Background Diversity in Institutional Review Board (IRB) membership is important for both intrinsic and instrumental reasons, including fairness, promoting trust, improving decision quality, and responding to systemic racism. Yet U.S. IRBs remain racially and ethnically homogeneous, even as gender diversity has improved. Little is known about IRB chairpersons’ perspectives on membership diversity and barriers to increasing it, as well as current institutional efforts to promote diversity, equity, and inclusion (DEI) within IRB membership.Methods We surveyed IRB chairpersons leading U.S. boards registered (...) with the Office for Human Research Protections. Here, we focus exclusively on responses from a subset of 388 chairpersons of IRBs at universities and academic medical centers (AMCs).Results Board chairs were predominantly white and evenly split between men and women. Only about half reported that their boards had at least one member who is Black or African American (51%), Asian (56%), or Hispanic (48%), with 85% of university/AMC boards comprised entirely (15%) or mostly (70%) of white members. Most IRB chairpersons (64%) reported satisfaction with the current diversity of their membership. Participants largely agreed that considering diversity in the selection of IRB members is important (91%), including to improve the quality of IRB deliberation (80%), with an emphasis on racial/ethnic (85%) and gender diversity (74%). Most participants (80%) reported some type of active DEI effort regarding board membership at their university/AMC and just over half (57%) expressed satisfaction with these efforts.Conclusions Our national survey found that although university/AMC IRB chairpersons report valuing diversity in board membership, it may be lacking in key areas. Going forward, it will be important to specify clear reasons for diversity in the IRB context, as well to establish targets for acceptable levels of board diversity and to match DEI efforts to those targets. (shrink)

Since the appearance of a widely influential book, Self-Knowledge and Self-ldentity, Sydney Shoemaker has continued to work on a series of interrelated issues in the philosophy of mind and metaphysics. This volume contains a collection of the most important essays he has published since then. The topics that he deals with here include, among others, the nature of personal and other forms of identity, the relation of time to change, the nature of properties and causality and the relation between (...) the two, dualism and immortality, and the nature of mental states. All the essays show the same care and precision in argument as the earlier book, but they also reveal a substantial shift in Professor Shoemaker's position to a form of materialism. In fact, a number of papers together constitute what is probably the most subtle and rigourous defence yet of a sophisticated functionalism in the account of the mind. (shrink)

Since the appearance of a widely influential book, Self-Knowledge and Self-ldentity, Sydney Shoemaker has continued to work on a series of interrelated issues in the philosophy of mind and metaphysics. This volume contains a collection of the most important essays he has published since then. The topics that he deals with here include, among others, the nature of personal and other forms of identity, the relation of time to change, the nature of properties and causality and the relation between (...) the two, dualism and immortality, and the nature of mental states. All the essays show the same care and precision in argument as the earlier book, but they also reveal a substantial shift in Professor Shoemaker's position to a form of materialism. In fact, a number of papers together constitute what is probably the most subtle and rigourous defence yet of a sophisticated functionalism in the account of the mind. (shrink)

Being a patient and living a life -- Clinical space and traits of healing -- False starts and frequent failures -- Three journeys : A.'Ibuprofen and love', B. 'Staying tuned up', C. 'We all want the same things' -- Being a patient : the moral field -- Rethinking healthcare ethics : the patient's moral authority.

Dr Sydney Brenner has played a major, and unique, role in biology during the past 40 years. His contributions have ranged from key work on the structure of the genetic code and the existence of mRNA through the development of Caenorhabditis elegans as a key model system in developmental biology to genomic analysis and function in vertebrates. BioEssays went to interview Dr Brenner at his home in the cathedral city of Ely, England, on the significance of the genome projects (...) for human biology, in particular, and for biology, in general. (shrink)

This chapter is a sustained reflection on the sorts of place-based knowledge that characterise making one’s way around in a Ruist world. As we know, Confucius and Mencius spent much of their lives travelling, and, I argue, this was essential in forming their vision of a comprehensive and cohesive world order. I suggest three motifs for place-based knowing: terrestrial geography, metaphysical geography, and moral geography. Terrestrial geography includes physical, topographical, and social geographical paradigms. These are connected by the importance of (...) travel, by way of which one experiences the physical counterparts of such thematic analogies as lofty mountains and resolute evergreens. Finding and forging pathways through life and avoiding stagnating dead-ends reveal the second motif, metaphysical geography. In metaphysical geography, the metaphor of smooth movement along clear paths represents success, understanding, even wisdom. Blocked, unnavigable, and dead-end paths represent failure, confusion, and ignorance. In moral geography, space, time, people, events, and things are oriented and relationally connected via moral landmarks and ties. Knowing what to do on behalf of oneself and the world is the most epistemologically potent geographical knowledge one may have. It requires a depth of knowledge both of oneself and the world, as well as how one’s moral acts will have the most profound effects. (shrink)

Money plays a powerful role in modern medicine, both in terms of how health services are organized and delivered and increasingly in how physicians understand themselves and their work. The phrase “the hegemony of money” is intended to capture that power.

It is commonplace to point out that Alfred Kinsey's taxonomic work on gall wasps provided a methodology for his studies of human sexual behavior. It is equally commonplace to point out that, when researching and presenting his sexual studies, Kinsey's professedly neutral scientific data were constrained by a social agenda. What I have done in this paper is to join these two claims and demonstrate, with particular reference to Kinsey's Sexual Behavior in the Human Male, how his zoology helped guide (...) Kinsey to a naturalistic ethics that, despite contrasts to, shared certain parallel logical failures with the traditional ethics of his critics. (shrink)

Two kinds of epistemological sceptical paradox are reviewed and a shared assumption, that warrant to accept a proposition has to be the same thing as having evidence for its truth, is noted. 'Entitlement', as used here, denotes a kind of rational warrant that counterexemplifies that identification. The paper pursues the thought that there are various kinds of entitlement and explores the possibility that the sceptical paradoxes might receive a uniform solution if entitlement can be made to reach sufficiently far. Three (...) kinds of entitlement are characterized and given prima facie support, and a fourth is canvassed. Certain foreseeable limitations of the suggested antisceptical strategy are noted. The discussion is grounded, overall, in a conception of the sceptical paradoxes not as directly challenging our having any warrant for large classes of our beliefs but as crises of intellectual conscience for one who wants to claim that we do. (shrink)

Wittgenstein's insistence in his later philosophy that explanation comes to an end in the explication of what it is to follow a rule provides a locus for the awakening of wonder, analogous to the mystical awe referred to in the "Tractatus". While Wittgenstein did not explore this analogy, it provides a point of entry into the examination of the relevance of his work to religious concerns. Every regular practice is built on capacities of reaction, uptake, and response which are the (...) endpoints of explanation, whose sheer givenness in their relation to our physical and social environment can bring on amazement. This wonder at the end of explanation has been explored -- from quite a different perspective -- by Stephen Gould, whose conclusions complement Wittgenstein's own. (shrink)

Francisco Suárez Sometimes called the "Eminent Doctor" after Paul V’s designation of him as doctor eximius et pius, Francisco Suárez was the leading theological and philosophical light of Spain’s Golden Age, alongside such cultural icons as Miguel de Cervantes, Tomás Luis de Victoria, and El Greco. Although initially rejected on grounds of deficient health … Continue reading Suárez, Francisco →.

The dynamic of religious expression employs symbolic language, actions, and art. These symbols are symbols of transcendence because it is transcendence which is the unique referent that sets apart symbols which give rise to religious understanding from symbols which do not. The main objective of this book is to demonstrate that in Louis Dupre's work all religious expression, insofar as it has a transcendent reference, is intrinsically symbolic. Religious language is never purely objective nor purely subjective, but a dialectical relation (...) with a transcendent dimension. True to the teachings of Dupre, this book uncovers that without a transcendent referent, religious symbols lose their religious significance. This is the plight of the (late-post)modern condition which resulted from the fracturing of nature into its cosmic, human and transcendent components. To regain a sense of transcendence the believer is forced to make an inward turn akin to the mystical practice of past ages. This does not recover a sense of transcendence for culture but can do so for the believer's personal spiritual life. (shrink)

"The fixed person for fixed duties, who in older societies was such a godsend, in the future ill be a public danger." Twenty years ago, a single legal metaphor accurately captured the role that American society accorded to physicians. The physician was "c- tain of the ship." Physicians were in charge of the clinic, the Operating room, and the health care team, responsible - and held accountabl- for all that happened within the scope of their supervision. This grant of responsibility (...) carried with it a corresponding grant of authority; like the ship's captain, the physician was answerable to no one regarding the practice of his art. However compelling the metaphor, few would disagree that the mandate accorded to the medical profession by society is changing. As a result of pressures from a number of diverse directions - including technological advances, the development of new health professionals, changes in health care financing and delivery, the recent emphasis on consumer choice and patients' rights - what our society expects phy- cians to do and to be is different now. The purpose of this volume is to examine and evaluate the conceptual foundations and the moral imp- cations of that difference. Each of the twelve essays of this volume assesses the current and future validity of the "captain of the ship" metaphor from a different perspective. The essays are grouped into four sections. In Section I, Russell Maulitz explores the physician's role historically. (shrink)

When health care providers make decisions to use resources, their devotion to the patient at hand must be mediated by a framework that puts individual autonomy and social equity into focus simultaneously. The concept of citizenship yields such a framework.

Despite the importance of Suárez’s defense of the freedom of the will at the threshold of early modern philosophy, his account has received scant recent attention. This paper aims partially to redress that neglect. Suárez’s position can be understood as a balancing act between desiring to attribute libertarian freedom to agents and desiring to maintain the will’s status as a rational appetite. Hence, he rejects an intellectualism that says that choices are necessitated by the intellect’s judgements (since he does not (...) think that the judgements themselves can be directly free), but affirms that only what is judged good can be chosen. (shrink)

Covering nearly 300 years of American religious writing, this anthology compiles selections from thirteen notable thinkers--including Thomas Hooker, Jonathan Edwards, Charles Hodge, Ralph Waldo Emerson, Josiah Royce, William James and H. Richard Niebuhr--to reveal the vital and creative history of Protestant theology in America. In his substantial Introduction, Sydney Ahlstrom relates the history of American theology in broad and accessible terms, tackling his subject with characteristic clarity, passion, and intellectual rectitude.

We will argue here that after more than 30 years of talk, theory, and clinical practice, we bioethicists still know far too little about what patients, subjects, and healthcare professionals are up to, morally. Bioethics is still near the beginning in grasping what it means to understand, much less to honor fully, the moral power and perspicacity of those bioethics is designed to serve. This is, of course, a serious charge, but one we will endeavor to show has merit. However, (...) we want to be clear from the start that we do not gainsay the important work that has been done in and through the influence of bioethics, both as a field of practical engagement and as a cultural movement, in improving how healthcare is delivered and how human subjects are treated. Thirty or 40 years—depending on how one marks the beginning point—is a very short time, and it is hard to imagine that wholesale changes, all of them in the right direction, could be the outcome for a field this young. Hence, we do not intend the title, “One Cheer for Bioethics,” as a wholesale indictment, but as an indication that there is a great deal of work yet to be done, and that following the currently dominant direction of the field is not likely to get us there. Our aim is to indicate just where future work should be focused, and to do so we will need to be critical of some of the preoccupations of the last three decades. a. (shrink)