Decentralized biobanking “de-bi” applies blockchain technology and web3 values to embed the procedural principles of transparency, accountability, and inclusion into the biomedical research ecosyst...

Medical rules of eligibility permit severely injured Iraqi and Afghan nationals to receive care in Coalition medical facilities only if bed space is available and their injuries result directly from Coalition fire. The first rule favors Coalition soldiers over host-nation nationals and contradicts the principle of impartial, needs-based medical care. To justify preferential care for compatriots, wartime medicine invokes associative obligations of care that favor friends, family, and comrades-in-arms. Associative obligations have little place in peacetime medical care but significantly affect (...) wartime medicine. The second rule suggests liability for collateral harm that is unsupported by international law and military ethics. Absent liability, there are pragmatic reasons to offer medical care to injured local civilians if it quells resentment and cements support for Coalition forces. In contrast to peacetime medicine, military necessity and associative obligations outweigh distributive principles based on medical need during war. (shrink)

Asymmetric conflict is changing the way that we practise and think about war. Torture, rendition, assassination, blackmail, extortion, direct attacks on civilians, and chemical weapons are all finding their way to the battlefield despite longstanding international prohibitions. This book offers a practical guide for policy makers, military officers, students, and others who ask such questions as: do guerillas deserve respect or long jail sentences? Are there grounds to torture guerillas for information or assassinate them on the battlefield? Is there room (...) for nonlethal weapons to subdue militants and safeguard the lives of noncombatants? Who are noncombatants in asymmetric war? What is the status of civilians who shelter and aid guerillas? And, do guerillas have any right to attack civilians, particularly those who aid and shelter members of the stronger army? If one side can expand the scope of civilian vulnerability, then why can't the other? (shrink)

Drawing on victim precipitation theory, we propose that certain employees are more likely to perceive abusive supervision because of their personality traits. Specifically, we hypothesize that subordinates’ emotional stability, conscientiousness, and agreeableness will be negatively related to perceived abuse from their supervisor and that negative emotions at work will mediate these relationships. We surveyed 222 employees and found that emotional stability and conscientiousness negatively predicted employees’ self-reports of abusive supervision and that this relationship was mediated by negative emotions. Thus, employees (...) lower in emotional stability or conscientiousness are more likely to experience negative emotions, which in turn is related to higher levels of abuse. (shrink)

Because the goal of military medicine is salvaging the wounded who can return to duty, military medical ethics cannot easily defend devoting scarce resources to those so badly injured that they cannot return to duty. Instead, arguments turn to morale and political obligation to justify care for the seriously wounded. Neither argument is satisfactory. Care for the wounded is not necessary to maintain an army's morale. Nor is there any moral or logical connection between the right to health care (a (...) universal human right) and the duty to defend one's nation (a local political duty). Once badly wounded, soldiers enjoy the same right to medical care as any similarly ill or injured individual. National health care systems grasp this point and offer few additional health care benefits to veterans. In the United States, however, lack of universal health coverage skews the debate to focus on special entitlements for veterans without considering the health care rights that other citizens enjoy. (shrink)

The Israeli Patient Rights Act attempts to accommodate personal autonomy within an avowedly paternalist communitarian state. Although Israel is still groping toward a solution, the legislation begins to show the different form a communitarian version of autonomy must take.

Responsible citizens are expected to combine ethical judgement with judiciously exercised social activism to preserve the moral foundation of democratic society and prevent political injustice. But do they? Utilizing a research model integrating insights from rational choice theory and cognitive developmental psychology this book carefully explores three exemplary cases of morally inspired activism: Jewish rescue in wartime Europe, abortion politics in the United States, and peace and settler activism in Israel. From all three analyses a single conclusion emerges: the most (...) politically competent individuals are, most often, the least morally competent. This is the central paradox of political morality. These findings cast doubt on strong models of political morality characterized by enlightened moral reasoning and concerted political action while affirming alternative weak models that fuse activism with sectarian moral interests. They provide empirical support to further upend the liberal vision of democratic character, education, and society. (shrink)

Disparities in maternal morbidity and mortality for Latinx populations are a paradigmatic example of the now widely acknowledged structural racism in U.S. health care that predisposed minorities to...

Medical ethics in times of war are fundamentally different from those in times of peace. War brings military and medical values into conflict, often overwhelming other moral obligations, such as a doctor's charge to relieve suffering, in the face of military necessity.

Medical ethics in times of war are fundamentally different from those in times of peace. War brings military and medical values into conflict, often overwhelming other moral obligations, such as a doctor's charge to relieve suffering, in the face of military necessity.

“Medicalized” weapons—those that rely on advances in neuroscience, physiology, and pharmacology—offer the prospect of reducing casualties and protecting civilians. They could be especially useful in modern asymmetric wars in which conventional states are pitted against guerrilla or insurgent forces. But may physicians and other medical workers participate in their development?

Experiments are generally thought of as actions or operations undertaken to test a scientific hypothesis in settings detached from the rest of society. In this paper a different notion of experiment will be discussed. It is an understanding that has been developed in the classical tradition of the Chicago School of Sociology since the 1890s, but has so far remained unexplored. This sociological understanding of experiment does not model itself strictly on the natural sciences. Rather, it implies a process of (...) societal self-experimentation without a fixed setting of a sociological experimenter. The paper discusses this notion of experiment in relation to the recursive dependency of the application and the production of sociological knowledge. It is contended that this concept of a self-experimental society offers theoretical insights that could well prove fruitful for a sociological concept of experiment beyond the realm of the laboratory. (shrink)

Unlike most Western nations, Israel does not recognize full separation of church and state but seeks instead a gentle fusion of Jewish and democratic values. Inasmuch as important religious norms such as sanctity of life may clash with dignity, privacy, and self-determination, conflicts frequently arise as Israeli lawmakers, ethicists, and healthcare professionals attempt to give substance to the idea of a Jewish-democratic state. Emerging issues in Israeli bioethics—end-of-life treatment, fertility, genetic research, and medical ethics during armed conflict—highlight this conflict vividly.

Social scientists have traditionally attempted to avoid extending strategies for acquiring experimental knowledge to the sphere of the social. Bruno Latour, however, has introduced a notion of the collective experiment, an experiment conducted by and with us all. In this short paper I seek to explore, by way of elucidating the talk of collective experiments, that Latour's notion has long since existed in the theory and practice of ecological design and restoration. Practitioners in ecological restoration projects find themselves in a (...) situation of double contingency, since neither do they know how nature will respond to their intervention nor is their interpretation of these responses already certain. Experimental practice in society then becomes the proceduralization of this contingency. (shrink)

The revelation that menstruation tracking apps share sensitive data with third parties, like Facebook, provoked a sense of violation among users. This case highlights the need to address ethics and governance of health data created outside of traditional healthcare contexts. Commodifying health data breaches trust and entails health and moral risks. Through the metaphor of The Wizard of Oz, we argue that these apps approximate healthcare without the professional competency, fiduciary duties, legal protections and liabilities such care requires and thus (...) represent an innovation in the annals of snake-oil salesmanship and the systematic devaluing of women’s bodies, lives, and work. (shrink)

ABSTRACT How should physicians act when faced with corporal punishment, such as amputation, or torture? In most cases, the answer is clear: international law, UN resolutions and universal codes of medical ethics absolutely forbid physicians from countenancing torture and corporal punishment in any form. An acute problem arises, however, in decent societies, but not necessarily liberal states, that are, nonetheless, welcome in the world community. The decent society is often governed, in whole or in part, by religious laws, and while (...) these states abridge various human rights they are peace loving, generally tolerant, and offer their citizens wide avenues for political participation. Under these circumstances the prohibition against corporal punishment and torture weakens, often compelling physicians to participate. This is true in two cases. In Rawls’ hypothetical nation of Kazanistan, Islamic law is the order of the day, and amputations and corporal punishment play an integral part in the execution of traditional Islamic justice. In Israel, torture is sometimes used to elicit the information needed to thwart impending terror attacks. In each case, a physician's participation is essential. In light of the near universal condemnation that accompanies torture and corporal punishment, physicians can only appeal to norms anchored in collective well‐being and concern for life that override respect for human dignity in these societies. Western societies have consistently rejected this reasoning, but it is part and parcel of life in the decent society. (shrink)

abstract During the current round of fighting in the Middle East, Israel has provoked considerable controversy as it turned to targeted killings or assassination to battle militants. While assassination has met with disfavour among traditional observers, commentators have, more recently, sought to justify targeted killings with an appeal to both self‐defence and law enforcement. While each paradigm allows the use of lethal force, they are fundamentally incompatible, the former stipulating moral innocence and the latter demanding the presumption of criminal guilt. (...) Putting aside the paradigm of law enforcement which demands due process and forbids extra‐judicial execution, the only possible avenue for justifying named killings lies in self‐defence. While named killings might be defensible on the grounds that there are no other ways to disable combatants when they fight without uniforms, the costs, including the cost of targeted killing emerging as an acceptable convention in its own right, should be sufficient to view the practice with a good deal of caution. (shrink)

The assumption in current U.S. mainstream medicine is that birthing requires hospitalization. In fact, while the American College of Obstetricians and Gynecologists supports the right of every birthing person to make a medically informed decision about their delivery, they do not recommend home birth owing to data indicating greater neonatal morbidity and mortality. In this article, we examine the evidence surrounding home birth in the United States and its current limitations, as well as the ethical considerations around birth setting.

Women most fully experience the consequences of human reproductive technologies. Men who convene to evaluate such technologies discuss "them": the women who must accept, avoid, or even resist these technologies; the women who consume technologies they did not devise; the women who are the objects of policies made by men. So often the input of women is neither sought nor listened to. The privileged insights and perspectives that women bring to the consideration of technologies in human reproduction are the subject (...) of these volumes, which constitute the revised and edited record of a Workshop on "Ethical Issues in Human Reproduction Technology: Analysis by Women" (EIRTAW), held in June, 1979, at Hampshire College in Amherst, Massachusetts. Some 80 members of the workshop, 90 percent of them women (from 24 states), represented diverse occupations and personal histories, different races and classes, varied political commitments. They included doctors, nurses, and scientists, lay midwives, consumer advocates, historians, and sociologists, lawyers, policy analysts, and ethicists. Each session, however, made plain that ethics is an everyday concern for women in general, as well as an academic profession for some. (shrink)

Abortion, particularly late‐term abortion, and neonaticide, selective non‐treatment of newborns, are feasible management strategies for fetuses or newborns diagnosed with severe abnormalities. However, policy varies considerably among developed nations. This article examines abortion and neonatal policy in four nations: Israel, the US, the UK and Denmark. In Israel, late‐term abortion is permitted while non‐treatment of newborns is prohibited. In the US, on the other hand, late‐term abortion is severely restricted, while treatment to newborns may be withdrawn. Policy in the UK (...) and Denmark bridges some of these gaps with liberal abortion and neonatal policy. Disparate policy within and between nations creates practical and ethical difficulties. Practice diverges from policy as many practitioners find it difficult to adhere to official policy. Ethically, it is difficult to entirely justify perinatal policy in these nations. In each nation, there are elements of ethically sound policy, while other aspects cannot be defended. Ethical policy hinges on two underlying normative issues: the question of fetal/newborn status and the morality of killing and letting die. While each issue has been the subject of extensive debate, there are firm ethical norms that should serve as the basis for coherent and consistent perinatal policy. These include 1) a grant of full moral and legal status to the newborn but only partial moral and legal status to the late‐term fetus 2) a general prohibition against feticide unless to save the life of the mother or prevent the birth of a fetus facing certain death or severe pain and suffering and 3) a general endorsement of neonaticide subject to a parent's assessment of the newborn's interest broadly defined to consider physical harm as well as social, psychological and or financial harm to related third parties. Policies in each of the nations surveyed diverging from these norms should be the subject of public discourse and, where possible, legislative reform. (shrink)

Bruno Latour once argued that science laboratories actively modify the wider society by displacing crucial actors outside the laboratory into the “field.” This article turns this idea on its head by using the case of geothermal energy utilization to demonstrate that in many cases it is the experimental setup outside the laboratory that is there first, with the activities normally associated with a laboratory setting only being decided upon and implemented post hoc. As soon as the actors involved perceive unknowns (...) and uncertainties, these are relocated to various kinds of closed laboratories to be dealt with in a more controlled environment. This is done, for instance, by inviting stakeholders to laboratory-like settings or by analyzing the geochemical composition of fluids in laboratories. Thus, the risk-laden production of new knowledge by means of real-world experimentation amounts to a practice of relocating the context of discovery in society to laboratories of justification sometimes defined as such post hoc. Experimental processes in society can then be conceptualized as “real” experiments and laboratory activities as merely temporarily subordinated components of the larger experiment. (shrink)

Background: The division of non-paid labor in heterosexual parents in the West is usually still gender-based, with mothers taking on the majority of direct caregiving responsibilities. However, in same-sex couples, gender cannot be the deciding factor. Inspired by Feinberg’s ecological model of co-parenting, this study investigated whether infant temperament, parent factors (biological relatedness to child, psychological adjustment, parenting stress, and work status), and partner relationship quality explained how first-time gay, lesbian, and heterosexual parents divided labor (childcare and family decision-making) when (...) their infants were four months and 12 months old. We also tested whether family type acted as a moderator. Method: Participants were drawn from [MASKED FOR REVIEW]. Only those who provided information about their biological relatedness (yes or no) to their child (N = 263 parents) were included. When infants were four months (T1), parents completed a password-protected online questionnaire exploring their demographic characteristics including work status and standardized online-questionnaires on task division (childcare and family decision-making), infant temperament, parental anxiety, parental depression, parental stress, and partner relationship satisfaction. When infants were 12-months-old (T2), parents provided information about task division and their biological relatedness to their children. Results: Linear mixed models showed that no factor explained the division of family decision making at T1 and T2. For relative time spent on childcare tasks at T1, biological relatedness mattered for lesbian mothers only: biologically related mothers appeared to spend more time on childcare tasks than did non-related mothers. Results showed that, regardless of family type, parents who were not working or were working part-time at T1 performed more childcare tasks at T1. This was still true at T2. The other factors did not significantly contribute to relative time spent on childcare tasks at T2. Conclusion: We had the opportunity to analyze the division of non-paid tasks in families where parenting was necessarily planned and in which gender could not affect that division. Although Feinberg’s model of co-parenting suggests that various factors are related to task division, we found that paid work outside the home was most important during the first year of parenthood in determining caregiving roles. (shrink)

Military medical ethics is garnering growing attention today among medical personal in the American and other armies. Short courses or workshops in “battlefield ethics” for military physicians, nurses, medics, social workers, and psychologists address the nature of patient rights in the military, care for detainees, enemy soldiers and local civilians, problems posed by limited resources, ethical questions arising in humanitarian missions, as well as end-of-life issues, ethics consultations, care for veterans, advance directives, and assisted suicide. Although many of these issues (...) are the core subjects of any bioethics curriculum, military medical ethics presents unique challenges to bioethics educators. (shrink)

ABSTRACT How should physicians act when faced with corporal punishment, such as amputation, or torture? In most cases, the answer is clear: international law, UN resolutions and universal codes of medical ethics absolutely forbid physicians from countenancing torture and corporal punishment in any form. An acute problem arises, however, in decent societies, but not necessarily liberal states, that are, nonetheless, welcome in the world community. The decent society is often governed, in whole or in part, by religious laws, and while (...) these states abridge various human rights they are peace loving, generally tolerant, and offer their citizens wide avenues for political participation. Under these circumstances the prohibition against corporal punishment and torture weakens, often compelling physicians to participate. This is true in two cases. In Rawls’ hypothetical nation of Kazanistan, Islamic law is the order of the day, and amputations and corporal punishment play an integral part in the execution of traditional Islamic justice. In Israel, torture is sometimes used to elicit the information needed to thwart impending terror attacks. In each case, a physician's participation is essential. In light of the near universal condemnation that accompanies torture and corporal punishment, physicians can only appeal to norms anchored in collective well‐being and concern for life that override respect for human dignity in these societies. Western societies have consistently rejected this reasoning, but it is part and parcel of life in the decent society. (shrink)

Volume 19, Issue 9, September 2019, Page 50-52.

Since 2022, the EU, US, and other nations have imposed medical sanctions on Russia to block the export of pharmaceuticals and medical devices and curtail clinical trials to degrade Russia’s military capabilities. While international law proscribes sanctions that cause a humanitarian crisis, an outcome averted in Russia, the military effects of medical sanctions have been lean. Strengthening medical sanctions risks violating noncombatant and combatant rights to healthcare. Each group’s claim is different. Noncombatants and severely injured soldiers who cannot return to (...) duty enjoy the right to adequate health care that sanctions cannot undermine. Combatants falling captive enjoy the same medical care that adversaries provide their own troops. Combatants yet to renounce hostilities, however, have no claim to medical attention and remain subject to sanctions. Nevertheless, medical sanctions prove unworkable in this complex environment of conflicting rights and command no place in a sustainable sanction regime. (shrink)

Competent patients who refuse life saving medical treatment present a dilemma for healthcare professionals. On one hand, respect for autonomy and liberty demand that physicians respect a patient’s decision to refuse treatment. However, it is often apparent that such patients are not fully competent. They may not adequately comprehend the benefits of medical care, be overly anxious about pain, or discount the value of their future state of health. Although most bioethicists are convinced that partial autonomy or marginal competence of (...) this kind demands the same respect as full autonomy, Israeli legislators created a mechanism to allow ethics committees to override patients’ informed refusal and treat them against their will. To do so, three conditions must be satisfied: physicians must make every effort to ensure the patient understands the risks of non-treatment, the treatment physicians propose must offer a realistic chance of significant improvement, and there are reasonable expectations that the patient will consent retroactively. Although not all of these conditions are equally cogent, they offer a way forward to assure care for certain classes of competent patients without abandoning the principle of autonomy altogether. These concerns reach past Israel and should engage healthcare professionals wary that respect for autonomy may sometimes cause avoidable harm. (shrink)

Although the abortion debate continues to simmer in many places, the general issue of a woman's right to an abortion, at least in the Western democracies, is largely settled. In its place, the question of late-term abortion begins to assume a prominence only recently attributed to abortion itself. The advent of sophisticated fetal screening techniques makes possible detection of potentially severe fetal anomalies that in many cases are detected only late in the pregnancy, resulting in the need for late-term abortion.

In its American context the case of baby Messenger, a preterm infant disconnected from life-support by his father and allowed to die has generated debate about neonatal treatment protocols. Limited by the legal and ethical norms of the United States, this case did not consider treatment protocols that might be available in other countries such as Denmark and Israel: threshold protocols whereby certain classes of newborns are not treated, and preemptive abortion allowing one to choose late-term abortion rather than risk (...) delivery. Each offers a viable and ethically sound avenue for dealing with the economic and social expense of anomalous newborns by aborting or not treating those most likely to burden the health care system. Objections that these protocols are antithetical to American bioethical principles are considered but rejected as each policy answers to economic justice, utility and respect for autonomy. (shrink)

Both trolleys and war leave innocent victims to suffer death and injury. Trolley problems accounting for the injured, and not only the dead, tease out intuitions about liability that enhance our understanding of the obligation to provide compensation and medical care to civilian victims of war. Like many trolley victims, civilians in war may suffer justifiable, excusable, or negligent harms that demand compensation. Chief among these is collateral harm befalling civilians. Collateral harm is endemic to war and comprises permissible but (...) unavoidable death or injury following necessary and proportionate military operations. Although state armies sometimes offer condolence payments for civilian death, injury, and property loss, they deny liability. Instead, they use compensation to enhance counterinsurgency efforts and assuage feelings of agent regret. As part of the medical rules of eligibility, Coalition forces in Iraq and Afghanistan also provided medical care to victims of collateral harm. However, they denied care to similarly sick or injured civilians. While compensation is often justified to cure the harm civilians suffer, the differential use of medical resources is not. Rather, medical care remains subject to the principle of beneficence and medical need. The duty to provide civilian healthcare in war, particularly in wars of humanitarian intervention, is far-reaching and imposes significant costs that military and medical ethics are yet to recognize. (shrink)

Vigilante violence tends to take place in areas or situations in which the state is unable or unwilling to provide for the safety of certain groups. Crime control vigilantism can be understood as an alternative means of controlling crime and providing security where the state does not. The violent punishment inherent in vigilante activity is generally with the ultimate goal of providing safety and security, and thus should theoretically “fit the crime” and not be excessive. However, in many acts of (...) vigilante violence this is not the case, and vigilantism takes on an extraordinarily violent character. This article examines vigilante violence in three South African townships through the micro-sociological perspective of violence developed by Randall Collins, “forward panic.” Forward panic is a process whereby the tension and fear marking most potentially violent conflict situations is suddenly released, bringing about extraordinary acts of violence. Based on data from eighteen interviews gathered from the Johannesburg townships of Diepsloot, Freedom Park, and Protea South, I analyze respondents’ accounts and experiences with vigilante violence using the framework of forward panic. The data confirm that many acts of vigilante violence in South Africa’s townships can be clearly categorized as episodes of forward panic and that although Collins’s conception of forward panic focuses on the individual, the conditions that create the emotional potential for forward panic in an individual can be structural and thus create the potential for forward panic in entire groups or parts of communities. (shrink)

ABSTRACTAre all forms of guerilla warfare apprehensible? Or can there be such a thing as just guerilla warfare? If so, what would be the reasonable requirements we would make of guerillas in order to consider them just? The remarks below, based on my new book The Ethics of Insurgency; A Critical Guide to Just Guerilla Warfare, summarize my attempts to answer those questions, discussing such issues as legitimate authority, just cause, and compliance with the laws of armed conflict, including the (...) use of human shields and ‘soft-war’ tactics such as cyber warfare. Three commentators thereafter delve into some of the most central critical questions and objections, to which I subsequently reply. (shrink)

Desde la Antigüedad hasta nuestros días, los historiadores de la filosofía han criticado, reformulado y asentido a diversas tesis en torno a las implicaciones que ha tenido la categoría de naturaleza en el pensamiento de los filósofos -y filósofas- antiguos, medievales y modernos. A pesar de las dificultades que implica una investigación históricamente tan extensa, lo que resulta evidente de la categoría de naturaleza es su carácter plurívoco, ya que el concepto, en tanto categoría filosófica, ha sufrido múltiples transformaciones con (...) el paso del tiempo. En el presente trabajo, se intentará echar luz sobre dichas transformaciones en el marco de una perspectiva histórica y filosófica. (shrink)

Book reviewed in this article: The Custom‐Made Child? Women‐Centered Perspectives. Helen B. Holmes, Betty B. Hoskins, Michael Gross, editors.

In 12 narratives, medical workers from Afghanistan, Darfur, Gaza, Iraq, Israel, Myanmar, and Ukraine describe the day-to-day challenges of providing quality medical care in austere conflict zones. Faced with severe shortages of supplies, overwhelmed by sick and injured civilians and soldiers, and subject to constant attacks on medical personnel and facilities, the contributors to this collection confront difficult dilemmas of justice, medical impartiality, neutrality, burnout, and moral injury as they struggle to fulfill their duties as medical professionals, military officers, and (...) conscientious citizens. (shrink)

Just war theory focuses primarily on bodily harm, such as killing, maiming, and torture, while other harms are often largely overlooked. At the same time, contemporary international conflicts increasingly involve the use of unarmed tactics, employing 'softer' alternatives or supplements to kinetic power that have not been sufficiently addressed by the ethics of war or international law. Soft war tactics include cyber-warfare and economic sanctions, media warfare, and propaganda, as well as non-violent resistance as it plays out in civil disobedience, (...) boycotts, and 'lawfare.' While the just war tradition has much to say about 'hard' war - bullets, bombs, and bayonets - it is virtually silent on the subject of 'soft' war. Soft War: The Ethics of Unarmed Conflict illuminates this neglected aspect of international conflict. (shrink)

This article contributes to research on emotion expression, attributions, and discrete work emotions by developing an observer-focused model to explain the outcomes of crying at work. Our model is focused on crying as a form of emotion expression because crying may be driven by different felt emotions or be used as a means of manipulation. In addition, the model focuses on observers, who must form perceptions of the emotion expression in order to determine an appropriate response. This model is particularly (...) valuable because it addresses the reality that an observer will develop an impression of another person’s emotion and intention, and that this impression may not always align with the reality of the emotion being experienced by the expresser. (shrink)