Taking Hobbesian logic as my starting point, I argue that Hobbesian diffidence, one of the causes of quarrel in the state of nature, does not disappear once the citizens enter civil society. Rather, diffidence is merely contained by the sovereign. Following Alice Ristroph, I argue that diffidence comes to shape what citizens demand of the state/sovereign in the criminal law. However, I show that Ristroph does not fully appreciate that the concept of diffidence is a racialized one, and as such, (...) race underlies how the citizens understand their own diffidence, what citizens demand of the sovereign, and how they demand it. Further, because diffidence itself is racialized, criminal law need not make explicit appeals to race. Once racialized diffidence becomes embedded in the criminal law, it remains there regardless of any conscious racial animus. I show that racial profiling is a prime example of how this racialized diffidence manifests. Thus, I present Hobbesian diffidence as a framework from which to understand racial oppression. This paper is primarily an application of Hobbes to contemporary issues rather than an exegesis and analysis of Hobbes’s views. (shrink)

“Ignorance,” Jim Hudson, the art dealer, declares shortly before the climactic scene in the 2017 film, Get Out. “They mean well, but they have no idea what real people will go through”...

Professional philosophy in the US remains relatively homogenous. I use four anecdotes to amplify some of the practices that may contribute to the dearth of underrepresented philosophers. Each anecdote highlights a different problem—lack of proper mentoring, stereotype threat, difficulties navigating sexism, and a sense of exclusion. Although I discuss each of these issues separately, it is certainly the case that these can and often do occur concurrently. I offer preliminary thoughts on how these problems could be addressed while keeping in (...) mind that philosophy in the US is a microcosm of the larger US society. (shrink)

Fabi and Goldberg have made an important contribution to the understanding of how bioethicists do bioethics, or more precisely, how bioethics research funding mechanisms reflect the values o...

The “happiness agenda” is a worldwide movement that claims that happiness is the highest good, happiness can be measured, and public policy should promote happiness. Against Happiness is a thorough and powerful critique of this program, revealing the flaws of its concept of happiness and advocating a renewed focus on equality and justice. Written by an interdisciplinary team of authors, this book provides both theoretical and empirical analysis of the limitations of the happiness agenda. The authors emphasize that this movement (...) draws on a parochial, Western-centric philosophical basis and demographic sample. They show that happiness defined as subjective satisfaction or a surplus of positive emotions bears little resemblance to the richer and more nuanced concepts of the good life found in many world traditions. Cross-cultural philosophy, comparative theology, and social and cultural psychology all teach that cultures and subcultures vary in how much value they place on life satisfaction or feeling happy. Furthermore, the ideas promoted by the happiness agenda can compete with rights, justice, sustainability, and equality—and even conceal racial and gender injustice. Against Happiness argues that a better way forward requires integration of cross-cultural philosophical, ethical, and political thought with critical social science. Ultimately, the authors contend, happiness should be a secondary goal—worth pursuing only if it is contingent on the demands of justice. (shrink)

The problems of racism and racially motivated violence in predominantly African American communities in the United States are complex, multifactorial, and historically rooted. While these problems are also deeply morally troubling, bioethicists have not contributed substantially to addressing them. Concern for justice has been one of the core commitments of bioethics. For this and other reasons, bioethicists should contribute to addressing these problems. We consider how bioethicists can offer meaningful contributions to the public discourse, research, teaching, training, policy development, and (...) academic scholarship in response to the alarming and persistent patterns of racism and implicit biases associated with it. To make any useful contribution, bioethicists will require preparation and should expect to play a significant role through collaborative action with others. (shrink)

Monica Colvin-Adams,1 Nonyelum Harcourt,1 Robert LeDuc,2 Ganesh Raveendran,1 Yassir Sonbol,3 Robert Wilson,1 Daniel Duprez11Cardiovascular Division, University of Minnesota, Minneapolis, MN, USA; 2Division of Biostatistics University of Minnesota, Minneapolis, MN, USA; 3Cardiovascular Division, St Luke's Hospital System, Sugar Land, TX, USAObjective: Arterial elasticity is a functional biomarker that has predictive value for cardiovascular morbidity and mortality in nontransplant populations. There is little information regarding arterial elasticity in heart transplant recipients. This study aimed to characterize small and large artery elasticity in (...) heart transplant recipients in comparison with an asymptomatic population free of overt cardiovascular disease. A second goal was to identify demographic and clinical factors associated with arterial elasticity in this unique population.Methods: Arterial pulse waveform was registered noninvasively at the radial artery in 71 heart transplant recipients between 2008 and 2010. SAEs and LAEs were derived from diastolic pulse contour analysis. Comparisons were made to a healthy cohort of 1,808 participants selected from our prevention clinic database. Multiple regression analyses were performed to evaluate associations between risk factors and SAE and LAE within the heart transplant recipients.Results: LAE and SAE were significantly lower in heart transplant recipients than in the normal cohort. Female sex and history of ischemic cardiomyopathy were significantly associated with reduced LAE and SAE. Older age and the presence of moderate cardiac allograft vasculopathy were also significantly associated with reduced SAE. Transplant duration was associated with increased SAE.Conclusion: Heart transplants are associated with peripheral endothelial dysfunction and arterial stiffness, as demonstrated by a significant reduction in SAE and LAE when compared with a healthy population. Furthermore, cardiac allograft vasculopathy is associated with a significant reduction in SAE, suggesting a potential use in screening heart transplant recipients at risk for developing this complication.Keywords: heart transplant, endothelial function, arterial elasticity, cardiac allograft vasculopathy. (shrink)

Intersectionality has become a significant intellectual approach for those thinking about the ways that race, gender, and other social identities converge in order to create unique forms of oppression. Although the initial work on intersectionality addressed the unique position of black women relative to both black men and white women, the concept has since been expanded to address a range of social identities. Here we consider how to apply some of the theoretical tools provided by intersectionality to the clinical context. (...) We begin with a brief discussion of intersectionality and how it might be useful in a clinical context. We then discuss two clinical scenarios that highlight how we think considering intersectionality could lead to more successful patient–clinician interactions. Finally, we extrapolate general strategies for applying intersectionality to the clinical context before considering objections and replies. (shrink)

The U.S. healthcare system has a long history of displaying racist contempt toward Black people. From medical schools’ use of enslaved bodies as cadavers to the widespread hospital practice of reporting suspected drug users who seek medical help to the police, the institutional practices and policies that have shaped U.S. healthcare systems as we know them cannot be minimized as coincidence. Rather, the very foundations of medical discovery, diagnosis, and treatment are built on racist contempt for Black people and have (...) become self-perpetuating. Yet, I argue that bioethics and bioethicists have a role in combatting racism. However, in order to do so, bioethicists have to understand the workings of contemptuous racism and how that particular form of racism manifests in U.S. healthcare institutions. Insofar as justice is part of the core mission of bioethics, then antiracism must also be part of the mission of bioethics. (shrink)

Hastings Center Report, Volume 52, Issue S1, Page S12-S17, March‐April 2022.

This chapter shows that feminist bioethics begins with critical engagement. Feminist bioethics as perspective centers the experiences of women – women's health, challenges that women primarily face within health care contexts, gaps in research that are only understood as gaps when one takes women seriously as women. The chapter highlights a few significant breakthroughs in feminist theory broadly that have informed feminist bioethics as perspective and as methodology – standpoint theory, relational autonomy, and intersectionality – in order to show how (...) an intentionally feminist lens can improve bioethics for everyone. Feminists understood that healthcare generally, and bioethics, in particular, were important sites for feminist thought. The traditional view of autonomy in bioethics is centered on the individual. The chapter also highlights an example of public practice, The Black Mamas Matter Alliance, that shows the important work of Black women's community advocacy as a blueprint for a public feminist bioethics. (shrink)

Camisha Russell argues that this contemporary moment of societal reckoning with the value of Black lives is also a moment for considering racism as a bioethical issue. She continues that bioethicis...

Bioethics, Volume 36, Issue 3, Page 283-289, March 2022.

Abstract:James Groves opens his 1978 foundational article, "Taking Care of the Hateful Patient," thusly, "Admitted or not, the fact remains that a few patients kindle aversion, fear, despair, or even downright malice in their doctors." Groves understood his article as pulling back the curtain on an experience that physicians had but that few dared discuss without shame. His taxonomy of four types of "hateful" patients: clingers, entitled demanders, manipulative help rejectors, and self-destructive deniers may still be instructive. However, the intervening (...) years have revealed that this taxonomy does not adequately capture the nuances present when patients are described as "difficult." This issue of Narrative Inquiry in Bioethics situates this complexity. Different kinds of providers in a variety of healthcare delivering institutions have offered accounts of their own interactions with so-called difficult patients. In each of these stories, the providers tell the reader how the providers were transformed through these interactions: what they learned about their patients, what they learned about patient care, what they could have done differently or better, and what lessons they have taken with them into subsequent encounters. (shrink)

Hastings Center Report, Volume 52, Issue 3, Page 49-51, May–June 2022.

Subjects enrolled in studies testing high risk interventions for incurable or progressive brain diseases may be vulnerable to deficiencies in informed consent, such as the therapeutic misconception. However, the definition and measurement of the therapeutic misconception is a subject of continuing debate. Our qualitative pilot study of persons enrolled in a phase I trial of gene transfer for Parkinson disease suggests potential avenues for both measuring and preventing the therapeutic misconception. Building on earlier literature on the topic, we developed and (...) tested an interview guide that focuses on how the subjects decided to participate, emphasizing the integration of subjects’ various statements that are relevant to assessing the therapeutic misconception, rather than evaluating them as isolated statements. The results indicate that a subject’s understanding of the purpose of research is best explored in juxtaposition to the subject’s motivation for participating. (shrink)

Written in response to what he recognizes as the problematic philosophical underpinnings of “orthodox research ethics,” Alex John London’s For the Common Good reimagines what is called for in any effort to create a better system of oversight and regulation in biomedical research. London weaves a common thread — justice — through this historical and critical account of the practice of research ethics and its organization of stakeholders, institutions and regulations. By introducing the idea of “a common good” London reframes (...) the narrative and responsibilities of the research ethics field to demonstrate that scientific research and regard for the rights and welfare of individuals are not mutually exclusive. This impressive monograph encourages its readers to push past the limitations of traditional research ethics to consider the context in which the discipline is embedded. That is, rather than settling for analysis at the level of researchers and research participants alone, London encourages us to expand our inquiry to encompass a wider array of stakeholders who co-labor in the social undertaking of biomedical knowledge production. London accomplishes the difficult task of upstream analysis — turning his attention to the conditions and assumptions which create ethical dilemmas rather than applying a retrospective ethical salve to injuries near-guaranteed by a broken system. As opposed to the limited domain of orthodox research ethics (researchers, participants, and the institutional bodies which regulate interaction between the two) London also considers the role and contributions of affected communities, pharmaceutical firms, philanthropic organizations, and journal editors among others. (shrink)

Bioethicists have long been concerned that seriously ill patients entering early phase (‘phase I’) treatment trials are motivated by therapeutic benefit even though the likelihood of benefit is low. In spite of these concerns, consent forms for phase I studies involving seriously ill patients generally employ indeterminate benefit statements rather than unambiguous statements of unlikely benefit. This seeming mismatch between attitudes and actions suggests a need to better understand research ethics committee members’ attitudes toward communication of potential benefits and risks (...) of early phase studies to potential subjects. We surveyed the members of two U.S. research ethics committees using a phase I gene transfer study scenario, and compared the results to a previous survey of potential subjects’ perceptions and attitudes toward benefit and risk for the same protocol. The results show that there is indeed a gap between the subjects’ perceptions and the committee members’ views on what is appropriate to be communicated to research subjects. This discrepancy is the product of both the commonly assumed optimism of the subjects and to a “protective pessimism” of the research ethics committee members. We discuss this discrepancy using “frameworks of trust” and demonstrate the need to incorporate these frameworks into the existing model of informed consent. (shrink)

Subjects enrolled in studies testing high risk interventions for incurable or progressive brain diseases may be vulnerable to deficiencies in informed consent, such as the therapeutic misconception. However, the definition and measurement of the therapeutic misconception is a subject of continuing debate. Our qualitative pilot study of persons enrolled in a phase I trial of gene transfer for Parkinson disease suggests potential avenues for both measuring and preventing the therapeutic misconception. Building on earlier literature on the topic, we developed and (...) tested an interview guide that focuses on how the subjects decided to participate, emphasizing the integration of subjects’ various statements that are relevant to assessing the therapeutic misconception, rather than evaluating them as isolated statements. The results indicate that a subject’s understanding of the purpose of research is best explored in juxtaposition to the subject’s motivation for participating. (shrink)

Depression is a widespread concern in the United States. Neuromodulation treatments are becoming more common but there is emerging concern for racial disparities in neuromodulation treatment utilization. This study focuses on Transcranial Magnetic Stimulation (TMS), a treatment for depression, and the structural and attitudinal barriers that racialized individuals face in accessing it. In January 2023 participants from the Twin Cities, Minnesota engaged in focus groups, coupled with an educational video intervention. Individuals self identified as non-white who had no previous TMS (...) exposure but had tried at least one treatment for their depression. Results revealed that the intervention did not notably change knowledge or stigma about TMS, but attitudes surrounding traveling for treatment changed. Notably, barriers like affordability, frequency of treatment, and lack of knowledge persist. Participants expressed a desire for more information, personal connection, and a tailored educational approach. The study suggests a need for multifaceted strategies to reduce disparities, focusing on education, community-based resources, and policy interventions. Immediate actions that can be taken include the creation of a TMS education program focused on patient engagement and awareness about TMS. (shrink)

This commentary places Jussim in dialogue with sociological perspectives on social reality and the political-academic nature of scientific paradigms. Specifically, we highlight how institutions, observers, and what is being observed intersect, and discuss the implications of this intersection on measurement within the social world. We then identify similarities between Jussim's specific narrative regarding social perception research, with noted patterns of scientific change.

As a result of the COVID-19 pandemic people have endured potentially stressful challenges which have influenced behaviors such as eating. This pilot study examined the effectiveness of two brief interventions aimed to help individuals deal with food cravings and associated emotional experiences. Participants were 165 individuals residing in United Kingdom, Finland, Philippines, Spain, Italy, Brazil, North America, South Korea, and China. The study was implemented remotely, thus without any contact with researchers, and involved two groups. Group one participants were requested (...) to use daily diaries for seven consecutive days to assess the frequency of experience of their food cravings, frequency of giving in to cravings, and difficulty resisting cravings, as well as emotional states associated with their cravings. In addition to completing daily food diaries, participants in group two were asked to engage in mindful eating practice and forming implementation intentions. Participants assessed their perceived changes in eating, wellbeing, and health at the beginning and end of the intervention. Repeated measures MANOVAs indicated that participants experienced significantly less food cravings, as well as lower intensities of unpleasant states associated with cravings across time. In contrast to our hypothesis, the main effects of the group were not significant. Participants reported less eating and enhanced wellbeing at the end of the study. Our findings can be used to inform future remote interventions to manage food cravings and associated emotions and highlight the need for alternative solutions to increase participant engagement. (shrink)

This study comparatively examines the dividends behavior in state-controlled firms versus family-controlled firms. With the sample of large industrial firms listed on the Main Board of Hong Kong Stock Exchange, we investigate the dividends payment rates, stability of dividends payment, the effects of firm size, profitability and growth opportunity on likelihood to pay dividends, as well as the concentration of dividend in state-controlled versus family-controlled firms. Based on the findings, we derive some ethical implications of dividends policy regarding the differences (...) in business ethical behavior, corporate social responsibility, corporate governance, business sustainability, and shareholder activism in state-controlled versus family-controlled firms, as well as the improvement in these respects through cross-listing in Hong Kong. (shrink)

This study explored the influence of the COVID-19 pandemic on perceived health behaviors; physical activity, sleep, and diet behaviors, alongside associations with wellbeing. Participants were 1,140 individuals residing in the United Kingdom, South Korea, Finland, Philippines, Latin America, Spain, North America, and Italy. They completed an online survey reporting possible changes in the targeted behaviors as well as perceived changes in their physical and mental health. Multivariate analyses of covariance on the final sample revealed significant mean differences regarding perceived physical (...) and mental health “over the last week,” as well as changes in health behaviors during the pandemic by levels of physical activity and country of residence. Follow up analyses indicated that individuals with highest decrease in physical activity reported significantly lower physical and mental health, while those with highest increase in physical activity reported significantly higher increase in sleep and lower weight gain. United Kingdom participants reported lowest levels of physical health and highest increase in weight while Latin American participants reported being most affected by emotional problems. Finnish participants reported significantly higher ratings for physical health. The physical activity by country interaction was significant for wellbeing. MANCOVA also revealed significant differences across physical activity levels and four established age categories. Participants in the oldest category reported being significantly least affected by personal and emotional problems; youngest participants reported significantly more sleep. The age by physical activity interaction was significant for eating. Discussed in light of Hobfoll conservation of resources theory, findings endorse the policy of advocating physical activity as a means of generating and maintaining resources combative of stress and protective of health. (shrink)

Background: Expanded newborn screening generates incidental results, notably carrier results. Yet newborn screening programmes typically restrict parental choice regarding receipt of this non-health serving genetic information. Healthcare providers play a key role in educating families or caring for screened infants and have strong beliefs about the management of incidental results. Methods: To inform policy on disclosure of infant sickle cell disorder (SCD) carrier results, a mixed-methods study of healthcare providers was conducted in Ontario, Canada, to understand attitudes regarding result management (...) using a cross-sectional survey (N = 1615) and semistructured interviews (N = 42). Results: Agreement to reasons favouring disclosure of SCD carrier results was high (65.1%–92.7%) and to reasons opposing disclosure was low (4.1%–18.1%). Genetics professionals expressed less support for arguments favouring disclosure (35.3%–78.8%), and more agreement with arguments opposing disclosure (15.7%–51.9%). A slim majority of genetics professionals (51.9%) agreed that a reason to avoid disclosure was the importance of allowing the child to decide to receive results. Qualitatively, there was a perceived “duty” to disclose, that if the clinician possessed the information, the clinician could not withhold it. Discussion: While a majority of respondents perceived a duty to disclose the incidental results of newborn screening, the policy implications of these attitudes are not obvious. In particular, policy must balance descriptive ethics (ie, what providers believe) and normative ethics (ie, what duty-based principles oblige), address dissenting opinion and consider the relevance of moral principles grounded in clinical obligations for public health initiatives. (shrink)

El objetivo de la formación doctoral es la generación y difusión de nuevo conocimiento, sin embargo, no es claro cómo los programas de doctorado en Colombia se relacionan con este tipo de producción académica. A partir de ello, en el presente estudio se presenta el panorama general de la producción académica a través de las instituciones de educación superior colombianas que ofertan programas de formación doctoral en psicología. La producción académica se obtuvo de la base de datos Scopus en una (...) muestra de 13 universidades. Tras una búsqueda inicial, se encontraron 1345 documentos, con los cuales se realizó un análisis de los indicadores de productividad y de las redes de colaboración al interior de la disciplina en el país. Posteriormente, esta información se contrastó con la información nacional registrada en el sistema de Currículum Vitae Latinoamericano y del Caribe de 193 profesores asociados a las universidades que ofertan los programas de doctorado. Al comparar la producción académica nacional e internacional, se encontró una mayor correlación entre la dirección de tesis de posgrado y la publicación en revistas nacionales. Por lo tanto, se puede afirmar que el impacto de la formación doctoral en la generación de nuevo conocimiento es relativo y tiene un alcance limitado, siendo principalmente las revistas nacionales el medio de difusión de este conocimiento. Se recomienda evaluar el impacto de los productos asociados a la formación posgradual y la visibilidad internacional, con énfasis en las revistas indexadas en bases de datos internacionales. (shrink)

El propósito central de este artículo es hacer un análisis desde una perspectiva constructivista del concepto de derecho de dos de los principios más importantes de la filosofía política de Kant: el principio del derecho y la idea del contrato original. El texto comienza con una breve exposición de lo que significa el constructivismo kantiano. A continuación se hace un análisis del concepto de derecho y de los atributos que definen a la ciudadanía, a saber: la libertad, la igualdad y (...) la independencia civil. En la última parte, se examina la concepción kantiana del contrato original y se trata de mostrar que hay, para Kant, deberes políticos tanto de derecho como de virtud. (shrink)

The Aymara Pentecostalism is one of the most important religious movements in Chile. In the last decades it has been produced a considerable amount of sociological and anthropological research about this movement and this has resulted in the emergency of a particular field. However, these studies have not the thematized the relevance of the theoretical assumptions that underlie in their analysis. Due to this, our aim is to develop an epistemological analysis of the theoretical assumptions behind the studies about the (...) Aymara Pentecostalism in Chile, elucidating specifically how they have used the difference between structure and action when they aim to understand the features of this socio-religious movement. This will allow us to elucidate the types of epistemological conflation that take place in the explanations develop by these authors, assessing its theoretical contribution. El pentecostalismo aymara es uno de los movimientos religiosos más distintivos de Chile. En las últimas décadas se ha producido una considerable cantidad de estudios sociológicos y antropológicos sobre este movimiento, generándose un incipiente campo de estudios al respecto. Sin embargo, estos estudios no han tematizado la adecuación de los supuestos teóricos que subyacen a sus análisis. Por ello, nuestro objetivo es realizar un análisis epistemológico de los supuestos teóricos que subyacen a los estudios sobre pentecostalismo aymara en Chile, distinguiendo específicamente cómo han utilizado la distinción entre estructura y acción a la hora de comprender las características de este movimiento socioreligioso. Esto nos permitirá distinguir los tipos de conflacionismo epistemológico presentes en las explicaciones esbozadas por los autores, evaluando así su rendimiento teórico. (shrink)

El artículo tiene como objetivo -a pesar de su modestia- contribuir a una mejor comprensión de la relación de parentesco de Antonin Artaud, con muchos de sus conrtemporáneos considerados como "vanguardistas". Al mismo tiempo, se pretende desmitificar la idea que se tiene de Artaud sólo como un hombre de teatro, si tenemos en cuenta su actuación en otras áreas. Sobretodo, su contribución al pensamiento y su constante necesidad de comunicarse con el mundo; principalmente, cuando afirma que "Europa se cristaliza, se (...) momifica lentamente bajo las ataduras de sus fronteras, sus fábricas, sus tribunales, sus universidades". Por otro lado, se tiene la pretensión de propiciar una discusión capaz de liberarlo de la condición de mero objeto de análisis para los estudios psiquiátricos.The purpose of this article -in spite of its modesty- is to contribute to a better understanding of kindred relations in Antonin Artaud, who along with many of his contemporaries is considered "vanguard". At the same time it intends to oppose the idea that one perveives of Artaud as only doing theater works. He also participates in several other areas, above all, he contributes to thought. He also needs to communicate with the world, mainly, when he affirms that "Europe crystallizes itself, mummifying slowly under the binding of its borders, its factories, its court, its universities". On the other hand, there is also the pretension of proposing a discussion capable of liberating himself from the condition of a mere object of analysis for psychiatric studies. (shrink)

El artículo tiene como objetivo –a pesar de su modestia– contribuir a una mejor comprensión de la relación de parentesco de Antonin Artaud, con muchos de sus conrtemporáneos considerados como “vanguardistas”. Al mismo tiempo, se pretende desmitificar la idea que se tiene de Artaud sólo como un..

Resumen Este artículo versa sobre la relación entre rendición de cuentas ética y transparencia en el marco de la ética empresarial. Se argumenta que a la rendición de cuentas le debe ser inherente la transparencia con el fin de que una auditoría sea verdaderamente ética y no un simple medio de incrementar la reputación ética empresarial. Para ello, se analiza el concepto de transparencia, visto desde la ética cívica, y cómo este se implica en un enfoque normativo de la teoría (...) de los stakeholders. Se finaliza abordando algunos parámetros mínimos de transparencia que la rendición de cuentas debe tener para que las empresas que los apliquen puedan ser efectivamente consideradas como empresas justas.This article revotes around the relationship between ethical accountability and tranpareng within the framework of business ethics. It is argued that, for the purpose of an audit to be really ethical rather than merely a tool to increase the levels of the reputation of the company, tranparency must be inherent to accountability. To do this, it is claimed that the concept of tranparency is anaced should be seen from the point of view of civic ethics, in order to establish how it is implied in a normative approach to stakeholders theory. The article ends arguing that any process of accountability must include some minimal normative components of transparency for it to be applied in companies wanting to be considered as fair companies. (shrink)