BackgroundVerbal autopsy is a pragmatic approach for generating cause-of-death data in contexts without well-functioning civil registration and vital statistics systems. It has primarily been conducted in health and demographic surveillance systems (HDSS) in Africa and Asia. Although significant resources have been invested to develop the technical aspects of verbal autopsy, ethical issues have received little attention. We explored the benefits and burdens of verbal autopsy in HDSS settings and identified potential strategies to respond to the ethical issues identified.MethodsThis research was (...) based on a case study approach centred on two contrasting HDSS in Kenya and followed the Mapping-Framing-Shaping Framework for empirical bioethics research. Data were collected through individual interviews, focus group discussions, document reviews and non-participant observations. 115 participants were involved, including 86 community members (HDSS residents and community representatives), and 29 research staff (HDSS managers, researchers, census field workers and verbal autopsy interviewers).ResultsThe use of verbal autopsy data for research and public health was described as the most common potential benefit of verbal autopsy in HDSS. Community members mentioned the potential uses of verbal autopsy data in addressing immediate public health problems for the local population while research staff emphasized the benefits of verbal autopsy to research and the wider public. The most prominent burden associated with the verbal autopsy was emotional distress for verbal autopsy interviewers and respondents. Moral events linked to the interview, such as being unsure of the right thing to do (moral uncertainty) or knowing the right thing to do and being constrained from acting (moral constraint), emerged as key causes of emotional distress for verbal autopsy interviewers.ConclusionsThe collection of cause-of-death data through verbal autopsy in HDSS settings presents important ethical and emotional challenges for verbal autopsy interviewers and respondents. These challenges include emotional distress for respondents and moral distress for interviewers. This empirical ethics study provides detailed accounts of the distress caused by verbal autopsy and highlights ethical tensions between potential population benefits and risks to individuals. It includes recommendations for policy and practice to address emotional and moral distress in verbal autopsy. (shrink)

Gaining informed consent among marginalized groups that include decisionally incapacitated individuals and those outside of the researcher's own geo-social and ethnic background still challenges many researchers. We suggest that there is a need for consideration of a different approach to research ethics in international settings. Based on extensive field work in West Africa on medical knowledge transfers and patient–healer relationships, this paper will discuss the challenges posed in obtaining informed individual consent in international settings. It is argued that while being (...) on the whole convincing, the top-down approach of the proposed solutions, which clearly dominates the participative approach, fails in building sustainable capacity, decision-making competency, and empowerment in the communities in which the research is conducted. Using appropriate decision aids can help resolve these issues. (shrink)

The Cambridge Companion to Piaget provides a comprehensive introduction to different aspects of Jean Piaget's work.

IntroductionThe present study investigates the association of lifetime interpersonal violence exposure, related posttraumatic stress disorder, and appraisal of the degree of threat posed by facial avatars.MethodsWe recorded self-rated responses and high-density electroencephalography among women, 16 of whom with lifetime IPV-PTSD and 14 with no PTSD, during a face-evaluation task that displayed male face avatars varying in their degree of threat as rated along dimensions of dominance and trustworthiness.ResultsThe study found a significant association between lifetime IPV exposure, under-estimation of dominance, and (...) over-estimation of trustworthiness. Characterization of EEG microstates supported that lifetime IPV-PTSD modulates emotional appraisal, specifically in encoding and decoding processing associated with N170 and LPP evoked potentials. EEG source localization demonstrated an overactivation of the limbic system, in particular the parahippocampal gyrus, in response to non-threatening avatars. Additionally, dysfunctional involvement of attention-related processing anterior prefrontal cortex was found in response to relatively trustworthy avatars in IPV-PTSD individuals compared with non-PTSD controls.DiscussionThis study showed that IPV exposure and related PTSD modulate individuals’ evaluation of facial characteristics suggesting threat. Atypical processing of these avatar characteristics was marked by group differences in brain regions linked to facial processing, emotion regulation, and memory. (shrink)

John Locke, Marylène Delbourg-Delphis. (56) — SIC COGITAVIT DE INTELLECTU HUMANO JO LOCKE AN 1671. INTELLECTUS HUMANUS CUM COGNITIONIS CERTITUDINE, ET ASSENSUS FIRMITATE. § 1. 1° J'imagine que toute ...

Depuis quelques années le nombre de publications en français sur la Chine s’est accéléré. En 2010, la revue Travail Genre et sociétés (n° 23) a consacré un dossier intitulé « Traditions et ruptures chinoises » (avec une carte et une chronologie de l’histoire de la Chine depuis 1949 tout à fait utiles). L’article de Tania Angeloff sur « La Chine au travail (1989-2009) : emploi, genre, migrations », comme l’ouvrage de Tania Angeloff et Marylène Lieber, nous permet de donner un (...) cadre général, av... (shrink)