Biomedical engineering technologies such as brain–machine interfaces and neuroprosthetics are advancements which assist human beings in varied ways. There are exciting yet speculative visions of how the neurosciences and bioengineering may influence human nature. However, these could be preparing a possible pathway towards an enhanced and even posthuman future. This article seeks to investigate several ethical themes and wider questions of enhancement, transhumanism and posthumanism. Four themes of interest are: autonomy, identity, futures, and community. Three larger questions can be asked: (...) will everyone be enhanced? Will we be “human” if we are not, one day, transhuman? Should we be enhanced or not? The article proceeds by concentrating on a widespread and sometimes controversial application: the cochlear implant, an auditory prosthesis implanted into Deaf patients. Cochlear implantation and its reception in both the deaf and hearing communities have a distinctive moral discourse, which can offer surprising insights. The paper begins with several points about the enhancement of human beings, transhumanism’s reach beyond the human, and posthuman aspirations. Next it focuses on cochlear implants on two sides. Firstly, a shorter consideration of what technologies may do to humans in a transhumanist world. Secondly, a deeper analysis of cochlear implantation’s unique socio-political movement, its ethical explanations and cultural experiences linked with pediatric cochlear implantation—and how those wary of being thrust towards posthumanism could marshal such ideas by analogy. As transhumanism approaches, the issues and questions merit continuing intense analysis. (shrink)

The idea of human-like robots with artificial intelligence (AI) engaging in sports has been considered in the light of robotics, technology and culture. However, robots with AI can also be used to clarify ethical questions in sports such as boxing with its inherent risks of brain injury and even death.This article develops an innovative way to assess the ethical issues in boxing by using a thought experiment, responding to recent medical data and overall concerns about harms and risks to boxers. (...) The thought experiment imagines a fight between a human and a robot. Critical issues about head trauma and brain injuries are then discussed. These can be summed up in two ethical questions: ‘why is it acceptable for a boxer to deliver concussive and recurrent subconcussive punches to a human head (skull and brain), powerful enough to achieve a knockout, or score more points, or to potentially inflict an injury immediately or eventually resulting in death?’, with the reciprocal question, ‘why is it acceptable to allow oneself to be injured in a like manner, possibly fatally, by an opponent?’The two questions are explored using the thought experiment in two matching perspectives: where the human boxer is attacking and the robot boxer is defending; and conversely, where the human boxer is on the receiving end of punches delivered by the robot. Each perspective opens with some general remarks, followed by an analysis of the boxing contest and eliciting some implications for future opportunities for the sport. (shrink)

Mild Cognitive Impairment (MCI) is a diagnostic category indicating cognitive impairment which does not meet diagnostic criteria for dementia such as Alzheimer’s disease. There are public health concerns about Alzheimer’s disease (AD) prompting intervention strategies to respond to predictions about the impacts of ageing populations and cognitive decline. This relationship between MCI and AD rests on three interrelated principles, namely, that a relationship exists between AD and MCI, that MCI progresses to AD, and that there is a reliable system of (...) classification of MCI. However, there are also several ethical issues and problems arising in the AD/MCI relationship. These include early diagnosis and interventions, the effects on people with MCI, and the newer neuroimaging and neuropharmacological approaches used in diagnosis and treatment. All these issues pose questions about the principles of MCI in relation to AD, with implications for how MCI is understood, diagnosed, treated, and experienced by patients. This article analyses four challenging areas for neuroethics: the definition and diagnosis of MCI; MCI in relation to AD; clinical implications of MCI for ethical disclosure, diagnosis, and treatment; and the research implications of MCI. The significant connections between these areas are often overlooked, together with uncertainties overall. Patients, healthcare systems and society are best served by informed clinicians, academics and researchers. After 35 years, the store of MCI knowledge is expanding and evolving. (shrink)

Academic scholarship has steadily reported unfavourable clinical findings on the sport of boxing, and national medical bodies have issued calls for restrictions on the sport. Yet, the positions taken on boxing by medical bodies have been subject to serious discussions. Beyond the medical and legal writings, there is also literature referring to the social and cultural features of boxing as ethically significant. However, what is missing in the bioethical literature is an understanding of the boxers themselves. This is apart from (...) their brain injuries, the debates about the degenerative brain disease known as chronic traumatic encephalopathy, and related issues about the disease. This article argues that the lives of boxers, their relationships, their careers, and their futures, also requires its own research, particularly in telling stories about their lives, and those lives and futures which boxing affects. The article uses two approaches. First, to imagine a more enduring “whole of life viewpoint” by using an extended future timeframe. Second, to consider perspectives of a person’s significant others. After reviewing the boxing literature, the article discusses social settings and then explores the hidden social relationships in life after boxing. With these longer time and close relationship viewpoints, three important themes emerge: family and kinship; age, stage and career; and the effects of boxing fatalities. These analyses are used in conjunction with relevant clinical findings. which complement the telling of stories to improve medical information, and engages professional and public empathy for people’s experience of illness and difficulties in coping. (shrink)

The face is the first thing that others notice and remember about a person. This is true for the severely facially burned patient, with disfigurement, impaired self-esteem and body image. They and others suffer from chronic devastating facial sequelae resulting from tumors, burns, or congenital malformations and trauma, e.g. ballistic injury to the face. Face transplantation is considered a way to restore eating, swallowing, and speech, and to reestablish esthetics.Alongside these vital bodily functions, the face plays a remarkable role in (...) a person’s identity. Societies place a high value on the face and this gives... (shrink)

Face transplantation is a landmark in reconstructive surgery involving vascularised composite allotransplantation. A recent issue of FT for patients who are blind has arisen. Some bioethicists recommend not excluding a patient who is blind, as this may amount to discrimination. From an ethical standpoint, FT for those with blindness is appropriate in selected candidates. This article seeks to add to the clinical evidence supporting FT for those with blindness by detailing a complementary psychosocial perspective. Currently, there is little relevant research (...) about the subjectivity of the blind. This is critical since the arguments against FT for the blind refer to their inability to see their face and to view the reaction of others to their disfigured faces. We begin with a brief look at examples of FT involving blindness and associated arguments. The next part is a multidisciplinary investigation of the experiences of the blind. These are gleaned from a close reading of the literature and drawing inferences, as direct studies are rare. The discussion analyses identity themes of the blind in relation to their faces: as they experience it; the face they wish to show to the world; and how others perceive and react to their face in a saturated environment of imagery and visual communication. Disability and the blind person’s experience of faces are well-founded considerations for medical practitioners and ethics boards in the process of FT decision-making. (shrink)

According to the dominant account of harming, to harm an agent is to cause her to occupy a harmed state. Matthew Hanser rejects this “state-based” account, arguing that each version of it faces counterexamples. Instead, Hanser argues, to harm an agent is to cause her to suffer harm, where suffering harm is undergoing an event: in particular, it is losing or being prevented from receiving a basic good. In this thesis, I argue that this “event-based” account is, at best, a (...) version of the state-based account. The identity of any event as the suffering of a harm, I argue, derives from the fact that it causes the agent to occupy a harmed state. I then defend the “counterfactual comparative” version of the state-based account against three prominent objections. The intended upshot of my arguments is that the state-based account of harming is superior to its event-based counterpart. (shrink)

The determination of death by neurological criteria (brain death) is practiced in at least 80 countries, though it is a matter of continuing controversy. At the same time, the brain is central to human life, thinking, and behavior; however, a growing “neurocentrism” or a brain‐focused image of human identity became established in most Western and in many non‐Western societies and acts as a forceful ideology. This paper seeks a broader theoretical and sociocultural basis to approaching death bioethically by analyzing criticisms (...) aimed at a neurologically focussed vision of human life, and then turning these towards the brain death criteria exposed to the criticism. The overall critique of the “neuro‐self” has scope to offer alternative perspectives to the contested issues in brain‐death criteria. Specifically, the paper examines two major shortcomings of a narrow brain view of life and culture. First, it considers the reduction of the individual to the brain: this is the crux of the neurological way of determining death, and is a way that is seemingly context‐independent and culturally neutral. Second, it considers how dimensions of society and culture for humans are detached from the brain and have little impact on clinical practice and thinking in brain‐death criteria; however, a deeper exploration reveals that they actually have direct relevance and that social and cultural factors have greater contributions to make to the current debates. (shrink)

Ever since Plato’s ‘Republic’ was written over two thousand years ago, one of the main concerns of social philosophy and later empirical social science was to understand the moral nature of human beings. The faculty to think and act in terms of overarching moral values is as much a defining hallmark of our species as is our intelligence, so _homo moralis_ is no less an appropriate term to describe humans as _homo sapiens_. This volume makes a case for the pivotal (...) role of social psychology as the core discipline for studying morality. The book is divided into four parts. First, the role of social psychological processes in moral values and judgments is discussed, followed by an analysis of the role of morality in interpersonal processes. The sometimes paradoxical, ironic effects of moral beliefs are described next, and in the final section the role of morality in collective and group behavior is considered. This book will be of interest to students and researchers in the social and behavioral sciences concerned with moral behavior, as well as professionals and practitioners in clinical, counseling, organizational, marketing and educational psychology where issues of ethics and morality are of importance. (shrink)

BackgroundHIV prevention research in resource-limited countries is associated with a variety of ethical dilemmas. Key amongst these is the question of what constitutes an appropriate standard of health care (SoC) for participants in HIV prevention trials. This paper describes a community-focused approach to develop a locally-appropriate SoC in the context of a phase III vaginal microbicide trial in Mwanza City, northwest Tanzania.MethodsA mobile community-based sexual and reproductive health service for women working as informal food vendors or in traditional and modern (...) bars, restaurants, hotels and guesthouses has been established in 10 city wards. Wards were divided into geographical clusters and community representatives elected at cluster and ward level. A city-level Community Advisory Committee (CAC) with representatives from each ward has been established. Workshops and community meetings at ward and city-level have explored project-related concerns using tools adapted from participatory learning and action techniques e.g. chapati diagrams, pair-wise ranking. Secondary stakeholders representing local public-sector and non-governmental health and social care providers have formed a trial Stakeholders' Advisory Group (SAG), which includes two CAC representatives.ResultsKey recommendations from participatory community workshops, CAC and SAG meetings conducted in the first year of the trial relate to the quality and range of clinic services provided at study clinics as well as broader standard of care issues. Recommendations have included streamlining clinic services to reduce waiting times, expanding services to include the children and spouses of participants and providing care for common local conditions such as malaria. Participants, community representatives and stakeholders felt there was an ethical obligation to ensure effective access to antiretroviral drugs and to provide supportive community-based care for women identified as HIV positive during the trial. This obligation includes ensuring sustainable, post-trial access to these services. Post-trial access to an effective vaginal microbicide was also felt to be a moral imperative.ConclusionParticipatory methodologies enabled effective partnerships between researchers, participant representatives and community stakeholders to be developed and facilitated local dialogue and consensus on what constitutes a locally-appropriate standard of care in the context of a vaginal microbicide trial in this setting.Trial registrationCurrent Controlled Trials ISRCTN64716212. (shrink)

The scientific, ethical, and policy issues raised by research involving the engraftment of human neural stem cells into the brains of nonhuman primates are explored by an interdisciplinary working group in this Policy Forum. The authors consider the possibility that this research might alter the cognitive capacities of recipient great apes and monkeys, with potential significance for their moral status.

In this article we build on the program of research in well-being marketing by further conceptualizing and refining the conceptual domain of the concept of consumer well-being (CWB). We then argue that well-being marketing is a business philosophy grounded in business ethics. We show how this philosophy is an ethical extension of relationship marketing (stakeholder theory in business ethics) and is superior to transactional marketing (a business philosophy grounded in the principles of consumer sovereignty). Additionally, we argue that well-being marketing (...) is based on duty ethics concepts, specifically the duty of beneficence and non-maleficence. Subsequently, we show how the well-being concept guides marketing decisions for consumer goods firms. (shrink)

Research has shown that corporate social responsibility (CSR) can have a positive impact on the firm’s reputation and financial performance. Moreover, CSR activities can have a positive impact on employees’ workplace experience. Consistent with past research, we argue that perceived organizational CSR value can have a positive impact on job satisfaction. We also argue that employees’ moral identity can play an important moderating role on the perceived CSR effect. Specifically, the current study was designed to test the predictive effects of (...) perceived organizational CSR value on job satisfaction. In addition, the study was designed to test the moderating roles of two moral identity dimensions, internalized and symbolic moral identity, on the effect of perceived organizational CSR value on job satisfaction. The study results were generally supportive of the hypotheses. Managerial implications of the study findings were also discussed. (shrink)

The purpose of this study was to develop and test a model capturing the effects of ethics institutionalization on employee experiences in work life and overall life satisfaction. It was hypothesized that explicit ethics institutionalization has a positive effect on implicit ethics institutionalization, which in turn enhances employee experiences in work life. It was also hypothesized that employee work life experiences have a positive effect on overall life satisfaction and happiness, moderated by work–family life conflict. Data were collected though a (...) survey of marketing managers in Italy. The data provide good but partial support for the model. Theoretical and managerial implications are discussed. (shrink)

Does the level of marketing activity in a country contribute to societal well-being or quality of life? Does economic efficiency also play a positive role in societal well-being? Does economic efficiency also moderate or mediate the marketing activity effect on societal well-being? Marketing activity refers to the pervasiveness of promotion expenditures and number of retail outlets per capita in a country. Economic efficiency refers to the extent to which the economy is unhampered by corruption, burdensome government regulation, and a large (...) informal economy. We used secondary data from the World Bank and other statistical sources to answer these questions. Our study findings suggest that both marketing activity and economic efficiency contribute positively to societal well-being, and that economic efficiency plays more of a mediator than moderator role between marketing activity and societal well-being. The public policy implication of this study is that increases in marketing activity and economic efficiency in countries characterized as low on both dimensions should significantly increase the quality of life in those countries. (shrink)

This paper examines the effects of moral philosophy and ethnocentrism on quality of life orientation in international marketing. It also provides a cross-cultural comparison of ethical values between Koreans and Americans. International quality-of-life (IQOL) orientation refers to marketers' disposition to make decisions to enhance the well-being of consumers in foreign markets while preserving the well-being of other stakeholders. It is hypothesized that marketers' moral philosophy and ethnocentrism influence the development of marketers' IQOL. Specifically, the higher the IQOL orientation of international (...) managers, the higher their moral idealism, the higher their moral relativism, and the lower their ethnocentrism. Also, it is hypothesized that American managers are likely to score higher on moral relativism but lower on moral idealism compared to their Korean counterparts. Also, Korean managers are expected to be more ethnocentric than American managers. Data were collected from business professionals who enrolled in professional MBA courses both from the U.S. and Korea. The results provided support for the hypothesized relationships. Managerial implications of these relationships are discussed. (shrink)

This paper looks at the ethics of opt-in vs. opt-out of organ donation as Scotland has transitioned its systems to promote greater organ availability. We first analyse studies that compare the donation rates in other regions due to such a system switch and find that organ increase is inconclusive and modest at best. This is due to a lack of explicit opt-out choices resulting in greater resistance and family override unless there are infrastructures and greater awareness to support such change. (...) The paper then looks at the difference between informed consent of the opt-in vs. presumed consent in the opt-out approaches. Patient autonomy and dignity are better reflected with informed consent. Eighteen months have passed since the new organ donation policy has come into effect, this paper recommends more research into organ donors’ psychological motivations to help governments and the healthcare profession obtain more organs for transplantation. (shrink)

This paper examines the effects of moral philosophy and ethnocentrism on quality of life orientation in international marketing. It also provides a cross-cultural comparison of ethical values between Koreans and Americans. International quality-of-life (IQOL) orientation refers to marketers' disposition to make decisions to enhance the well-being of consumers in foreign markets while preserving the well-being of other stakeholders. It is hypothesized that marketers' moral philosophy and ethnocentrism influence the development of marketers' IQOL. Specifically, the higher the IQOL orientation of international (...) managers, the higher their moral idealism, the higher their moral relativism, and the lower their ethnocentrism. Also, it is hypothesized that American managers are likely to score higher on moral relativism but lower on moral idealism compared to their Korean counterparts. Also, Korean managers are expected to be more ethnocentric than American managers. Data were collected from business professionals who enrolled in professional MBA courses both from the U.S. and Korea. The results provided support for the hypothesized relationships. Managerial implications of these relationships are discussed. (shrink)

We pose the question: Is consumer sovereignty in the healthcare market fact or fiction? Consumer sovereignty in healthcare implies that society benefits at large when healthcare organizations compete to develop high quality healthcare products while reducing the cost of doing business (reflected in low prices), and when consumers choose wisely among healthcare products by purchasing those high quality products at low prices. We develop a theoretical model that encourages systematic empirical research to investigate whether consumer sovereignty in healthcare is fact (...) or fiction. In doing so, we develop a series of theoretical propositions that may demonstrate that consumer sovereignty is more fiction than fact. Specifically, healthcare consumers lack the ability, motivation, and opportunity to choose healthcare products that are high in quality and low in price. Similarly, healthcare firms lack the ability, motivation, and opportunity to compete in ways to develop and market higher quality products at lower prices. (shrink)

Behavior, language, development, identity, and science—all of these phenomena are commonly characterized as 'social' in nature. But what does it mean to be 'social'? Is there any intrinsic 'mark' of the social shared by these phenomena? In the first book to shed light on this foundational question, twelve distinguished philosophers and social scientists from several disciplines debate the mark of the social. Their varied answers will be of interest to sociologists, anthropologists, philosophers, psychologists, and anyone interested in the theoretical foundations (...) of the social sciences. (shrink)

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)

Over 40 years of research have shown that traumatic brain injury affects brain volume. However, technical and practical limitations made it difficult to detect brain volume abnormalities in patients suffering from chronic effects of mild or moderate traumatic brain injury. This situation improved in 2006 with the FDA clearance of NeuroQuant®, a commercially available, computer-automated software program for measuring MRI brain volume in human subjects. More recent strides were made with the introduction of NeuroGage®, commercially available software that is based (...) on NeuroQuant® and extends its utility in several ways. Studies using these and similar methods have found that most patients with chronic mild or moderate traumatic brain injury have brain volume abnormalities, and several of these studies found—surprisingly—more abnormal enlargement than atrophy. More generally, 102 peer-reviewed studies have supported the reliability and validity of NeuroQuant® and NeuroGage®. Furthermore, this updated version of a previous review addresses whether NeuroQuant® and NeuroGage® meet the Daubert standard for admissibility in court. It concludes that NeuroQuant® and NeuroGage® meet the Daubert standard based on their reliability, validity, and objectivity. Due to the improvements in technology over the years, these brain volumetric techniques are practical and readily available for clinical or forensic use, and thus they are important tools for detecting signs of brain injury. (shrink)

In this engaging and provocative new book, Lee Eisenberg, bestselling author of The Number, dares to tackle nothing less than what it takes to find enduring meaning and purpose in life. He explains how from a young age, each of us is compelled to take memories of events and relationships and shape them into a one-of-a-kind personal narrative. In addition to sharing his own pivotal memories (some of them moving, some just a shade embarrassing), Eisenberg presents striking research culled from (...) psychology and neuroscience, and draws on insights from a pantheon of thinkers and great writers-Tolstoy, Freud, Joseph Campbell, Virginia Woolf, among others. We also hear from men and women of all ages who are wrestling with the demands of work and family, ever in search of fulfillment and satisfaction. It all adds up to a fascinating story, delightfully told, one that goes straight to the heart of how we explain ourselves to ourselves-in other words, who we are and why. (shrink)

Humanist sociologists are activists rooted in the reality of history and change and guided by a concern for the 'real life' problems of equality, peace, and social justice. They view people as active shapers of social life, capable of creating societies in which everyone's potential can unfold. Alfred McClung Lee introduces this volume with 'Sociology: Humanist and Scientific' and develops the theme that a sociology that is humanist is also scientific. The other nine selections are grouped into four parts: 'The (...) Individual and Social Life;' 'Social Institutions: Technology, Science, and Formal Organization;' 'Political Structures: Issues of Justice and Equality;' and 'Methodological Critiques and Counterproposals.'. (shrink)

Freedom and the Rule of Law takes a critical look at the historical beginnings of law in the United States, and how that history has influenced current trends regarding law and freedom. Anthony Peacock has compiled articles that examine the relationship between freedom and the rule of law in America. The rule of law is fundamental to all liberal constitutional regimes whose political orders recognize the equal natural rights of all.

Despite the supreme political and economic significance of boundaries--and ongoing challenges to existing national boundaries--scant attention has been paid to their ethics. This volume explores how diverse ethical traditions understand the political and property rights reflected in territorial and jurisdictional boundaries. It is the first book to bring together thinkers from a range of traditions, both religious and secular, to discuss the ethics of boundaries. Each contributor represents a tradition's views on questions surrounding the use of boundaries to delimit property (...) and political rights. What does it mean to own something? What resources should not be privately owned? What justifies the erection of political boundaries between one people and another? How ''hard'' should such boundaries be? What rights extend to minorities within a state? Should territorial boundaries coincide with social ones? Does national autonomy have an ethical basis, or is it an aspect of modern power politics? Should we aim for a more inclusive community than that afforded by modern nation-states? Cross-chapter dialogue and a substantive conclusion draw out similarities and differences among the traditions represented, traditions that include Christianity, classical liberalism, Confucianism, international law, Islam, Judaism, liberal egalitarianism, and natural law. In addition to the editors, the contributors are Nigel Biggar, Joseph Boyle, Joseph Chan, Russell Hardin, Will Kymlicka, Loren Lomasky, Robert McCorquodale, Richard B. Miller, David Novak, Sulayman Nyang, Michael Nylan, Raul C. Pangalangan, Daniel Philpott, Jeremy Rabkin, Hillel Steiner, M. Raquibuz Zaman, and Noam J. Zohar. (shrink)

This essay reconsiders Paul Ramsey’s “medical indications” policy and argues that his reconstruction of the case of Joseph Saikewicz demonstrates that there is more room for caretakers to decline treatments for “voiceless dependents” than his interlocutors have sometimes thought. It furthermore draws on Ramsey’s earlier work to propose ways that Ramsey might have improved his policy, and argues that the shortcomings of Ramsey’s view arise from his bracketing of age in making determinations about what form of medical care is (...) owed. The reading of Ramsey set forth here suggests Cathleen Kaveny’s depiction of the ‘medical indications’ policy in Ethics at the Edges of Law is too rigid and inflexible, even while it affirms other aspects of her critique. (shrink)