This article examines the relationship between bioethics and the therapeutic standards in HIV prevention research in the developing world, focusing on the closure of the pre-exposure prophylaxis (PrEP) trials in the early 2000s. I situate the PrEP trials in the historical context of the vertical transmission debates of the 1990s, where there was protracted debate over the use of placebos despite the existence of a proven intervention. I then discuss the dramatic improvement in the clinical management of HIV and the (...) treatment access movement, and consider how these contexts have influenced research practice. I argue that as HIV prevention trials oblige researchers to observe the rate at which vulnerable people under their care acquire HIV, there is an obligation to provide antiretroviral treatment to seroconverters and other health care benefits that fall within the scope of researchers' entrustment, both to avoid exploitation and to enact reciprocal justice. I argue against propositions that the obligations to provide specific benefits are vague, fall only upon researchers and sponsors, and create injustices by privileging the few over the many. Finally, I contend that the realisation of a broader standard of care in HIV prevention research broadens the role of research from being a simple tool to produce knowledge to a complex intervention that can play a part in the reduction of health disparities. (shrink)

Journal of Philosophy of Education, EarlyView.

Background Person-centred care is based on ethical principles, and it is regarded as high-quality care. Care of older persons should embrace person-centredness. During the pandemic, older persons were highlighted as a vulnerable group at risk of developing serious illness and/or suffering death from COVID-19. Several pandemic-related measures were introduced in residential care facilities (RCFs) to reduce this risk, which influenced the possibilities to lead and provide a person-centred care. Aim This study’s aim was to explore ethical challenges in relation to (...) person-centredness during the COVID-19 pandemic, from the perspective of leaders in RCFs. Research design The study had a qualitative descriptive design. Participants and research context Semi-structured interviews were conducted with 26 leaders working in RCFs in Sweden. Data were analysed using conventional content analysis. Ethical considerations The study was approved by the Swedish Ethical Review Authority. The participants received oral and written information about the study and gave written consent. The study was conducted in accordance with the Declaration of Helsinki. Findings The overarching ethical challenge was Having to disregard the individual needs of the person in order to protect the group and society. This included (a) Protecting the group versus promoting the older person’s autonomy; (b) Being forced to lead care based on uncertainty instead of evidence; (c) Striving to provide dignified care but lacking opportunities; and (d) Going far beyond ordinary duty and endangering one’s own and the staff’s health. Discussion The ethical challenges meant being torn between the person’s individual needs and protecting the group and society, with clashing ethical principles as a consequence. Conclusions The leaders faced ethical situations resulting in undignified and compromised person-centred care, which has implications for stakeholders and management who need to address the work conditions in RCFs. (shrink)

This essay reflects on three strategic visions of how society might develop in the direction of a more environmentally responsible culture. These strategies - green technology, ecocentrism, and civic environmentalism - offer promising elements of what we need. However, each fails in different ways to successfully explain how citizens, caught up in consumerist practices and their supporting belief systems, can be led to take the transformative steps needed to build a culture that engages responsibly and respectfully with the natural environment. (...) This essay aims to acknowledge the contributions of these three approaches, while also critically reflecting on their limitations. The core limitation is the unresolved clash between ecocentrism's focus on the vulnerability of nature's intrinsic value to any anthropogenic intervention and civic environmentalism's focus on the revival of strong civic democracy as a gateway to environmental health. (shrink)

After the fall of an oppressive regime, public interpretation of the past provides the normative backbone for the new society’s institutional framework. This narrative also molds temporality on a collective level, elevating some events and eras above the floating river of time, while omitting or suppressing others. In all societies, collective memory, and the temporality embedded within it, are mediated within the public domain. This paper argues that the hyper-accelerated time of transition leaves its mediating function vulnerable and prone to (...) slip into manipulation. By monopolizing the public interpretation of the past and manipulating public temporality, political regimes undermine the processes of healing and reconciliation, which require us to recognize different voices and interpretations. A manipulated temporality, that clashes with the personal temporality of lived experience, may violate personal identity and dignity and impede the democratic project. (shrink)

The story of Naboth’s vineyard (1 Kings 21:1-16) is one played out during the dynasty of Omri in Northern Israel (866-842 BCE) and speaks to an era in which socio-economics were largely dominated by political elites. The narrative concerns inter alia a clash between two arrangements of land ownership, inheritance and possession by others. Thus, from a socio – analytical perspective, the story has lessons to impart to 2022 South Africa where the issue of the land redistribution is an important (...) one given that even after a quarter of a century post-apartheid, millions of people continue to have no real access to land. Many people are thus left precariously exposed and vulnerable. The story imparts the truth that a leader of a state is bound to respect the proprietary rights of his citizens. In any event, viewed from a theological perspective, all the resources of creation are to be utilised to serve the common good and we are all custodians of creation. This includes people who have no private property of their own and who are for the most part excluded and side-lined by those in positions of power. The story of Naboth’s vineyard is thus a simple one where a sovereign sees something he wants, and then formulates a strategy to get it. In Naboth’s story, the king had him killed. This is a very constructive rendition of what happens when there’s no justice and the dominant powers get to terminate those who stand in their way. Justice tends to break down when people lose perspective of who they are concerning God who ultimately forgives us when we atone. (shrink)

The legacy of totalitarianism thwarts discourse and practice of academic freedom in post-Soviet universities. For legacy-holders, “academic freedom” causes disorientation, irresponsibility, demoralization and inequity. They see more threats than benefits from empowering decision-makers who are non-compliant with local bureaucracy. For innovators, freedoms enhance flexibility and creativity. However, granting such freedom also reinforces value clashes on campuses and tends to intensify feelings of guilt and shame in regard to actions which show a disrespect of authority and tradition. While both legacy-holders and (...) innovators endeavour to redefine their practices and norms in their teaching, they appear to still struggle to shed their predispositions to a paternalistic and colonial philosophy of education. Presumably curative, their engagement with international networks of scholarship exposes their particular positions of vulnerabilities to that end. Both groups continue to push patriotism and cultural idiosyncrasy in order to hedge their power and status in the global marketplace of ideas. As in the past, a discourse of anti-westernization prevails, shoring up legacies of regulative thinking, indoctrination, and insularity. Progressive academics succeed primarily by taking bold steps to go above and beyond the dominant discourses and norms within their universities and policy-building communities. This article explicates why, in turn, a “surrogate academic freedom” tends to emerge as a conundrum across the post-Soviet higher education space. (shrink)

The paper examines the migration policy regime in Thailand using a human security lens. It suggests that insecurities experienced by migrants are partly caused or exacerbated by a migration policy regime, consisting of migration laws and regulations and non-migration related policies and programs, that pushes migrants into irregular forms of mobility and insecure employment options. These effects are worse for women migrants who have fewer resources to access legal channels while they are relegated to insecure employment in the reproductive or (...) informal sectors. Using a gender and human security analysis, therefore, reveals how the migration policy regime, often informed by a restrictive national security approach, can clash with the human security needs of migrants by creating a large pool of unprotected irregular migrants with women occupying the most vulnerable forms of employment. In conclusion, it is suggested that this ‘en-gendering’ of human insecurities could be overcome if gender equality was designed into policies and guided their implementation. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Ethics in Light of ChildhoodDavid Cloutier (bio)Review of Ethics in Light of Childhood John Wall Washington, D.C.: Georgetown University Press, 2010. 204 pp. $34.95.John Wall’s ambitious volume contends that “considerations of childhood should not only have greater importance but fundamentally transform how morality is understood” (1). He rightly suggests that “the story of childhood cannot be told in one-dimensional formulas of either innocence and vulnerability or unruliness and (...) undevelopment” (7), but instead require a new paradigm for ethics: “childism.” He questions three historical views of childhood: the “top-down,” the “bottom-up,” and the developmentalist. Wall splendidly moves beyond these views and demonstrates that considering children should instruct us in the limitations of ordinary approaches to ethics—not only for children’s sake but for adults too.How so? Wall’s constructive section considers ontology, teleology, and de-ontology. In them, relying heavily on twentieth-century continental philosophy, supplemented by some social-scientific literature and numerous anecdotal examples, he develops an overall approach to the moral life. First, he argues for an ontology of “restless and endless play” (36) reflective of the human capacity for creativity possessed by both children and adults. Secondly, the moral life has a teleology of “narrative expansion,” with a constant movement toward a “more richly diverse life story” (60). Finally, moral obligation involves a constant “decentering” of the self in which “the world I create for myself should be disrupted and stretched out as far as possible by genuine human difference” (88). Building on the insights of top-down and bottom-up traditions, and going beyond the “flatly unilinear assumptions” of developmental “stageism” (81) ethics involves a constant circularity, exemplified in the final three chapters on specific issues. For example, families who “create increasingly expansive family worlds” engage in top-down transmission of tradition, developmental formation of relationality, and bottom-up nurturing of otherness (149). These qualities apply not only to children but to parents as well, and thus satisfy Wall’s desire for an ethics that is fully “child-inclusive” and that does not privilege adult agents. He succeeds admirably at demonstrating that the real agency children actually possess and exercise, as well as their vulnerability and passivity, are not simply incomplete versions of what adults possess fully.I would raise two concerns. First, the book works so hard to avoid any kind of linearity that criteria enabling judgment seem lacking—for example, surely some [End Page 195] forms of “disruption” are not to be welcomed (especially by children). The telos of “narrative expansion” so strongly refuses to privilege any perspective that it threatens to empty out what one might gingerly call “adult commitments”—to stable love, production, civic life, and fine arts—all of which require virtue (absent here), and which seem necessary for children to flourish. Aspiring “to go on creating oneself endlessly” (58) can be a fruitful depiction of adult life, or it can be an immature escapism. Without a thicker telos, the distinction is difficult to make.Second, his category of “childism” (3) forces him to artificially avoid any telos of maturation. In parallel with other “isms” (e.g., feminism), he argues that children are “full human beings,” live in “fully meaningful moral worlds,” and are “full participants in... human moral experience” (29). “Full” appears throughout, but the inclusion parallel clashes with maturation in human life. True, children and adults have both agency and vulnerability (39), but children, generally speaking, are more vulnerable and are less capable agents, and thus will have particular needs (and also offer particular gifts to adults). “Childism” sometimes obscures the particularities of childhood, and how we are bodily and culturally directed toward some “maturity.” Yet these concerns should not diminish Wall’s achievement in displaying how childhood can teach adults much about ethics.David CloutierMount St. Mary’s UniversityDavid Cloutier David Cloutier is an associate professor of theology at Mount St. Mary’s University. He received his BA from Carleton College and his PhD from Duke University. He is the author of Love, Reason, and God’s Story: An Introduction to Catholic Sexual Ethics (Anselm/St. Mary’s Press, 2008) and editor of Leaving... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Fortuyn, Van Gogh, Hirsi AliWhy the Unholy Trinity Was Driven Out of the NetherlandsHenri Beunders (bio)“Vulnerability” and “tolerance” are pretty vague notions. A lot of suggestions, images, and good intentions cling to them, while scientific clarity is virtually absent.The same goes for the Netherlands. Abroad, my country had the image of a tolerant, liberal, and free society, a place where things could be said and done that were forbidden (...) elsewhere. So the question is: how on earth did this country turn into a battlefield due to a clash of civilizations almost overnight?I will try to explain to you how and why in the past decades the Netherlands became so vulnerable that in 2002 a political revolt broke out quite unexpectedly, a revolt that lasted for years and still is not over yet. The crisis resulted in two people becoming victims of political killings, while a third had to flee the country. Because all three of these people were liberal individualists who criticized two types of religion—the political-cultural left, or “Red Church,” and fundamentalist Islam—I will refer to them as the unholy trinity, an unholy trinity that had to be exorcized to restore the peace.Freedom of speech and freedom of religion are key factors in the Dutch crisis. Cultural wars and mimetic rivalry are other factors. Americanization and the advent of the multicultural society are the forces profondes. [End Page 201]I: Tolerance and the Dutch ConstitutionLet us talk briefly about tolerance first. Everybody seems to be in favor of it, except when we collectively decide we must not tolerate things, like drunk driving, smoking in public buildings, and so on.In the present Dutch constitution, created in 1983, article 1 begins with these sentences: “All persons in the Netherlands shall be treated equally in equal circumstances. Discrimination on the grounds of religion, belief, political opinion, race, or sex or on any other grounds whatsoever shall not be permitted.”1In essence, the constitution states that a colored Dutchman has the right to be treated in the same way as a white one. This has, however, nothing to do with tolerance. Tolerance means that a dominant group permits a nondominant group to have opinions or lifestyles that seem to deviate from the usual order. If we ask natives to be tolerant toward exotic immigrants, this implies hierarchy. There is a group that tolerates, and there is a group that is tolerated. In the strict sense of the word, tolerance implies discrimination and is therefore hostile to the constitution.As a Dutch historian once remarked, every philosopher who thought about these things, like John Locke, Mirabeau, or Thomas Paine, knew that the notion of religious tolerance is useless if you assume all men by nature to have inviolable rights anyway, like those of freedom of thought, expression, and religion.2Of course, a nation-state has to be intolerant sometimes, for instance, when freedom of religion is used to undermine the state, when, for example, the state is promoting violence, which in democratic societies is the monopoly of the state. This is a matter of principle. The rest is a matter of political debate.At this point we have to conclude that trying to give meaning to a word such as tolerance can be very complicated and confusing, and that such a word has to be used very carefully. The same goes for all those other container words, like racism, fascism, populism, and so forth, that have been used so frequently in recent decades to label and scapegoat people and things that are feared or simply disliked. But words are important.The idle and gratuitous manner in which container words of this kind are used to denounce “the enemy” represents the other side of the so-called liberal, “tolerant” society of the Netherlands. All this name calling definitely keeps you from researching and facing the things that are really going on. During the 1990s, this name calling resulted in the dominance of political correctness, a phenomenon that leaves no room for doubt as to who the angels and devils are in society, and it implies that there is no need to look... (shrink)

There is no doubt that the Philosophy of Nature constituted in Hegel’s mind an integral part of his system. Even in the early years of collaboration with Schelling at Jena, when Hegel’s contribution was to be the formulation of a logic consistent with Schelling’s new idealism, Hegel repeatedly produced sketches of a theory of nature. Though that early creative period in fact culminated with the Phenomenology of Spirit, a Philosophy of Nature eventually found its canonical place in the Encyclopedia, and (...) remained there through the various editions that the work underwent in Hegel’s lifetime. Yet, despite its obvious structural importance, this part of Hegel’s system has been the spot most vulnerable to the attacks of its enemies, and also, on the part of the sympathetic critics, the place where their different lines of interpretation have clashed the loudest. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Women, Ethics, and Inequality in US Healthcare: “To Count among the Living” by Aana Marie Vigen, and: New Feminist Christianity: Many Voices, Many Views ed. by Mary E. Hunt and Diann L. NeuKelly Denton-BorhaugWomen, Ethics, and Inequality in US Healthcare: “To Count among the Living” By Aana Marie Vigen NEW YORK: PALGRAVE MACMILLAN, 2011. 304 PP. $31.11New Feminist Christianity: Many Voices, Many Views Edited by Mary E. Hunt (...) and Diann L. Neu WOODSTOCK, VT: SKYLIGHT PATHS, 2010. 384 PP. $24.99In this age of the Supreme Court Hobby Lobby decision, which declared that corporation owners’ religious commitments could provide a basis for denial of their employees’ critical reproductive health insurance benefits (with particular impact on the lives of women), ethical investigation of medical sociology, theology, and the realities of women’s lives is more important than ever. Originally released in 2006, Aana Marie Vigen’s Women, Ethics, and Inequality in US Healthcare makes important headway through these complex waters. And for this volume in the Palgrave Macmillan Series on Black Religion / Womanist Thought / Social Justice, editors Dwight N. Hopkins [End Page 202] and Linda E. Thomas set forth the goal to “pioneer conceptual work and boundary-pushing effort engaging Black Religion or Womanist thought, and social justice” (xiv).Rereleased in paperback in 2011 with a new preface, Vigen’s updated health statistics reveal how racial-ethnic minorities “continue to be overrepresented among the ranks of the uninsured and/or of those living in poverty” (xliii). Her project is to better understand what enables and perpetuates this inequitable distribution and oppression, and to suggest methods of redress and reform. But in order to accomplish any of this, society in general and especially those with socioeconomic power—including administrative leaders in health care, medical providers, and ethicists—need to listen much more deeply to the stories of those who are most vulnerable and are being most negatively affected by current health care systems and practices. For Vigen, this meant a decision to focus on in-depth interviews with eight black and Latina women with breast cancer, in addition to six health care providers.With this method, Vigen pursues a very ambitious goal to, as she puts it, “begin a conversation among several distinct dialogue partners: medical sociology, biomedical ethics, ethnography, theology, and feminist social ethics” (5). She uses a “reflexive” practice, striving for openness to the new insights and ideas that emerged from this creative, multidisciplinary encounter. However, even before launching her interviews, her analysis of the process to seek approval from the Institutional Research Board illustrates the “clash of cultures” she would encounter, as she writes, “one cannot take for granted that others will share the view that women of color are able to speak truth in their own right and out of their own experiences—without comparison to others—about human personhood, dignity, and adequate healthcare quality” (107). It is to Vigen’s credit that she remained undeterred; if anything, the struggle she encountered with powerful leaders helped to confirm and focus the value of this work: not to tell every story, “but to tell a few with care and attention to detail” (108).Vigen’s ethnographical method makes it possible for her to illuminate and address not only stark inequities but also much subtler dynamics of racism combined with socioeconomic discrimination. Along the way, she illustrates a wide variety of experiences of oppression. In contrast to the experience of white patients, these female patients of color tended to be sent to the accounting/financing office before being allowed to see the doctor (144). Though white patients may express strong emotions in medical settings, some women of color felt pressured to reassure white doctors that they could be rational and not overly emotional (141). Socioeconomic and racial discrimination often reinforced one another in these settings. Perhaps most alarming, Vigen notes, the white care providers she interviewed seemed to be very unconscious of [End Page 203] their own racial identity and its role in medical care encounters (165). Her final chapter concludes with a series of immensely practical ethical mandates that would help alter these oppressive patterns. Clergy, students of ethics, and anyone... (shrink)

Trust is taken to be one of the foundational values in the doctor-patient relationship, facilitating access to the benefits of health care and providing a guarantee against possible harms. Despite this foundational role, some doctors betray the trust of their patients. Trusting involves granting discretionary powers and makes the truster vulnerable to the trustee. Patients trust medical practitioners to act with goodwill and to act competently. Some patients carry pre-existing vulnerabilities, for reasons such as gender, poverty, age, ethnicity, or (...) disability, and these vulnerabilities can be exacerbated when such patients extend their trust to a doctor. Gender stereotypes reduce women's ability to challenge and thereby assess their doctor's competency. In addition, women are more likely to be distrusted by their doctors and have their experiences of medical symptoms discounted. In this paper, we analyze two extreme examples of breaches of medical trust that exploited the vulnerability of women in the health care system: the "unfortunate experiment" at the National Women's Hospital in New Zealand and the Harold Shipman murders of elderly patients in the United Kingdom, examining the potential role of gender in the outcomes with regard to trust. Major breaches of medical trust such as these typically lead to government inquiries, revisions of ethical guidelines, and substantive policy change in an effort to re-establish public and patient trust. We argue that the medical profession has an ethical obligation to put mechanisms in place to protect vulnerable patients from abuses of trust, to monitor colleagues' competence, and to be prepared to blow the whistle to protect patients who are not in a position to recognize misplaced trust. Such mechanisms will act disprosportionately to reduce harm to women as patients. (shrink)

In spite of many and varied concerns that the processes of institutional ethical review are flawed, cumbersome, and in need of reform, these processes do provide effective protection in certain sit...

The understanding of decision-making systems has come together in recent years to form a unified theory of decision-making in the mammalian brain as arising from multiple, interacting systems (a planning system, a habit system, and a situation-recognition system). This unified decision-making system has multiple potential access points through which it can be driven to make maladaptive choices, particularly choices that entail seeking of certain drugs or behaviors. We identify 10 key vulnerabilities in the system: (1) moving away from homeostasis, (...) (2) changing allostatic set points, (3) euphorigenic signals, (4) overvaluation in the planning system, (5) incorrect search of situation-action-outcome relationships, (6) misclassification of situations, (7) overvaluation in the habit system, (8) a mismatch in the balance of the two decision systems, (9) over-fast discounting processes, and (10) changed learning rates. These vulnerabilities provide a taxonomy of potential problems with decision-making systems. Although each vulnerability can drive an agent to return to the addictive choice, each vulnerability also implies a characteristic symptomology. Different drugs, different behaviors, and different individuals are likely to access different vulnerabilities. This has implications for an individual's susceptibility to addiction and the transition to addiction, for the potential for relapse, and for the potential for treatment. (shrink)

Background: Neglect and abuse of elders in care institutions is a recurring issue in the media. Elders in care institutions are vulnerable due to their physical, cognitive, and verbal limitations. Such vulnerabilities may make them more susceptible to mistreatment by caregivers on whom they are heavily dependent. Objectives: The goal was to understand caregivers’ concerns about ensuring correct and proper treatment, as well as their experiences with neglect and abuse of older patients. This article examines resources and challenges of (...) professional ethics within the care setting. Research design: A study was conducted to explore the quality of care provided to older patients in nursing homes, geriatrics institutions, and ambulant care in the northwest region of Switzerland. Participants and research context: A total of 23 semi-structured interviews were conducted with nursing staff of varying experience levels. Ethical considerations: Ethical approval was granted by the competent regional ethics commission, Ethikkomission Nordwest-und Zentralschweiz EKNZ [Ethics Commission Northwest and Central Switzerland]. Findings: Three themes emerged from our data analysis: professional identity, professional context, and professional relationships. Our findings indicate mutual vulnerabilities within these three themes, characterizing the interactions between nursing staff and older patients. Study participants believe that incidences of error, neglect, and abuse are consequences of their own vulnerability since they are not able to meet the demands of an overstraining work situation. Discussion: Different aspects of this mutual vulnerability are described and critically discussed as challenges for professional ethics. Conclusion: Early education, continuous training as well as better management and response from the institution are necessary to maintain professionalism while handling mutual vulnerabilities. (shrink)

In Denmark, secure care institutions are gender-integrated and accommodate young people with a wide range of psychiatric and social troubles. The large majority of young people are placed here in surrogate custody, and a minority, mostly girls, are placed here in protective care. Based on a qualitative study of gendered practices and experiences in Danish secure care institutions, this article provides insight into how gender and pathology merge to produce vulnerabilities in care. The study finds that while girls are (...) viewed through a lens of pathology, secure care practices largely fail to provide treatment for girls. Drawing on feminist scholarship on penal–welfare responses to women, I argue that institutional practices contribute to the production of disordered selves and the marginalization of girls in secure care. This demonstrates how welfare provision for the most marginalized girls reproduces and reinforces the inequalities that brought them into secure care. The study hereby supplements an emerging scholarship on how gender underpins penal–welfare responses and interventions. (shrink)

With more than half of individuals incarcerated having serious mental health concerns, correctional settings offer excellent opportunities for epidemiological, prevention, and intervention research. However, due to unique ethical and structural challenges, these settings create risks and vulnerabilities for participants not typically encountered in research populations. We surveyed 1,224 researchers, Institutional Review Board members, and IRB prisoner representatives to assess their perceptions of risks and vulnerabilities associated with mental health research conducted in correctional settings. Highest ranked risks were related (...) to privacy, stigma, and confidentiality; lowest ranked risks were related to prisoners’ loss of privileges or becoming targets of violence due to having participated in research. Cognitive impairment, mental illness, lack of autonomy, and limited access to services emerged as the greatest sources of vulnerability; being male, being female, being older than age 60, being a minority, and being pregnant were the lowest ranked sources of vulnerability. Researchers with corrections experience perceived lower risks and vulnerabilities than all other groups, raising the question whether these researchers accurately appraise risk and vulnerability based on experience, or if their lower risk and vulnerability perceptions reflect potential bias due to their vested interests. By identifying areas of particular risk and vulnerability, this study provides important information for researchers and research reviewers alike. (shrink)

Conceptualisations of vulnerability of research participants in the international standards of ethics of research involving humans underwent a shift from a group-membership (categorical) to an individual-oriented (analytic) approach to vulnerability. However, the categorical view has not been jettisoned completely, and so its role needs to be examined or explained. It is argued in this chapter that a restricted use of the categorical approach can be justified if protection of vulnerable research participants is seen against the background of the dynamics of (...) study design, review and implementation, and if recognition and protection of participants with vulnerabilities is construed as a process in which researchers and ethics review bodies are involved rather than as a labelling device. From this perspective, the suitability of approach to conceptualisation of vulnerability depends on the kind and scope of the available information on participants. The process of study design, ethics review, and implementation involves different users of the ethics standards at different stages in the lifetime of a project: researchers and members of ethics review bodies. The concepts of individual vulnerability (in the analytic approach) and that of group-membership vulnerability (in the categorical approach) can play their protective roles complementarily in the process of identification of vulnerabilities of participants and protection of participants with vulnerabilities. (shrink)

Sexual consent is advocated around the world to reduce sexual assault. The widespread affirmative consent model emphasizes a need for unambiguous consent. In this paper, we contribute to a deeper understanding of how ambiguities in the initiations of sexual activities are routinely solved to achieve consent. Drawing on conversation analytic research on joint decision-making, and a dataset of 80 cases of sexual initiation in contemporary TV-series and movies, we investigate the interactional practices by which sexual activities are presented as consensual (...) and how consent is achieved across sequences of interaction. We found there to be social advantages of synchronous initiation, compared to sequential verbal initiations, which were associated with various social vulnerabilities. These vulnerabilities could however be circumvented by two practices, each of which made use of a distinct combination of verbal and embodied resources. While ambiguities exist, our results oppose the idea of sexual consent as a practically hopeless and awkward endeavor. Instead, consent consists of joint action that is achieved through recognizable and systematic ways. (shrink)

The development of ethical guidelines and regulations regarding human subjects research has focused upon protection of vulnerable populations by relying on a limited typology of vulnerabilities. This results in several challenges: First, Institutional Review Boards struggle to interpret and apply the regulations because they are often vague and inconsistent. Second, applying the regulations to subjects who fit within multiple categories of vulnerability can lead to contradictions and the rejection of research that would be permissible if only one category were (...) applicable. Finally, some potential subjects have social and other context-based vulnerabilities that are not described in the federal regulations... (shrink)

Many experimental brain-computer interfaces (BCIs) are currently being medically tested in paralyzed patients. While the new generations of implantable BCIs move rapidly ahead at trying to increase the patients’ well-being, ethical concerns about their potential effects on patients’ psychological dimensions (e.g. sense of agency and control) are growing. An important ethical concern to explore is how BCIs may introduce unprecedented vulnerabilities to implanted individuals.Our chapter shows that, on the one hand, BCIs can empower the sense of self and control, (...) which contribute to well-being. On the other hand, they can introduce unprecedented vulnerabilities, for example, by inducing radical distress, feelings of loss of control, and a rupture of patient identity, which decrease one’s well-being. To investigate a possible solution to this problem we propose to understand the implementation of a BCI system in one’s body through the capability approach. This calls for a careful ethical examination of new morally salient issues prior to seeing an increase in BCI-related psychological effects in an open market. (shrink)

This paper examines a case of failed interdisciplinary collaboration, between experimental stem cell research and theoretical systems biology. Recently, two groups of theoretical biologists have proposed dynamical systems models as a basis for understanding stem cells and their distinctive capacities. Experimental stem cell biologists, whose work focuses on manipulation of concrete cells, tissues and organisms, have largely ignored these proposals. I argue that ‘failure to communicate’ in this case is rooted in divergent views of explanation: the theoretically-inclined modelers are committed (...) to a version of the covering-law view, while experimental stem cell biologists aim at mechanistic explanations. I propose a way to reconcile these two explanatory approaches to cell development, and discuss the significance of this result for interdisciplinary collaboration in systems biology and beyond. (shrink)

Visual cultures are being increasingly discussed in the history of science literature, although relatively very little of that work concerns the nuclear age. In addition, within the discrete yet bourgeoning literature on global nuclear art and culture, Oceania is often overlooked despite its central role in the development of the American, British, and French nuclear weapon capabilities, as well as their associated colonial legacies. This article serves to redress both concerns by examining the visual politics of Maralinga in relation to (...) settler-colonial and Aboriginal experiences, vulnerabilities and presentations. I do so by surveying artworks with a connection to the Australian experience of nuclear colonialism and find that the figure of biological life has been conspicuously left absent from contemporary non-Indigenous Australian depictions of British nuclear testing in Australia. (shrink)

Debates about effective responses to the COVID-19 pandemic have emphasized the paramount importance of digital tracing technology in suppressing the disease. So far, discussions about the ethics of this technology have focused on privacy concerns, efficacy, and uptake. However, important issues regarding power imbalances and vulnerability also warrant attention. As demonstrated in other forms of digital surveillance, vulnerable subpopulations pay a higher price for surveillance measures. There is reason to worry that some types of COVID-19 technology might lead to the (...) employment of disproportionate profiling, policing, and criminalization of marginalized groups. It is, thus, of crucial importance to interrogate vulnerability in COVID-19 apps and ensure that the development, implementation, and data use of this surveillance technology avoids exacerbating vulnerability and the risk of harm to surveilled subpopulations, while maintaining the benefits of data collection across the whole population. This paper outlines the major challenges and a set of values that should be taken into account when implementing disease surveillance technology in the pandemic response. (shrink)

Current approaches to cyber-security are not working. Rather than producing more security, we seem to be facing less and less. The reason for this is a multi-dimensional and multi-faceted security dilemma that extends beyond the state and its interaction with other states. It will be shown how the focus on the state and “its” security crowds out consideration for the security of the individual citizen, with detrimental effects on the security of the whole system. The threat arising from cyberspace to (...) (national) security is presented as possible disruption to a specific way of life, one building on information technologies and critical functions of infrastructures, with relatively little consideration for humans directly. This non-focus on people makes it easier for state actors to militarize cyber-security and (re-)assert their power in cyberspace, thereby overriding the different security needs of human beings in that space. Paradoxically, the use of cyberspace as a tool for national security, both in the dimension of war fighting and the dimension of mass-surveillance, has detrimental effects on the level of cyber-security globally. A solution out of this dilemma is a cyber-security policy that is decidedly anti-vulnerability and at the same time based on strong considerations for privacy and data protection. Such a security would have to be informed by an ethics of the infosphere that is based on the dignity of information related to human beings. (shrink)

The European emigration on the other side of the Atlantic was a complex phenomenon. The areas inhabited by Romanians got acquainted to this phenomenon towards the end of the nineteenth century and the beginning of the twentieth. Therefore, starting with the year 1895, a certain mixture of causes led to a massive migration to America, especially of the Romanians from the rural areas. The purpose of our study is to explore the causes of the Romanian emigration across the ocean up (...) to the First World War to present the Romanian emigrants' features (occupation, age, gender, social status, religious affiliation, the way they were distributed across the North-American territory) and to bring forth essential aspects of the way they embraced the assimilation process. From a methodological standpoint our analyses are based upon official data of the US Census. This data is being interpreted in the light of some reference papers referring to the period that makes the object of our study. A certain amount of information presented here relies on our research activity in the Metropolitan Archives of Sibiu, where the ecclesiastic correspondence of that time provides very interesting data.  . (shrink)

The ongoing global pandemic of Covid-19 has exposed SARS-CoV-2 as a potent non-human actant that resists the joint scientific, public health and socio-political efforts to contain and understand both the virus and the illness. Yet, such a narrative appears to conceal more than it reveals. The seeming agentiality of the novel coronavirus is itself but one manifestation of the continuous destruction of biodiversity, climate change, socio-economic inequalities, neocolonialism, overconsumption and the anthropogenic degradation of nature. Furthermore, focusing on the virus – (...) an entity that holds an ambiguous status between the ‘living’ and ‘non-living’ – brings into question the issue of the agentiality of non/living matter. While the story of viral potency seems to get centre stage, overshadowing the complex and perverse entanglement of processes and phenomena which activated these potentials in the first place, the Covid-19 pandemic also becomes a prism that sheds light on the issues of environmental violence; social and environmental injustices; more-than-human agentiality; and ethico-political responses that the present situation may mobilise. -/- This article serves as a written record of joint conversations between artists and researchers in the working group ‘Non/Living Queerings’ that formed part of the online series of events ‘Braiding Friction’ organised by the research project Biofriction. The article strives to capture the collective effort of braiding and weaving a variety of situated perspectives, theoretical toolboxes, knowledges and experiences against the background of the ongoing Covid-19 pandemic. In particular, the text focuses on the issues of crisis, ‘amplification effect’, viral agency and the changing notions of humanity. (shrink)

This paper examines the structural features of the U.S. Health Care System that make it particularly vulnerable to fraud, and which help to account for the types of fraud that arise and the difficulties authorities confront in controlling them. These structural features include the predominance of fee-for-service structures, private sector involvement in health care delivery and health insurance, highly automated cl aims processing systems, and a processing culture and audit mentality that emphasize process accuracy over verification. The paper also discusses (...) the underlying pathology of fraud as a white-collar crime problem, and explains how the more general challenges of controlling fraud are exacerbated by particular features of the health system. The central and unsolved problem of False Claims is examined in some detail. A series of recent governmental responses to medically impossible claims of various types is shown to align more closely with a claims-process-improvement mindset than with a crime-control approach. A more mature crime-control orientation is a pre-requisite for any serious progress in reducing the levels of fraud in the U.S. health system. (shrink)

Among the numerous moral commodities that political orders can produceand protect, classical liberalism assigns primacy to liberty, understoodas noninterference. As the nineteenth century advanced into its secondhalf, this primacy was increasingly seen as myopic. A more defensibleliberalism will devote itself to a wider range of basic human interests:this critique gained virtually unanimous acceptance within the newliberalism. Yet, surprisingly, during the past two decades classicalliberalism seems to have enjoyed a resurrection. This essay arguesthat it is well merited, that the superficial plausibility (...) of the newliberal critique shielded a confusion between the questions of whichgoods matter and how they are properly to be afforded politicalrecognition. (shrink)

This article examines Swedish migrant women to the United States. It asks how racially privileged European migrants adapt to US racial and gender hierarchies that require them to relinquish their economic security and gender autonomy in a neoliberal state? Drawing upon interviews and focus group discussions with 33 Swedish women and three of their spouses, and participant observation between 2006 and 2008 in a network for Swedish speaking women living in the US, the article discusses how a group of ‘white’ (...) migrant women who arrive in the US with an ideology of gender egalitarianism negotiate a more socially conservative and economically vulnerable lifestyle, as the wives of upper-middle-class men. The article argues that while Swedish women benefit from their racial and social privileges in the US they lose their sense of economic security, acquiring new anxieties that make them reluctant to renounce their Swedish citizenship which they conceive of as a ‘flexible’ resource. (shrink)

AimVisual functions of the dorsal stream are considered vulnerable in children with early brain damage. Considering the recognition of objects in suboptimal representations a dorsal stream dysfunction, we examined whether children with early brain damage and impaired object recognition had either general or selective dorsal stream dysfunctions.MethodIn a group of children with early brain damage we evaluated the dorsal stream functioning. To determine whether these patients had an increased risk of a dorsal stream dysfunction we compared the percentage of patients (...) with impaired object recognition, assessed with the L94, with the estimated base rate. Then we evaluated the performance levels on motion perception, visual attention and visuomotor tasks in patients with and without object recognition abnormalities. A general dorsal stream dysfunction was considered present if a patient showed at least one abnormally low score in two out of three additional dorsal stream functions.ResultsSix of the eighteen patients with object recognition problems scored abnormally low on at least two additional dorsal stream functions. This was significantly higher than the base rate. The difference of 24.1% between the patients with and without object recognition problems was not significant. Of the patients with object recognition problems 72.2% had at least 1 dorsal weakness, whereas this was only the case in 27.3% of patients without object recognition problems. Compared to patients with normal object recognition, patients with object recognition problems scored significantly more abnormally low on motion perception and visual attention but did not differ on visuomotor skills.ConclusionChildren with object recognition problems seem at risk for other dorsal stream dysfunctions, but dysfunctions might be rather specific than general. Multiple functions/aspects should be evaluated in neuropsychological assessment of children at risk. (shrink)

Biggar’s excellent book allows examination of the adequacy of Christian just war theory over key events of the last century’s British military and interventionary history. I attempt infiltration of key positions behind a creeping barrage, following the contours of Biggar’s arguments, finally firing corrosive Greek fire into the deep Latinate redoubts of Fortresses Augustine and Aquinas. I shall explain why the audit of Biggar’s ambitious defensive system shows a very mixed balance sheet for just war theory.

One of liberalism’s core commitments is to safeguarding individuals’ autonomy. And a central aspect of liberal social justice is the commitment to protecting the vulnerable. Taken together, and combined with an understanding of autonomy as an acquired set of capacities to lead one’s own life, these commitments suggest that liberal societies should be especially concerned to address vulnerabilities of individuals regarding the development and maintenance of their autonomy. In this chapter, we develop an account of what it would mean (...) for a society to take seriously the obligation to reduce individuals’ autonomy-related vulnerabilities to an acceptable minimum. In particular, we argue that standard liberal accounts underestimate the scope of this obligation because they fail to appreciate various threats to autonomy. (shrink)

Roma communities across Europe still remain a neglected population group by way of the social and economic disadvantage that largely characterizes their lives. Roma communities continue to experience structural socioeconomic health inequalities on the grounds of their ethnic origin, alarmingly unveiling a pattern of systematic discrimination and ethnic marginalization. Without any doubt, such a highly worrying situation calls for States to incorporate Roma health rights within their law and policy agendas in a manner consistent with right to health requirements. Against (...) this background, this paper seeks to identify an operational human rights framework for States as a driver for better informed policies and implementation as well as for Roma engagement in the deliberations about their life prospects. The paper argues that continuing, concerted, and proactive State engagement is required for effectively addressing the structural obstacles impeding Roma socioeconomic health rights realization and maximizing Roma opportunities for well-being. (shrink)

Male fertility–related mHealth (MFmHealth), including smartphone applications that allow men to test their fertility at home, is getting some attention now and then. In this commentary, I argue that MFmHealth technology has the potential to undermine established norms around male reproduction but cannot be examined using traditional individualist frameworks in bioethics. Instead, theoretical literature on the concept of vulnerability in feminist bioethics allow a theoretical alliance with critical studies of men and masculinities. Proposed benefits like empowerment, shared responsibility, and democratization (...) may justify disruptive innovation but may also obscure more fundamental ethical concerns about vulnerability and social justice. (shrink)

Vulnerability and resistance have often been seen as opposites, with the assumption that vulnerability requires protection and the strengthening of paternalistic power at the expense of collective resistance. Focusing on political movements and cultural practices in different global locations, including Turkey, Palestine, France, and the former Yugoslavia, the contributors to Vulnerability in Resistance articulate an understanding of the role of vulnerability in practices of resistance. They consider how vulnerability is constructed, invoked, and mobilized within neoliberal discourse, the politics of war, (...) resistance to authoritarian and securitarian power, in LGBTQI struggles, and in the resistance to occupation and colonial violence. The essays offer a feminist account of political agency by exploring occupy movements and street politics, informal groups at checkpoints and barricades, practices of self-defense, hunger strikes, transgressive enactments of solidarity and mourning, infrastructural mobilizations, and aesthetic and erotic interventions into public space that mobilize memory and expose forms of power. Pointing to possible strategies for a feminist politics of transversal engagements and suggesting a politics of bodily resistance that does not disavow forms of vulnerability, the contributors develop a new conception of embodiment and sociality within fields of contemporary power. -/- Contributors. Meltem Ahiska, Athena Athanasiou, Sarah Bracke, Judith Butler, Elsa Dorlin, Basak Ertür, Zeynep Gambetti, Rema Hammami, Marianne Hirsch, Elena Loizidou, Leticia Sabsay, Nükhet Sirman, Elena Tzelepis. (shrink)