The profession of medicine is predicated upon an ethical mandate: first do no harm. However, critics charge that the medical profession’s culture and its public health mission are being undermined by the pharmaceutical industry’s wide-ranging influence. In this article, we analyze how drug firms influence psychiatric taxonomy and treatment guidelines such that these resources may serve commercial rather than public health interests. Moving beyond a conflict-ofinterest model, we use the conceptual and normative framework of institutional corruption to examine how organized (...) psychiatry’s dependence on drug firms has distorted science. We suggest that academic-industry relationships have led to the corruption of the evidence base upon which accurate diagnosis and sound treatment depend. We describe the current dependency corruption and argue that transparency alone is not a solution — and sometimes even produces iatrogenic effects. Furthermore, we argue that the corruption of the evidence base for diagnostic and practice guidelines renders obsolete the traditional informed consent process, and we offer suggestions for reforming this process. (shrink)

The possibility that industry is exerting an undue influence on the culture of medicine has profound implications for the profession's public health mission. Policy analysts, investigative journalists, researchers, and clinicians have questioned whether academic-industry relationships have had a corrupting effect on evidence-based medicine. Psychiatry has been at the heart of this epistemic and ethical crisis in medicine. This article examines how commercial entities, such as pharmaceutical companies, influence psychiatric taxonomy and treatment guidelines. Using the conceptual framework of institutional corruption, we (...) show that organized psychiatry's dependence on drug firms has led to a distortion of science. We describe the current dependency corruption and argue that transparency alone is not a solution. We conclude by taking the position that the corruption of the evidence base in diagnostic and practice guidelines has compromised the informed consent process, and we suggest strategies to address this problem. (shrink)

The author of this paper discusses why the issue of financial conflicts of interest in psychiatry has important public health implications for women and why FCOI complicate the informed consent process. For example, when psychiatric diagnostic and treatment guidelines are unduly influenced by industry, informed consent becomes a critical issue, because women may be assigned diagnostic labels that are not valid and may also be receiving imbalanced or even inaccurate information about their mental health treatment options. However, mere disclosure of (...) industry relationships is an insufficient solution. Following Ells, the author offers a more robust account of autonomy, inspired by Foucault, to strengthen informed consent practices. In addition to addressing power relations, this Foucauldian account of autonomy emphasizes the relational and dialogical aspect of the physician–patient relationship. (shrink)

Drawing primarily from the work of Julia Kristeva and Judith Butler, the author suggests that a postmodern approach to identity can be used to challenge the essentialism that pervades both feminist empiricism and standpoint theory, and thus move feminist psychology in a more emancipatory direction. A major premise of this paper is that an engagement with postmodernism redirects our attention to symbolic constructions of femininity and to the sociopolitical grounding of experience.

Drawing primarily from the work of Julia Kristeva and Judith Butler, the author suggests that a postmodern approach to identity can be used to challenge the essentialism that pervades both feminist empiricism and standpoint theory, and thus move feminist psychology in a more emancipatory direction. A major premise of this paper is that an engagement with postmodernism redirects our attention to symbolic constructions of femininity and to the sociopolitical grounding of experience.

The last in a series of examinations, this paper articulates Husserl's mature position on the nature of a phenomenologically informed human science. Falling between the naïve positivity of a naturalistic approach to psychology and the transcendental view of consciousness at the base of phenomenological philosophy, we argue that a human scientific psychology—while not itself transcendental in nature needs to re-arise upon the transcendental ground as an empirical—but no longer transcendentally naïve—discipline through Husserl's notion of the "return to positivity." This notion (...) of the return allows us to avoid "transcendental psychologism," differentiating psychological from transcendental subjectivity but from a transcendental, rather than naïve perspective. In this way, the return to positivity reclaims psychology as a worldly, but no longer naïve, discipline. To facilitate an understanding of the different perspectives in question, and the process of leaving the naturalistic perspective in order to return to it once armed with a transcendental understanding and its associated tools, we continue to develop the illustrative example of anorexia provided in the first part of this series. In conclusion, we discuss the implications of this framework for transcendental reforms both of clinical practice and of psychological research. (shrink)

Individuals often describe objects in their world in terms of perceptual dimensions that span a variety of modalities; the visual (e.g., brightness: dark–bright), the auditory (e.g., loudness: quiet–loud), the gustatory (e.g., taste: sour–sweet), the tactile (e.g., hardness: soft vs. hard) and the kinaesthetic (e.g., speed: slow–fast). We ask whether individuals use perceptual dimensions to differentiate emotions from one another. Participants in two studies (one where respondents reported on abstract emotion concepts and a second where they reported on specific emotion episodes) (...) rated the extent to which features anchoring 29 perceptual dimensions (e.g., temperature, texture and taste) are associated with 8 emotions (anger, fear, sadness, guilt, contentment, gratitude, pride and excitement). Results revealed that in both studies perceptual dimensions differentiate positive from negative emotions and high arousal from low arousal emotions. They also differentiate among emotions that are similar in arousal and valence (e.g., high arousal negative emotions such as anger and fear). Specific features that anchor particular perceptual dimensions (e.g., hot vs. cold) are also differentially associated with emotions. (shrink)

Stem cell research. Drug company influence. Abortion. Contraception. Long-term and end-of-life care. Human participants research. Informed consent. The list of ethical issues in science, medicine, and public health is long and continually growing. These complex issues pose a daunting task for professionals in the expanding field of bioethics. But what of the practice of bioethics itself? What issues do ethicists and bioethicists confront in their efforts to facilitate sound moral reasoning and judgment in a variety of venues? Are those immersed (...) in the field capable of making the right decisions? How and why do they face moral challenge -- and even compromise -- as ethicists? What values should guide them? In The Ethics of Bioethics, Lisa A. Eckenwiler and Felicia G. Cohn tackle these questions head on, bringing together notable medical ethicists and people outside the discipline to discuss common criticisms, the field's inherent tensions, and efforts to assign values and assess success. Through twenty-five lively essays examining the field's history and trends, shortcomings and strengths, and the political and policy interplay within the bioethical realm, this comprehensive book begins a much-needed critical and constructive discussion of the moral landscape of bioethics. (shrink)

In this paper I critique two popular, non-scientific attitudes toward genetically engineered foods. In doing so, I will be employing the concepts of ambiguity, purity/impurity, control/resistance, and unity/diversity as developed by Latina feminist metaphysicians. I begin by casting a critical eye toward a specific anti-biotech account of transgenic food crops, an account that I will argue relies on an anti-feminist metaphysics. I then cast that same critical eye toward a specific pro-biotech account, arguing that it also relies on such an (...) anti-feminist metaphysics. I will argue further that this metaphysics yields a less accurate account of genetics. I end by arguing that if we adopt a Latina feminist metaphysics we can more accurately understand plants, genetics, and genetic engineering. (shrink)

One finds in the systems of natural languages some explicit means of elaborating not only upon the directness of the causal relationship believed to exist between two events X and Y (i.e. some means of specifying just how inevitably event X gives or gave rise to event Y), but also some manner of indicating just who or what is understood to be the primary instigator of the caused event. The goal of the present paper is to explore these notions in (...) detail and arrive at a formal, logic-based means of capturing them. (shrink)

In this article, we explore how a posthumanist stance has enabled us to work a different consideration of the way in which voice is constituted and constituting in educational inquiry; that is, we position voice in a posthuman ontology that is understood as attributable to a complex network of human and nonhuman agents that exceed the traditional understanding of an individual. Drawing on the work of Deleuze and Guattari, Barad, and Bennett, we present a research artifact that illustrates how this (...) posthuman voice is productively bound to an agentic assemblage. The reconfiguration of a posthuman voice with/in an educational research artifact further enables us to explore various analytic questions: What happens when voice exceeds language and is more than vocalized words emanating from a speaking subject? If the materiality of voice is not limited to sound, how do we account for it? That is, how might the materiality of voice be located in the space of intra-action among human and non-human objects? We conclude with implications for thinking qualitative methodology in education differently. (shrink)

Department of Philosophy and Center for Health Policy, Research and Ethics, George Mason University, 4400 University Avenue, MS 2D7, Fairfax, VA 22030, USA. Tel.: +1 703 993 1724; Fax: +1 5703 993 1555; Email: leckenwi{at}gmu.edu ' + u + '@' + d + ' '//--> . Abstract Here I consider the migration of health workers and propose a conception of transnational justice that can best address the concerns it raises, including the perpetuation of global health inequities. My focus will be (...) on nurses and direct care workers (DCWs), also called paraprofessionals—the vast majority of whom are women—coming from the global South to the United States. In the first part of the paper I will identify the factors behind this flow of what I will hereafter call ‘care workers’. From there, I will describe a conception of transnational justice that seems especially promising and explore selected policy options. Finally, I will conclude by offering specific prescriptions for action on the part of a wide range of agents, including institutions as well as individuals. CiteULike Connotea Del.icio.us What's this? (shrink)

COVID 19 has highlighted with lethal force the need to re-imagine and re-design the provisioning of human resources for health, starting from the reality of our radical interdependence and concern for global health and justice. Starting from the structured health injustice suffered by migrant workers during the pandemic and its impact on the health of others in both destination and source countries, I argue here for re-structuring the system for educating and distributing care workers around what I call a global (...) ecological ethic. Rather than rely on a system that privileges nationalism, that is unjust, and that sustains and even worsens injustice, including health injustice, and that has profound consequences for global health, a global ecological ethic would have us see health as interdependent and aim at “ethical place-making” across health ecosystems to enable people everywhere to have the capability to be healthy. (shrink)

The Declaration of Helsinki is recognised worldwide as a cornerstone of research ethics. Working in the wake of the Nazi doctors’ trials at Nuremberg, drafters of the Declaration set out to codify the obligations of physician-researchers to research participants. Its significance cannot be overstated. Indeed, it is cited in most major guidelines on research involving humans and in the regulations of over a dozen countries.Although it has undergone five revisions,1 and most recently incorporated language aimed at addressing concerns over research (...) carried out in resource-poor countries,2–5 the Declaration could go much farther in addressing the profoundly altered landscape of research with humans. Research involving humans is now a global enterprise and often involves participants from resource-poor countries. Rather than being carried out at single institutions by veteran researchers, many studies are now conducted at many locations—including sites that are not academic medical centres—by new and relatively inexperienced investigators. A growing number of projects involve novel agents, based on innovative work in genomics and proteomics. Increasingly, research is sponsored by the for-profit sector. National governments and professional organisations around the globe provide laws, regulations and standards for the conduct of research involving humans. Considerable scholarship also critiques and guides this endeavour.In light of the current effort of the World Medical Association to revise the Declaration, we offer ideas on how to re-conceive the concept of “vulnerability” and its links with the principle of justice and, in turn, redirect the attention of researchers towards those who might be so designated.In the research context, “vulnerability” is associated with an inability partly or totally to protect one’s own interests. Typically, conceptions of vulnerability centre upon characteristics associated with particular groups that …. (shrink)

Introduction 1.1 GOALS This book is devoted to an in-depth investigation of some of the properties of Logical Form (LF). In particular, the primary aim of ...

Tracy, Shariff, and Cheng (2010) present a timely and eloquent review of the current research on the emotion pride in terms of a naturalist framework. The present commentary not only echoes arguments relating to pride’s adaptive function, but also highlights some points of theoretical clarification. Specifically, we question the necessity of the naturalist approach and the emphasis on two facets of pride.

Critical congenital heart disease screening is rapidly becoming the standard of care in the United States after being added to the Recommended Uniform Screening Panel in 2011. Newborn screens typically do not require affirmative parental consent. In fact, most states allow parents to exempt their baby from receiving the required screen on the basis of religious or personally held beliefs. There are many ethical considerations implicated with allowing parents to exempt their child from newborn screening for CCHD. Considerations include the (...) treatment of religious exemptions in our current legal system, as well as medical and ethical principles in relation to the rights of infants. Although there are significant benefits to screening newborns for CCHD, when a parent refuses for religious or personal beliefs, in the case of CCHD screening, the parental decision should stand. (shrink)

BackgroundAustralian health and medical research funders support substantial research efforts, and incentives within grant funding schemes influence researcher behaviour. We aimed to determine to what extent Australian health and medical funders incentivise responsible research practices.MethodsWe conducted an audit of instructions from research grant and fellowship schemes. Eight national research grants and fellowships were purposively sampled to select schemes that awarded the largest amount of funds. The funding scheme instructions were assessed against 9 criteria to determine to what extent they incentivised (...) these responsible research and reporting practices: publicly register study protocols before starting data collection, register analysis protocols before starting data analysis, make study data openly available, make analysis code openly available, make research materials openly available, discourage use of publication metrics, conduct quality research, collaborate with a statistician, and adhere to other responsible research practices. Each criterion was answered using one of the following responses: “Instructed”, “Encouraged”, or “No mention”.ResultsAcross the 8 schemes from 5 funders, applicants were instructed or encouraged to address a median of 4 of the 9 criteria. Three criteria received no mention in any scheme. Importantly, most incentives did not seem strong as applicants were only instructed to register study protocols, discourage use of publication metrics and conduct quality research. Other criteria were encouraged but were not required.ConclusionsFunders could strengthen the incentives for responsible research practices by requiring grant and fellowship applicants to implement these practices in their proposals. Administering institutions could be required to implement these practices to be eligible for funding. Strongly rewarding researchers for implementing robust research practices could lead to sustained improvements in the quality of health and medical research. (shrink)

Pharmaceutical firms seek to fulfill their responsibilities to stakeholders by developing drugs that treat diseases. We evaluate the social and financial costs of developing new drugs relative to the realized benefits and find the industry falls short of its potential. This is primarily due to legislation-mandated reliance on animal test results in early stages of the drug development process, leading to a mere 10 percent success rate for new drugs entering human clinical trials. We cite hundreds of biomedical studies from (...) journals including Nature, Science, and the Journal of the American Medical Association to show animal modeling is ineffective, misleading to scientists, unable to prevent the development of dangerous drugs, and prone to prevent the development of useful drugs. Legislation still requires animal testing prior to human testing even though the pharmaceutical sector has better options that were unavailable when animal modeling was first mandated. We propose that the U.S. Food and Drug Administration and Congress should work together to abolish regulations and policies that require animal use. Doing so will benefit pharmaceutical industry stakeholders, including patients whose health depends on drugs and the many people who rely on the financial well-being of pharmaceutical firms. (shrink)

The purpose of this qualitative case study is to understand and critique the gendered political processes in the search for an athletic director following a merger between men’s and women’s intercollegiate athletic departments in a U.S. university. Semi-structured interviews were used to ask 55 athletic department stakeholders their perceptions of the search process and associated politics. Findings indicated gendered political activities occurred along gender-affiliated departmental lines. Political strategies contributed to gendered processes favoring certain masculinities and male candidates in the search (...) for an athletic director. While gender equity was an important consideration in the search process, because of the controversial nature of the merger and the politics expressed, the belief that hiring a man was essential to the merger’s success was widely accepted by many stakeholder groups. The findings are positioned in the critical management and sport literature. This research contributes to our understanding of the complexity of gender relations and provides insight into the gendered political processes that inform leadership searches. (shrink)

Lisa Kemmerer | : This article explores whether or not animal activists who engage in violence might legitimately be labelled “terrorists.” To this end, I examine common assumptions concerning the use of pre-emptive counter-violence in order to defend the comparatively defenceless. Through the use of casuistry, this essay compares specific hypothetical instances of killing comparatively defenceless individuals, beginning with scenarios that offer a clear general consensus, moving to more controversial cases. This indicates that contemporary violence on behalf of animal (...) liberation, often assumed to be rash and radical, is actually quite restrained. The intent of this paper is not to make claims as to how liberationists ought to behave, but rather to highlight egregious inconsistencies in our attitudes toward violence on behalf of those who are comparatively defenceless. | : Cet article vise à déterminer si les activistes animaliers qui se livrent à des actes violents doivent légitimement ou non être taxés de « terroristes ». À cette fin, j’examine les idées courantes relatives à l’utilisation de la violence préventive dans le but de défendre des êtres qui sont relativement sans défense. À l’aide de la casuistique, cet essai compare des exemples hypothétiques spécifiques de meurtres d’individus relativement sans défense, en commençant avec des scénarios qui offrent un consensus général clair, pour passer ensuite à des cas plus controversés. Cette recherche montre que la violence contemporaine perpétrée au nom de la libération des animaux, que l’on considère souvent comme étant téméraire et radicale, est en fait assez retenue. L’objectif de cet article ne consiste pas à prendre position au sujet de la façon dont les libérationnistes devraient se comporter, mais plutôt à mettre en évidence les incohérences flagrantes de nos attitudes face à la violence perpétrée au nom des êtres qui sont relativement sans défense. (shrink)

Worldwide, the aging population is growing by leaps and bounds, affecting all regions and most countries (WHO 2006a; Weinberger 2007). These changing demographics generate a greater need for long-term care, whether provided in homes or institutional settings such as assisted living facilities and nursing homes. The majority of those in need will dwell in developing countries. Most will be women. The current state of the dependent elderly and of long-term care systems around the world is, by all accounts, precarious and (...) in urgent need of attention. While there are important differences in these systems and among populations living under different social, political, economic, and health-care structures.. (shrink)

Many businesses, including professional sport teams, are designing and engaging in socially responsible initiatives which benefit stakeholders as well as the businesses themselves. Gaining insight into stakeholders' expectations regarding corporations' corporate social responsibility initiatives through dialogue is important as the way a business is viewed and evaluated by stakeholders underlies subsequent interactions. Based on semi-structured interviews with 42 diverse stakeholders involved in a professional sport team's CSR initiative we found that stakeholders' expectations of the team's involvement in the community related (...) to social and institutional norms, values, and benefits. The team also appeared to be meeting stakeholder expectations about being socially responsible in the community. This study provides new insights into a firm's CSR expectations through engaging in stakeholder management and interaction. Future research directions and practical suggestions are offered for organizations attempting to understand and meet stakeholders' expectations in the area of CSR. (shrink)

The issues are familiar to most in bioethics by now, through professional or personal experiences (or both). The rapidly expanding population of elderly persons who require care is raising critical...

Egg and sperm have, understandably, been the “stars” of mammalian fertilization biology, particularly because artificial reproductive technologies allow for fertilization to occur outside of the female reproductive tract without other apparent contributions from either sex. Yet, recent research, including an exciting new paper, reveals unexpected and important contributions of seminal plasma to fertility. For example, seminal plasma proteins play critical roles in modulating female reproductive physiology, and a new study in mice demonstrates that effects of some of these proteins on (...) the female can even affect the health of her progeny. Furthermore, although several actions of seminal plasma have been conserved across taxa, male accessory glands and their products are diverse – even among mammals. Taken together, these studies suggest that the actions of seminal plasma components are important to understand, and also to consider in future development of assisted reproductive technologies (ART) for humans, farm species and endangered species of mammals. (shrink)

In a White House ceremony on May 16, 1997, President Clinton issued an apology on behalf of the nation for the Tuskegee Syphilis Study, a forty-year research project in which African-American men were deceived and denied treatment in order to document the natural course of syphilis. Reflection on this occasion can give us pause to take pride in the progress made toward more ethical research with humans. The President's apology is perhaps the most public of a number of recent events (...) representing a renewed attention to ethics in research with human participants. Alongside it stand the efforts of treatment activists for people with acquired immune deficiency syndrome and the revelations of the human radiation experiments. In 1995, President Clinton called for the creation of the National Bioethics Advisory Commission, which was charged with a host of projects aimed at investigating the organization and function of the federal system for overseeing human subjects research in the United States, and giving guidance on specific forms of research. (shrink)

In a White House ceremony on May 16, 1997, President Clinton issued an apology on behalf of the nation for the Tuskegee Syphilis Study, a forty-year research project in which African-American men were deceived and denied treatment in order to document the natural course of syphilis. Reflection on this occasion can give us pause to take pride in the progress made toward more ethical research with humans. The President's apology is perhaps the most public of a number of recent events (...) representing a renewed attention to ethics in research with human participants. Alongside it stand the efforts of treatment activists for people with acquired immune deficiency syndrome and the revelations of the human radiation experiments. In 1995, President Clinton called for the creation of the National Bioethics Advisory Commission, which was charged with a host of projects aimed at investigating the organization and function of the federal system for overseeing human subjects research in the United States, and giving guidance on specific forms of research. (shrink)

This study investigated the cognitive processes involved in inductive reasoning. Sixteen undergraduates solved quadratic function–finding problems and provided concurrent verbal protocols. Three fundamental areas of inductive activity were identified: Data Gathering, Pattern Finding, and Hypothesis Generation. These activities are evident in three different strategies that they used to successfully find functions. In all three strategies, Pattern Finding played a critical role not previously identified in the literature. In the most common strategy, called the Pursuit strategy, participants created new quantities from (...) x and y, detected patterns in these quantities, and expressed these patterns in terms of x. These expressions were then built into full hypotheses. The processes involved in this strategy are instantiated in an ACT‐based model that simulates both successful and unsuccessful performance. The protocols and the model suggest that numerical knowledge is essential to the detection of patterns and, therefore, to higher‐order problem solving. (shrink)

Empathy is a developmental process whereby individuals come to understand the emotional states of others. While the exact nature of this process remains unknown, PAM's utility is that it establishes empathy along a continuum of behavior ranging from emotional contagion to cognitive forms, a very useful distinction for understanding the phylogeny and ontogeny of this important process. The model will undoubtedly fuel future research, especially from comparative domains where data are most problematic.