Medical students commonly learn how to administer pelvic exams by practicing on unconscious patients, often without first obtaining explicit consent from patients to do so. While twenty-one states currently have laws that require teaching hospitals to obtain consent from patients to participate in this educational experience, opposition from the medical community has stymied legislative progress. In this paper, I respond to the two most common reasons offered to oppose legislation, which appeal to (1) the educational benefits of these exams, or (...) (2) protecting institutional autonomy. Kantian ideas about autonomy help to illuminate the problematic ways in which these arguments supplant the importance of women’s choices over how their bodies are used while seeking medical treatment. Ultimately, neither argument offers sufficient reason to oppose laws that require explicit consent before administering training pelvic exams. (shrink)

This paper poses a series of objections to Sofia Jeppsson’s hard-line reply to Pereboom’s four-case manipulation argument. According to Jeppsson, the compatibilist can resist Pereboom’s argument by disregarding facts about what caused an agent to act (the ‘causal perspective’) and focusing primarily on the agent’s own perspective of their action (the ‘agential perspective’). Jeppsson argues that we have an obligation to disregard the causal perspective. This is for two reasons: (I) we must disregard the causal facts of the agent’s action, (...) including whether they have been manipulated, since the agent has reason to disregard them; and (II) the causal perspective is not obviously relevant to judgments of moral responsibility. In this paper, I show that both (I) and (II) can be undermined because the causal perspective provides information that is necessary for moral deliberations. This is because it would seem that at least one necessary condition for an agent to be considered morally responsible is that the agent’s actions are not fully controlled by someone else. Since this is information that we can only obtain via the causal perspective, we do not have an obligation to disregard this perspective and so need not accept the compatibilist’s hard-line account. (shrink)

The judicial system in a liberal democracy is deemed to be an independent branch of government with judges free from political agendas or societal pressures. In reality, judges are often influenced by their economic and social backgrounds, gender, race, religion, and sexuality. This volume explores the representation of different identities in the judiciary in the United States. The contributors investigate the pipeline, ambition, institutional inclusion, retention, and representation of groups previously excluded from federal, state, and local judiciaries. This study demonstrates (...) how diversity on the bench improves the quality of justice, bolsters confidence in the legitimacy of the courts, and provides a vital voice in decision-making power for formerly disenfranchised populations. (shrink)

This book critically reflects upon how images are mobilised within certain knowledge traditions, beyond the established categories of art, scientific visualisations and religious images. Thinking through and with images across ages, the authors seek to expand our understanding of the relationship between the visual and the epistemic.

The authors consider the relationship between knowledge and image, though multi-faceted, to be one of reciprocal dependence. But how do images carry and convey knowledge? The ambiguities of images means that interpretations do not necessarily follow the intention of the image producers. Through an array of different cases, the chapters critically reflect upon how images are mobilised and used in different knowledge practices, within certain knowledge traditions, in different historical periods. They question what we take for granted, what seems evident, (...) what goes without saying. This approach spans across established categories such as «scientific imaging», «religious images» and «artworks», and considers how images may contribute meaning across such categories. (shrink)

The pelvic exam is used to assess the health of female reproductive organs and so involves digital penetration by a physician. However, it is common practice for medical students to acquire experience in administering pelvic exams by performing them on unconscious patients without prior authorization. In this article, we argue that such unauthorized pelvic exams (UPEs) are sexual assault. Our argument is simple: in any other circumstance, unauthorized digital penetration amounts to sexual assault. Since there are no morally significant differences (...) between UPEs and other instances of digital penetration, UPEs are sexual assault. So, insofar as one is against sexual assault, one should be against UPEs. (shrink)

Recent research suggests holding a structural, rather than interpersonal, understanding of racism is associated with greater impetus to address racial disparities. We believe greater acknowledgment of structural racism also functions to mitigate against empathic failures in response to structural injustices. Given South Africa’s situatedness as a country characterized by historical racialized oppression and continuing unjust legacies, it is appropriate to examine these ideas there. Across three studies, we tested the hypotheses that members of advantaged groups’ perspective taking and empathic concern (...) may be compromised in response to people challenging the unequal status quo, and that a priori perceptions about the impact of structural racism may mitigate or exacerbate such empathic failures. In Study 1, a national sample of White South Africans endorsed perceptions of interpersonal racism more readily than perceptions of structural racism, and expressed high levels of competitive victimhood for perceived anti-White structural racism. Studies 2 and 3 showed that White participants at a historically White university responded with impaired perspective taking and intergroup empathy bias in response to people challenging structural disparities. Finally, reduced recognition of continuing structural racism predicted greater intergroup empathy bias, which, in turn, was associated with reduced willingness to engage in intergroup discussions about past harm. We propose that greater acknowledgment of structural racism is necessary not only to surmount intergroup empathic failures, but also to transcend the socioeconomically unequal legacies of apartheid and beyond. (shrink)

Executive functions (EFs) and impulsivity are dimensions of self-regulation that are both related to psychopathology. However, self-report measures of impulsivity and laboratory EF tasks typically display small correlations, and existing research indicates that impulsivity and EFs may tap separate aspects of self-regulation that independently statistically predict psychopathology in adulthood. However, relationships between EFs, impulsivity, and psychopathology may be different in childhood compared to adulthood. Here, we examine whether these patterns hold in the baseline assessment of the Adolescent Brain and Cognitive (...) Development (ABCD) sample, a national sample of over 11,000 children (including 749 twin pairs) ages 9–10 years. We examine the phenotypic and genetic relationships among latent variables for different components of EFs and multiple facets of impulsivity. Additionally, we assess how EFs and impulsivity relate to composite measures and latent variables of psychopathology derived from parent report. EFs were weakly correlated with impulsivity, and the strength varied by impulsivity facet, emphasizing their separability. We did not identify significant genetic and environmental correlations between EFs and impulsivity. Moreover, controlling for their small relationships with each other, both EFs and some facets of impulsivity statistically predicted an Externalizing factor, attention problems, and social problems, and twin analyses suggested these relationships were genetic in origin. These findings indicate that EFs and impulsivity represent phenotypically and genetically separable aspects of self-regulation that are both transdiagnostic correlates of psychopathology in childhood. (shrink)

Psychopathy is a disorder characterized by severe and frequent moral violations in multiple domains of life. Numerous studies have shown psychopathy-related limbic brain abnormalities during moral processing; however, these studies only examined negatively valenced moral stimuli. Here, we aimed to replicate prior psychopathy research on negative moral judgments and to extend this work by examining psychopathy-related abnormalities in the processing of controversial moral stimuli and positive moral processing. Incarcerated adult males (N = 245) completed a functional magnetic resonance imaging protocol (...) on a mobile imaging system stationed at the prison. Psychopathy was assessed using the Hare Psychopathy Checklist–Revised (PCL-R). Participants were then shown words describing three types of moral stimuli: wrong (e.g., stealing), not wrong (e.g., charity), and controversial (e.g., euthanasia). Participants rated each stimulus as either wrong or not wrong. PCL-R total scores were correlated with not wrong behavioral responses to wrong moral stimuli, and were inversely related to hemodynamic activity in the anterior cingulate cortex in the contrast of wrong > not wrong. In the controversial > noncontroversial comparison, psychopathy was inversely associated with activity in the temporal parietal junction and dorsolateral prefrontal cortex. These results indicate that psychopathy-related abnormalities are observed during the processing of complex, negative, and positive moral stimuli. (shrink)

This study identified and compared the attitudes of visitors toward zoo-housed little penguins, their enclosure and visitor experience that may influence the way visitors behave toward little penguins at two Australian zoos. Visitor attitudes were assessed using an anonymous questionnaire, targeting visitor beliefs, and experiences, where visitors were randomly approached at the penguin exhibit after they had finished viewing the penguins. Visitors were given two options to complete the questionnaire, on an iPad during their zoo visit or online (URL sent (...) via email) after their zoo visit. A total of 638 participants (495 at Melbourne Zoo and 143 at Taronga Zoo) completed the questionnaire, 42% were completed onsite during their zoo visit and 58% were completed online after their zoo visit. Most participants were living in Australia, non-zoo members, female, previously or currently owned a pet, aged between 26 and 35 years and had a University degree. Results showed that the attitude dimensions of visitors were consistent between the two zoos which indicates that these measures of attitudes were stable over time and location. Overall, visitors at both zoos had positive attitudes toward little penguins, penguin welfare, the enclosure, and visitor experience. However, whether these positive attitudes and positive visitor experience influenced the way visitors behaved toward the penguins remains unclear. There were some differences in visitor attitudes toward the perceived “aggressiveness” and “timidness” of little penguins, “negative penguin welfare”, “experience with the penguins”, “learning”, “visual barriers” and the way visitors rated their overall experience at the penguin enclosure. While the reasons for the differences in visitor attitudes and visitor experience between the zoos were not clear, some factors such as penguin behavior and enclosure design, may have been attributable to these differences. Also, a relationship was found between visitor attitudes and how visitors rated the welfare of penguins, the enclosure and visitor experience at the enclosure; more positive visitor attitudes were associated with higher ratings of penguin welfare, the enclosure and visitor experience. The practical implications of these results for zoos is unclear because the differences in visitor attitudes were numerically small. This requires further comparisons between zoos or enclosures that are more markedly different than the penguin enclosures in the present study and further research on how visitors assess zoo animals, enclosures and visitor experience. (shrink)

The present study investigated the respective roles of withdrawal, language, and context-inappropriate anger in the development of emotion knowledge among a subsample of 4 and 5 year-old preschoolers. Measures included parent-reported withdrawn behavior, externalizing behavior, and CI anger, as well as child assessments of receptive language and EK. Ultimately, findings demonstrated that receptive language mediated the relationship between withdrawn behavior and situational EK. However, CI anger significantly interacted with receptive language, and, when incorporated into a second-stage moderated mediation analysis, moderate (...) levels of CI anger rendered the indirect effect of withdrawn behavior on situational EK via receptive language insignificant. Cumulatively, these findings demonstrate a mechanism by which withdrawal may impact EK. They also indicate that such an effect may be attenuated in children with moderate levels of CI anger. Implications of these findings are discussed. (shrink)

Female leaders continue to face bias in the workplace compared to male leaders. When employees are evaluated differently because of who they are rather than how they perform, an ethical dilemma arises for leaders and organizations. Thus, bridging role congruity and social identity leadership theories, we propose that gender biases in leadership evaluations can be overcome by manipulating diversity at the team level. Across two multiple-source, multiple-wave, and randomized field experiments, we test whether team gender composition restores gender equity in (...) leadership evaluations. In Study 1, we find that male leaders are rated as more prototypical in male-dominated groups, an advantage that is eliminated in gender-balanced groups. In Study 2, we replicate and extend this finding by showing that leader gender and team gender composition interact to predict trust in the leader via perceptions of leader prototypicality. The results show causal support for the social identity model of organizational leadership and a boundary condition of role congruity theory. Beyond moral arguments of fairness, our findings also show how, in the case of gender, team diversity can create a more level playing field for leaders. Finally, we outline the implications of our results for leaders, organizations, business ethics, and society. (shrink)

This paper examines the outcomes of Preserving the Past Together, a workshop series designed to build the capacity of local heritage managers to engage in collaborative and community-based approaches to archaeology and historic preservation. Over the past two decades practitioners of these approaches have demonstrated the interpretive, methodological, and ethical value of integrating Indigenous perspectives and methods into the process and practice of heritage management and archaeology. Despite these benefits, few professional resources exist to support the development of collaborative relationships (...) between local heritage managers and Tribal nations. Filling this need, Preserving the Past Together’s interactive workshops and keynote lectures involved participants in a discussion of the central themes in collaborative and Indigenous approaches to archaeology today, highlighting the local challenges and opportunities that exist for archaeologists, heritage managers, and Tribal nations to work together to care for the past. This paper presents an overview of the event series’ goals, the strategies it used to foster collaboration among the diverse stakeholders of the Salish Sea, and the next steps the project’s co-directors are taking to further support communication and collaboration between stewards and stakeholders in the Pacific Northwest. (shrink)

Previous research shows that manipulations (e.g. levels-of-processing) that facilitate true memory often increase susceptibility to false memory. An exception is the generation effect. Using the Deese/Roediger–McDermott (DRM) paradigm, Soraci et al. found that generating rather than reading list items led to an increase in true but not false memories. They argued that generation led to enhanced item-distinctiveness that drove down false memory production. In the current study, we investigated the effects of generative processing on valenced stimuli and after a delayed (...) retention interval to examine factors that may lead to a generation effect that increases false memories. At the immediate test, false recognition rates for both negative and neutral valanced critical lures were similar across read and generate conditions. However, after a one-week delay, we saw a valence differentiation, with a generation effect for false recognition but only for negative stimuli. The roles of item-specific and relational processing during encoding and their interaction with long-term retention are discussed. (shrink)

Cannabis sativa L. is grown and marketed under a large number of named strains. Strains are often associated with phenotypic traits of interest to consumers, such as aroma and cannabinoid content. Yet genetic inconsistencies have been noted within named strains. We asked whether genetically inconsistent samples of a commercial strain also display inconsistent aroma profiles. We genotyped 32 samples using variable microsatellite regions to determine a consensus strain genotype and identify genetic outliers for four strains. Results were used to select (...) 15 samples for olfactory testing. A genetic outlier sample was available for all but one strain. Aroma profiles were obtained by 55 sniff panelists using quantitative sensory evaluation of 40 odor descriptors. Within a strain, aroma descriptor frequencies for the genetic outlier were frequently at odds with those of the consensus samples. It appears that within-strain genetic differences are associated with differences in aroma profile. Because these differences were perceptible to untrained panelists, they may also be noticed by retail consumers. Our results could help the cannabis industry achieve better control of product consistency. (shrink)

This article integrates research on gendered organizations and the work-family interface to investigate an innovative workplace initiative, the Results-Only Work Environment, implemented in the corporate headquarters of Best Buy, Inc. While flexible work policies common in other organizations “accommodate” individuals, this initiative attempts a broader and deeper critique of the organizational culture. We address two research questions: How does this initiative attempt to change the masculinized ideal worker norm? And what do women’s and men’s responses reveal about the persistent ways (...) that gender structures work and family life? Data demonstrate the ideal worker norm is pervasive and powerful, even as employees begin critically examining expectations regarding work time that have historically privileged men. Employees’ responses to ROWE are also gendered. Women are more enthusiastic, while men are more cautious. Ambivalence about and resistance to change is expressed in different ways depending on gender and occupational status. (shrink)

SAMANTHA GREY | : Prevailing connotations of reconciliation orbit concord or harmonious coexistence, meaning that concern for justice is necessarily subordinated to a more casually pragmatic peace. Bringing justice considerations to the fore means focusing on reparations as a key element of reconciliation’s suite of activities—but reparations are necessarily a matter of process, which precludes considering elements of the “package” in isolation from one another, as is the case with traditional evaluative criteria of motivation or proportion. Accordingly, this article (...) proposes that reparations are better framed as a considered reaction to the unjust allocation of burdens, so that subsequent reallocations serve justice by answering the needs and demands of survivors. Taking cues from a variety of sources both within and beyond the transitional justice literature, the work at hand attempts just such a retrospective reframing by looking at a recently completed Canadian reparations process: the Indian Residential Schools Settlement Agreement. | : Les connotations dominantes de la réconciliation gravitent autour de la concorde ou de la coexistence harmonieuse, signifiant que le souci de la justice est nécessairement subordonné à une paix plus pragmatique. Mettre les considérations de justice au premier plan implique de mettre l’accent sur les réparations comme un élément clé de la série d’activités de la réconciliation, mais les réparations sont nécessairement une question de processus, ce qui exclut de considérer ses éléments isolément, comme c’est le cas des critères évaluatifs traditionnels de motivation ou de proportion. En conséquence, cet article propose que les réparations sont mieux conçues comme une réaction réfléchie à l’attribution injuste des charges, de sorte que les réallocations ultérieures servent la justice en répondant aux besoins et aux exigences des survivants. S’inspirant d’une variété de sources à l’intérieur et à l’extérieur de la littérature sur la justice transitionnelle, le présent travail tente un tel recadrage rétrospectif en examinant un processus canadien de réparations récemment terminé : la Convention de règlement relative aux pensionnats indiens. (shrink)

In another tumultuous term of the United States Supreme Court in 2022-2023 a series of critical cases implicate instant and forthcoming changes in multiple fronts that collectively shift the national public health law and policy environment.

The ontologies of Slavoj Žižek and Gilles Deleuze are incommensurable. Rather than appropriate one at the expense of the other, this essay uses Žižek’s notion of parallax to think the two philosophers together, without mediation. Both Deleuze and Žižek provide mirrored philosophical images, with the point of divergence being absolute lack. Deleuze argues that lack, or the being of negation, is an error of representational understanding, while Žižek conceives his philosophy as being driven by absolute lack. A stark opponent of (...) Žižek’s precursor, Hegel, Deleuze rejects opposition as a constitutive feature of reality. However, Žižek mirrors Deleuze’s very concepts in his Lacanian reading of Hegel, while said concepts retain identical terms. For instance, Žižek calls l’objet petit a “difference,” while his term for absolute negation is “repetition,” and finally, he refers to his philosophical system as the “non-All”. These singular concepts in Žižek’s thought share an identical language with that of Deleuze. Deleuze’s philosophy is one of “difference,” while its mode of proliferation is “repetition,” and finally, he often refers to his philosophy as the “One-All”. Mapping these common terms that do not denote a common language, but incommensurable, inverse logics, it becomes evident that Deleuze and Žižek are mirror images of one another, infinitely fragmenting across the expanse of their respective positions. Thus, by triangulating ontology from their unique perspectives, a new ontological shift emerges—one that resists mediation and admixture. (shrink)

Although researchers have investigated the impact of social isolation on well-being, the recent quarantines due to COVID-19 resulted in a social isolation environment that was unique to any examined in the past. Because sleep is one of the endogenous drives that impacts short and long-term health and well-being, it is important to consider how social isolation during the COVID-19 government-mandated quarantines affected sleep and sleep habits. A number of researchers have addressed this question during the last 2 years by examining (...) several concepts related to possible changes in sleep during the quarantines. To best understand these recent results, the current mini review provides a background on the pre-pandemic literature on the effects of social isolation and loneliness with a focus on sleep and then summarizes the recent literature on sleep and sleep habits. In general, sleep was negatively impacted for many people during the pandemics but not all. One group that seemed to benefit from the pandemic in terms of sleep patterns, were younger people who could more easily adapt their sleep times to match their internal chronobiology. Given the potential broad impact of sleep on health and well-being, better understanding how social isolation impacts sleep is an important consideration for individuals, work organizations, and governments. (shrink)

À la suite des récentes décisions légales reconnaissant plus de deux parents à certains enfants canadiens, nous nous demandons s’il existe des raisons morales pour limiter à deux le nombre de parents qu’un enfant peut avoir. Nous examinons quelques arguments traditionnels soutenant cette position et nous trouvons qu’ils ne suffisent pas pour la justifier. Nous présentons aussi un argument inspiré par le travail de Brighouse et Swift au sujet des bienfaits d’être parent, et nous montrons qu’il n’est pas assez fort (...) pour soutenir la nécessité de limiter à deux le nombre de parents. En terminant, nous suggérons quelques autres façons de séparer de façon positive l’idée de «parent» des notions traditionnelles. (shrink)

RésuméLa mort d'une personne peut-elle être intrinsèquement mauvaise pour la personne qui meurt? Et pourquoi est-il mal de tuer une autre personne? Je soutiens qu'une réponse adéquate à l'une ou l'autre de ces questions requiert d'apprécier l'importance morale de l'autonomie. J'examine ici la conception dominante de ce qui rend la mort mauvaise — la théorie de la dépossession —, ainsi que deux conceptions rivales de ce qui fait qu'il est mal de tuer — la théorie de la dépossession appliquée à (...) l'acte de tuer, et la thèse des droits liminaux de Judith Thomson. Bien que mon objectif principal dans cet article soit d'établir l'importance de l' autonomie pour expliquer à lafois que la mort est mauvaise et qu'il est mal de tuer, je pense également qu'une réflexion sur ce qui rend la mort mauvaise nous apprend quelque chose au sujet des droits et de leur force, et qu'une réflexion sur les droits nous apprend quelque chose quant à ce qui fait que la mort et l'immortalité sont toutes deux de mauvaises choses. (shrink)

I argue that Samantha Vice understates the moral resources white people have available to them to minimize their falling into distorted ways of perceiving and responding to the world caused by bare white advantage. In doing so, she paints an unjustifiably pessimistic picture of white civic involvement in South Africa, and anywhere where white people are unjustly advantaged, such as the United States. I delineate two similar but distinct antiracist moral identities the 'white ally' and the 'person committed to (...) racial justice'-that can guide civic engagement, as well as provide a counterweight to the distortions of whiteness. I argue that Vice's recommendation of withdrawal from public engagement in humble silence is not the most morally appropriate response to white privilege. (shrink)

This book presents a novel account of the aesthetics of animals. The author argues that the appreciation of animal beauty carries profound ethical consequences for our relations to our fellow creatures.

This paper is a response to recent student protests at South African universities, and the essentialising rhetoric and practices that characterise South African public debates. I explore the likely responses of white South Africans to views that seem to make their whiteness inescapable and necessarily morally bad.

In _Biocultural Creatures_, Samantha Frost brings feminist and political theory together with findings in the life sciences to recuperate the category of the human for politics. Challenging the idea of human exceptionalism as well as other theories of subjectivity that rest on a distinction between biology and culture, Frost proposes that humans are biocultural creatures who quite literally are cultured within the material, social, and symbolic worlds they inhabit. Through discussions about carbon, the functions of cell membranes, the activity (...) of genes and proteins, the work of oxygen, and the passage of time, Frost recasts questions about the nature of matter, identity, and embodiment. In doing so, she elucidates the imbrication of the biological and cultural within the corporeal self. In remapping the relation of humans to their habitats and arriving at the idea that humans are biocultural creatures, Frost provides new theoretical resources for responding to political and environmental crises and for thinking about how to transform the ways we live. (shrink)

This article surveys recent feminist contributions to moral philosophy with an emphasis on those works which engage with debates within mainstream ethics. The article begins by examining a tension said to arise from the two criteria a theory must meet if it is to count as feminist moral theory: the women's experience requirement and the feminist conclusion requirement. Subsequent sections deal with feminist relational theories of rights, feminist work on responsibility and feminist contractarian approaches to ethics. A final section looks (...) at the application of some feminist moral theories to the problem of abortion. (shrink)

Déjà vu and involuntary autobiographical memories (IAMs) are differentiated by a number of factors including metacognition. In contrast to IAMs, déjà vu activates regions associated with self-awareness including the right dorsolateral prefrontal cortex.

Background The review of human participant research by Research Ethics Committees or Institutional Review Boards is a complex multi-faceted process that cannot be reduced to an algorithm. However, this does not give RECs/ IRBs permission to be inconsistent in their specific requirements to researchers or in their final opinions. In England the Health Research Authority coordinates 67 committees, and has adopted a consistency improvement plan including a process called “Shared Ethical Debate” where multiple committees review the same project. Committee reviews (...) are compared for consistency by analysing the resulting minutes. Methods We present a description of the ShED process. We report an analysis of minutes created by research ethics committees participating in two ShED exercises, and compare them to minutes produced in a published “mystery shopper” exercise. We propose a consistency score by defining top themes for each exercise, and calculating the ratio between top themes and total themes identified by each committee for each ShED exercise. Results Our analysis highlights qualitative differences between the ShED 19, ShED 20 and “mystery shopper” exercises. The quantitative measure of consistency showed only one committee across the three exercises with more than half its total themes as top themes. The average consistency scores for the three exercises were 0.23, 0.35 and 0.32. There is a statistically significant difference between the ShED 19 exercise, and the ShED 20 and mystery shopper exercises. Conclusions ShED exercises are effective in identifying inconsistency between ethics committees and we describe a scoring method that could be used to quantify this. However, whilst a level of inconsistency is probably inevitable in research ethics committee reviews, studies must move beyond the ShED methodology to understand why inconsistency occurs, and what an acceptable level of inconsistency might be. (shrink)

The review of human participant research by Research Ethics Committees or Institutional Review Boards is a complex multi-faceted process that cannot be reduced to an algorithm. However, this does not give RECs/ IRBs permission to be inconsistent in their specific requirements to researchers or in their final opinions. In England the Health Research Authority coordinates 67 committees, and has adopted a consistency improvement plan including a process called “Shared Ethical Debate” where multiple committees review the same project. Committee reviews are (...) compared for consistency by analysing the resulting minutes. We present a description of the ShED process. We report an analysis of minutes created by research ethics committees participating in two ShED exercises, and compare them to minutes produced in a published “mystery shopper” exercise. We propose a consistency score by defining top themes for each exercise, and calculating the ratio between top themes and total themes identified by each committee for each ShED exercise. Our analysis highlights qualitative differences between the ShED 19, ShED 20 and “mystery shopper” exercises. The quantitative measure of consistency showed only one committee across the three exercises with more than half its total themes as top themes. The average consistency scores for the three exercises were 0.23, 0.35 and 0.32. There is a statistically significant difference between the ShED 19 exercise, and the ShED 20 and mystery shopper exercises. ShED exercises are effective in identifying inconsistency between ethics committees and we describe a scoring method that could be used to quantify this. However, whilst a level of inconsistency is probably inevitable in research ethics committee reviews, studies must move beyond the ShED methodology to understand why inconsistency occurs, and what an acceptable level of inconsistency might be. (shrink)

The concept of medical necessity is often used to explain or justify certain decisions—for example, which treatments should be allowed under certain conditions—as though it had an obvious, agreed-upon meaning as well as an inherent normative force. In introducing this special issue of Clinical Ethics on medical necessity, we argue that the term, as used in various discourses, generally lacks a definition that is clear, non-circular, conceptually plausible, and fit for purpose. We propose that future work on this concept should (...) address three main questions: what medical necessity is (i.e., what makes something medically necessary, as opposed to something else); what the concept does (what ‘work’ is it doing when invoked in different settings); and what should follow, normatively, from the fact that something is indeed medically necessary (on some plausible conception). (shrink)

Thomas Hobbes is an iconic figure who serves as an easy reference for pundits commenting on the brutality of war as well as for critics of a distinctly modern individualism in which calculating and rapacious self-interest is the cause of the violence, destruction, and exploitation endemic to the contemporary world. Frost's reading of Hobbes's philosophy shows us that underlying such visions of self and politics is another iconic figure: that of the Cartesian subject. What gives the iconic Hobbes his hardcore (...) individualism and its corollary accounts of instrumentalism, conflict, and absolutism is a Cartesian rendering of the self as split into mind and body. Carefully elaborating Hobbes's materialist ontology, _Lessons from a Materialist Thinker_ challenges both our implicit Cartesian assumptions about the self and the commonplace Hobbes that so readily figures violence in our political imagination. Through his materialism, Hobbes presents an alternative modern account of self-consciousness, reason, agency, power, freedom, and responsibility. In doing so, he shows that our fundamental intersubjectivity and interdependence require that we pursue peace above all else. (shrink)