Nous remercions Dan Frost et Rebecca Guy de nous avoir autorisés à reproduire ce texte qui a déjà paru dans Recherches et pratiques pédagogiques en langues de spécialité, Vol. 35, N° spécial 1 | 2016 : Du secteur Lansad et des langues de spécialité. Résumé : La production orale pose de nombreuses difficultés pour les apprenants francophones en anglais et peut-être plus encore dans le secteur Lansad où ils sont souvent adultes et où le temps et les ressources (...) sont particulièrement limités. Le langage et - Linguistique et théorie du langage – Nouvel article. (shrink)

Phase 1 healthy volunteer clinical trials—which financially compensate subjects in tests of drug toxicity levels and side effects—appear to place pressure on each joint of the moral framework justifying research. In this article, we review concerns about phase 1 trials as they have been framed in the bioethics literature, including undue inducement and coercion, unjust exploitation, and worries about compromised data validity. We then revisit these concerns in light of the lived experiences of serial participants who are income-dependent on phase (...) 1 trials. We show how participant experiences shift attention from discrete exchanges, behaviors, and events in the research enterprise to the ongoing and dynamic patterns of serial participation in which individual decision-making is embedded in collective social and economic conditions and shaped by institutional policies. We argue in particular for the ethical significance of structurally diminished voluntariness, routine powerlessness in setting the terms of exchange, and incentive structures that may promote pharmaceutical interests but encourage phase 1 healthy volunteers to skirt important rules. (shrink)

In phase I clinical trials, healthy volunteers are dosed with investigational drugs and subjected to blood draws and other bodily monitoring procedures. In exchange, they are paid. Healthy volunteers are, in a very direct sense, selling access to their bodies for pharmaceutical companies and their associates to run drugs through. In his ethnographic study of socalled professional guinea pigs, Roberto Abadie writes, "Paid volunteers are well aware of the demand for an idealized, perfectly healthy volunteer. They also realize that their (...) body is a valued commodity in clinical trials research". It is perhaps surprising, then, that commodification is little discussed in the bioethics literature on phase I... (shrink)

By analyzing descriptions of illusory and nonillusory figures, Richer called into question the common assumption that illusory and nonillusory perceptions were experientially the same and differed only in terms of their accuracy. The present study attempted to replicate Richer's work with a focus on identifying within the subjects' descriptions any orienting attitudes corresponding to these two forms of perception. Nineteen student volunteers were asked to describe two illusory figures and a nonillusory control of similar complexity. The descriptions revealed consistent differences (...) between the two forms. However, the Hering and Zollner figures were not always described in illusory terms, and surprisingly, several subjects described the control as if it were illusory. Further, perceptual accuracy was not guaranteed by nonillusory experience. Subjects described the figures from within one of three different orienting attitudes-atomizing, representational, and geometrical-organizing. The latter attitude appeared necessary for the phenomena of illusory perception and experience. Though the present findings confirmed Richer's distinction between illusory and nonillusory experience, they also indicate the need for further differentiation- illusory perception versus illusory experience. Finally, the findings also supported Luria's and Segall, Campbell, and Herskovits's position on the importance of particular cultural and educational experiences and codes in relation to perceptual illusions. (shrink)

. This paper follows the journey of two small fluid units throughout the nineteenth century in Anglo-American medicine and pharmacy, explaining how the non-uniform “drop” survived while the standardized minim became obsolete. I emphasize two roles these units needed to fulfill: that of a physical measuring device, and that of a rhetorical communication device. First, I discuss the challenges unique to measuring small amounts of fluid, outlining how the modern medicine dropper developed out of an effort to resolve problems with (...) the “minimometer,” which measured minims. Second, I explain how drops, utilized in “the open drop method” of administering general anesthesia, effectively communicated a gradual process and epistemically valuable heuristic to the audience of practitioners, whose attention to individual medical outcomes was important for verifying the proper dosage. The standardized minim was never able to achieve success as the drop’s intended replacement; the non-uniform drop better served the relevant epistemic goals within the practical contexts for which these units were designed. The surprising historical trajectory of drops should cause us to question the common equivocation of “standardization” with “progress” in the history and philosophy of measurement. This study also exemplifies how examining non-standard measurement practices can be instructive for better understanding the role and function of standardization within epistemology of measurement. (shrink)

Analyses of Kafka’s The Trial often read the text as an existentialist work, arguing that the novel metaphorizes the absurdity of a modern world where God no longer exists. However, I agree with Slavoj Žižek, who posits that such a modernist reading ignores what is most vital in Kafka’s text—that the absence of God is “always already filled by an inert, obscene, revolting presence”. I argue that this “revolting presence” for Josef K is the presence of the Court; The Trial (...) describes the subject within a society organized by the symbolic order, the big Other, the symbolic network of rules regulating our lives and structuring our reality. For this reason, I read The Trial as pointing the way toward critical postmodernism. But a strictly postmodernist reading of The Trial cannot work without the Lacanian intervention of the split subject. Readings of The Trial based solely on the framework of Foucault’s power/knowledge theory, without a consideration of Lacanian subject formation, are incomplete. Foucault posits that individuals only become subjects via discourse, becoming subjects either through interpellation or via relationship to power. This begs the question, how does an individual become the desiring subject? How does a defendant such as Josef K. come to accept the power of the Court? I answer these questions by applying a necessary psychoanalytic intervention to Foucauldian readings of The Trial, interpreting the text as the narration of Josef K.’s unconscious experience as a split subject in relation to the big Other. (shrink)

Ongoing evaluation of a clinical ethics consultation service (ECS) allows for continuous quality improvement, a process-based, data-driven approach for improving the quality of a service. Evaluations by stakeholders involved in a consultation can provide realtime feedback about what is working well and what might need to be improved. Although numerous authors have previously presented data from research studies on the effectiveness of clinical ethics consultation, few ECSs routinely send evaluations as an ongoing component of their everyday clinical activities. The primary (...) purpose of this article is to equip and encourage others to engage in ongoing evaluation of their own ECS. Toward that end, the following resources are shared: (1) the survey tool used to gather the evaluation data, (2) the procedure used to elicit and collate responses, and (3) how the resulting data are used to support continuous quality improvement and justify the continued financial support of the ECS to hospital administration. (shrink)

Research-oriented universities are known for prolific research activity that is often supported by students in faculty-guided research. To maintain ethical standards, universities require on-going training of both faculty and students to ensure Responsible Conduct of Research (RCR). However, previous research has indicated RCR-based training is insufficient to address the ethical dilemmas that are prevalent within academic settings: navigating issues of authorship, modeling relationships between faculty and students, minimization of risk, and adequate informed consent. U.S. universities must explore ways to identify (...) and improve RCR concerns for current (faculty) and future researchers (students). This article reports the findings of a self-study (_N_ = 50) of research stakeholders (students and faculty) at a top tier research institution. First, we report on their perceived importance of applying RCR principles. Second, we explore relationships between stakeholder backgrounds (e.g., prior training, field, and position) and how they ranked the degree of ethical concerns in fictitious vignettes that presented different unethical issues university students could encounter when conducting research. Vignette rankings suggested concerns of inappropriate relationships, predatory authorship and IRB violations which were judged as most unethical, which was dissimilar to what sampled researchers reported in practice as the most important RCR elements to understand and adhere to for successful research. Regression models indicated there was no significant relationship between individuals’ vignette ethics scores and backgrounds, affirming previous literature suggesting that training can be ineffectual in shifting researcher judgments of ethical dilemmas. Recommendations for training are discussed. (shrink)

Rebecca Farinas takes seven major figures from the American philosophical canon and examines their relationship with an artistic or scientific interlocutor. In so doing, she provides a unique insight into the origins of American philosophy and, through case studies such as the friendship between Alain Locke and the biologist E.E. Just and the collaboration between Jane Addams and George Herbert Mead, sheds new light on these thinkers' ideas.

Research uses of human bodies maintained by mechanical ventilation after being declared dead by neurological criteria, were first published in the early 1980s with a renewed interest in research on the newly or nearly dead occurring in about last decade. While this type of research may take many different forms, recent technologic advances in genomic sequencing along with high hopes for genomic medicine, have inspired interest in genomic research with the newly dead. For example, the Genotype-Tissue Expression program through the (...) National Institutes of Health aims to collect large numbers of diverse human tissues with the eventual goal of elucidating the genetic bases of common diseases through a better understanding of the relationship between genetic variation and gene expression. (shrink)

Recent advances in next generation sequencing along with high hopes for genomic medicine have inspired interest in genomic research with the newly dead. However, applicable law does not adequately determine ethical or policy responses to such research. In this paper we propose that such research stands at a crossroads between other more established biomedical clinical and research practices. In addressing the ethical and policy issues raised by a particular research project within our institution comparatively with these other practices, we illustrate (...) the moral significance of paying careful heed to where one looks for guidance in responding to ethical questions raised by a novel endeavor. (shrink)

The truth of a myth, your Honor, is not its words but its patterns.Why would a novel want to undermine its own words? Surely, literature is made of words, and any ambitious novel would want to wear its words proudly, declaiming their truth as well as their beauty. Yet we know that novels produced in smaller languages, which possess fewer publishers and fewer readers, have needed to make their words accessible, both to distant audiences and to translators in dominant languages. (...) And some works in dominant languages, when they are produced in spaces far from the centers of publishing, have likewise had to retract idiomatic phrases, alter references to regional languages, and provide glossaries. But why would a.. (shrink)

An innovative examination of the ways in which dance and philosophy inform each other, Dance and Philosophy brings together authorities from a variety of disciplines to expand our understanding of dance and dance scholarship. Featuring an eclectic mix of materials from exposes to dance therapy sessions to demonstrations, Dance and Philosophy addresses centuries of scholarship, dance practice, the impacts of technological and social change, politics, cultural diversity and performance. Structured thematically to draw out the connection between different perspectives, this books (...) covers: - Philosophy practice and how it corresponds to dance - Movement, embodiment and temporality - Philosophy and dance traditions in everyday life - The intersection between dance and technology - Critical reflections on dance Offering important contributions to our understanding of dance as well as expanding the study of philosophy, this book is key to sparking new conversations concerning the philosophy of dance. (shrink)

This essay explores three issues in respect for autonomy that pose unfinished business for the concept. By this, I mean that the dialogue over them is ongoing and essentially unresolved. These are: whether we ought to respect persons or their autonomous choices; the role of relational autonomy; and whether nonhuman animals can be autonomous. In attending to this particular set of unfinished business, I highlight some critical moral work left aside by the concept of respect for autonomy as understood in (...) Beauchamp and Childress’ Principles of Biomedical Ethics. Specifically, while significant pragmatic traction is gained by the authors’ focus on autonomous choice, carving such a focus out from the broader questions of moral respect and the autonomy of the person leaves aside a number of questions that we might have thought a view about respect for autonomy in biomedicine ought to answer. These include: How should physicians respond when autonomous patients make decisions that appear nonautonomous? What is the impact of the view that autonomy is “relational” for cross-cultural differences in how autonomy is respected? If chimpanzees can be autonomous, what does that mean for how they should be treated? (shrink)

A 2011 National Academies of Sciences report called for an “Information Commons” and a “Knowledge Network” to revolutionize biomedical research and clinical care. We interviewed 41 expert stakeholders to examine governance, access, data collection, and privacy in the context of a medical information commons. Stakeholders' attitudes about MICs align with the NAS vision of an Information Commons; however, differences of opinion regarding clinical use and access warrant further research to explore policy and technological solutions.

A volume in Transforming Education for the Future Spirituality and spiritual experiences have been the bedrock of every civilization and together form one of the highest mechanisms for making sense of the world for billions of people. Current research paradigms, due to their limitation to empirical, sensory, psychologically, or culturally constructed realities, fail to provide a framework for exploring this essential area of human experience. The development of a spiritual research paradigm will provide researchers from the social sciences and education (...) the tools and abilities to systematically explore fundamental questions regarding human spiritual experiences and spiritual growth. A spiritual research paradigm requires an ontology that considers all reality to be multidimensional, interconnected, and interdependent. It requires an epistemology that integrates knowing from outer sources as well as inner contemplation, acknowledging our integration of soul and spirit with the body and mind. Three additional aspects are useful to a spiritual research paradigm: axiology, methodology, and teleology. An axiology concerns what is valued, good, and ethical. A methodology is the appropriate approach to systematic inquiry. A fifth and less frequently mentioned aspect is teleology, an explanation of the goal or end (telos) to which new knowledge is applied, such as gaining wisdom and truth, touching the divine, increasing inner peace, exploring hidden dimensions, or improving society. This book takes the first step to develop such a research paradigm. We draw from world spiritual traditions as well as scholarship that has arisen from contemplative practices. We also attempt to build a bridge between science and spirituality. Spiritual research is not necessarily opposed to scientific research; in fact, each can shed light on the other. (shrink)

Human beings with diminished decision-making capacities are usually thought to require greater protections from the potential harms of research than fully autonomous persons. Animal subjects of research receive lesser protections than any human beings regardless of decision-making capacity. Paradoxically, however, it is precisely animals’ lack of some characteristic human capacities that is commonly invoked to justify using them for human purposes. In other words, for humans lesser capacities correspond to greater protections but for animals the opposite is true. Without explicit (...) justification, it is not clear why or whether this should be the case. Ethics regulations guiding human subject research include principles such as respect for persons—and related duties—that are required as a matter of justice while regulations guiding animal subject research attend only to highly circumscribed considerations of welfare. Further, the regulations guiding research on animals discount any consideration of animal welfare relative to comparable human welfare. This paper explores two of the most promising justifications for these differences␣between the two sets of regulations. The first potential justification points to lesser moral status for animals on the basis of their lesser capacities. The second potential justification relies on a claim about the permissibility of moral partiality as␣found in common morality. While neither potential justification is sufficient to justify the regulatory difference as it stands, there is possible common ground between supporters of some regulatory difference and those rejecting the current difference. (shrink)

Adoption of technology in agriculture can significantly reorganize production and relationships amongst humans, animals, technology, and the natural environment. However, the adoption of agricultural technology is not homogenous, and diversity in integration leads to a diversity of outcomes and impacts. In this study, we examine the adoption of automated milking systems in small and midsize dairy farms in the US Midwest, the Netherlands, and Denmark. In contrast to technological determinism, we find significant variation amongst adopters in the implementation of AMS (...) and corresponding variation in outcomes. Adopters have significant discretion in determining the use of AMS, which leads to a diversity of possible outcomes for family and non-family labor, human–cow relationships, animal welfare, the environment, and financial resiliency. Adoption and implementation are shaped by both structural factors, such as debt load and labor market variation, and by farmers’ individual personality traits and values, such as a willingness to release control to technology. Rather than uniform adoption and impacts of technology, we highlight the importance of context, the co-constitution of technology and users, and the diversity of technology adoption and its associated impacts. (shrink)

Pregnancy is a frequently applied exclusion criteria for many forms of research. Common justifications for this exclusion include the potential for teratogenicity, as well as the potential for physiologic changes in pregnancy to impact the research itself. The systematic exclusion of pregnant persons from clinical studies has created a significant gap in knowledge regarding medication safety and efficacy in pregnancy, which continues to cause significant harm to pregnant persons in need of medical therapy. To produce meaningful data and facilitate effective (...) knowledge translation to the clinical setting, special consideration to the pharmacology of pregnancy, as well as to outcomes of concern for this population is essential. The exclusion of pregnant participants from research is not ethically justifiable, as it violates the principles of autonomy, justice and nonmaleficence. While the inclusion of pregnant patients in research presents it’s own challenges, with appropriate methodological, ethical, and clinical considerations, we may be able to narrow the knowledge gap and improve drug availability and safety for pregnant patients and their children. (shrink)

Opioid litigation continues a growing public health litigation trend in which governments seek to hold companies responsible for population harms related to their products. The litigation can serve to address gaps in regulatory and legislative policymaking and in market self-regulation pervasive in the prescription opioid domain. Moreover, prior opioid settlements have satisfied civil tort litigation objectives of obtaining compensation for injured parties, deterring harmful behavior, and holding certain opioid manufacturers, distributors and pharmacies accountable for their actions. In this way, opioid (...) litigation represents progress over prior public health litigation campaigns involving tobacco, lead paint, and asbestos, which had more limited tort litigation effects. Although opioid litigation is not a comprehensive solution to the opioid crisis, it can complement other strategies and infuse much needed money, behavior changes, and public accountability for prescription opioid and related harms. (shrink)

Drawing on theoretical work on humans’ adaptive capacity, we propose that supervisors’ perception of top management’s high bottom-line mentality (BLM) has a dysfunctional effect on their ethical leadership practices. Specifically, we suggest that these perceptions hinder supervisors’ empathy, which eventuates in less ethical leadership practices. We also investigate, in a first-stage moderated mediation model, how supervisors high in trait mindfulness are resistant to the ill effects of perceptions of top management’s high BLM. Supervisors high (versus low) in this trait are (...) less likely to respond to perceptions of top management’s high BLM with reduced empathy that then hinders ethical leadership. Results from a multi-wave, multi-source sample of working adults from the Chinese high technology industry provide general support for our theoretical model. Theoretical and practical implications are discussed. (shrink)

Drawing on theoretical work on humans’ adaptive capacity, we propose that supervisors’ perception of top management’s high bottom-line mentality (BLM) has a dysfunctional effect on their ethical leadership practices. Specifically, we suggest that these perceptions hinder supervisors’ empathy, which eventuates in less ethical leadership practices. We also investigate, in a first-stage moderated mediation model, how supervisors high in trait mindfulness are resistant to the ill effects of perceptions of top management’s high BLM. Supervisors high (versus low) in this trait are (...) less likely to respond to perceptions of top management’s high BLM with reduced empathy that then hinders ethical leadership. Results from a multi-wave, multi-source sample of working adults from the Chinese high technology industry provide general support for our theoretical model. Theoretical and practical implications are discussed. (shrink)

A person of good character treats other sentient beings with care and compassion. Yet virtue ethics apparently has trouble accounting for the moral status of nonhuman animals because of its focus on excellent character traits, rather than the moral “patient,” and because of its non-codifiability, at least in some forms. The task of this article is to answer the question: How can virtue ethics account for the moral value of nonhuman animals in the context of biomedical research? I argue that (...) it can do so through attention to animal good lives, human-animal bonds, and the virtues themselves. The virtue ethics resources I draw on to support nonhuman animal value are not the same as those typically brought to bear in moral status discussions, but I suggest that moral status as usually conceived has its own problems as a tool for use in practical contexts like animal research. (shrink)

While bioethics as a field has concerned itself with methodological issues since the early years, there has been no systematic examination of how ethics is incorporated into research on the Ethical, Legal and Social Implications of the Human Genome Project. Yet ELSI research may bear a particular burden of investigating and substantiating its methods given public funding, an explicitly cross-disciplinary approach, and the perceived significance of adequate responsiveness to advances in genomics. We undertook a qualitative content analysis of a sample (...) of ELSI publications appearing between 2003 and 2008 with the aim of better understanding the methods, aims, and approaches to ethics that ELSI researchers employ. We found that the aims of ethics within ELSI are largely prescriptive and address multiple groups. We also found that the bioethics methods used in the ELSI literature are both diverse between publications and multiple within publications, but are usually not themselves discussed or employed as suggested by bioethics method proponents. Ethics in ELSI is also sometimes undistinguished from related inquiries. (shrink)

The target article is focused on locating the popularity of imaginary worlds in our adaptations for exploration. This commentary touches on developmental influences, vicarious enjoyment, the challenging of societal mores, plot, and whether men and women are drawn to the same features in the same ways.

Mr. C is a twenty‐two‐year‐old who was flown to a level‐1 trauma center after diving headfirst into shallow water. Prior to this accident, he was in excellent health. At the scene, he had been conscious but was paralyzed and had no sensation below his neck. The emergency medical services team immobilized Mr. C's neck with a cervical collar and intubated him for airway protection before transport. As Mr. C's medical care proceeds, he expresses a desire for extubation, although it was (...) not clear that he had the capacity to make this (or any other) decision. It also was unclear whether this desire reflected his authentic wishes to be allowed to die or stemmed from feelings of discomfort and agitation. Over a period of several days, Mr. C's sedation was lightened, and the psychiatry service conducted a formal decision‐making capacity assessment. Mr. C continues to express a desire to withdraw life‐sustaining medical treatment. However, the psychiatry service is concerned that Mr. C seems to lack adequate insight into what it would mean to die.What does it mean to respect Mr. C's autonomy? (shrink)

Should monkeys be used in painful and often deadly infectious disease research that may save many human lives? This is the challenging question that Anne Barnhill, Steven Joffe, and Franklin G. Miller take on in their carefully argued and compelling article “The Ethics of Infection Challenges in Primates.” The authors offer a nuanced and even-handed position that takes philosophical worries about nonhuman primate moral status seriously and still appreciates the very real value of such research for human welfare. Overall, they (...) argue for an extension and revision of the recommendations regarding chimpanzee research offered by the Institute of Medicine in 2011; the practical upshot of their argument would allow for infection challenge research for promising interventions for Ebola and Marburg virus diseases but not for smallpox or the common cold. The IOM recommendations regarding chimpanzee research put in motion an exceptionalist policy for this great ape population. Barnhill and colleagues’ proposal would enlarge the scope of that exceptionalism to embrace NHPs other than great apes. But is such exceptionalism warranted? It is not obvious to me either that the more sophisticated capacities of a species as a whole give it greater ethical protections or that less intellectually or socially sophisticated animals ought to therefore receive less protection when it comes to painful experimental interventions. (shrink)

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)

Drawing on conservation of resources theory, we contribute to the behavioral ethics literature by examining how and why organizational socialization processes can affect newcomers’ adoption of unethical behaviors. Specifically, we contend that quality peer coaching provides newcomers with enhanced self-resources that diminishes emotional exhaustion and thus indirectly reduces newcomer unethical conduct. Conversely, peer coach unethical conduct increases newcomers’ emotional exhaustion, and thus indirectly increases newcomers’ own unethical acts. Our research also identifies newcomers’ goal orientations as important individual differences that moderate (...) the proposed mediation effects. Newcomers with high mastery orientations respond to high emotional exhaustion by harnessing more resources and identifying new work strategies, thereby engaging in less unethical conduct. Conversely, newcomers with high performance orientations give into emotional exhaustion and engage in unethical conduct as a way of outperforming others while conserving resources. We tested our theoretical model using a sample of peer coaches and newcomers from the Real Estate industry, using objective reporting of peer coaches’ and newcomers’ unethical conduct over a nine-month period. (shrink)

Most hospitals and nursing homes have individuals who engage in ethics consultation, and most do so with very little, if any, training. The goal of this article is not to advance the scholarly literature on training clinical ethics consultants, but instead to provide a road map for individuals doing ethics consultation who would like more training. In this way, I hope to advance the field in some small way, by educating, empowering, and encouraging small- to medium-sized hospitals to train the (...) members of their ethics committee who engage in ethics consultation. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Breathing TogetherRebecca L. Walkowitz (bio)For the first seven years of my career, I taught a very large lecture course once, and sometimes twice, a year in a graded auditorium filled seat-to-seat with as many as 350 undergraduates. The course focused on a cluster of themes that linked art and violence–how art resists violence, how art animates violence, how art expresses violence, how violence spurs art– and traced those themes (...) through the history of British fiction from Joyce, Woolf, and Forster through Barker, Burgess, Ishiguro, and Rushdie. I loved teaching that class. I loved and was sometimes terrified and almost always invigorated by being in that room with those students. Needless to say, no one wore masks. Far from it.I remember the feel of the crowded, anonymous, yet intimate room. Intimate, because a group of 20 or 30 very avid students occupied the first few rows, and I came to value and recognize their attentive faces. I could hear their little sounds as they scratched out notes, adjusted their laptops, whispered to each other, and rustled papers. Intimate, because I was standing at my full, not very substantial height on a stage, and they were looking up at my body and listening to my voice for 50 minutes twice a week. And intimate, in another sense, because they would sometimes forget that we were there together live and behave in ways that I have never experienced in a smaller classroom. One day, two students in the last row, which in the slanted auditorium was directly level with my elevated gaze, spent most of the lecture kissing ardently. I was impressed by their enthusiasm and by the duration of their embrace. At the end of the lecture, I quick-stepped up the aisle to remind them: this is not TV; we are here together. I smiled while I said it, and they apologized for distracting me. I smile as I think about it now.During the COVID lockdown, I missed the embodied experience of large gatherings, including large lectures. The Zoom classroom, for all its affordances, can't replicate the accidental encounters, the risk and energy of embodied presentation, the warmth of individual eye contact, and the shoulder experiences of the class period: what happens in the time just before and the time just after the actual class takes place. The shoulder experiences are truly precious, as any seasoned teacher knows, because [End Page 258] they allow us to shift the scale of encounter up and down, and they allow us to interact in spontaneous and less formal ways than we do when the entire class is gathered as one. Close up and informally, we are more likely to use our faces and our hands: smiling, nodding, tilting, waving, and pressing our palms together to say thank you.There is a kind of social intimacy and a kind of social violence that can only be illustrated in a very large group, and I appreciated my lecture for allowing me to experience that. The most terrifying day of my class each semester was the day I spoke about– and performed!–the shock of involuntary, inchoate expression in E. M. Forster's A Room with a View. Like other Bloomsbury artists, Forster was committed to ushering out traditional ideas of self-restraint and maturity and ushering in greater communication between men and women, between social classes, and between ages about sexuality, desire, and the experiences of the body. The word of the day was "play": life needed more play, more honesty, more curiosity, and less seriousness, less decorum, and less lying to ourselves and others.What does this look like in the classroom? On the day in question, we would talk about the scenes in the novel in which characters are criticized for disruptive actions they cannot or do not control, such as fainting, laughing, bleeding, getting carried away, or expressing sounds in addition to words. I would explain that there are two problems with these actions: they are accidental or unintentional, and they involve an unexpected, unregulated expression of the body in public. Even worse, the actions take place in what our grandparents used to call "mixed... (shrink)

This article empirically examines how healthy volunteers evaluate and make sense of the risks of phase I clinical drug trials. This is an ethically important topic because healthy volunteers are exposed to risk but can gain no medical benefit from their trial participation. Based on in-depth qualitative interviews with 178 healthy volunteers enrolled in various clinical trials, we found that participants focus on myriad characteristics of clinical trials when assessing risk and making enrolment decisions. These factors include the short-term and (...) long-term effects; required medical procedures; the type of trial, including its design, therapeutic area of investigation, and dosage of the drug; the amount of compensation; and trust in the research clinic. In making determinations about the study risks, participants rely on information provided during the consent process, their own and others’ experiences in clinical trials, and comparisons among studies. Our findings indicate that the informed consent process succeeds in communicating well about certain types of risk information while simultaneously creating lacunae that are problematically filled by participants through their collective experiences and assumptions about risk. We discuss the ethical implications of these findings and make recommendations for improving the consent process in healthy volunteer trials. (shrink)

This article empirically examines how healthy volunteers evaluate and make sense of the risks of phase I clinical drug trials. This is an ethically important topic because healthy volunteers are exposed to risk but can gain no medical benefit from their trial participation. Based on in-depth qualitative interviews with 178 healthy volunteers enrolled in various clinical trials, we found that participants focus on myriad characteristics of clinical trials when assessing risk and making enrolment decisions. These factors include the short-term and (...) long-term effects; required medical procedures; the type of trial, including its design, therapeutic area of investigation, and dosage of the drug; the amount of compensation; and trust in the research clinic. In making determinations about the study risks, participants rely on information provided during the consent process, their own and others’ experiences in clinical trials, and comparisons among studies. Our findings indicate that the informed consent process succeeds in communicating well about certain types of risk information while simultaneously creating lacunae that are problematically filled by participants through their collective experiences and assumptions about risk. We discuss the ethical implications of these findings and make recommendations for improving the consent process in healthy volunteer trials. (shrink)

This article empirically examines how healthy volunteers evaluate and make sense of the risks of phase I clinical drug trials. This is an ethically important topic because healthy volunteers are exposed to risk but can gain no medical benefit from their trial participation. Based on in-depth qualitative interviews with 178 healthy volunteers enrolled in various clinical trials, we found that participants focus on myriad characteristics of clinical trials when assessing risk and making enrolment decisions. These factors include the short-term and (...) long-term effects; required medical procedures; the type of trial, including its design, therapeutic area of investigation, and dosage of the drug; the amount of compensation; and trust in the research clinic. In making determinations about the study risks, participants rely on information provided during the consent process, their own and others’ experiences in clinical trials, and comparisons among studies. Our findings indicate that the informed consent process succeeds in communicating well about certain types of risk information while simultaneously creating lacunae that are problematically filled by participants through their collective experiences and assumptions about risk. We discuss the ethical implications of these findings and make recommendations for improving the consent process in healthy volunteer trials. (shrink)

Mr. Galanas, an eighty‐six‐year‐old man, intentionally shot himself in the chest and abdomen. Surprisingly, the bullet damaged only his distal pancreas and part of his colon, requiring a diverting colostomy to prevent leakage of bowel fluids into his abdomen. After being admitted, he lies intubated in the intensive care unit awaiting surgery to repair his colon. He is responsive but does not demonstrate clear decision‐making capacity. He grudgingly accepts pain medications but refuses antibiotics and antidepressants. He has a living will (...) that gives his wife durable power of attorney and also explicitly states a desire to refuse all medical interventions if he is permanently unconscious or in an end‐stage condition. Mrs. Galanas reports frequent conversations in which her husband said he would not want to be sustained on life support. She also says that he often mentioned he would not want an ostomy bag—a likely, albeit temporary, outcome of the proposed surgery. His physicians are nervous about withholding medical interventions when Mr. Galanas's injury is the result of a suicide attempt and his prognosis is good. Should the care team surgically repair his injured colon, regardless of the patient's capacity, his advance directive, and his wife's statement that he would not want surgery or other life‐sustaining treatment? (shrink)

This article empirically examines how healthy volunteers evaluate and make sense of the risks of phase I clinical drug trials. This is an ethically important topic because healthy volunteers are exposed to risk but can gain no medical benefit from their trial participation. Based on in-depth qualitative interviews with 178 healthy volunteers enrolled in various clinical trials, we found that participants focus on myriad characteristics of clinical trials when assessing risk and making enrolment decisions. These factors include the short-term and (...) long-term effects; required medical procedures; the type of trial, including its design, therapeutic area of investigation, and dosage of the drug; the amount of compensation; and trust in the research clinic. In making determinations about the study risks, participants rely on information provided during the consent process, their own and others’ experiences in clinical trials, and comparisons among studies. Our findings indicate that the informed consent process succeeds in communicating well about certain types of risk information while simultaneously creating lacunae that are problematically filled by participants through their collective experiences and assumptions about risk. We discuss the ethical implications of these findings and make recommendations for improving the consent process in healthy volunteer trials. (shrink)

Despite some improvements in access to evidence-based medications for opioid use disorder, treatment rates remain low at under a quarter of those with need. High costs for brand name products in these medication markets have limited the volume of drugs purchased, particularly through public health insurance and grant programs. Brand firm anti-competitive practices around the leading buprenorphine product Suboxone — including product hops, citizen petitions and Risk Evaluation and Mitigation Strategy abuses — helped to maintain high prices by extending brand (...) exclusivity periods and hindering generic drug entry. Remedies to address costly anti-competitive activities include adoption of the proposed CREATES Act and modernization of the Hatch-Waxman Act by the Congress, and implementation of substantive modifications to the Food and Drug Administration citizen petition filing procedures. Given the persistence of these abuses, prescriptive changes are favorable to the procedural and clarifying steps thus far favored by the federal government. Extrapolating from the 37% price declines attributable to generic entry for buprenorphine tablets in 2011, our calculations suggest that implementing these remedies to facilitate generic competition with Suboxone film would have resulted in savings of approximately $703 million overall and $203 million to Medicaid in 2017. (shrink)

A volume in Transforming Education for the Future Series Editors Jing Lin, University of Maryland and Rebecca L. Oxford, Alabama A & M University This book will expand the horizon of higher education, helping students, faculty and administrators to return to their roots and be in touch with their whole being. This book stresses that learning is much more than just accumulating knowledge and skills. Learning includes knowing ourselves-mind, body, and spirit. The learning of compassion, care, and service are (...) as crucial or even more important in higher education in order for universities to address students' individual needs and the society's needs. Higher education must contribute to a better world. The book acknowledges that knowing not only comes from outside, but also comes from within. Wisdom is what guides students to be whole, true to themselves while learning. There are many ancient and modern approaches to gaining wisdom and wellness. This book talks about contemplative methods, such as meditation, qigong, yoga, arts, and dance, that help people gain wisdom and balance in their lives and enhance their ability to be reflective and transformative educators and learners. (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...

: Offering an introduction to both John Dewey's philosophy of education and the 4-H Youth Development Program, this paper draws clear connections between these two topics. Concepts explored include Dewey's principles of continuity and interaction, and contagion with respect to learning. Roles of educational leaders (including teachers) are investigated in the context of a discussion about the structuring of opportunities for students to develop habits of meaningful and life-long learning. Specific examples are described in depth to demonstrate, from a Deweyan (...) perspective, the educational process and value of 4-H participation. Brief comments are made about the place of 4-H in the U.S. system of public education. (shrink)