Clinical trials play a crucial role in generating evidence about healthcare interventions and improving outcomes for current and future patients. For individual trial participants, however, there are inevitably trade‐offs involved in clinical trial participation, given that trials have traditionally been designed to benefit future patient populations rather than to offer personalised care. Failure to understand the distinction between research and clinical care and the likelihood of benefit from participation in clinical trials has been termed the ‘therapeutic misconception’. The evolution of (...) the clinical trials landscape, including greater integration of clinical trials into healthcare and development of novel trial methodologies, may reinforce the significance of the therapeutic misconception and other forms of misunderstanding while at the same time (paradoxically) challenging its salience. Using cancer clinical trials as an exemplar, we describe how methodological changes in early‐ and late‐phase clinical trial designs, as well as changes in the design and delivery of healthcare, impact upon the therapeutic misconception. We suggest that this provides an impetus to re‐examine the ethics of clinical research, particularly in relation to trial access, participant selection, communication and consent, and role delineation. (shrink)

Evidence suggests that one reason doctors provide certain interventions in assisted reproductive technologies (ART) is because of patient demand. This is particularly the case when it comes to unproven interventions such as ‘add‐ons’ to in vitro fertilisation (IVF) cycles, or providing IVF cycles that are highly unlikely to succeed. Doctors tend to accede to demands for such interventions because patients are willing to do and pay ‘whatever it takes’ to have a baby. However, there is uncertainty as to what moral (...) weight should be placed on patient‐led demands in ART, including whether it is acceptable for such demands to be invoked as a justification for intervention. We address this issue in this paper. We start by elucidating what we mean by ‘patient‐led demand’ and synthesise some of the evidence for this phenomenon. We then argue that a doctor's professional role morality (PRM) yields special responsibilities, particularly in commercialised healthcare settings such as ART, because of the nature of professions as social institutions that are distinct from markets. We argue on this basis that, while there may be reasons (consistent with PRM) for doctors to accede to patient demand, this is not always the case. There is often a gap in justification between acceding to patient‐led demands and providing contested interventions, particularly in commercial settings. As a result, acceding to demand in such settings needs a strong justification to be consistent with PRM. (shrink)

Like all human activities, scientific research is infused with values. Scientific discovery can, for example, be valued as an end in itself. The phrase ethical values is an umbrella term for much of what people care about aside from knowledge for its own sake. Ethical values encompass reasons for caring about the harms caused by climate impacts or the injustice of how those harms are distributed. The closer that research gets to informing real-world actions, the more the design of that (...) research can be examined from the perspective of ethical values. Which societal challenges does the research aim to inform? From whose perspective does a policy analysis view potential outcomes? In this chapter we use a series of examples to illustrate how researchers’ choices regarding the treatment of uncertainties can have important consequences from the perspective of ethical values. Our aims in this chapter are: to familiarize readers with the key concept of coupled ethical–epistemic choices; to build capacity for recognizing such choices within the treatment of uncertainties; to encourage engagement with ethical values as a part of climate change research; and to offer some guidance on how to start doing so. (shrink)

Synthetic biology is a broad term covering multiple scientific methodologies, technologies, and practices. Pairing biology with engineering, synbio seeks to design and build biological systems, either through improving living cells by adding in new functions, or creating new structures by combining natural and synthetic components. As with all new technologies, synthetic biology raises a number of ethical considerations. In order to understand what these issues might be, and how they relate to those covered in ethics literature on synbio, we conducted (...) an interview study with practicing synthetic biologists affiliated with a synthetic biology centre in Australia. Scientists identified a range of ethical challenges germane to the field, including precarious employment, pressures from industry, gender inequity, and the negative effects of the hyping of synbio. These challenges differed markedly from those identified in the ethics literature, whose treatment of the harms and benefits of synbio remains largely speculative and abstract. In our discussion of the pragmatic, every day ethical issues synthetic biologists face, we illustrate how issues of waste or research integrity play pivotal roles in everything from lived experiences in the laboratory, to long-term research trajectories guiding the field. In a confirmation of the ethical relevance of our participant’s views on the field, we argue that the subjects they raise must be included in any ethical analysis of synbio as a field. (shrink)

The kind of theological schools that prevail in the US today emerged as hubs of networks of voluntary societies in the early national period. Through a brief history of Lyman Beecher and Lane Theological Seminary, I show both the power of these networks of voluntary associations to connect free individuals and their role in the project of white Protestant settlement. Now every part of those networks is eroding. Critics who blame this erosion on narcissistic individuals understate the individualizing powers of (...) neoliberal orders. We cannot scold people back into community. Instead, we should begin with ideals that exist, in however ideological a form, in the present. Drawing on thinkers like Theodor Adorno, Ulrich Beck, Wendy Brown, Judith Butler, bell hooks, Alicia Garza, and Rowan Williams, I argue for a critical redemption of “authenticity” that could reorient theological schools and renew forms of sociality to which they are connected. (shrink)

Consumer engagement in decisions about the funding of medicines is often framed as a good in and of itself and as an activity that should be universally encouraged. A common justification for calls for consumer engagement is that it enhances equity. In this paper we systematically critique this assumption. We show that consumer engagement may undermine equity as well as enhance it and show that a simple relationship cannot be assumed but must be justified and demonstrated. In concluding, we present (...) a number of challenges that need to be overcome in order for consumer engagement to contribute to health technology assessment in a morally and politically sound manner. (shrink)

Tetrapods have two distinct nasal chemosensory systems, the main olfactory system and the vomeronasal system (VNS). Defined by certain morphological components, the main olfactory system is present in all groups of vertebrates, while the VNS is found only in tetrapods. Previous attempts to identify a VNS precursor in teleost fish were limited by functional and morphological characters that could not clearly distinguish between homologous and analogous systems. In the past decade, several genes that specifically function in the VNS have been (...) discovered. Here we first describe recent evolutionary studies of mammalian VNS‐specific genes. We then review evidence showing the presence and tissue‐specific expression of the VNS‐specific genes in teleosts, as well as co‐expression patterns of these genes in specific regions of the teleost olfactory epithelium. We propose that a VNS precursor exists in teleosts and that its evolutionary origin predated the separation between teleosts and tetrapods. BioEssays 28: 709–718, 2006. © 2006 Wiley Periodicals, Inc. (shrink)

With the publication of this book psychotherapy finally arrives at the mainstream of mental health practice. This volume is an essential companion for every practising psychiatrist, clinical psychologist, psychotherapy counsellor, mental health nurse, psychotherapist, and mental health practitioner. It is integrative in spirit, with chapters written by an international panel of experts who combine theory and research with practical treatment guidelines and illustrative case examples to produce an invaluable book. Part One gives a comprehensive account of all the major psychotherapeutic (...) approaches. Parts Two and Three systematically describe psychotherapeutic approaches to the major psychiatric disorders and personality disorders. Many chapters are multi-authored and describe the psychodynamic, cognitive behavioural and other approaches for treating these illnesses. Part Four examines applications and modifications of psychotherapy across the lifecycle. Part Five describes psychotherapy with specific populations such as medical patients and those where gender is an issue, and finally Part Six tackles some of the special topics of concern to psychotherapists including ethics, legal issues, and psychotherapy and neuroscience. The first of its kind, this is a 'must have' volume for all trainee and practising psychological therapists, whatever their background - psychiatry, psychology, social work, or nursing. (shrink)

Lloyd (2009) contends that climate models are confirmed by various instances of fit between their output and observational data. The present paper argues that what these instances of fit might confirm are not climate models themselves, but rather hypotheses about the adequacy of climate models for particular purposes. This required shift in thinking—from confirming climate models to confirming their adequacy-for-purpose—may sound trivial, but it is shown to complicate the evaluation of climate models considerably, both in principle and in practice.

Whether in characterizing Catharine MacKinnon's theory of gender as itself pornographic or in identifying liberalism as unable to make good on its promises, Wendy Brown pursues a central question: how does a sense of woundedness become the basis for a sense of identity? Brown argues that efforts to outlaw hate speech and pornography powerfully legitimize the state: such apparently well-intentioned attempts harm victims further by portraying them as so helpless as to be in continuing need of governmental protection. "Whether (...) one is dealing with the state, the Mafia, parents, pimps, police, or husbands," writes Brown, "the heavy price of institutionalized protection is always a measure of dependence and agreement to abide by the protector's rules." True democracy, she insists, requires sharing power, not regulation by it; freedom, not protection.Refusing any facile identification with one political position or another, Brown applies her argument to a panoply of topics, from the basis of litigiousness in political life to the appearance on the academic Left of themes of revenge and a thwarted will to power. These and other provocations in contemporary political thought and political life provide an occasion for rethinking the value of several of the last two centuries' most compelling theoretical critiques of modern political life, including the positions of Nietzsche, Marx, Weber, and Foucault. (shrink)

Perceptual experience supports the assignment of confidences in belief – doxastic confidences. To explain this fact, many philosophers appeal to Perceptual Indeterminacy, which holds that perceptual content can be more or less determinate. Others instead appeal to Perceptual Confidence, which says that perceptual experience supports doxastic confidences because it assigns confidences too. Morrison argues that a primary reason to favour Perceptual Confidence is that it is uniquely capable of accounting for bell-shaped doxastic confidence distributions; we call this the bell curve (...) objection to Perceptual Indeterminacy. Here we show that two recent defences of Perceptual Indeterminacy, due to Nanay and Raleigh and Vindrola, fail to adequately address the bell curve objection. But we also argue that all is not lost for proponents of Perceptual Indeterminacy. They can counter the bell curve objection by embracing a third view, which we call Perceptual Noise. (shrink)

Tolerance is generally regarded as an unqualified achievement of the modern West. Emerging in early modern Europe to defuse violent religious conflict and reduce persecution, tolerance today is hailed as a key to decreasing conflict across a wide range of other dividing lines-- cultural, racial, ethnic, and sexual. But, as political theorist Wendy Brown argues in Regulating Aversion, tolerance also has dark and troubling undercurrents. Dislike, disapproval, and regulation lurk at the heart of tolerance. To tolerate is not to (...) affirm but to conditionally allow what is unwanted or deviant. And, although presented as an alternative to violence, tolerance can play a part in justifying violence--dramatically so in the war in Iraq and the War on Terror. Wielded, especially since 9/11, as a way of distinguishing a civilized West from a barbaric Islam, tolerance is paradoxically underwriting Western imperialism. Brown's analysis of the history and contemporary life of tolerance reveals it in a startlingly unfamiliar guise. Heavy with norms and consolidating the dominance of the powerful, tolerance sustains the abjection of the tolerated and equates the intolerant with the barbaric. Examining the operation of tolerance in contexts as different as the War on Terror, campaigns for gay rights, and the Los Angeles Museum of Tolerance, Brown traces the operation of tolerance in contemporary struggles over identity, citizenship, and civilization. (shrink)

Wendy Brown's work commands widespread attention and respect, and there has been considerable interest as to how it would develop after "States of Injury." This book will not disappoint.

Journal of Political Philosophy, Volume 29, Issue 4, Page 429-455, December 2021.

In 1904, Norwegian physicist Vilhelm Bjerknes published what would become a landmark paper in the history of meteorology. In that paper, he proposed that daily weather forecasts could be made by calculating later states of the atmosphere from an earlier state using the laws of hydrodynamics and thermodynamics (Bjerknes 1904). He outlined a set of differential equations to be solved and advocated the development of graphical and numerical solution methods, since analytic solution was out of the question. Using these theory-based (...) equations to produce daily forecasts, however, turned out to be more difficult than anticipated. Graphical solution techniques had limited success, and a first attempt to use .. (shrink)

Concern for human vulnerability seems to be at the heart of bioethical inquiry, but the concept of vulnerability is under-theorized in the bioethical literature. The aim of this article is to show why bioethics needs an adequately theorized and nuanced conception of vulnerability. We first review approaches to vulnerability in research ethics and public health ethics, and show that the bioethical literature associates vulnerability with risk of harm and exploitation, and limited capacity for autonomy. We identify some of the challenges (...) emerging from this literature: in particular, how to reconcile universal human vulnerability with a context-sensitive analysis of specific kinds and sources of vulnerability; and how to reconcile obligations to protect vulnerable persons with obligations to respect autonomy. We then briefly survey some of the theoretical resources available within the philosophical literature to address these challenges, and to assist in understanding the conceptual connections between vulnerability and related concepts such as harm, exploitation, needs, and autonomy. We also sketch out a taxonomy of sources and kinds of vulnerability. Finally, we consider the implications for policy evaluation of making vulnerability an explicit and central focus of bioethics. Our investigation is in the form of a broad survey motivating a research agenda rather than a detailed analysis. (shrink)

Bioethics is a practically oriented discipline that developed to address pressing ethical issues arising from developments in the life sciences. Given this inherent practical bent, some form of advocacy or activism seems inherent to the nature of bioethics. However, there are potential tensions between being a bioethics activist, and academic ideals. In academic bioethics, scholarship involves reflection, rigour and the embrace of complexity and uncertainty. These values of scholarship seem to be in tension with being an activist, which requires pragmatism, (...) simplicity, certainty and, above all, action. In this paper I explore this apparent dichotomy, using the case example of my own involvement in international efforts to end forced organ harvesting from prisoners of conscience in China. I conclude that these tensions can be managed and that academic bioethics requires a willingness to be activist. (shrink)

This article explores some of the roles of computer simulation in measurement. A model-based view of measurement is adopted and three types of measurement—direct, derived, and complex—are distinguished. It is argued that while computer simulations on their own are not measurement processes, in principle they can be embedded in direct, derived, and complex measurement practices in such a way that simulation results constitute measurement outcomes. Atmospheric data assimilation is then considered as a case study. This practice, which involves combining information (...) from conventional observations and simulation-based forecasts, is characterized as a complex measuring practice that is still under development. The case study reveals challenges that are likely to resurface in other measuring practices that embed computer simulation. It is also noted that some practices that embed simulation are difficult to classify; they suggest a fuzzy boundary between measurement and non-measurement. 1 Introduction2 A Contemporary View of Measurement3 Three Types of Measurement4 Can Computer Simulations Measure Real-World Target Systems?5 Case Study: Atmospheric Data Assimilation5.1 Why data assimilation?5.2 A complex measuring practice under development5.3 Epistemic iteration6 The Boundaries of Measurement7 Epistemology, Not Terminology. (shrink)

This chapter contains sections titled: Introduction Qualitative Hedonism Objections to Mill's Qualitative Hedonism: Internal Inconsistency and Value Pluralism The Judgment of Competent Agents: Self‐Development and Value Measurement Self‐Development and Virtue Ethics Further Reading.

We call attention to an underappreciated way in which non-epistemic values influence evidence evaluation in science. Our argument draws upon some well-known features of scientific modeling. We show that, when scientific models stand in for background knowledge in Bayesian and other probabilistic methods for evidence evaluation, conclusions can be influenced by the non-epistemic values that shaped the setting of priorities in model development. Moreover, it is often infeasible to correct for this influence. We further suggest that, while this value influence (...) is not particularly prone to the problem of wishful thinking, it could have problematic non-epistemic consequences in some cases. (shrink)

A number of recent discussions comparing computer simulation and traditional experimentation have focused on the significance of “materiality.” I challenge several claims emerging from this work and suggest that computer simulation studies are material experiments in a straightforward sense. After discussing some of the implications of this material status for the epistemology of computer simulation, I consider the extent to which materiality (in a particular sense) is important when it comes to making justified inferences about target systems on the basis (...) of experimental results. (shrink)

Much ink has been spilled on the pros and cons of U.S. president Barack Obama's decision not to strike the regime of Syrian president Bashar al-Assad after that regime launched a deadly chemical weapons attack in 2013. Often missing from those debates, however, are the perspectives of Syrians themselves. While not all Syrians oppose Assad, and not all opponents endorsed intervention, many Syrian oppositionists resolutely called for Obama to uphold his “red line” militarily. As part of the roundtable “The Ethics (...) of Limited Strikes,” this essay analyzes diverse expressions of such opinion and finds that they highlight three dimensions of the ethical case for limited strikes against Assad. First, they remind us that the ethical context of the red line question was many Syrians’ sense of abandonment by the international community. Second, they emphasize the ethical stakes of the limited strikes; namely an opportunity to hold the Syrian regime accountable, weaken it from within, and thus change the equation of the war. Third, they make sense of the ethical consequences of the nonintervention outcome, and especially its effect in deepening civilians’ despair, accelerating extremism, and convincing Assad and his allies that they could kill with impunity. These views controvert both legalistic arguments precluding military intervention and assumptions that U.S. intervention is always imperialist and warmongering. In this case, consideration of the case for military intervention from the viewpoint of those on whose behalf the intervention would have taken place challenges us to think deeply about circumstances in which limited strikes might be not only ethically justified but also imperative. (shrink)

According to an adequacy-for-purpose view, models should be assessed with respect to their adequacy or fitness for particular purposes. Such a view has been advocated by scientists and philosophers...

Low-income women and, disproportionately low-income women of color seeking reproductive and pregnancy care are increasingly subject to what this article terms carceral care – care compromised by its’ proximity to punishment systems. This article identifies the legal and health care practice mechanisms leading to carceral care and proposes solutions designed to stop criminalization at the bedside.

Recent calls for retraction of a large body of Chinese transplant research and of Dr Jiankui He’s gene editing research has led to renewed interest in the question of publication, retraction and use of unethical biomedical research. In Part 1 of this paper, we briefly review the now well-established consequentialist and deontological arguments for and against the use of unethical research. We argue that, while there are potentially compelling justifications for use under some circumstances, these justifications fail when unethical practices (...) are ongoing—as in the case of research involving transplantations in which organs have been procured unethically from executed prisoners. Use of such research displays a lack of respect and concern for the victims and undermines efforts to deter unethical practices. Such use also creates moral taint and renders those who use the research complicit in continuing harm. In Part 2, we distinguish three dimensions of ‘non-use’ of unethical research: non-use of published unethical research, non-publication, and retraction and argue that all three types of non-use should be upheld in the case of Chinese transplant research. Publishers have responsibilities to not publish contemporary unethical biomedical research, and where this has occurred, to retract publications. Failure to retract the papers implicitly condones the research, while uptake of the research through citations rewards researchers and ongoing circulation of the data in the literature facilitates subsequent use by researchers, policymakers and clinicians. (shrink)

ABSTRACT:In a world filled with poverty, environmental degradation, and moral injustice, social enterprises offer a ray of hope. These organizations seek to achieve social missions through business ventures. Yet social missions and business ventures are associated with divergent goals, values, norms, and identities. Attending to them simultaneously creates tensions, competing demands, and ethical dilemmas. Effectively understanding social enterprises therefore depends on insight into the nature and management of these tensions. While existing research recognizes tensions between social missions and business ventures, (...) we lack any systematic analysis. Our paper addresses this issue. We first categorize the types of tensions that arise between social missions and business ventures, emphasizing their prevalence and variety. We then explore how four different organizational theories offer insight into these tensions, and we develop an agenda for future research. We end by arguing that a focus on social-business tensions not only expands insight into social enterprises, but also provides an opportunity for research on social enterprises to inform traditional organizational theories. Taken together, our analysis of tensions in social enterprises integrates and seeks to energize research on this expanding phenomenon. (shrink)

An underexamined insight of W. E. B. Du Bois’s John Brown is that John Brown worked for much of his life to cultivate democratic relationships with the Black Americans with and for whom he worked. Brown did so through practicing deference and deliberation, and by seeking authorization. However, Brown’s commitment to these practices faltered at a crucial moment in decision making: when he raided Harpers Ferry absent widespread support. Examining this aspect of John Brown brings into relief an overlooked tragic (...) choice Brown made: To act in accordance with his own substantive vision of what justice required, Brown eschewed democratic ideals and practices that grounded the distinctive relations of equality he had cultivated with the Black communities with and for whom he worked. (shrink)

Medical-legal partnerships connect legal advocates to healthcare providers and settings. Maintaining effectiveness of medical-legal partnerships and consistently identifying opportunities for innovation and adaptation takes intentionality and effort. In this paper, we discuss ways in which our use of data and quality improvement methods have facilitated advocacy at both patient (client) and population levels as we collectively pursue better, more equitable outcomes.

ABSTRACT:In a world filled with poverty, environmental degradation, and moral injustice, social enterprises offer a ray of hope. These organizations seek to achieve social missions through business ventures. Yet social missions and business ventures are associated with divergent goals, values, norms, and identities. Attending to them simultaneously creates tensions, competing demands, and ethical dilemmas. Effectively understanding social enterprises therefore depends on insight into the nature and management of these tensions. While existing research recognizes tensions between social missions and business ventures, (...) we lack any systematic analysis. Our paper addresses this issue. We first categorize the types of tensions that arise between social missions and business ventures, emphasizing their prevalence and variety. We then explore how four different organizational theories offer insight into these tensions, and we develop an agenda for future research. We end by arguing that a focus on social-business tensions not only expands insight into social enterprises, but also provides an opportunity for research on social enterprises to inform traditional organizational theories. Taken together, our analysis of tensions in social enterprises integrates and seeks to energize research on this expanding phenomenon. (shrink)

'Is politics gendered? Wendy Brown things so, and argues for this point with elegance, imagination and pungent phrases. Brown's book is challenging, provocative and...original; it does force us to question the degree to which gender controls our politics.'-THE REVIEW OF POLITICS.

This article is a translation into Spanish of Wendy Brown's article “Suffering rights as paradoxes,” originally published in Constellations in 2000. In this paper, the author considers the difficult relation between selected feminist ambitions and rights discourse in the United States. This translation is part of the dossier “Feminist Political Theory: Tensions, Dilemmas and Debates,” published in Las Torres de Lucca, International Journal of Political Philosophy in July 2020.

On the 24th June 2015, Feminist Legal Studies and the London School of Economics Law Department hosted an afternoon event with Professor Wendy Brown, Class of 1936 First Professor of Political Science, University of California. Professor Brown kindly agreed to discuss her scholarship on feminist theory, and its relationship to both the law and neoliberalism. The event included an interview by Dr Katie Cruz and a Q&A session, which are presented here in an edited version of the transcript. Sumi (...) Madhock, Professor of Gender Studies, LSE chaired the interview and discussion and introduced Professor Brown’s work. Katie Cruz asked Wendy Brown to reflect upon topics that span her scholarship and activism, including the state of critical, feminist, and Left approaches to rights, neoliberalism, despair and utopianism, and the future of feminist theory and practice in the context of neoliberalism and current debates about intersectionality. Participants in the discussion asked questions on a wide range of issues, including the limits of feminist engagement with law as a tool for social change, the dominance of neoliberalism, imperialist feminism, Islamophobia, secularism, and our attachment to the figure of homo politicus. (shrink)