Review of Tolstoy and Spirituality (Academic Studies Press, 2018), edited by Pedrag Cicovacki and Heidi Nada Grek, with articles by Miran Bozovic, Predrag Cicovacki, Abdusalam A. Guseynov, Robert Holmes, Božidar Kante, Rosamund Bartlett, Diana Dukhanova, Liza Knapp, Inessa Medzhibovskaya, Donna Tussing Orwin, Mikhail Shishkin, and Alexandra Smith.

There is little information about the content of ethics consultations in pediatrics. We sought to describe the reasons for consultation and ethical principles addressed during EC in pediatrics through retrospective review and directed content analysis of EC records at St. Jude Children's Research Hospital. Patient-based EC were highly complex and often involved evaluation of parental decision making, particularly consideration of the risks and benefits of a proposed medical intervention, and the physician's fiduciary responsibility to the patient. Nonpatient consultations provided guidance (...) in the development of institutional policies that would broadly affect patients and families. This is one of the few existing reviews of the content of pediatric EC and indicates that the distribution of ethical issues and reasons for moral distress are different than with adults. Pediatric EC often facilitates complex decision making among multiple stakeholders, and further prospective research is need.. (shrink)

Does the decision to relax by taking a drive rather than by taking a walk cause harm? In particular, do the additional carbon emissions caused by such a decision make anyone worse off? Recently several philosophers have argued that the answer is no, and on this basis have gone on to claim that act-consequentialism cannot provide a moral reason for individuals to voluntarily reduce their emissions. The reasoning typically consists of two steps. First, the effect of individual emissions on the (...) weather is miniscule: the planet’s meteorological system is so large, and the size of individual emissions so tiny, that whatever impact an individual emission has on the weather must be vanishingly small. Second, vanishingly small impacts aren’t morally relevant because no one could possibly tell the difference between such an impact occurring and it not occurring. In this paper, we show why both steps are mistaken, and hence why act-consequentialism implies that each of us has an individual obligation to do what we can to stop damaging the climate, including by refraining from, or perhaps by purchasing offsets against, our own individual luxury carbon emissions. (shrink)

Despite recent advances in HIV prevention and treatment, high HIV incidence persists among people who inject drugs. Difficult legal and political environments and lack of services for PWID likely contribute to high HIV incidence. Some advocates question whether any HIV prevention research is ethically justified in settings where healthcare system fails to provide basic services to PWID and where implementation of research findings is fraught with political barriers. Ethical challenges in research with PWID include concern about whether research evidence will (...) be translated into practice; concerns that research might exacerbate background risks; and ethical challenges regarding the standard of HIV prevention in research. While these questions arise in other research settings, for research with PWID, these questions are especially controversial. This paper analyses four ethical questions in determining whether research could be ethically acceptable: Can researchers ensure that research does not add to the burden of social harms and poor health experienced by PWID? Should research be conducted in settings where it is uncertain whether research findings will be translated into practice? When best practices in prevention and care are not locally available, what standard of care and prevention is ethically appropriate? Does the conduct of research in settings with oppressive policies constitute complicity? We outline specific criteria to address these four ethical challenges. We also urge researchers to join the call to action for policy change to provide proven safe and effective HIV prevention and harm reduction interventions for PWID around the world. (shrink)

Despite recent advances in HIV prevention and treatment, high HIV incidence persists among people who inject drugs. Difficult legal and political environments and lack of services for PWID likely contribute to high HIV incidence. Some advocates question whether any HIV prevention research is ethically justified in settings where healthcare system fails to provide basic services to PWID and where implementation of research findings is fraught with political barriers. Ethical challenges in research with PWID include concern about whether research evidence will (...) be translated into practice; concerns that research might exacerbate background risks; and ethical challenges regarding the standard of HIV prevention in research. While these questions arise in other research settings, for research with PWID, these questions are especially controversial. This paper analyses four ethical questions in determining whether research could be ethically acceptable: Can researchers ensure that research does not add to the burden of social harms and poor health experienced by PWID? Should research be conducted in settings where it is uncertain whether research findings will be translated into practice? When best practices in prevention and care are not locally available, what standard of care and prevention is ethically appropriate? Does the conduct of research in settings with oppressive policies constitute complicity? We outline specific criteria to address these four ethical challenges. We also urge researchers to join the call to action for policy change to provide proven safe and effective HIV prevention and harm reduction interventions for PWID around the world. (shrink)

Comparative pride—that is, pride in how one compares to others in some respect—is often thought to be warranted. In this paper, I argue that this common position is mistaken. The paper begins with an analysis of how things seem when a person feels pride. Pride, I claim, presents some aspect of the self with which one identifies as being worthy. Moreover, in some cases, it presents this aspect of the self as something one is responsible for. I then go on (...) to argue that when the focus of one's pride is comparative, things are never as pride makes them seem. The core problem is that if the performance in which one takes pride is really valuable, the fact that it is superior to the performance of others does nothing to contribute to that value. I conclude with a discussion of why so many are inclined to validate comparative pride and a response to those who claim that comparisons are essential to pride because they must be used to set standards of excellence. (shrink)

Volume 20, Issue 10, October 2020, Page 82-83.

Volume 19, Issue 10, October 2019, Page 97-98.

Volume 20, Issue 4, May 2020, Page 111-113.

Eyal et al have recently argued that researchers should consider conducting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) human challenge studies to hasten vaccine development. We have conducted (J. L.) and overseen (L. D.) human challenge studies and agree that they can be useful in developing anti-infective agents. We also agree that adults can autonomously choose to undergo risks with no prospect of direct benefit to themselves. However, we disagree that SARS-CoV-2 challenge studies are ethically appropriate at this time, for (...) 3 reasons: (1) current scientific knowledge of SARS-CoV-2 infection is insufficient to manage risks; (2) autonomous decision making, while necessary, does not override concerns about risk; and (3) undertaking challenge studies now would imperil confidence in the research enterprise, potentially undermining the global response to the coronavirus disease 2019 (COVID-19) pandemic. (shrink)

As part of the regulatory review process, both the Food and Drug Administration and Office for Human Research Protections (U.S. Department of Health and Human Services [HHS]...

How cautious should regulators be? A standard answer is consequentialist: regulators should be just cautious enough to maximize expected social value. This paper charts the prospects of a nonconsequentialist - and more precautionary - alternative. More specifically, it argues that a contractualism focused on ex ante consent can motivate the following regulatory criterion: regulators should permit a socially beneficial risky activity only if no one can be expected to be made worse off by it. Broadly speaking, there are two strategies (...) regulators can use to help risky activities satisfy this criterion: regulators can mandate strict safety standards that protect those who would otherwise stand to lose, and they can require that some of the benefits of the activity be redirected to them. In developing these themes, the paper aims to provide a theoretical grounding for those who oppose using risk-cost-benefit analysis as the primary regulatory standard, and in particular, for advocates of the precautionary principle. (shrink)

Volume 20, Issue 10, October 2020, Page 39-41.

Volume 19, Issue 11, November 2019, Page 39-41.

Envy of others' material possessions is a potent motivator of consumerism. This makes it a prudentially and morally hazardous emotional response. After outlining these hazards, I present an analysis of the emotion of envy. Envy, I argue, presents things in the following way: the envier lacks some good that her rival possesses; this difference between them is bad for the envier; this difference reflects poorly on the envier's worth; and this difference is undeserved. I then discuss the conditions under which (...) these presentations can be satisfied by differences in material possessions. My conclusion is that no difference in material possessions can simultaneously be all the ways envy presents it as being. Consequently, economic envy is systematically irrational: it is never a warranted response to the distribution of material wealth. Recognising this bolsters the prudential and moral case for reducing the degree to which we feel it and for resisting the inclinations it gives rise to when we do. (shrink)

As medicine and science advance, new ethical questions emerge. Over time, deliberation and analysis result in a somewhat settled approach to a problem. Often the settled approach is based on group...

Narrative has proven itself a continuous as well as adaptable means for environmentally oriented expression. Its role goes beyond the mediation of pre-existing knowledge imported into the realm of storytelling from other domains; rather, influential models of the natural world tend to circulate as storyworlds. This special issue of SubStance proceeds from the premise that narratives are not only a sequence of signs encoding a story but also “invisible, elusive representations that exist only in the mind”. Narrative forms generate and (...) transfer environmental knowledge; moreover, any specifically narrative concerns are important contributing factors to the models of agency, change... (shrink)

ZusammenfassungDie Erforschung der Antarktis galt um 1900 als eine der letzten großen Herausforderungen im Zuge der Erschließung der Welt. Viele Nationen beteiligten sich daran, darunter das deutsche Kaiserreich. So fanden im Jahrzehnt vor dem Ersten Weltkrieg auch zwei deutsche Antarktisexpeditionen statt: von 1901 bis 1903 unter der Leitung von Erich von Drygalski und in den Jahren 1911/12 unter der Leitung Wilhelm Filchners. Die Forschung hat das Verhältnis zwischen den Unternehmen der verschiedenen Nationen bislang oftmals mit einem Fokus entweder auf Wettbewerb (...) oder Zusammenarbeit beschrieben. Dieser Aufsatz zeigt, dass internationale Kooperation und Konkurrenz die deutsche Antarktisexploration in spannungsreicher Gleichzeitigkeit prägten. Dabei nutzten die Akteure von Beginn an beide Interaktionsmodi als argumentative Ressourcen und verfolgten bewusst und situativ variabel Handlungsoptionen nach sowohl kompetitiven als auch kooperativen Logiken. Die Akteure bemühten sich darum, keinen der beiden Modi überwiegen zu lassen, sondern ein Gleichgewicht zu wahren, um die sowohl aus Wettbewerb als auch aus Zusammenarbeit entstehenden Vorteile für sich nutzen zu können. Gerade die genauen Kriterien der Konkurrenz wurden dabei zum Teil in der Schwebe gehalten, um sich hier alle Möglichkeiten offen zu halten. Bei der retrospektiven Bewertung ihrer Expeditionen durch die deutsche Öffentlichkeit gelang es ihnen jedoch nicht, die Deutungshoheit über Erfolg und Misserfolg der Unternehmen zu gewinnen: Weder der Verweis auf erfolgreiche Kooperationen, noch auf den Sieg im Wettbewerb um wissenschaftliche Leistungen konnte in der öffentlichen Wahrnehmung im deutschen Kaiserreich die Niederlage beim Erreichen möglichst südlicher Breiten ausgleichen. (shrink)

This article seeks to advance ethical dialogue on choosing standards of prevention in clinical trials testing improved biomedical prevention methods for HIV. The stakes in this area of research are high, given the continued high rates of infection in many countries and the budget limitations that have constrained efforts to expand treatment for all who are currently HIV-infected. New prevention methods are still needed; at the same time, some existing prevention and treatment interventions have been proven effective but are not (...) yet widely available in the countries where they most urgently needed. The ethical tensions in this field of clinical research are well known and have been the subject of extensive debate. There is no single clinical trial design that can optimize all the ethically important goals and commitments involved in research. Several recent articles have described the current ethical difficulties in designing HIV prevention trials, especially in resource limited settings; however, there is no consensus on how to handle clinical trial design decisions, and existing international ethical guidelines offer conflicting advice. This article acknowledges these deep ethical dilemmas and moves beyond a simple descriptive approach to advance an organized method for considering what clinical trial designs will be ethically acceptable for HIV prevention trials, balancing the relevant criteria and providing justification for specific design decisions. (shrink)

In crafting our paper on addressing the ethical challenges in HIV prevention research with people who inject drugs, 1 we had hoped to stimulate further discussion and deliberation about the topic. We are pleased that three commentaries on our paper have begun this process. 2 3 4 The commentaries rightly bring up important issues relating to community engagement and problems in translating research into practice in the fraught environments in which PWID face multiple risks. These risks include acquisition of HIV (...) as well as criminalisation, stigma and lack of access to needed healthcare, prevention and social services. We take this opportunity to respond to the excellent points raised by the commentators. All of the commentaries support our emphasis on robust community engagement with PWID and other stakeholders in designing and conducting HIV prevention research, but urge us to go farther. Wolfe highlights the... (shrink)

In this paper Grice's requirements for assertability are imposed on the disjunction of Classical Logic. Defining material implication in terms of negation and disjunction supplemented by assertability conditions, results in the disappearance of the most important paradoxes of material implication. The resulting consequence relation displays a very strong resemblance to Schurz's conclusion-relevant consequence relation.

In crafting our paper on addressing the ethical challenges in HIV prevention research with people who inject drugs,1 we had hoped to stimulate further discussion and deliberation about the topic. We are pleased that three commentaries on our paper have begun this process.2 3 4 The commentaries rightly bring up important issues relating to community engagement and problems in translating research into practice in the fraught environments in which PWID face multiple risks. These risks include acquisition of HIV as well (...) as criminalisation, stigma and lack of access to needed healthcare, prevention and social services. We take this opportunity to respond to the excellent points raised by the commentators. All of the commentaries support our emphasis on robust community engagement with PWID and other stakeholders in designing and conducting HIV prevention research, but urge us to go farther. Wolfe highlights the difficulty of even engaging with community members in oppressive settings, where authorities severely restrict civil liberties of PWID so that even discussing issues related to drug use and enforcement may place individuals at risk. To overcome such limitations, he appropriately suggests interviewing confidentially those who have previously been detained in closed settings as part of the community engagement process. Similarly, Wolfe observes that critical issues can be overlooked with a narrow focus on study procedures if contextual factors before, during or after a study are ignored. For example, he cites the risk of overdose for study participants who have been abstinent during a study and subsequently resume injecting when the study concludes. These kinds of risks may not be obvious …. (shrink)

If stem cell-based therapies are developed, we will likely confront a difficult problem of justice: for biological reasons alone, the new therapies might benefit only a limited range of patients. In fact, they might benefit primarily white Americans, thereby exacerbating long-standing differences in health and health care.

The American Journal of Bioethics, Volume 12, Issue 6, Page 33-34, June 2012.

We report on the deliberations of an interdisciplinary group of experts in science, law, and philosophy who convened to discuss novel ethical and policy challenges in stem cell research. In this report we discuss the ethical and policy implications of safety concerns in the transition from basic laboratory research to clinical applications of cell-based therapies derived from stem cells. Although many features of this transition from lab to clinic are common to other therapies, three aspects of stem cell biology pose (...) unique challenges. First, tension regarding the use of human embryos may complicate the scientific development of safe and effective cell lines. Second, because human stem cells were not developed in the laboratory until 1998, few safety questions relating to human applications have been addressed in animal research. Third, preclinical and clinical testing of biologic agents, particularly those as inherently complex as mammalian cells, present formidable challenges, such as the need to develop suitable standardized assays and the difficulty of selecting appropriate patient populations for early phase trials. We recommend that scientists, policy makers, and the public discuss these issues responsibly, and further, that a national advisory committee to oversee human trials of cell therapies be established. **NB we did not reccommend a NAC, we think it might be appropriate**. (shrink)

This article studies the conceptions of social justice of women active in transnational migrant politics over a period of roughly 20 years in the Netherlands. The novel focus on migrant women reveals that transnational politics is almost completely male-dominated and -directed. Two of the exceptions found in this article include a leftist and a Kurdish women organization supporting the communist cause in the 1980s and the Kurdish struggle in the 1990s in Turkey, respectively. In both organizations gender equality was subordinated (...) to broader ideologies of political parties in their homeland. Leftist activists in the cold war era supported a narrow definition of the "politics of redistribution," while and Kurdish activists, combined classical features of the latter with those of traditional identity politics. (shrink)

This article proposes a more culturalist and variegated conception of the individual than that presented by individualization theorists. Inspired by the approach of the individual advocated by Émile Durkheim, Talcott Parsons and John Meyers, it first outlines the general script of the individual-as-actor that informs modern individualism as well as the generic characteristics that are routinely attributed to persons such as agency and free will. It subsequently reconstructs three predominant interpretations of this general script, i.e. utilitarian, moral and expressive individualism. (...) For each variant, the intellectual genesis and overall definition of the institutionalization in specific societal domains and the dominant articulations in social theory are briefly presented. With this threefold distinction, the aim is to synthesize the extensive literature on individualism and to show the sociological strengths of approaching subjectivity in terms of institutionalized scripts. (shrink)

Seeking to explain the emergence of anti-trafficking initiatives, scholars have explored two sets of ideas—national security and gender equality—thought to shape policy. In this study, we examine whether such ideational influence accounts for Sweden's evolving anti-trafficking policy over the past decade. As powerful domestic ideas about gender inequality informed the adoption of an abolitionist prostitution policy in the 1990s, one would expect similar ideas to influence domestic responses to the related issue of cross-border trafficking.However, our case study shows that the (...) policy area of trafficking has largely followed a different ideational path. Gendered ideas, periodically nested in a human rights discourse, have been salient in the public debate on trafficking in human beings, especially during the campaign to boycott the 2006 FIFA World Cup. However, they have exerted substantially less influence on Swedish legislative initiatives to combat trafficking, with security concerns still holding sway. (shrink)