This chapter contains sections titled: Introduction Background Incentives and guidance from the criminal law Other regulatory incentives and guidance Civil incentives Conclusion.

Imprisonment may sometimes be a justified form of punishment. Yet the U.S. carceral system suffers from appalling problems of justice—in who is put into prisons, in how imprisoned people are treated, and in downstream personal and community health impacts. Medical personnel working in prisons and jails take on risky work for highly vulnerable and underserved patients. They are to be lauded for their professional commitments. Yet at the same time, prison care undercuts the ability of medical personnel to uphold their (...) own professional standards and sometimes fails in even basic health protection. Doctors in prisons are stuck between their commitment to vulnerable patients and complicity in a system that requires their participation to uphold its constitutionality. Medical ethics is frayed in prisons, and the problem deserves our attention. (shrink)

Purpose: We sought to examine the ethical, legal, and social implications (ELSI) literature research and scholarship types, topics, and contributing community fields of training as a first step to charting the broader ELSI community’s future priorities and goals. Methods: We categorized 642 articles and book chapters meeting inclusion criteria for content in both human genetics or genomics and ethics or ELSI during a 5-year period (2003–2008) according to research and scholarship types, topics, and the area of advanced training of the (...) first-listed author. Research and scholarship type categories were developed and characterized through in-depth review of 95 randomly sampled publications from the larger group. Results: There is a single dominant approach to ELSI, which focuses on ethical and other social issues “downstream” of advances in genomics, the contributors to which predominately have advanced training in medicine or science fields other than social science. A comparatively low percentage of publications primarily offer policy recommendations, and these are much more likely to be written by those with advanced training in law than is the case for the literature as a whole. Social science studies predominately employ qualitative methods and vary significantly with respect to the extent and types of recommendations offered. Two further types of ELSI research and scholarship offer alternative models for so-called “normative” work in this field. Conclusion: Considering topics, training, and types of ELSI research and scholarship from the most recent past allows for a baseline perspective that is sorely needed in charting this field’s future course. (shrink)

Biodefense and emerging infectious disease animal research aims to avoid or ameliorate human disease, suffering, and death arising, or potentially arising, from natural outbreaks or intentional deployment of some of the world’s most dreaded pathogens. Top priority research goals include finding vaccines to prevent, diagnostic tools to detect, and medicines for smallpox, plague, ebola, anthrax, tularemia, and viral hemorrhagic fevers, among many other pathogens (National Institute of Allergy and Infectious Diseases [NIAID] priority pathogens). To this end, increased funding for conducting (...) research, developing research facilities, and purchasing (stockpiling) developed vaccines, diagnostic tools, and therapeutics .. (shrink)

Advances in DNA sequencing technology open new possibilities for public health genomics, especially in the form of general population preventive genomic sequencing. Such screening programs would sit at the intersection of public health and preventive health care, and thereby at once invite and resist the use of clinical ethics and public health ethics frameworks. Despite their differences, these ethics frameworks traditionally share a central concern for individual rights. We examine two putative individual rights—the right not to know, and the child’s (...) right to an open future—frequently invoked in discussions of predictive genetic testing, in order to explore their potential contribution to evaluating this new practice. Ultimately, we conclude that traditional clinical and public health ethics frameworks, and these two rights in particular, should be complemented by a social justice perspective in order adequately to characterize the ethical dimensions of general population PGS programs. (shrink)

In the United States at present, the death penalty is a possible sentence in 31 out of 50 states, as well as within the military and for federal cases. In the U.S., numbers of executions are declin...

From the late 1950s through the early 1970s, Harry F. Harlow's primate laboratory at the University of Wisconsin–Madison undertook a series of studies on infant rhesus macaque monkeys that gained the attention of both animal welfare advocates and the scientific community.1 Establishing one of the first primate research laboratories in 1932, Harlow began his career as a primate researcher by studying primate learning capabilities and shredding previous assumptions within psychology that primates were restricted to the conditioned learning of a rat. (...) As his need for subjects in particular age ranges and easily susceptible to study grew in the 1950s, he again broke research ground by establishing a captive breeding... (shrink)

Moral psychology studies the features of cognition, judgement, perception and emotion that make human beings capable of moral action. Perspectives from feminist and race theory immensely enrich moral psychology. Writers who take these perspectives ask questions about mind, feeling, and action in contexts of social difference and unequal power and opportunity. These essays by a distinguished international cast of philosophers explore moral psychology as it connects to social life, scientific studies, and literature.

This article offers a philosophical reading of Elena Ferrante’s Neapolitan Novels by bringing the tetralogy into conversation with Jean-Paul Sartre’s phenomenological ontology. In addition to highlighting the striking similarities between Ferrante’s notion of smarginatura (‘dissolving margins’) and Sartre’s depiction of the existential sensation of nausea, this article argues that the two main characters of Ferrante’s tetralogy, Lila Cerullo and Elena Greco, respectively exemplify Sartre’s ontological categories of ‘being-for-oneself’ and ‘being-for-others’ in his phenomenological account of human existence. However, Ferrante—like Simone de (...) Beauvoir before her—goes beyond Sartre in her ability to offer an account of the imperfect existential freedom of women, who remain constrained in their pursuit of authenticity by social and cultural factors. Drawing on Ferrante’s assertion that readers ‘are both Elena and Lila’ as well as her recent claim that there are within her two kinds of writing (broadly equated to the ‘compliant’ Elena and ‘impetuous’ Lila), we establish Ferrante’s exploration of the ambivalent features of human subjectivity as a consummate philosophical and literary project. (shrink)

Rousseau argued forcefully for the superiority of a life lived in accordance with “the simplest impulses of nature,” but his complex understanding of the relationship between humans and “nature” is rarely cited as a source of inspiration by those seeking to reform the human relationship with the natural world. We argue that the complexities of Rousseau's political thought illuminate important connections between his works and the programs put forth by deep ecology. In Part One, we explore the theoretical connections between (...) Rousseau's account of the human fall from nature and major works of radical environmentalism. In Part Two, we offer suggestions for a reconsideration of Rousseau's work that may illuminate the paradoxical political requirements of deep ecology's recommendations for a more ecological human life. We hope to illustrate howa careful reading of Rousseau'swork may serve as the basis for fruitful questioning of environmentalist thought. (shrink)

This quarter’s issue of the Kennedy Institute of Ethics Journal dives deeply into questions concerning who is the proper target of medical interventions, and under what circumstances. Mary Jean Walker and James Franklin’s article, “An Argument Against Drug Testing Welfare Recipients,” and Maggie Taylor’s “Too Close to the Knives: Children’s Rights, Parental Authority, and Best Interests in the Context of Elective Pediatric Surgeries” both ask hard questions about when medical interventions can be imposed without consent, purportedly in order to (...) secure non-medical, social benefits for their recipients. Lauren Freeman and Saray Ayala López’s “Sex Categorization in Medical Contexts: A Cautionary Tale,” questions who... (shrink)

Rousseau argued forcefully for the superiority of a life lived in accordance with "the simplest impulses of nature," but his complex (some would say contradictory) understanding of the relationship between humans and "nature" is rarely cited as a source of inspiration by those seeking to reform the human relationship with the natural world. We argue that the complexities of Rousseau's political thought illuminate important connections between his works and the programs put forth by deep ecology. In Part One, we explore (...) the theoretical connections between Rousseau's account of the human fall from nature and major works of radical environmentalism. In Part Two, we offer suggestions for a reconsideration of Rousseau's work that may illuminate the paradoxical political requirements of deep ecology's recommendations for a more ecological human life. We hope to illustrate how a careful reading of Rousseau's work may serve as the basis for fruitful questioning of environmentalist thought. (shrink)

The important roles of prediction and prior experience are well established in music research and fit well with Clark's concept of unified perception, cognition, and action arising from hierarchical, bidirectional predictive processing. However, in order to fully account for human musical intelligence, Clark needs to further consider the powerful and variable role of affect in relation to prediction error.

What accounts for the continued lack of clarity over the legal procedures for the patenting of DNA sequences? The patenting system was built for a "bricks-and-mortar" world rather than an information economy. The fact that genes are both material molecules and informational systems helps explain the difficulty that the patent system is going to continue to have.

This paper addresses how interactions between UK palliative care nursing staff and the bodies of the deceased they care for function as a mechanism to help them make sense of death in line with their work as carers. Through an analysis of postmortem care rituals, I will argue that nurses play an integral role in the ‘making of the dead’, and look at how this functions in relation to their role as carers of bodies in line with associated states of (...) personal wellbeing. Further to this, there is an argument to be made for the recognition of the nurse’s place in biomedical models as managers of the transient body; as the constructors of the well, sick, living and dead body. (shrink)

BackgroundPast research shows that physicians experience high ill-being but also high well-being.ObjectiveTo shed light on how medical faculty’s experiences of their job demands and job resources might differentially affect their ill-being and their well-being with special attention to the role that the work-life interface plays in these processes.MethodsQualitative thematic analysis was used to analyze interviews from 30 medical faculty at a top research hospital in Canada.FindingsMedical faculty’s experiences of work-life conflict were severe. Faculty’s job demands had coalescing effects on their (...) stress, work-life conflict, and exhaustion. Although supportive job resources helped to mitigate the negative effects of job demands, stimulating job resources contributed to greater work-life conflict, stress, and exhaustion. Thus, for these medical faculty job resources play a dual-role for work-life conflict. Moreover, although faculty experienced high emotional exhaustion, they did not experience the other components of burnout. Some faculty engaged in cognitive reappraisal strategies to mitigate their experiences of work-life conflict and its harmful consequences.ConclusionThis study suggests that the precise nature and effects of job demands and job resources may be more complex than current research suggests. Hospital leadership should work to lessen unnecessary job demands, increase supportive job resources, recognize all aspects of job performance, and, given faculty’s high levels of work engagement, encourage a climate that fosters work-life balance. (shrink)

Access to abortion is becoming increasingly restricted for many women in the United States. Besides the longstanding financial barriers facing low-income women in most states, a newer source of scarcity has emerged. The relatively small number of physicians willing to perform the procedure is compromising the ability of women in certain parts of the country to obtain an abortion.Do physicians have a duty to respond to this situation? Do they have a professional responsibility to ensure that abortions are reasonably available (...) to the women who want to terminate their pregnancies? Or, is abortion so morally and socially controversial as to remove any professional obligation to provide reasonable access?Both law and medical ethics have traditionally protected physicians’ freedom to refuse to perform any procedure, including abortion, that conflicts with their religious or other moral beliefs. (shrink)

Although the teaching of medical ethics and law in medical education is an old story that has been told many times in medical literature, recent studies show that medical students and physicians lack confidence when faced with ethical dilemmas and medico-legal issues. The adverse events rates and medical lawsuits are on the rise whereas many medical errors are mostly due to negligence or malpractices which are preventable. While it is true that many medical schools teach their students medical law and (...) ethics, there are wide variations in what is being taught because there is no universally agreed syllabus. Yet the knowledge of medical law and ethics is closely relevant to the medical profession and that failure in abiding the law may result in serious civil or even criminal consequences. While this paper does not propose to lay detailed analysis of the relevant areas of law or ethics, it proposes to cover some legal areas so as to highlight and bring to attention the need for a medical law and ethics course. This article also considers the problems faced and recommendation as to future directions to be taken with respect to teaching medical law and ethics. It concludes with a suggested course outline for the teaching of medical law and ethics. (shrink)

Access to abortion is becoming increasingly restricted for many women in the United States. Besides the longstanding financial barriers facing low-income women in most states, a newer source of scarcity has emerged. The relatively small number of physicians willing to perform the procedure is compromising the ability of women in certain parts of the country to obtain an abortion.Do physicians have a duty to respond to this situation? Do they have a professional responsibility to ensure that abortions are reasonably available (...) to the women who want to terminate their pregnancies? Or, is abortion so morally and socially controversial as to remove any professional obligation to provide reasonable access?Both law and medical ethics have traditionally protected physicians’ freedom to refuse to perform any procedure, including abortion, that conflicts with their religious or other moral beliefs. (shrink)