This article investigates a high-profile and ongoing dilemma for healthcare professionals, namely whether the existence of a duty of care to genetic relatives of a patient is a help or a hindrance in deciding what to do in cases where a patient’s genetic information may have relevance to the health of the patient’s family members. The English case ABC v St George’s Healthcare NHS Trust and others considered if a duty of confidentiality owed to the patient and a putative duty (...) of care to the patient’s close relatives could coexist in this context. This article examines whether embracing the concept of coexisting duties could enable HCPs to respect duties in line with their clinical judgement, thereby providing legal support and clarity to professionals to allow them to provide the best possible genetics service to both the patient and their family. We argue that these dual duties, framed as a novel, composite duty to consider the interests of genetic relatives, could allow HCPs to exercise and act on their professional judgements about the relative value of information to family members, without fears of liability for negligence or breach of confidence. (shrink)
Population-level biomedical research offers new opportunities to improve population health, but also raises new challenges to traditional systems of research governance and ethical oversight. Partly in response to these challenges, various models of public involvement in research are being introduced. Yet, the ways in which public involvement should meet governance challenges are not well understood. We conducted a qualitative study with 36 experts and stakeholders using the World Café method to identify key governance challenges and explore how public involvement can (...) meet these challenges. This brief report discusses four cross-cutting themes from the study: the need to move beyond individual consent; issues in benefit and data sharing; the challenge of delineating and understanding publics; and the goal of clarifying justifications for public involvement. The report aims to provide a starting point for making sense of the relationship between public involvement and the governance of population-level biomedical research, showing connections, potential solutions and issues arising at their intersection. We suggest that, in population-level biomedical research, there is a pressing need for a shift away from conventional governance frameworks focused on the individual and towards a focus on collectives, as well as to foreground ethical issues around social justice and develop ways to address cultural diversity, value pluralism and competing stakeholder interests. There are many unresolved questions around how this shift could be realised, but these unresolved questions should form the basis for developing justificatory accounts and frameworks for suitable collective models of public involvement in population-level biomedical research governance. (shrink)
Anthropology diffracted : originary humanicity -- Just figures?: forensic clairvoyance, mathematics, and the language question -- Enumerating language : "The unreasonable effectiveness of mathematics" -- Natural convers(at)ions : or, what if culture was really nature all along? -- (Con)founding "the human" : rethinking the incest taboo -- Culpability and the double-cross : Irigaray with Merleau-Ponty.
This comprehensively updated and expanded revision of the successful second edition continues to provide detailed coverage of the ever-growing range of research topics in vision. In Part I, the treatment of visual physiology has been extensively revised with an updated account of retinal processing, a new section explaining the principles of spatial and temporal filtering which underlie discussions in later chapters, and an up-to-date account of the primate visual pathway. Part II contains four largely new chapters which cover recent psychophysical (...) evidence and computational model of early vision: edge detection, perceptual grouping, depth perception, and motion perception. The models discussed are extensively integrated with physiological evidence. All other chapters in Parts II, III, and IV have also been thoroughly updated. (shrink)
Using the British mental health services as a case study, this book critically reviews the various social, political and intellectual developments which have shaped psychiatric practice and the delivery of mental health services.
Background: There is general consensus internationally that unfair distribution of the benefits of research is exploitative and should be avoided or reduced. However, what constitutes fair benefits, and the exact nature of the benefits and their mode of provision can be strongly contested. Empirical studies have the potential to contribute viewpoints and experiences to debates and guidelines, but few have been conducted. We conducted a study to support the development of guidelines on benefits and payments for studies conducted by the (...) KEMRI-Wellcome Trust programme in Kilifi, Kenya. Methods: Following an initial broad based survey of cash, health services and other items being offered during research by all programme studies (n = 38 studies), interviews were held with research managers (n = 9), and with research staff involved in 8 purposively selected case studies (n = 30 interviewees). Interviews explored how these ‘benefits’ were selected and communicated, experiences with their administration, and recommendations for future guidelines. Data fed into a consultative workshop attended by 48 research staff and health managers, which was facilitated by an external ethicist.FindingsThe most commonly provided benefits were medical care (for example free care, and strengthened quality of care), and lunch or snacks. Most cash given to participants was reimbursement of transport costs (for example to meet appointments or facilitate use of services when unexpectedly sick), but these payments were often described by research participants as benefits. Challenges included: tensions within households and communities resulting from lack of clarity and agreement on who is eligible for benefits; suspicion regarding motivation for their provision; and confusion caused by differences between studies in types and levels of benefits. Conclusions: Research staff differed in their views on how benefits should be approached. Echoing elements of international benefit sharing and ancillary care debates, some research staff saw research as based on goodwill and partnership, and aimed to avoid costs to participants and a commercial relationship; while others sought to maximise participant benefits given the relative wealth of the institution and the multiple community needs. An emerging middle position was to strengthen collateral or indirect medical benefits to communities through collaborations with the Ministry of Health to support sustainability. (shrink)
Do you ever wonder why some people just rub you the wrong way? Or why you automatically click with others? Or maybe you even ask yourself, "Who am I, really?" Wouldn't it be wonderful if you could understand why people are the way they are--and even better understand yourself? Now you can! And it's simple and fun! Based on the ancient Five Elements model from Chinese medicine, Dr. Vicki Matthews has developed a simple way to describe our five basic personality (...) types and the predictable ways in which they interact. Take your first step toward happier and more harmonious relationships in every area of your life--including a better relationship with yourself! The result of years of personal and professional experience, this invaluable book can improve every relationship you have and make your life better! -- Publisher. (shrink)
Ethical decision-making frameworks assist in identifying the issues at stake in a particular setting and thinking through, in a methodical manner, the ethical issues that require consideration as well as the values that need to be considered and promoted. Decisions made about the use, sharing, and re-use of big data are complex and laden with values. This paper sets out an Ethics Framework for Big Data in Health and Research developed by a working group convened by the Science, Health and (...) Policy-relevant Ethics in Singapore Initiative. It presents the aim and rationale for this framework supported by the underlying ethical concerns that relate to all health and research contexts. It also describes a set of substantive and procedural values that can be weighed up in addressing these concerns, and a step-by-step process for identifying, considering, and resolving the ethical issues arising from big data uses in health and research. This Framework is subsequently applied in the papers published in this Special Issue. These papers each address one of six domains where big data is currently employed: openness in big data and data repositories, precision medicine and big data, real-world data to generate evidence about healthcare interventions, AI-assisted decision-making in healthcare, public-private partnerships in healthcare and research, and cross-sectoral big data. (shrink)
Over the last two decades our understanding of the relationship of gender, politics and the state has been transformed almost beyond recognition by the mutual interrogation of feminism and political science. This volume provides an overview of this dynamic and growing field, which reflects both its expanding empirical scope and the accompanying theoretical development and debate. The first three essays focus primarily on conceptual and theoretical issues: the meaning of 'gender'; the state's role in the construction of gender within the (...) public and private sphere; and the political representation of gender differences within liberal democracy. The remaining six provide analyses of more concrete issues of state policy and participation in differeing national political contexts: abortion politics in Ireland; the local politics of prostitution in Britain, the impact on women's political participation of economic change in China, Latin America and political change in Russia, and the gender impact of state programmes of land reform. (shrink)
This paper recommends that experimental analysts of language development abandon for the purposes of experimental inquiry both the term "language" and the concept it designates. In support of this recommendation, the paper dis cusses the multiple meanings of "language," the proposal that "language" refers to behavior, the implicit acceptance by behavior analysts of psycholinguistic thought despite their ostensible rejection of it, and the nature of language as a subject matter. In addition, the nature of common-sense psychology, the domain of behavior (...) analysis, the formal nature of Chomskyan linguistics, and the rela tion between psychology and behavior analysis are discussed. (shrink)
This article aims to present a Žižekian reading of the British author David Herbert Lawrence. The contemporary continental philosopher has tackled each of the British author’s reoccurring themes individually and thus may be used as a keystone for a valid literary interpretatio n. The paper begins by shedding light on the representation of Western ideology, moves further into the comprehension of the impacts of modern cultural capital and the limitations of industrialization. While at the same time the dissertation targets another (...) component of the romantic poet’s many writings which are characterized by the regeneration of the subject’s carnal presence as a defense mechanism against the prevalent culture of de-humanization. The argument at hand is that the reconstruction of the bodily image rendered through Lawrence’s erotic literature is not one that portrays promiscuity, but rather demonstrates a transgression of the Lacanian symbolic and the attainment of a partial rendition of a Hegelian totality. Lawrence’s six novels and set of poems are thoroughly analyzed from a strictly Žižekian p erspective to demonstrate that th e two authors share thematic representations, a common worldview and propose a manifestation of how literary analyses may be conveyed using Žižek as a philosophical lens for literary interpretation. (shrink)
With contributions from leading scholars in constitutional law, this volume examines how carefully designed and limited doctrines of proportionality can improve judicial decision-making, how it is applied in different jurisdictions, its role on constitutionalism outside the courts, and whether the principle of proportionality actually advances or detracts from democracy. Contributions from some of the seminal thinkers on the development of scholarship on proportionality extend their prior work and engage in an important dialogue on the topic. Some offer substantial critiques, others (...) defend the doctrine and offer important clarifications and extensions of their prior work. Throughout, the authors engage not only with case law from around the world but also with existing scholarly treatments of the subject. Mathematical treatments are avoided, making the book accessible to readers from both 'soft' and hard' social science backgrounds. (shrink)
The COVID-19 pandemic has both exposed and created deep rifts in society. It has thrust us into deep ethical thinking to help justify the difficult decisions many will be called upon to make and to protect from decisions that lack ethical underpinnings. This paper aims to highlight ethical issues in six different areas of life highlighting the enormity of the task we are faced with globally. In the context of COVID-19, we consider health inequity, dilemmas in triage and allocation of (...) scarce resources, ethical issues associated with research, ethical considerations relating to tracing apps, and exit strategies such as immunity passports and COVID-19 vaccines. Finally, we consider environmental issues in light of COVID-19. The paper also offers some ethical reflection on these areas as many parts of the world contemplate the recovery phase. (shrink)
Background: Depression is the largest cause of mental ill health worldwide. Although interventions such as Dance Movement Therapy (DMT) may offer interesting and acceptable treatment options, current clinical guidelines do not include these interventions in their recommendations mainly because of what is perceived as insufficient research evidence. The 2015 Cochrane review on DMT for depression includes only three RCTs leading to inconclusive results. It is therefore, necessary to also look beyond such designs in order to identify and assess the range (...) of current evidence. Methods: We therefore, conducted a systematic review of studies that aimed to explore the effectiveness in the use of DMT with people with depression. This led to a qualitative narrative synthesis followed by a subgroup analysis and a sensitivity analysis. In all meta-analyses a random effects model was used with Standardised Mean Differences (SMD) to accommodate for the heterogeneity of studies and outcome measures. Results: From the 817 studies reviewed, eight studies met our inclusion criteria. 351 people with depression (mild to severe) participated, 192 of whom attended DMT groups while receiving treatment as usual (TAU) and 159 received TAU only. Qualitative findings suggest there was a decrease in depression scores in favour of DMT groups in all studies. Subgroup analysis performed on depression scores before and three months after the completion of DMT groups suggested changes in favour of the DMT groups. When sensitivity analysis was performed, RCTs at high risk of bias were excluded, leaving only studies with adult clients up to the age of 65. In these studies, the highest effect size was found favouring DMT plus TAU for adults with depression, when compared to TAU only. Conclusions: Based on studies with moderate to high quality, we concluded that DMT is an effective intervention in the treatment of depression with adults. Furthermore, by drawing on a wide range of designs with diverse quality, we were able to compile a comprehensive picture of relevant trends. Despite the fact that there remains a paucity of high-quality studies, the results have relevance to both policy-making and clinical practice, and become a platform for further research. (shrink)
In the hundred years since its publication, Wittgenstein’s Tractatus Logico-Philosophicus has become a contemporary classic with the peculiarity that it is surrounded by an aura of mystery: what is really Wittgenstein’s aim in writing the Tractatus, how are we to understand the last two propositions of the Tractatus that enjoin us to detach ourselves from the book itself and keep silent, can the Tractatus be anything other than a positivist and anti-metaphysical treatise, and so on? Here we will argue that (...) the answer to these questions must consider what the ethical meaning of the Tractatus might be and, closely related to that, what its importance is and that of the ineffable in general. (shrink)
Barcelona has become one of the most touristic cities in the world, with more than 18 million visitors per year, coming to a city with only 1.7 million inhabitants. The model of tourism is depredatory, destroying old neighborhoods and pushing Catalans out of the city. At the same time, people from the Global South come to the city, but in more precarious conditions. They find a city that does not welcome them and that puts them in the worst conditions. I (...) want to focus on two movies that present Barcelona as an ill city. On the one hand, we have Woody Allen’s Vicky, Cristina, Barcelona, a movie that shows the upper-class American tourism in a European city. On the other hand, Alejandro González Iñárritu’s Biutiful, also starred by Javier Bardem, shows us another story about Barcelona. This is a movie that pays attention to the bottom of the well, Spanish lower-class workers struggling shoulder to shoulder with lower class migrants, people who will never enjoy the life that Allen`s characters have. In this paper I want to show how film can represent illness in different ways. To do so, I first explain, very briefly, the Barcelona model, a model of inclusive, modern city that Vicky and Cristina enjoy. But, this model insofar as it includes people, it excludes them. I will show the construction of the City from 1888 to 1992/2004 and how it has created spaces of inclusion and exclusion. In the second part, I will analyze the right to housing and the housing crisis that is currently affecting the city. In this part, I want to focus both in the crisis and in the social mobilization that it has brought about. After constructing this context, I will analyze the two movies, as instruments to show/hide the diseases of the city. (shrink)
On December 22, 1988, Chico Mendes, the leader of the struggle to preserve the Amazonian rainforest, stepped out of the back door of his house and was assassinated. Chico was a seringueiro, a rubber tapper who collects latex from the trees of the forest. He had a vision of the people of the rainforest living in balance with the natural world, supporting their communities through harvesting the natural, renewable forest products in a sustainable manner. It was for this (...) vision that he was murdered by the powerful ranchers of the region, who wish to burn the forests and expand their vast estates. And it is also for this vision that he has become for many throughout the world a hero of the earth, a saint of ecology. (shrink)
This collection of essays explores conceptions of toleration and tolerance in Asia and the West. It tests the assumption in contemporary Western political discourse and theory that toleration is a uniquely Western virtue and finds that many other traditions have comparable ideas and practices in grappling with religious and cultural diversity.
International health research in malaria-endemic settings may include screening for sickle cell disease, given the relationship between this important genetic condition and resistance to malaria, generating questions about whether and how findings should be disclosed. The literature on disclosing genetic findings in the context of research highlights the role of community consultation in understanding and balancing ethically important issues from participants’ perspectives, including social forms of benefit and harm, and the influence of access to care. To inform research practice locally, (...) and contribute to policy more widely, this study aimed to explore the views of local residents in Kilifi County in coastal Kenya on how researchers should manage study-generated information on sickle cell disease and carrier status. (shrink)
In ancient Rome, there was no need for people to have distinct names, they followed that of their tribe. For instance, a family of four children would classify their kids as young, middle, old, and first-born. There was no need for them to have their own identity because this identity was no expected to serve any purpose. Although two thousand years have gone by, this ideological reproduction of the self into a miniature replica is still present within contemporary Levantine societies. (...) This paper will particularly shed light on 21 st century Lebanon and its system of ideological stratification and inheritance; this structure functions on the basis of an advanced rendition of primitive tribalism, known as sectarianism. Consequently, this sectarian identity enables the othering of the self from its own surrounding as well as any “outsider”. This constant and inter-generational practice is classified as a manifestation of persistence. (shrink)
In exploring phenomenological literature, it is evident that the term ‘phenomenology’ holds rather different meanings depending upon the context. Phenomenology has been described as both a philosophical movement and an approach to human science research. The phenomenology of Husserl, Heidegger, Gadamer, and Merleau-Ponty was philosophical in nature and not intended to provide rules or procedures for conducting research. The Canadian social scientist, van Manen, however, introduced specific guidelines for conducting human science research, which is rooted in hermeneutic phenomenology and this (...) particular method has been employed in professional disciplines such as education, nursing, clinical psychology, and law. The purpose of this paper is to explore the difference between the phenomenological method as described by van Manen and that of other philosophers such as Husserl, Heidegger, Gadamer, and Merleau-Ponty. In so doing, the author aims to address the blurred boundaries of phenomenology as a research method and as a philosophical movement and highlight the influence of these blurred boundaries on nursing knowledge development. (shrink)
There is a growing expectation, or even requirement, for researchers to deposit a variety of research data in data repositories as a condition of funding or publication. This expectation recognizes the enormous benefits of data collected and created for research purposes being made available for secondary uses, as open science gains increasing support. This is particularly so in the context of big data, especially where health data is involved. There are, however, also challenges relating to the collection, storage, and re-use (...) of research data. This paper gives a brief overview of the landscape of data sharing via data repositories and discusses some of the key ethical issues raised by the sharing of health-related research data, including expectations of privacy and confidentiality, the transparency of repository governance structures, access restrictions, as well as data ownership and the fair attribution of credit. To consider these issues and the values that are pertinent, the paper applies the deliberative balancing approach articulated in the Ethics Framework for Big Data in Health and Research to the domain of Openness in Big Data and Data Repositories. Please refer to that article for more information on how this framework is to be used, including a full explanation of the key values involved and the balancing approach used in the case study at the end. (shrink)
Montesquieu is famous as a tireless critic of despotism, which he associates overtly with Asia and the Middle East and not with the apparently more moderate Western models of governance found throughout Europe. However, Vickie B. Sullivan argues that a creaful reading of Montesquieu's enormously influential The Spirit of the Law reveals the surprising result that he recognizes that Europe itself is susceptible to despotic practices - and that the threat emanates not from the East but rather from certain despotic (...) ideas that inform Western institutions and practices. Sullivan guides readers through Montesquieu's sometimes veiled yet sharply critical accounts of Machiavelli, Hobbes, Aristotle, and Plato, as well as various Christian thinkers have brough forth despotic ideas in the form, for example, of brutal Machiavellianism, of Hobbes's justifications for the rule of one, of Plato's reasoning that denied slaves the right of natural defense, and of the Christian teachings that equated heresy with treason. Such ideas, Montesquieu shows, inform such revered European institutions as the French monarchy and the Roman Catholic Church. In this new reading of Montesquieu's masterwork, Sullivan corrects the misconception that it offers simple, objective observations, showing it to be instead a powerful critique of European politics that would become remarkably and regrettably prescient after Montesquieu's death, when despotism repeatedly emerged in Europe with virulent intensity. -- from dust jacket. (shrink)
A key ethical issue arising in data linkage research relates to consent requirements. Patients’ consent preferences in the context of health research have been explored but their consent preferences regarding data linkage specifically have been under-explored. In addition, the views on data linkage are often those of patient groups. As a result, little is known about lay people’s views and their preferences about consent requirements in the context of data linkage. This study explores lay people’s views and justifications regarding the (...) acceptability of conducting data linkage research without obtaining consent. (shrink)
This study of philanthropy among large Black-owned businesses provides insights into a sector of business giving which has not been studied. Results indicate that philanthropy and ethical justifications play a more important role in minority business enterprises than in non-minority firms studied previously.
The COVID-19 pandemic has had a significant impact globally. Most affected, however, are those individuals and groups routinely disadvantaged by the social injustice created by the misdistribution of power, money, and resources. Simple measures that prevent the spread of COVID-19, such as frequent hand washing and social distancing, are unavailable to millions of people in the wealthiest of nations and in the poorest of nations. Disadvantaged groups are impacted more directly and in disproportionately higher numbers due to existing poor health, (...) and the disruption of services central to securing an income and an education will have lasting consequences for their futures. The unintended effect of exclusionary government policies is that privileged citizens and healthcare systems are also at greater risk. This paper seeks to highlight the impact of COVID-19 on those already suffering health inequities through consideration of some of the social determinants of health on groups in affluent and poorer nations. It also highlights some of the factors that may assist in tackling health inequities as we emerge from this pandemic. (shrink)
In this manuscript, I analyze Slavoj Žižek’ s debate with the Canadian clinical psychologist Jordan Peterson. The terms “Venus envy” and “academic inferiority complex” are used based on classical psychoanalytic jargon. Jordan Peterson and Slavoj Žižek are interpreted as the representatives of the opposing ends of our contemporary academic postmodern spectrum. Žižek demonstrates the unchained M arxist, and Peterson embodies the persona of the capitalist educator. T his article is a gateway to shed light on the decaying core of postmodern (...) ideology in contemporary academic discourse. (shrink)