Importance Informed consent is essential to ethical, rigorous research and is important to recruitment and retention in cancer trials.Objective To examine cancer clinical trial (CCT) participants’ perceptions of informed consent processes and variations in perceptions by cancer type.Design and Setting and Participants Cross-sectional survey from mixed-methods study at National Cancer Institute–designated Northeast comprehensive cancer center. Open-ended and forced-choice items addressed: (1) enrollment and informed consent experiences and (2) decision-making processes, including risk-benefit assessment. Eligibility: CCT participant with gastro-intestinal or genitourinary, hematologic-lymphatic (...) malignancies, lung cancer, and breast or gynecological cancer (N = 334).Main Outcome Measures Percentages satisfied with consent process and information provided; and assessing participation’s perceptions of risks/benefits. Multivariable logistic or ordinal regression examined differences by cancer type.Results Most patient-participants felt well informed by the consent process (more than 90% overall and by cancer type) and. most (87.4%) reported that the consent form provided all the information they wanted, although nearly half (44.8%) reported that they read the form somewhat carefully or less. More than half (57.9%) said that talking to research staff (i.e., the consent process) had a greater impact on participation decisions than reading the consent form (2.1%). A third (31.1%) were very sure of joining in research studies before the informed consent process (almost half of lung cancer patients did—47.1%). Most patients personally assessed the risks and benefits before consenting. However, trust in physicians played an important role in the decision to enroll in CCT.Conclusions and Relevance Cancer patients rely less on written features of the informed consent process than on information obtained from the research staff and their own physicians. Research should focus on information and communication strategies that support informed consent from referring physicians, researchers, and others to improve patient risk-benefit assessment and decision-making. (shrink)

One of the core problems with engineering ethics education is perceptual. Although ethics is meant to be a central component of today’s engineering curriculum, it is often perceived as a marginal requirement that must be fulfilled. In addition, there is a mismatch between faculty and student perceptions of ethics. While faculty aim to communicate the nuances and complexity of engineering ethics, students perceive ethics as laws, rules, and codes that must be memorized. This paper provides some historical context to better (...) understand these perceptual differences, and suggests that curriculum constraints are important contributing factors. Drawing on the growing scholarship of student engagement approaches to pedagogy, the paper explores how students can be empowered to effect change in the broader engineering curriculum through engineering ethics. The paper describes a student engagement approach to pedagogy that includes students as active participants in curriculum design—a role that enables them to critically reflect about why ethics is a requirement. Including students in the process of curriculum design leads students to reframe ethics as an integrative tool with the capacity to bring together different engineering departments and build bridges to non-engineering fields. This paper argues that students can and should play an active and important role in relocating ethics from the periphery to the core of the engineering curriculum. (shrink)

Emotions are often portrayed as subjective judgments that pose a threat to rationality and morality, but there is a growing literature across many disciplines that emphasizes the centrality of emotion to moral reasoning. For engineers, however, being rational usually means sequestering emotions that might bias analyses—good reasoning is tied to quantitative data, math, and science. This paper brings a new pedagogical perspective that strengthens the case for incorporating emotions into engineering ethics. Building on the widely established success of active and (...) collaborative learning environments, in particular the problem-based learning philosophy and methodology, the paper articulates new strategies for incorporating emotion into engineering ethics education. An ethics education pilot study is analyzed to explore how PBL can engage students’ emotions. Evidence suggests that PBL empowers students to cultivate value for engineering ethics and social responsibility, and in doing so, redefine the societal role of the engineer. Taking students’ emotions seriously in engineering ethics offers an effective strategy to meaningfully engage students in ethical learning. (shrink)

Background:Clinical investigation is a growing field employing increasing numbers of nurses. This has created a new specialty practice defined by aspects unique to nursing in a clinical research context: the objectives, setting, and nature of the nurse–participant relationship. The clinical research nurse role may give rise to feelings of ethical conflict between aspects of protocol implementation and the duty of patient advocacy, a primary nursing responsibility. Little is known about whether research nurses experience unique ethical challenges distinct from those experienced (...) by nurses in traditional patient-care settings.Research objectives:The purpose of the study was to describe the nature of ethical challenges experienced by clinical research nurses within the context of their practice.Research design:The study utilized a qualitative descriptive design with individual interviews.Participants and research context:Participating nurses self-identified as having experienced ethical challenges during screening. The majority were Caucasian, female, and worked in outpatient settings. Approximately 50% had > 10 years of research experience.Ethical considerations:The human subjects review board approved the study. Written informed consent was obtained.Findings:Predominant themes were revealed: the inability to provide a probable good, or/do no harm, and dual obligations. The following patterns and subthemes emerged: conflicted allegiances between protocol implementation, needs of the participant, desire to advance science, and tension between the nurse–patient therapeutic relationship versus the research relationship.Discussion:Participants described ethical challenges specific to the research role. The issues are central to the nurse–participant relationship, patient advocacy, the nurse’s role in implementing protocols, and/or advancing science.Conclusion:Ethical challenges related to the specialized role of clinical research nurses were identified. More research is warranted to fully understand their nature and frequency and to identify support systems for resolution. (shrink)

Little is known about how certain patient characteristics can affect the timing of an ethics consultation, which has been hypothesized to affect patient length of stay. This study assessed how specific patient characteristics affect the timing of an ethics consultation, namely, age (over 65 years), race, Medicaid status, the presence of a living will, the presence of a health care proxy, and the absence of decisional capacity. Moving beyond the typical case-series evaluation of an ethics consultation service, this study used (...) an innovative approach to model how predisposing, enabling, and need factors affect health behavior and subsequently affect health outcomes for patients who received an ethics consultation at a Catholic health care system in Oklahoma. (shrink)

In the _World Library of Educationalists_, international experts themselves compile career-long collections of what they judge to be their finest pieces – extracts from books, key articles, salient research findings, major theoretical and practical contributions – so the world can read them in a single manageable volume, allowing readers to follow the themes of their work and see how it contributes to the development of the field. Mary James has researched and written on a range of educational subjects which (...) encompass curriculum, pedagogy and assessment in schools, and implications for teachers´ professional development, school leadership and policy frameworks. She has written many books and journals on assessment, particularly assessment for learning and is an expert on teacher learning, curriculum, leadership for learning and educational policy. Starting with a specially written introduction in which Mary gives an overview of her career and contextualises her selection, the chapters are divided into three parts: Educational Assessment and Learning Educational Evaluation and Curriculum Development Educational Research and the Improvement of Practice Through this book, readers can follow the different strands that Mary James has researched and written about over the last three decades, and clearly see her important contribution to the field of education. (shrink)

Use of humanities content in American medical education has been debated for well over 60 years. While many respected scholars and medical educators have purported the value of humanities content in medical training, its inclusion remains unstandardized, and the undergraduate medical curriculum continues to be focused on scientific and technical content. Cited barriers to the integration of humanities include time and space in an already overburdened curriculum, and a lack of consensus on the exact content, pedagogy and instruction. Edmund Pellegrino, (...) physician and scholar of the latter twentieth century, spent much of his professional life promoting the value and importance of the humanities in medical education, seeking the best way to incorporate and teach this content in clinically relevant ways. His efforts included the founding of multiple enterprises starting in the 1960s and 1970s to promote human values in medical education, including the Society for Health and Human Values and its Institute on Human Values in Medicine. Regardless of his efforts and those of many others into the current century, the medical humanities remains a curricular orphan, unable to find a lasting home in medical education and training. (shrink)

Human Nature offers a wide-ranging and holistic view of human nature from all perspectives: scientific, historical, and sociological. Mary Clark takes the most recent data from a dozen or more fields, and works it together with clarifying anecdotes and thought-provoking images to challenge conventional Western beliefs with hopeful new insights. Balancing the theories of cutting-edge neuroscience with the insights of primitive mythologies, Mary Clark provides down-to-earth suggestions for peacefully resolving global problems. Human Nature builds up a coherent, and (...) above all positive, picture of who we really are. (shrink)

Mary Daly had a complicated relationship to the Catholic tradition. While it is commonly assumed that she rejected it thoroughly, this article offers a more nuanced look at the various ways in which it shaped her thinking. What is clear is that she had a decisive impact on the Catholic tradition, indeed on religion in general. Language about the divine, images of deities, human participation in things spiritual will never be the same after her thorough-going feminist critique. Her legacy (...) is multi-faceted like the woman herself. (shrink)

Researchers have recently documented the unexpected opportunities war can present for women. While acknowledging the devastating effects of mass violence, this burgeoning field highlights war’s potential to catalyze grassroots mobilization and build more gender sensitive institutions and legal frameworks. Rwanda and Bosnia-Herzegovina serve as important examples of this phenomenon, yet a closer examination of both cases reveals the limits on women’s capacity to take part in and benefit from these postwar shifts. This article makes two key contributions. First, it demonstrates (...) how the postwar political settlement created hierarchies of victimhood that facilitated new social divisions and fractured women’s collective organizing. Second, it argues that while war creates certain opportunities for women, a revitalization of patriarchy in the aftermath can undermine these gains. Drawing on more than 250 interviews with women in both countries, this article ultimately questions the extent to which postwar mobilization can be maintained or harnessed for genuine gender emancipation. (shrink)

We review the findings of Cho et al.(1) on the crystal structure of a p53 tumor suppressor‐DNA complex. The core DNA binding domain of p53 folds into a structure termed a β‐sandwich, which organizes two loops and a loop‐sheet‐helix structure on one surface of p53 to interact with the consensus DNA recognition sequence of p53. These structures help to explain the functions of wild‐type p53 and the effects of tumor‐associated mutations on p53 DNA binding, transactivation and suppression of cellular proliferation.

It is widely accepted that translational research practitioners need to acquire special skills and knowledge that will enable them to anticipate, analyze, and manage a range of ethical issues. While there is a small but growing literature that addresses the ethics of translational research, there is a dearth of scholarship regarding how this might apply to engineers. In this paper we examine engineers as key translators and argue that they are well positioned to ask transformative ethical questions. Asking engineers to (...) both broaden and deepen their consideration of ethics in their work, however, requires a shift in the way ethics is often portrayed and perceived in science and engineering communities. Rather than interpreting ethics as a roadblock to the success of translational research, we suggest that engineers should be encouraged to ask questions about the socio-ethical dimensions of their work. This requires expanding the conceptual framework of engineering beyond its traditional focus on “how” and “what” questions to also include “why” and “who” questions to facilitate the gathering of normative, socially-situated information. Empowering engineers to ask “why” and “who” questions should spur the development of technologies and practices that contribute to improving health outcomes. (shrink)

Mary E. Hunt agrees with Rosemary Radford Ruether’s conclusion that women-church and women priests ‘both have their place in a vision of renewed church and renewed priestly ministry.’ She observes that the ‘either/or’ frame plays into what many feminists have tried to avoid with integrity, namely, setting progressive Catholic women against one another in the public arena. The writer explores the evolving relationship between and among the various feminist individuals and groups that are engaged in this work. She describes (...) how they co-operate to transform kyriarchal Roman Catholicism and meet the needs of the world. (shrink)

HIV/AIDS has changed from a disease of white gay men in the United States to a pandemic that largely involves women and dependent children in developing countries. Many theologies of disease are necessary to cope with the variety of expressions of this pandemic. Christian theoethical reflection on HIV/AIDS has been largely focused on sexual ethics, with uneven and mainly unhelpful results. Among the ethical issues that shape future useful conversations are globalized economics and resource sharing, the morality and economics of (...) the pharmaceutical industry, and the need for sex education and access to reproductive choice. Considering such issues in international, interreligious, multiscientific contexts is a concrete next step for the religion‐and‐science dialogue. It will put the powerful tools of both fields to the service of the common good. (shrink)

This is a critical look at the question of design from a feminist theological perspective. The author analyzes James Moore's 1995 Zygon article, “Cosmology and Theology: The Reemergence of Patriarchy.” Then she looks at the relationship between science and religion from a feminist perspective, focusing on the kyriarchal nature of theology itself in light of the myriad power issues at hand. Finally, she suggests that, instead of pondering the notion of design, scientists and theologians might more fruitfully look for new (...) ground for dialogue since feminist scholars are asking very different questions, not just answering questions differently. (shrink)

Marcella Althaus-Reid's Indecent Theology: Theological Perversions in Sex, Gender and Politics brings a liberationist view to postmodern analysis, a queer eye to Christianity, and a theologian's critique to culture. It marks the beginning of what Hunt hopes will be sustained reflection by Latin American women on the relationship between sexuality and theo-politics.

Current controversies about the ordination of women have shown the need for a re‐examination of what the Christian Church means by priesthood. This article looks at the Epistle to the Hebrews’ contribution to our understanding. To that end it focuses on the institution of priesthood in its first‐century Jewish context and shows the use made of it by the author of Hebrews in his presentation of Christian faith.Section 1 emphasizes some all‐important differences between the NT’s use of the language of (...) priesthood and ours. Not least, it nowhere uses “priest” to designate Christian ministers. All the more striking, therefore, is Hebrews’ depiction of Jesus as “high priest”.Section 2 discusses Judaism’ Day of Atonement ceremonies – Hebrews’ dominant cultic model. In the comparison drawn between Christ’s death and exaltation with these rites, he becomes not only the high priest but also the expiatory victim.As far as Judaism’ cultic institutions are concerned, however, Jesus was not and never could be a priest, since he was of the tribe of Judah rather than Levi. Hence Hebrews appeals to Melchizedek. How this non‐Israelite model is used by Hebrews to subvert the whole notion of priesthood as caste is discussed in section 3.Finally, in section 4 Isaacs concludes that for Hebrews there is no longer a role for an ongoing priesthood, since Jesus has definitively achieved access to God, which was its raison d’être. Melchizedekian high priesthood is unique to Christ; neither inherited nor transmitted. Hence, unlike other NT authors, for Hebrews even the church as a corporate body is not a priesthood. As its closing chapters show, in this Epistle the cultic model gives way to the more inclusive one of pilgrimage. (shrink)

Few, if any, present‐day undergraduate degree courses in Theology include in their syllabus a study of the Epistle to the Hebrews or other New Testament writings other than the Gospels and the Pauline epistles. The result is in effect that we create a canon within a canon.This paper, originally read at a postgraduate seminar, gives reasons why Hebrews in particular should not be neglected.Hebrews provides evidence of the diversity of early Christian tradition, for example, with its teaching that it is (...) impossible to be re‐admitted to the community of faith, having once abandoned it, and with its unique use of Israel’s day of Atonement rites in its presentation of Christ. Moreover, the very genre of Hebrews merits particular interest.Hebrews also evidences a Christian community which has yet to break with Judaism. Its thoroughly Jewish background illustrates for students of the New Testament the necessity of knowing the Jewish Scriptures as well as the writings of the New Testament. Moreover, a study of the Epistle could make a constructive contribution to present‐day Jewish–Christian dialogue, even if in the past it has been enlisted on the side of a thinly‐disguised anti‐Semitism.Finally, Hebrews brings the student face to face with the metaphorical character of much of the language of the New Testament – a form of language which is not to be taken less seriously than other kinds of language; and in this case, Hebrews’ Day of Atonement metaphors issue in new insights – in an innovative theology of access to God.For this and other reasons, the study of Hebrews has an important contribution to make to theology degree syllabuses. (shrink)

This essay situates Object Lessons in the contemporary academic spaces of women’s studies in India. A decade ago, Object Lessons offered an extensive critique of identity knowledges in the US academy with a special focus on women’s studies. What might its relevance be in the contemporary Indian context? The institutionalisation of women’s studies in India has been shaped by the resources of the social sciences, with their empirical bent and especially their connection to state and development policy. This makes for (...) specific differences with the US context while many concerns are shared. The essay also looks at how gender as a category has been deployed in specific contexts in contrast to that of “women”, in the light of Wiegman’s cautions over seeking resolutions to particular problems through a preferential treatment of categories. By way of concluding thoughts on the Indian situation, women’s studies in India is hypervisible compared to other identity knowledges. In spite of its marginal and precarious location in the academy, it carries a disproportionate political burden, one that a heterogeneous student body is shouldering in their struggles for a sustainable future. (shrink)