Seven COVID-19 vaccines are now being distributed and administered around the world (figure correct at the time of submission), with more on the horizon. It is widely accepted that healthcare workers should have high priority. However, questions have been raised about what we ought to do if members of priority groups refuse vaccination. Using the case of influenza vaccination as a comparison, we know that coercive approaches to vaccination uptake effectively increase vaccination rates among healthcare workers and reduce patient morbidity (...) if properly implemented. Using the principle of least restrictive alternative, we have developed an intervention ladder for COVID-19 vaccination policies among healthcare workers. We argue that healthcare workers refusing vaccination without a medical reason should be temporarily redeployed and, if their refusal persists after the redeployment period, eventually suspended, in order to reduce the risk to their colleagues and patients. This ‘conditional’ policy is a compromise between entirely voluntary or entirely mandatory policies for healthcare workers, and is consistent with healthcare workers’ established professional, legal and ethical obligations to their patients and to society at large. (shrink)

This valuable book will give educators solution-based methods and research-based resources to improve classroom culture, as well as enabling schools to elevate students' engagement and academic achievement.

Rapid growth in structural and functional brain research has led to increasing ethical discussion of what to do about incidental findings within the brains of healthy neuroimaging research participants that have potential health importance, but which are beyond the original aims of the study. This dilemma has been widely debated with respect to general neuroimaging research but has attracted little attention in the context of neuromarketing studies. In this paper, I argue that neuromarketing researchers owe participants the same ethical obligations (...) as other neuroimaging researchers. The financial resources available to neuromarketing firms and the social value of neuromarketing studies should command greater attention to the elucidation and management of incidental findings. However, this needs to be balanced against finite resources available within most public health systems. (shrink)

It has been forty years since the first multi-channel cochlear implant was used in Australia. While heralded in the hearing world as one of the greatest inventions in modern medicine, not everyone reflects on this achievement with enthusiasm. For many people in the Deaf community, they see the cochlear implant as a tool that reinforces a social construct that pathologizes deafness and removes Deaf identity. In this paper, I set out the main arguments for and against cochlear implantation. While I (...) conclude that, on balance, cochlear implants improve the well-being and broaden the open futures of deaf children, this does not justify mandating implants in circumstances where parents refuse them because this may compound unintended harms when society interferes in the parent-child relationship. For this reason, I argue that parental refusal of cochlear implantation falls within Gillam’s concept of the zone of parental discretion. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Sacramental Character and the Pattern of Theological Life:Medieval Context and Early Modern ReceptionReginald M. Lynch O.P.In question 63 of the tertia pars, Thomas Aquinas defines the so-called character that is conferred by certain sacraments (namely baptism, confirmation, and holy orders), as a secondary effect caused by the sacraments, with grace itself identified as the primary effect. As separated instruments of the humanity of Christ, in his mature work (...) in the Summa theologiae Aquinas argues that all Christian sacraments are perfective instrumental causes of the effect of the Incarnation in the human persons who receive them.1 As instrumental means by which these effects are conferred, therefore, for Aquinas the sapiential intelligibility of the sacraments is found in the larger sweep of sacra doctrina and the Incarnation, wherein the ratio and necessity of these larger theological themes contextualize Aquinas's understanding of the necessity of the sacraments themselves as instrumental extensions of the same.2 Taken in itself, aspects of what would later become the question of sacramental character for Scholastics first emerged as a doctrinal topic in the context of patristic debates over the permanence of the sacrament of baptism.3 In the Latin West, the influence of Augustine's distinction between the permanence of the sacramentum received in baptism and its use in charity proved to be a ubiquitous influence [End Page 1337] for later Latin theology.4 Concerning the metaphysical nature of this character, however, in both his Sentences commentary and Summa theologiae, Aquinas joins an ongoing conversation among thirteenth-century Scholastics about the utility of the Aristotelian categories for describing sacramental character. What is sacramental character specifically, and how should this be understood in relation to the wider speculative complexities of grace, the infused virtues and gifts, and beatitude? Because of continued controversy over the role of Aristotelianism in theology during the second half of the thirteenth century, many Scholastics of Aquinas's generation analyzed the quiddity of sacramental character from an Aristotelian perspective, working to describe the doctrine inherited from the Church's tradition using Aristotelian terminology. As will be shown, although some argued that sacramental character should be understood as a habitus, Aquinas argues that character is better understood as a power.The second and third sections of this article will explore the development of Scholastic accounts of the quiddity of sacramental character during the medieval and early modern periods, and the wider theological implications of these conversations. In the final analysis, it is my aim to show not only that Aquinas's account of sacramental character is intrinsically fitting on theological grounds, but that Aquinas's account of sacramental character as a qualitative power conveys and preserves the received theological tradition more effectively than the options proposed by some of his contemporaries. With these larger objectives in mind, the first section of this article serves as a necessary historical prelude—what, precisely, is at stake from the wider perspective of the Church's theological tradition in these medieval and early modern Scholastic debates? Accordingly, the first section will provide an overview of the historical development of the doctrine of sacramental character, focusing specifically on the way in which certain Augustinian doctrinal concepts and linguistic usages developed in later medieval usage and ultimately came to be incorporated into the framework of Peter Lombard's Sentences—the text that would serve as the common backdrop for the Scholastic conversations about the "quiddity" of this same doctrine.In the following, therefore, this article will begin by examining the origins of the doctrine of sacramental character in Latin theology in Augustine's baptismal theology. Building on this foundation, our attention will turn to Peter Lombard's reception of Augustine's as the context in which [End Page 1338] thirteenth-century Scholastic debates about sacramental character would develop. Although the specific metaphysical questions that Scholastics like Aquinas and Bonaventure would entertain do not form part of Augustine's approach to this issue, Lombard's particular articulation of Augustine's sacramental theology would provide the textual and conceptual backdrop against which these later Scholastic conversations would develop. Accordingly, the second section of this article will build on the first, beginning with a consideration of Aquinas... (shrink)

In today’s online data-driven world, people constantly shed data and deposit digital footprints. When individuals access health services, governments and health providers collect and store large volumes of health information about people that can later be retrieved, linked and analysed for research purposes. This can lead to new discoveries in medicine and healthcare. In addition, when securely stored and de-identified, the privacy risks are minimal and manageable. In many jurisdictions, ethics committees routinely waive the requirement for researchers to obtain consent (...) from data subjects before using and linking these datasets in an effort to balance respect for individuals with research efficiency. In this paper, I explore the ethical justification for using routinely collected health data for research without consent. I conclude that, not only is this morally justified but also that data subjects have a moral obligation to contribute their data to such research, which would obviate the need for ethics committees to consider consent waivers. In justifying this argument, I look to the duty of easy rescue, distributive justice and draw analogies with vaccination ethics. (shrink)

Research Ethics, Volume 18, Issue 2, Page 151-162, April 2022. In today’s online data-driven world, people constantly shed data and deposit digital footprints. When individuals access health services, governments and health providers collect and store large volumes of health information about people that can later be retrieved, linked and analysed for research purposes. This can lead to new discoveries in medicine and healthcare. In addition, when securely stored and de-identified, the privacy risks are minimal and manageable. In many jurisdictions, ethics (...) committees routinely waive the requirement for researchers to obtain consent from data subjects before using and linking these datasets in an effort to balance respect for individuals with research efficiency. In this paper, I explore the ethical justification for using routinely collected health data for research without consent. I conclude that, not only is this morally justified but also that data subjects have a moral obligation to contribute their data to such research, which would obviate the need for ethics committees to consider consent waivers. In justifying this argument, I look to the duty of easy rescue, distributive justice and draw analogies with vaccination ethics. (shrink)

Conversion therapy refers to a range of unscientific, discredited and harmful heterosexist practices that attempt to re-align an individual’s sexual orientation, usually from non-heterosexual to heterosexual. In Australia, the state of Victoria recently joined Queensland and the Australian Capital Territory in criminalising conversion therapy. Although many other jurisdictions have also introduced legislation banning conversion therapy, it persists in over 60 countries. Children are particularly vulnerable to the harmful effects of conversion therapy, which can include coercion, rejection, isolation and blame. However, (...) if new biotechnologies create safe and effective conversion therapies, the question posed here is whether it would ever be morally permissible to use them. In addressing this question, we need to closely examine the individual’s circumstances and the prevailing social context in which conversion therapy is employed. I argue that, even in a sexually unjust world, conversion therapy may be morally permissible if it were the only safe and effective means of relieving intense anguish and dysphoria for the individual. The person providing the conversion therapy must be qualified, sufficiently independent from any religious organisation and must provide conversion therapy in a way that is positively affirming of the individual and their existing sexuality. (shrink)

This paper follows the history of an object. The purpose of doing so is to come to terms with a distinctive kind of research object – which we are calling a ‘test object’ – as well as to chronicle a significant line of research and technology development associated with the broader nanoscience/nanotechnology movement. A test object is one of a family of epistemic things that makes up the material culture of laboratory science. Depending upon the case, it can have variable (...) shadings of practical, mathematical and epistemic significance. Clear cases of test objects have highly regular and reproducible visible properties that can be used for testing instruments and training novices. The test object featured in this paper is the silicon 7×7, a particular surface configuration of silicon atoms. Research on this object over a period of several decades has been closely bound up with the development of novel instruments for visualizing atomic structures. Despite having little direct commercial value, the Si 7×7 also has been a focal object for the formation of a research community bridging industry and academia. It exhibits a complex structure that became a sustained focus of observation and modelling. Our study follows shifts in the epistemic status of the Si 7×7, and uses it to re-examine familiar conceptions of representation and observation in the history, philosophy and social study of science. (shrink)

Curbside ethics consultations occur when an ethics consultant provides guidance to a party who seeks assistance over ethical concerns in a case, without the consultant involving other stakeholders, conducting his or her own comprehensive review of the case, or writing a chart note. Some have argued that curbside consultation is problematic because the consultant, in focusing on a single narrative offered by the party seeking advice, necessarily fails to account for the full range of moral perspectives. Their concern is that (...) any guidance offered by the ethics consultant will privilege and empower one party’s viewpoint over—and to the exclusion of—other stakeholders. This could lead to serious harms, such as the ethicist being reduced to a means to an end for a clinician seeking to achieve his or her own preferred outcome, the ethicist denying the broader array of stakeholders input in the process, or the ethicist providing wrongheaded or biased advice, posing dangers to the ethical quality of decision-making. Although these concerns are important and must be addressed, we suggest that they are manageable. This paper proposes using conflict coaching, a practice developed within the discipline of conflict management, to mitigate the risks posed by curbside consultation, and thereby create new spaces for moral discourse in the care of patients. Thinking of curbside consultations as an opportunity for clinical ethics conflict coaching can more fully integrate ethics committee members into the daily ethics of patient care and reduce the frequency of ethically harmful outcomes. (shrink)

Depression might be associated with accelerated cellular aging. However, does this result in an irreversible state or is the body able to slow down or recover from such a process? Telomeres are DNA‐protein complexes that protect the ends of chromosomes and generally shorten with age; and therefore index cellular aging. The majority of studies indicate that persons with depression have shorter leukocyte telomeres than similarly aged non‐depressed persons, which may contribute to the observed unfavorable somatic health outcomes in the depressed (...) population. Some small‐scale preliminary studies raise the possibility that behavioral or pharmacological interventions may either slow down or else reverse this accelerated telomere shortening, possibly through increasing the activity of the telomere‐lengthening enzyme telomerase. This paper covers the current state of evidence in the relationship between depression and the telomere‐telomerase system and debates whether depression‐related cellular aging should be considered a reversible process or permanent damage. (shrink)

Over the past decade, interest in human enhancement has waxed and waned. The initial surge of interest and funding, driven by the US Army’s desire for a ‘Future Force Warrior’ has partly given way to the challenges of meeting operational demands abroad. However the ethical opportunities provided by soldier enhancement demand that investigation of its possibilities continue. Benefits include enhanced decision-making, improved force capability, reduced force size and lower casualty rates. These benefits — and enhancement itself — carry concomitant risks, (...) including morale issues due to tension between enhanced and unenhanced soldiers, the issues of enhanced veterans and ownership of enhanced bodies, challenges to the army’s core values and personal identity issues. A range of measures should be designed to highlight the opportunities offered by enhancement while also minimising the potential risks. This includes providing advice on which areas the army ought to demonstrate restraint in research for ethical reasons. (shrink)

Curbside ethics consultations occur when an ethics consultant provides guidance to a party who seeks assistance over ethical concerns in a case, without the consultant involving other stakeholders, conducting his or her own comprehensive review of the case, or writing a chart note. Some have argued that curbside consultation is problematic because the consultant, in focusing on a single narrative offered by the party seeking advice, necessarily fails to account for the full range of moral perspectives. Their concern is that (...) any guidance offered by the ethics consultant will privilege and empower one party’s viewpoint over—and to the exclusion of—other stakeholders. This could lead to serious harms, such as the ethicist being reduced to a means to an end for a clinician seeking to achieve his or her own preferred outcome, the ethicist denying the broader array of stakeholders input in the process, or the ethicist providing wrongheaded or biased advice, posing dangers to the ethical quality of decision-making. Although these concerns are important and must be addressed, we suggest that they are manageable. This paper proposes using conflict coaching, a practice developed within the discipline of conflict management, to mitigate the risks posed by curbside consultation, and thereby create new “spaces” for moral discourse in the care of patients. Thinking of curbside consultations as an opportunity for “clinical ethics conflict coaching” can more fully integrate ethics committee members into the daily ethics of patient care and reduce the frequency of ethically harmful outcomes. (shrink)

In nursing, expectations of honesty and integrity are clearly stipulated throughout professional standards and codes of conduct, thus the concept of academic integrity has even more impetus in preparing students for graduate practice. However, a disparity between policy and practice misses the opportunity to instil the principles of academic integrity, and at its core honesty, a pivotal trait in the nursing profession. This study draws upon the experience of the nursing faculty to explore how academic integrity policy of deterrence operate (...) in nursing education.While participants deplored cheating behaviours, they expressed frustration in having to ‘police’ large numbers of students who had little awareness of the academic standards to meet policy requirements. In addition, they were cynical because of a perceived lack of severity in sanctions for students who repeatedly breached integrity. Participants expressed a moral obligation as educators to meet student learning needs and preferred to engage with students in a more meaningful way to uphold academic integrity. The ambivalence to detect and report breaches in integrity undermines the effectiveness of policy. Therefore, faculty must recognise the importance of their role in detecting and escalating cases of dishonesty and execute deterrence in a more consistent way. To do this, greater support at an institutional level, such as smaller class sizes, inclusion in decision making around sanctions and recognition of additional workload, will enable faculty to uphold policy. Although policing was not their preferred approach, the role of faculty in detecting and reporting cases of misconduct is crucial to increase the certainty of students getting caught, which is essential if policy is to be effective in deterring dishonest behaviour. (shrink)

In an era of transition and tension in American health care, Dorothy M. Owens offers a model of empathic communication that benefits both patients and physicians. Drawing from concepts in the domains of psychology and theology, she constructs a model of empathy that is ethical and reciprocal. An integrated model of empathy recognizes the physical, psychological, spiritual, and social nature of human beings. Empathy is a clinically useful, time-effective communication skill that can be taught in medical and pastoral education. Dr. (...) Owens's unique approach to empathy is applicable to other professional and personal relationships as well. (shrink)

Largely due to the cultural and political shift of the Enlightenment, Western societies in the eighteenth century emerged from sectarian conflict and embraced a more religiously moderate path. In nine original essays, leading scholars ask whether exporting the Enlightenment solution is possible—or even desirable—today. Contributors begin by revisiting the Enlightenment's restructuring of the West, examining its ongoing encounters with Protestant and Catholic Christianity, Judaism, Islam, and Hinduism. While acknowledging the necessity of the Enlightenment emphasis on toleration and peaceful religious coexistence, (...) these scholars nevertheless have grave misgivings about the Enlightenment's spiritually thin secularism. The authors ultimately upend both the claim that the West's experience offers a ready-made template for the world to follow and the belief that the West's achievements are to be ignored, despised, or discarded. (shrink)

Walter Savage Landor's exasperated marginal comment on line 13 of Horace, C. 1. 4 has sent modern commentators scurrying to the poem's defence. The skirmish has been won for Horace, but at the expense perhaps of magnifying the importance of line 13: A. Y. Campbell insisted that pallida mors, far from being irrelevant, was ‘the focus of the whole poem’.

The aim of this virtual special issue is to bring together philosophical and historical perspectives to address long-standing issues in the interpretation, utility, and impacts of quantitative genetics methods and findings. Methodological approaches and the underlying scientific understanding of genetics and heredity have transformed since the field's inception. These advances have brought with them new philosophical issues regarding the interpretation and understanding of quantitative genetic results. The contributions in this issue demonstrate that there is still work to be done integrating (...) old and new methodological and conceptual frameworks. In some cases, new results are interpreted using assumptions based on old concepts and methodologies that need to be explicitly recognised and updated. In other cases, new philosophical tools can be employed to synthesise historical quantitative genetics work with modern methodologies and findings. This introductory article surveys three general themes that have dominated philosophical discussion of quantitative genetics throughout history: (1) how methodologies have changed and transformed our knowledge and interpretations; (2) whether or not quantitative genetics can offer explanations relating to causation and prediction; and (3) the importance of defining the phenotypes under study. We situate the contributions in this virtual special issue within a historical framework addressing these three themes. (shrink)

A self-fulfilling prophecy in neuroprognostication occurs when a patient in coma is predicted to have a poor outcome, and life-sustaining treatment is withdrawn on the basis of that prediction, thus directly bringing about a poor outcome for that patient. In contrast to the predominant emphasis in the bioethics literature, we look beyond the moral issues raised by the possibility that an erroneous prediction might lead to the death of a patient who otherwise would have lived. Instead, we focus on the (...) problematic epistemic consequences of neuroprognostic SFPs in settings where research and practice intersect. When this sort of SFP occurs, the problem is that physicians and researchers are never in a position to notice whether their original prognosis was correct or incorrect, since the patient dies anyway. Thus, SFPs keep us from discerning false positives from true positives, inhibiting proper assessment of novel prognostic tests. This epistemic problem of SFPs thus impedes learning, but ethical obligations of patient care make it difficult to avoid SFPs. We then show how the impediment to catching false positive indicators of poor outcome distorts research on novel techniques for neuroprognostication, allowing biases to persist in prognostic tests. We finally highlight a particular risk that a precautionary bias towards early withdrawal of life-sustaining treatment may be amplified. We conclude with guidelines about how researchers can mitigate the epistemic problems of SFPs, to achieve more responsible innovation of neuroprognostication for patients in coma. (shrink)

The “happiness agenda” is a worldwide movement that claims that happiness is the highest good, happiness can be measured, and public policy should promote happiness. Against Happiness is a thorough and powerful critique of this program, revealing the flaws of its concept of happiness and advocating a renewed focus on equality and justice. Written by an interdisciplinary team of authors, this book provides both theoretical and empirical analysis of the limitations of the happiness agenda. The authors emphasize that this movement (...) draws on a parochial, Western-centric philosophical basis and demographic sample. They show that happiness defined as subjective satisfaction or a surplus of positive emotions bears little resemblance to the richer and more nuanced concepts of the good life found in many world traditions. Cross-cultural philosophy, comparative theology, and social and cultural psychology all teach that cultures and subcultures vary in how much value they place on life satisfaction or feeling happy. Furthermore, the ideas promoted by the happiness agenda can compete with rights, justice, sustainability, and equality—and even conceal racial and gender injustice. Against Happiness argues that a better way forward requires integration of cross-cultural philosophical, ethical, and political thought with critical social science. Ultimately, the authors contend, happiness should be a secondary goal—worth pursuing only if it is contingent on the demands of justice. (shrink)

This article provides an ethical analysis of the U.S. practice guideline update on disorders of consciousness. Our analysis focuses on the guideline’s recommendations regarding the use of investigational neuroimaging methods to assess brain‐injured patients. Complex and multifaceted ethical issues have emerged because these methods alter the clinical understanding of consciousness. We address issues of false hope, patient suffering, and cost. We argue that, in spite of these concerns, there is significant benefit to using neuroimaging to assess brain‐injured patients in most (...) cases. (shrink)

ABSTRACT This essay argues that science education can gain from close engagement with the history of science both in the training of prospective vocational scientists and in educating the broader public about the nature of science. First it shows how historicizing science in the classroom can improve the pedagogical experience of science students and might even help them turn into more effective professional practitioners of science. Then it examines how historians of science can support the scientific education of the general (...) public at a time when debates over “intelligent design” are raising major questions over the kind of science that ought to be available to children in their school curricula. It concludes by considering further work that might be undertaken to show how history of science could be of more general educational interest and utility, well beyond the closed academic domains in which historians of science typically operate. (shrink)

Over the past decade, we have witnessed some early signs of progress in the battle against international bribery and corruption, a problem that throughout the history of commerce had previously been ignored. We present a model that we then use to assess progress in reducing bribery. The model components include both hard law and soft law legislation components and enforcement and compliance components. We begin by summarizing the literature that convincingly argues that bribery is an immoral and unethical practice and (...) that the economic harm it causes falls most heavily on those least able to absorb it. The next section summarizes the main provisions of anti-bribery legislation including the Foreign Corrupt Practices Act (FCPA), the Organization for Eco nomic Development's Convention on Combating Bribery of Foreign Officials in International Business Transactions, the United Nations Convention Against Corruption and the laws of selected countries. We conclude this section with a discussion of the "moral imperialism" argument for not imposing Western laws and values on other cultures. The next section focuses on the roles played by NGOs including Transparency International (TI), the World Economic Forum (WEF), and the International Chamber of Commerce. We review trends in enforcement and prosecution, including a review of the United States' enforcement processes, mechanisms for cross-border legal assistance, a discussion of the distinctive nature of FCPA cases, and an assessment of what the future holds for enforcement. The final section focuses on compliance processes for corporations aimed at reducing the risk of FCPA and related violations. This section also addresses the ethics of gift giving and "grease" payments. The article concludes with a summary and suggestions for further research. Throughout the article, we reference important bribery cases and include comments from several authorities who are on the front lines of the battle against international bribery. (shrink)

ABSTRACT This essay argues that science education can gain from close engagement with the history of science both in the training of prospective vocational scientists and in educating the broader public about the nature of science. First it shows how historicizing science in the classroom can improve the pedagogical experience of science students and might even help them turn into more effective professional practitioners of science. Then it examines how historians of science can support the scientific education of the general (...) public at a time when debates over “intelligent design” are raising major questions over the kind of science that ought to be available to children in their school curricula. It concludes by considering further work that might be undertaken to show how history of science could be of more general educational interest and utility, well beyond the closed academic domains in which historians of science typically operate. (shrink)

What processes underlie the formation of new memories? What determines their strength? Where are the changes underlying memory located? With contributions from leading experts, this book offers the most up-to-date attempts to answer these and many more critical questions.