DBS Think Tank IX was held on August 25–27, 2021 in Orlando FL with US based participants largely in person and overseas participants joining by video conferencing technology. The DBS Think Tank was founded in 2012 and provides an open platform where clinicians, engineers and researchers can freely discuss current and emerging deep brain stimulation technologies as well as the logistical and ethical issues facing the field. The consensus among the DBS Think Tank IX speakers was that DBS expanded in (...) its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. After collectively sharing our experiences, it was estimated that globally more than 230,000 DBS devices have been implanted for neurological and neuropsychiatric disorders. As such, this year’s meeting was focused on advances in the following areas: neuromodulation in Europe, Asia and Australia; cutting-edge technologies, neuroethics, interventional psychiatry, adaptive DBS, neuromodulation for pain, network neuromodulation for epilepsy and neuromodulation for traumatic brain injury. (shrink)

The adoption of the new International Health Regulations in May 2005 represents an historic development for international law and public health. This article describes the IHR revision process and analyzes why the new IHR constitute an advance in global health governance.

The World Health Assembly adopted the new International Health Regulations on May 23, 2005. The new IHR represent the culmination of a decade-long revision process and an historic development for international law and public health. The new IHR appear at a moment when public health, security, and democracy have become intertwined, addressed at the highest levels of government. The United Nations Secretary-General Kofi Annan, for example, identified IHR revision as a priority for moving humanity toward “larger freedom.” This article analyzes (...) the new IHR and their implications for global health and security in the 21st century.The WHA instructed the WHO Director-General to revise the IHR in 1995 because the Regulations did not provide an effective framework for addressing the international spread of disease. Doubts about the IHR's effectiveness had, however, been present long before 1995. The critiques identified the narrow scope of the regulations, the lack of compliance by states, and the absence of a strategy for responding to rapid changes in public health's global economic and technological environments. (shrink)

The incident in May-June 2007 involving a U.S. citizen traveling internationally while infected with drug-resistant tuberculosis involved the U.S. federal government's application of its quarantine and isolation powers. The incident and the isolation order raised numerous important issues for public health governance, law, and ethics. This article explores many of these issues by examining how the exercise of quarantine powers provides a powerful lens through which to understand how societies respond to and attempt to govern threats posed by dangerous, contagious (...) pathogens. The article considers historical aspects of governmental power to quarantine and isolate individuals and groups; analyzes the current state of quarantine and isolation law in the United States in light of the recent incident with drug-resistant tuberculosis; and explores global aspects of public health governance and law highlighted by this incident. (shrink)

Dramatic events involving dangerous microbes often focus attention on isolation and quarantine as policy instruments. The incident in May-June 2007 involving Andrew Speaker and drug-resistant tuberculosis joins other communicable disease crises that have forced contemplation or actual application of quarantine powers. Implementation of quarantine powers, which encompasses authority for both isolation and quarantine actions, is important not only for the handling of a specific event but also because the use of such authority provides a window on broader issues of public (...) health and the legal rules, ethical principles, and governance systems that support it. Debates about quarantine powers reflect political and social attitudes about public health that often tell us more about this policy endeavor than acts of isolation and quarantine themselves. (shrink)

About the Author:Lawrence E. Schmidt is professor, religious ethics, University of Toronto.Scott Marratto is a teaching fellow in the Foundation Year Programme, University of King's College, Halifax.

This paper aims to critique the phenomenon of advanced patient autonomy and choice in healthcare within the specific context of self-testing devices. A growing number of self-testing medical devices are currently available for home use. The premise underpinning many of these devices is that they assist individuals to be more autonomous in the assessment and management of their health. Increased patient autonomy is assumed to be a good thing. We take issue with this assumption and argue that self-testing provides a (...) specific example how increased patient autonomy and choice within healthcare might not best serve the patient population. We propose that current interpretations of autonomy in healthcare are based on negative accounts of liberty to the detriment of a more relational understanding. We also propose that Kantian philosophy is often applied to the healthcare arena in an inappropriate manner. We draw on the philosophical literature and examples from the self-testing process to support these claims. We conclude by offering an alternative account of autonomy based on the interrelated concepts of relationality, care and responsibility. (shrink)

Diagnostic self-testing devices are being developed for many illnesses, chronic diseases and infections. These will be used in hospitals, at point-of-care facilities and at home. Designed to allow earlier detection of diseases, self-testing diagnostic devices may improve disease prevention, slow the progression of disease and facilitate better treatment outcomes. These devices have the potential to benefit both the individual and society by enabling individuals to take a more proactive role in the maintenance of their health and by helping society improve (...) health and reduce health costs. However, the full implications of future home-based diagnostic technology for individuals and society remain unclear due to their novelty. We argue that the development of diagnostic tools, especially for home use, will heighten a number of ethical challenges. This paper will explore some of the ethical implications of home-based self-testing diagnostic devices for the autonomous and relational dimensions of the person. This will be facilitated by examining the impact of diagnostic devices for individual autonomy, for the delivery of accurate diagnosis and for the personal significance of the information for the user. The latter will be examined using Charles Taylor's view of personhood and his emphasis on human agency and interpretation. While the ethical issues are not necessarily new, the development of home-based self-testing diagnostic devices will make issues regarding autonomy, accuracy of information and personal significance more and more demanding. This will be the case particularly when an individual's autonomous choices come into conflict with the person's relational responsibilities. (shrink)

Although informed consent is important in clinical research, questions persist regarding when it is necessary, what it requires, and how it should be obtained. The standard view in research ethics is that the function of informed consent is to respect individual autonomy. However, consent processes are multidimensional and serve other ethical functions as well. These functions deserve particular attention when barriers to consent exist. We argue that consent serves seven ethically important and conceptually distinct functions. The first four functions pertain (...) principally to individual participants: providing transparency; allowing control and authorization; promoting concordance with participants' values; and protecting and promoting welfare interests. Three other functions are systemic or policy focused: promoting trust; satisfying regulatory requirements; and promoting integrity in research. Reframing consent around these functions can guide approaches to consent that are context sensitive and that maximize achievable goals. (shrink)

Recent empirical work has offered strong support for ‘biased pluralism’ and ‘economic elite’ accounts of political power in the United States, according a central role to ‘business interest groups’ as a mechanism through which corporate influence is exerted. Here, we propose an additional channel of influence for corporate interests: the ‘policy-planning network,’ consisting of corporate-dominated foundations, think tanks, and elite policy-discussion groups. To evaluate this assertion, we consider one key policy-discussion group, the Council on Foreign Relations. We first briefly review (...) the origins of this organization and then review earlier findings on its influence. We then code CFR policy preferences on 295 foreign policy issues during the 1981–2002 period. In logistic regression analyses, we find that the preferences of more affluent citizens and the CFR were positive, statistically significant predictors of foreign policy outcomes while business interest group preferences were not. These findings are discussed with a consideration of the patterns of CFR ‘successes’ and ‘failures’ for the issues in our dataset. Although a full demonstration of a causal connection between corporate interests, the policy-planning network and policy outcomes requires further research, we conclude that this has been shown to be a plausible mechanism through which corporate interests are represented and that ‘biased pluralism’ researchers should include it in their future investigations. (shrink)

This article presents the results of a study that investigated the roles that religiosity and ones money ethic play in determining consumer attitudes/beliefs in various situations regarding questionable consumer practices. One dimension of religiosity – intrinsic religiousness – was studied. Four separate dimensions of a money ethic scale were initially examined, but only one was used in the final analyses. Results indicated that both intrinsic religiousness and one’s money ethic were significant determinants of most types of consumer ethical beliefs.

This article presents the results of a study that investigated the role that religiosity plays in determining consumer attitudes/beliefs regarding various questionable consumer practices. Additionally, other personal factors were examined including idealism, relativism, consumer alienation and selected demographics such as income and age. All of these constructs were examined as antecedents of consumer ethical beliefs. The results of a post hoc analysis indicated that religiosity was a significant determinate of both idealism and relativism, and since idealism and relativism determine consumer (...) ethical beliefs, religiosity is a significant indirect determinate of consumer ethical beliefs. (shrink)

This article presents the results of an exploratory study that investigated the role that religiosity plays in determining consumer attitudes/beliefs in various situations regarding questionable consumer practices. Two dimensions of religiosity – intrinsic and extrinsic religiousness – were studied. Results indicated that an intrinsic religiousness was a significant determinant of consumer ethical beliefs, but extrinsic religiousness was not related to those beliefs.

This article presents the results of a study that investigated the roles that one’s money ethic, religiosity and attitude toward business play in determining consumer attitudes/beliefs in various situations regarding questionable consumer practices. Two dimensions of religiosity – intrinsic and extrinsic religiousness – were studied. A global scale of money ethic was examined, as was a global measure of attitude toward business. Results indicate that both types of religiosity as well as one’s money ethic and attitude toward business were significant (...) determinants of at least some types of consumer ethical beliefs. (shrink)

This article presents the results of a study that investigated the roles that one's money ethic, religiosity and attitude toward business play in determining consumer attitudes/beliefs in various situations regarding questionable consumer practices. Two dimensions of religiosity - intrinsic and extrinsic religiousness - were studied. A global scale of money ethic was examined, as was a global measure of attitude toward business. Results indicate that both types of religiosity as well as one's money ethic and attitude toward business were significant (...) determinants of at least some types of consumer ethical beliefs. (shrink)

The ethics literature has identified moral motivation as a factor in ethical decision-making. Furthermore, moral identity has been identified as a source of moral motivation. In the current study, we examine religiosity as an antecedent to moral identity and examine the mediating role of self-control in this relationship. We find that intrinsic and extrinsic dimensions of religiosity have different direct and indirect effects on the internalization and symbolization dimensions of moral identity. Specifically, intrinsic religiosity plays a role in counterbalancing the (...) negative impact of extrinsic religiosity on the internalization of moral identity. Further, intrinsic religiosity also counterbalances the negative and indirect impact of extrinsic religiosity on symbolization of moral identity via self-control. Lastly, self-control does not play a mediating role in the impact of religiosity on the internalization dimension of moral identity. We conclude that this study presents important findings that advance our understanding of the antecedents of moral identity, and that these results may have implications for the understanding of ethical decision-making. (shrink)

Studies in marketing ethics often revealed that ethical gaps do exist between marketers and other groups in society. The existence of these ethical gaps could be extremely counterproductive for marketing management. In order to effectively narrow these gaps, a marketing manager must first have a better understanding of causes of these gaps. To this end, this study compares marketing professionals with consumers on some important determinants of the ethical decision-making process. In particular, the marketers and consumers were compared with respect (...) to their personal moral philosophies and ethical perceptions in marketing situations. The data were obtained from a national survey of the practitioner members of the American Marketing Association and members of a consumer panel of a major southern university in the United States. The results generally indicate that marketing professionals are different from consumers with respect to some of the determinants of ethical decisions investigated. Some important managerial implications based on these findings were discussed. (shrink)

This study examined the effect of various antecedent variables on marketers’ perceptions of the role of ethics and socialresponsibility in the overall success of the firm. Variables examined included Hofstede’s cultural dimensions , as well as corporate ethical values and enforcement ofan ethics code. Additionally, individual variables such as ethical idealism and relativism were included. Results indicated that most ofthese variables impacted marketers’ perceptions of the importance of ethics and social responsibility, although to varying degrees.

To better illuminate aspects of stress that are relevant to the moral domain, we present a definition and theoretical model of “moral stress.” Our definition posits that moral stress is a psychological state born of an individual’s uncertainty about his or her ability to fulfill relevant moral obligations. This definition assumes a self-and-others relational basis for moral stress. Accordingly, our model draws from a theory of the self (identity theory) and a theory of others (stakeholder theory) to suggest that this (...) uncertainty arises as a manager faces competing claims for limited resources from multiple stakeholders and/or across multiple role identities. We further propose that the extent to which the manager is attentive to the moral aspects of the claims (i.e., moral attentiveness) moderates these effects. We identify several consequences of managerial moral stress and discuss theoretical, empirical, and practical implications of our approach. Most importantly, we argue that this work paves an important path for considering stress through the lens of morality. (shrink)

Selection pressure from health risk is hypothesized to have shaped adaptations motivating individuals to attempt to become valued by other individuals by generously and recurrently providing beneficial goods and/or services to them because this strategy encouraged beneficiaries to provide costly health care to their benefactors when the latter were sick or injured. Additionally, adaptations are hypothesized to have co-evolved that motivate individuals to attend to and value those who recurrently provide them with important benefits so they are willing in turn (...) to provide costly care when a valued person is disabled or in dire need. Individuals in egalitarian foraging bands can provide a number of valuable benefits, such as defense, diplomacy, food, healing, information, technical skill, or trading savvy. We therefore expect that humans have evolved psychological mechanisms motivating the pursuit and cultivation of a difficult-to-replace social role based on the provisioning of a benefit that confers a fitness advantage on its recipients. We call this phenomenon social niche specialization. One such niche that has been well-documented is meat-sharing. Here we present cross-cultural evidence that individuals cultivate two other niches, information and tool production, that serve (among other things) to buffer health risk. (shrink)

The straw man fallacy consists in inappropriately constructing or selecting weak versions of the opposition’s arguments. We will survey the three forms of straw men recognized in the literature, the straw, weak, and hollow man. We will then make the case that there are examples of inappropriately reconstructing stronger versions of the opposition’s arguments. Such cases we will call iron man fallacies. The difference between appropriate and inappropriate iron manning clarifies the limits of the virtue of open-mindedness.

Measurement of scientific productivity is difficult. The measures used (impact factor of the journal, citations to the paper being measured) are crude. But these measures are now so universally adopted that they determine most things that matter: tenure or unemployment, a postdoctoral grant or none, success or failure. As a result, scientists have been forced to downgrade their primary aim from making discoveries to publishing as many papers as possible—and trying to work them into high impact factor journals. Consequently, scientific (...) behaviour has become distorted and the utility, quality and objectivity of articles has deteriorated. Changes to the way scientists are assessed are urgently needed, and I suggest some here. (shrink)

The contributors in _Expanding and Restricting the Erotic_ offer a multidisciplinary perspective on the ways in which what is considered acceptable within the realm of the erotic has altered over time to the current situation where the erotic is being both expanded and restricted.