily-self integration and its vulnerabilities. Beyond reported associations between OBEs and specific brain regions, however, there have been few investigations of neurochemical systems relevant to OBEs. Ketamine, a drug used recreationally to achieve dissociative experiences, provides a real-world paradigm for investigating neurochemical effects. We investigate the strength of the association of OBEs and ketamine use relative to other common drugs of abuse. Self-report data from an online survey indicate that both (...) lifetime frequency of ketamine use and OBEs during ketamine intoxication were more strongly related to the frequency of OBEs and related phenomena than other drugs. Moreover, the apparent effects of other drugs could largely be explained by associated ketamine use. The present results, consistent with the role of NMDA receptors in OBEs, should encourage future studies of the role of neurochemical systems in OBEs. (shrink)

This chapter focuses on the way that cultures change and how cultural diversity is created, maintained and lost. Human culture is the inevitable result of the way our species acquires its behavior. We are extremely social animals and an overwhelming proportion of our behavior is socially learned. The behavior of other animals is largely a product of innate evolved determinants of behavior combined with individual learning. They make quite modest use of social learning while we acquire a massive cultural repertoire (...) from the people we associate with (Richerson & Boyd, 2005: Chapter 2). Expertise in exploiting our environment, values about what matters in life and even feelings about whom to trust and whom to hate are mostly “absorbed” from those around us. (shrink)

In this paper, the authors revisit the pre-service teacher practicum experience and propose that mobile technology, with its ability to provide instant communication and immediate access to resources, could minimise the “disconnect” between theory and the school classroom and improve the experience for all parties involved. However, before this project began, the wide-ranging ethical considerations surrounding the use of mobile technologies had to be addressed. This paper outlines a range of issues that should be considered whenever mobile technologies are to (...) be employed when researching in schools. (shrink)

This target article considers the ethical implications of providing prenatal diagnosis (PND) and antenatal screening services to detect fetal abnormalities in jurisdictions that prohibit abortion for these conditions. This unusual health policy context is common in the Latin American region. Congenital conditions are often untreated or under-treated in developing countries due to limited health resources, leading many women/couples to prefer termination of affected pregnancies. Three potential harms derive from the provision of PND in the absence of legal and safe abortion (...) for these conditions: psychological distress, unjust distribution of burdens between socio-economic classes, and financial burdens for families and society. We present Iran as a comparative case study where recognition of these ethical issues has led to the liberalization of abortion laws for fetuses with thalassemia. We argue that physicians, geneticists and policymakers have an ethical and professional duty of care to advocate for change in order to ameliorate these harms. (shrink)

By placing the theories of Jung and Patañjali in dialogue with one another, Consciousness in Jung and Patañjali illuminates significant differences between dual and nondual psychological theory and teases apart the essential discernments that theoreticians must make between epistemic states and ontic beliefs.

Jung’s individuation process, the central process of human development, relies heavily on several core philosophical and psychological ideas including the unconscious, complexes, the archetype of the Self, and the religious function of the psyche. While working to find empirical evidence of the psyche’s religious function, Jung studied a variety of subjects including the Eastern liberatory traditions of Buddhism and Patañjali’s Classical Yoga. In these traditions, Jung found substantiation of his ideas on psychospiritual development. Although Jung’s career in soul work was (...) lengthy, throughout, he aimed to steer clear of metaphysics. Patañjali’s metaphysics, on the other hand, are straightforward, and his ontological commitments are evident. Because Jung’s ontological commitments were not explicit, his theories, when seen through Patañjali’s lens, confuse ontological questions with epistemic issues. As a result, when comparing the Jungian and Patañjalian notions of the Self, Jung’s insightful ideas seem to be constructed upon a considerably shaky foundation. Yet, utilizing the exceptionally consistent ontological and epistemological commitments of Patañjali Yoga, as well as the objective measures of affective neuroscience, brings credence to the innate aspects and instinctual nature of Jung’s archetype of the Self, and assists in answering the question of whether the archetype is innate or emergent. (shrink)

Materialist and fundamentalist reductive ideologies obscure our capacity to directly experience the numinous. Thus, importantly, given the weight of the observable and measurable in orthodox science, and oftentimes a dismissal of both the soul and the subjective, a viable means of reconciling science and religious experience has continued to elude us. As a counter-measure to this obscuration, Jungian-oriented depth psychology has developed as an empirical science of the unconscious, researching both subject and object and offering theories and practices that foster (...) the psychospiritual development of the personality. Despite cultural and epochal differences, comparable evidence to Jung's process of psychospiritual development can be found in the Eastern liberatory tradition of Patañjali's Classical Yoga. However, given the elevated presence of neuroscience, no psychology, and especially no psychology that supports the soul, seems likely to survive much longer without finding an alliance with the objective measures of brain science. When considering the radically empirical measures of Jung and Patañjali, affective neuroscience may offer us a contemporary and objective means of languaging the bridge between the transcendent and immanent and fostering a contemporary science of the sacred. (shrink)

For both Jung and Patañjali our human desire to understand “God” is as real as any other instinct. Jung’s and Patañjali’s models further align in their emphasis on the teleological directedness of the psyche, and their aim at reconciling science and religious experience. As an atheist, Freud was in disagreement, but all three scholars align in their emphasis on the study of affect as an empirical means of entering into the psyche. For Patañjali, the nadir of affect lays in transcending (...) sorrow and stabilizing the mind. Mental stability in turn produces the capacity to fully differentiate between the binding states of mind, which lead to human suffering, and the experience of pure consciousness resting in authentic nature. Contemporary brain research indicates that conscious states are inherently affective—further, the upper brainstem is intrinsically conscious whereas the cortex is not; it derives its consciousness from the brainstem. Understanding consciousness, then, may have less to do with reflective cognition than with instinct. This research spotlights the phenomena of affect, as it appears to not only draw us back to the highly significant rupture of the Freud Jung dialogue, but also forward into formulating a contemporary clinical picture of the drive towards (or away from) religious experience. (shrink)

Our current scientific exploration of reality oftentimes appears focused on epistemic states and empiric results at the expense of ontological concerns. Any scientific approach without explicit ontological arguments cannot be deemed rational however, as our very Being can never be excluded from the equation. Furthermore, if, as many nondual philosophies contend, subject/object learning is to no avail in the attainment of knowledge of ontic reality, empiric science will forever bear out that limitation. Putting Jung's depth psychology in dialogue with Patañjali's (...) yoga philosophy is one way to attempt an alliance between dualistic and nondualistic models. Jung's assertion of an unconscious is what notably sets him apart from Patañjali. Furthermore, whereas Patañjali distinguishes between pure consciousness and the contents of consciousness, Jung does not. Although both Jung and Patañjali attempt to ground their work in the direct experience of life, and guide us towards wholeness, looking at Jung through the lens of nonduality, wholeness appears beyond reach. It is through Jung's synchronicity hypothesis where we may be able to forge a bridge between the models. This bridge allows a contemporary argument for an understanding of the ontic reality of pure consciousness, and subsequently the discrimination between things as they are and things as they appear. Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 _ _. (shrink)

Empirical evidence suggests that some health professionals believe consent procedures for the emerging technology of non-invasive prenatal diagnosis (NIPD) should become less rigorous than those currently used for invasive prenatal testing. In this paper, we consider the importance of informed consent and informed choice procedures for protecting autonomy in those prenatal tests which will give rise to a definitive result. We consider whether there is anything special about NIPD that could sanction a change to consent procedures for prenatal diagnosis or (...) otherwise render informed decision-making less important. We accept the claim that the absence of risk of miscarriage to some extent lessens the gravity of the decision to test compared with invasive methods of testing. However, we also claim that the definitive nature of the information received, and the fact that the information can lead to decisions of great significance, makes NIPD an important choice. This choice should only be made by means of a rigorous and appropriately supported decision-making process (assuming that this is what the pregnant woman wants). We conclude that, on balance, consent procedures for NIPD should mirror those for invasive testing, albeit without the need to emphasise procedure-related risk. (shrink)

The law often calls on the concept of public interest for assistance. Privacy law makes use of this concept in several ways, including to justify consent waivers for secondary research on health information. Because the law sees information privacy as a means for individuals to control their personal information, consent can only be set aside in special circumstances. Ballantyne and Schaefer argue that only public interest, and only a broad conception of public interest, can do the special ‘normative justificatory work’ (...) to override consent requirements. Other, similar-sounding concepts, such as public benefit, public good and social value, also provide useful services. But none more so than public interest. In fact, they argue, public interest is the superior concept precisely because it can capture those concepts as well as a range of other interests. Our response focuses on this claim. We argue their strategy is not as promising as it might first seem. Ballantyne and Schaefer construe the important role that public interest plays in this context as their endpoint. They claim that unless the concept is open and content-rich, it will lose some of its importance. But by refusing to place limits around it, their inquiry leads us back to a catch-all concept that lacks clear focus or meaning. In reply, we argue that, for practically minded theorists, a narrow conception of public interest is more useful. Further, the narrowing of public interest in this context can be achieved by first analysing it in its legal, rather than ethical, sense. (shrink)

Recent scientific advances mean the widespread introduction of non-invasive prenatal diagnosis (NIPD) for chromosomal aneuploidies may be close at hand, raising the question of how NIPD should be introduced as part of antenatal care pathways for pregnant women. In this paper, the authors examine the ethical implications of three hypothetical models for using NIPD for aneuploidy in state-funded healthcare systems and assess which model is ethically preferable. In comparing the models, the authors consider their respective timings; how each model would (...) fit with current screening and diagnostic tests offered to pregnant women; the implications of offering NIPD at different stages of pregnancy; and the potential for each model to support reproductive autonomy and informed decision-making. The authors conclude by favouring a model that would be offered at 11–13 weeks gestation, alongside existing combined screening, provided that this is accompanied by measures to maximise informed decision-making, for example, provision of adequate pretest and post-test counselling. (shrink)

Crime, Justice and Human Rights is an introduction to the philosophy, law and politics of human rights, uniquely tailored to criminologists and criminal justice practitioners. Integrating human rights and criminological frameworks across a range of subject areas - from criminalization and state crime, to crime prevention and critical analyses of the operation of the police, courts and penal system - the authors highlight both the potential and the limitations of human rights in informing new directions in criminology. Featuring case material (...) from Europe, North America, Australia and beyond, this critical, multidisciplinary text supports the teaching of human rights across a wide range of criminological topics, and assists students, researchers and independent readers to incorporate human rights paradigms into their criminological analysis. (shrink)

Phillips & Silverstein's focus on schizophrenia as a failure of “cognitive coordination” is welcome. They note that a simple hypothesis of reduced Gamma synchronisation subserving impaired coordination does not fully account for recent observations. We suggest that schizophrenia reflects a dynamic compensation to a core deficit of coordination, expressed either as hyper- or hyposynchronisation, with neurotransmitter systems and arousal as modulatory mechanisms.

This chapter examines whether religion is adaptive: if it changes from one generation to another, from a specific culture to another, and how other domains of culture influence changes in a certain religion. It begins by providing the basics of evolution, including adaptation and selection of characteristics at multiple levels. It explains how religion promotes cooperation, and which elements of religion contribute to this and how effective they are. Also, it explores how established churches depend and select a certain frequency (...) of believers, as in the same community, same culture, etc. The chapter concludes that even in the presence of biological and cultural complexity and diversity, religions are unlikely to support generalizations about adaptation versus maladaptation. (shrink)

Multiple studies show that periodic reanalysis of genomic test results held by clinical laboratories delivers significant increases in overall diagnostic yield. However, while there is a widespread consensus that implementing routine reanalysis procedures is highly desirable, there is an equally widespread understanding that routine reanalysis of individual patient results is not presently feasible to perform for all patients. Instead, researchers, geneticists and ethicists are beginning to turn their attention to one part of reanalysis—reinterpretation of previously classified variants—as a means of (...) achieving similar ends to large-scale individual reanalysis but in a more sustainable manner. This has led some to ask whether the responsible implementation of genomics in healthcare requires that diagnostic laboratories routinely reinterpret their genomic variant classifications and reissue patient reports in the case of materially relevant changes. In this paper, we set out the nature and scope of any such obligation, and analyse some of the main ethical considerations pertaining to a putative duty to reinterpret. We discern and assess three potential outcomes of reinterpretation—upgrades, downgrades and regrades—in light of ongoing duties of care, systemic error risks and diagnostic equity. We argue against the existence of any general duty to reinterpret genomic variant classifications, yet we contend that a suitably restricted duty to reinterpret ought to be recognised, and that the responsible implementation of genomics into healthcare must take this into account. (shrink)

Genomic screening at population scale generates many ethical considerations. One is the normative role that people’s preferences should play in determining access to genomic information in screening contexts, particularly information that falls beyond the scope of screening. We expect both that people will express a preference to receive such results and that there will be interest from the professional community in providing them. In this paper, we consider this issue in relation to the just and equitable design of population screening (...) programs like reproductive genetic carrier screening (RGCS). Drawing on a pluralistic public health ethics perspective, we claim that generating and reporting information about genetic variants beyond the scope of the screening program usually lacks clinical, and perhaps personal, utility. There are both pragmatic and ethical reasons to restrict information provision to that which fits the stated purpose of the program. (shrink)

Clinical ethics committees (CECs) in the United Kingdom (UK) have developed significantly over the past 15 years. The issue of access to and participation in clinical ethics consultation by patients and family members has, however, gone largely unrecognized. There are various dimensions to this kind of contact, including patient notification, consent and participation. This study reports the first specific investigation of patient contact with UK CECs. A questionnaire study was carried out with representatives from UK CECs. Results suggest that patient (...) participation in clinical ethics consultation is low and unlikely to change significantly in the near future. Attitudes towards patients having a role in clinical ethics consultation are mixed, with a variety of reasons put forward both for and against patient participation. These results are discussed in the light of common themes in the literature and the practical and political context of clinical ethics support in the UK. (shrink)