In developing their policy on paediatric medical assistance in dying (MAID), DeMichelis, Shaul and Rapoport decide to treat euthanasia and physician-assisted suicide as ethically and practically equivalent to other end-of-life interventions, particularly palliative sedation and withdrawal of care (WOC). We highlight several flaws in the authors’ reasoning. Their argument depends on too cursory a dismissal of intention, which remains fundamental to medical ethics and law. Furthermore, they have not fairly presented the ethical analyses justifying other end-of-life decisions, analyses and decisions (...) that were generally accepted long before MAID was legal or considered ethical. Forgetting or misunderstanding the analyses would naturally lead one to think MAID and other end-of-life decisions are morally equivalent. Yet as we recall these well-developed analyses, it becomes clear that approving of some forms of sedation and WOC does not commit one to MAID. Paediatric patients and their families can rationally and coherently reject MAID while choosing palliative care and WOC. Finally, the authors do not substantiate their claim that MAID is like palliative care in that it alleviates suffering. It is thus unreasonable to use this supposition as a warrant for their proposed policy. (shrink)

Authorship transgressions, duplicate data reporting and reporting/data errors compromise the integrity of biomedical publications. Using a standardized template, we raised concerns with journals about each of these characteristics in 33 pairs of publications originating from 15 preclinical trials reported by a group of researchers. The outcomes of interest were journal responses, including time to acknowledgement of concerns, time to decision, content of decision letter, and disposition of publications at 1 year. Authorship transgressions affected 27/36 publications. The median proportion of duplicate (...) data within pairs of publications was 45%. Data/reporting discrepancies [median 3 ] were present in 28/33 pairs. Journals acknowledged receipt of concerns for 53% and 94% of publications by 1 month and 9 months, respectively. After 1 year, journals had communicated decisions for 16/36 publications. None of the decision letters specifically addressed each of the concerns raised. Decisions were no action, correction and retraction for 9, 3 and 4 publications, respectively: the amounts of duplicate data reporting and data/reporting discrepancies were similar irrespective of journal decision. Authorship transgressions affected 6/9 publications for which no action was decided. Journal responses to concerns about duplicate publication, authorship transgressions, and data/reporting discrepancies were slow, opaque and inconsistent. (shrink)

Dynamic intra-individual variability (IIV) in cardiac vagal control across multiple situations is believed to contribute to adaptive cognition under stress; however, a dearth of research has empirically tested this notion. To this end, we examined 25 U.S. Army Soldiers (all male, Mean Age= 30.73, SD = 7.71) whose high-frequency heart rate variability (HF-HRV) was measured during a resting baseline and during three conditions of a shooting task (training, low stress, high stress). Response inhibition was measured as the correct rejection of (...) friendly targets during the low and high stress conditions. We tested the association between the standard deviation of HF-HRV across all four task conditions (IIV in vagal control) and changes in response inhibition between low and high stress. Greater differences in vagal control between conditions (larger IIV) were associated with higher tonic vagal control during rest, and stronger stress-related decreases in response inhibition. These results suggest that flexibility in vagal control is supported by tonic vagal control, but this flexibility also uniquely relates to adaptive cognition under stress. Findings are consistent with neurobehavioral and dynamical systems theories of vagal function. (shrink)

Performance measurement has far-reaching implications for not-for-profit organizations because it serves to legitimize, attract resources, and preserve expectations of stakeholders. However, the existing theory and practice of not-for-profit performance measurement have fallen short, due in part, to an overuse of profit-oriented philosophies. Therefore, we examine not-for-profit performance measurement by utilizing Marques’ “five spiritual practices of Buddhism.” Marques’ spiritual practices—a pro-scientific philosophy, greater personal responsibility, healthy detachment, collaboration, and embracing a wholesome view—are the foundation of our research design. Responses from senior (...) not-for-profit practitioners support the linkages between spiritual practices and not-for-profit performance measurement. We identify three essential performance measurement principles and elaborate on their capacity to generate awareness, higher meaning, and connectedness within not-for-profits. (shrink)

Business Ethics, the Environment & Responsibility, Volume 31, Issue 2, Page 589-600, April 2022.

This paper documents a quantitative study into socially responsible principles and practices adopted in registered clubs in New South Wales Australia to manage one of their social impacts – problem gambling. The survey utilised an adapted version of Aupperle''s (1982) corporate social responsibility instrument to measure the priority given to economic, legal, ethical and discretionary principles in club machine gambling operations. The survey also assessed support for certain management practices in responsible gambling. The results indicate (...) that the participating club managers prioritise economic, legal, ethical and discretionary principles respectively, and that these are statistically related to practices they have implemented and support in responsible gambling. The managers most favoured secondary harm minimisation practices, followed by reactive primary intervention. Less favoured were proactive primary intervention and discretionary practices. These principles and practices contrast markedly with those advocated by key stakeholder groups, as expressed in semi-structured interviews and submissions to the NSW Gaming Inquiry. Non-industry stakeholders favoured a more balanced set of principles and a more holistic set of management practices in responsible gambling. The results also provide validation of Aupperle''s (1982) instrument when applied to corporate management of a single social impact and for Carroll''s (1979, 1991) construct of corporate social responsibility. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Convention for Protection of Human Rights and Dignity of the Human Being with Regard to the Application of Biology and Biomedicine: Convention on Human Rights and BiomedicineCouncil of EuropePreambleThe Member States of the Council of Europe, the other States and the European Community signatories hereto,Bearing in mind the Universal Declaration of Human Rights proclaimed by the General Assembly of the United Nations on 10 December 1948;Bearing in mind the (...) Convention for the Protection of Human Rights and Fundamental Freedoms of 4 November 1950;Bearing in mind the European Social Charter of 18 October 1961;Bearing in mind the International Covenant on Civil and Political Rights and the International Covenant on Economic, Social and Cultural Rights of 16 December 1966;Bearing in mind the Convention for the Protection of Individuals with Regard to Automatic Processing of Personal Data of 28 January 1981;Bearing also in mind the Convention on the Rights of the Child of 20 November 1989;Considering that the aim of the Council of Europe is the achievement of a greater unity between its members and that one of the methods by which that aim is to be pursued is the maintenance and further realisation of human rights and fundamental freedoms;Conscious of the accelerating developments in biology and medicine;Convinced of the need to respect the human being both as an individual and as a member of the human species and recognising the importance of ensuring the dignity of the human being; [End Page 277]Conscious that the misuse of biology and medicine may lead to acts endangering human dignity;Affirming that progress in biology and medicine should be used for the benefit of present and future generations;Stressing the need for international co-operation so that all humanity may enjoy the benefits of biology and medicine;Recognising the importance of promoting a public debate on the questions posed by the application of biology and medicine and the responses to be given thereto;Wishing to remind all members of society of their rights and responsibilities;Taking account of the work of the Parliamentary Assembly in this field, including Recommendation 1160 (1991) on the preparation of a Convention on bioethics;Resolving to take such measures as are necessary to safeguard human dignity and the fundamental rights and freedoms of the individual with regard to the application of biology and medicine;Have agreed as follows:Chapter IGeneral provisionsArticle 1. (Purpose and object)Parties to this Convention shall protect the dignity and identity of all human beings and guarantee everyone, without discrimination, respect for their integrity and other rights and fundamental freedoms with regard to the application of biology and medicine.Each Party shall take in its internal law the necessary measures to give effect to the provisions of this Convention.Article 2. (Primacy of the human being)The interests and welfare of the human being shall prevail over the sole interest of society or science.Article 3. (Equitable access to health care)Parties, taking into account health needs and available resources, shall take appropriate measures with a view to providing, within their jurisdiction, equitable access to health care of appropriate quality. [End Page 278]Article 4. (Professional standards)Any intervention in the health field, including research, must be carried out in accordance with relevant professional obligations and standards.Chapter IIConsentArticle 5. (General rule)An intervention in the health field may only be carried out after the person concerned has given free and informed consent to it.This person shall beforehand be given appropriate information as to the purpose and nature of the intervention as well as on its consequences and risks.The person concerned may freely withdraw consent at any time.Article 6. (Protection of persons not able to consent)1. Subject to Articles 17 and 20 below, an intervention may only be carried out on a person who does not have the capacity to consent, for his or her direct benefit.2. Where, according to law, a minor does not have the capacity to consent to an intervention, the intervention may only be carried out with the authorisation of his or her representative or an authority or a person or... (shrink)

This paper discusses the post-trial access to drugs for patients who participated in clinical trials in Brazil. The ethical guidance for clinical trials in Brazil is arguably one of the clearest in the world in attributing to research sponsors the responsibility for providing post-trial drugs to patients who participated in their experiments. The Federal Constitution recognizes health as a fundamental right to be fulfilled by the State. Based on the Brazilian constitution and on the National Health Council resolutions, courts have (...) been accepting patients' claims and ordering the State and the pharmaceutical companies to provide these patients with the tested treatment in the quantity and duration they need it. This generous interpretation of the duties of the pharmaceutical companies and the State makes the Brazilian model for post-trial access unique when compared to the experience of other countries and thus should be followed with attention by future research in order to assess its consequences for patients, research sponsors, and the public health system. (shrink)

This paper discusses so-called post-trial access to drugs for patients who participated in clinical trials in Brazil. Brazil is currently a relevant country for the pharmaceutical industry due to the dimensions of its actual and potential market. As a consequence, the number of pharmaceutical trials has been rising. It is the largest market for pharmaceutical companies in Latin America, the 8th biggest in the world and second only to China among the so-called BRICS’s emerging countries. The demand for pharmaceutical products (...) in the country has been increasing by double digits over the last few years, reaching 20% in 2008. Not surprisingly, we are also witnessing a steady increase in the number of applications by national and international pharmaceutical companies before ethical research authorities for authorization to perform clinical trials of drugs. (shrink)

The need for continuing provision of beneficial experimental interventions after research is concluded remains a controversial topic in bioethics for research. Based on the principle of beneficence, justice as reciprocity, concerns about exploitation and fair benefits, participants should be able to have continuing access to benefits beyond the research period. However, there is no consensus about whether or not post-trial provision of beneficial interventions should be mandatory for participants from developing countries. This paper summarises recommendations from international and (...) national guidelines. Ethical principles and practical issues relating to post-trial provision are also discussed. In conclusion, post-trial provision is not necessary in all situations and a set of criteria are proposed to identify the situations that beneficial interventions should be provided beyond the research period. However, mandatory post-trial supply of beneficial experimental interventions should be assured for those who still need and are able to benefit from them but have no alternative access. Mandatory provision is based on universal bioethical principles such as beneficence and justice. Furthermore, difficulties associated with implementation of post-trial provision are not unmanageable. Careful advanced planning and a comprehensive partnership among relevant parties would be very helpful in solving these difficulties in practice, which therefore should not be taken as an excuse to escape post-trial responsibility. (shrink)

Background: This article describes the types of community‐wide benefits provided by investigators conducting public health research in South Asia as well as their self‐reported reasons for providing such benefits.Methods: We conducted 52 in‐depth interviews to explore how public health investigators in low‐resource settings make decisions about the delivery of ancillary care to research subjects. In 39 of the interviews respondents described providing benefits to members of the community in which they conducted their study. We returned to our narrative dataset to (...) find answers to two questions: What types of community‐wide benefits do researchers provide when conducting public health intervention studies in the community setting, and what reasons do researchers give when asked why they provided community‐wide benefits?Findings: The types of community‐wide benefits delivered were directed to the health and well‐being of the population. The most common types of benefits delivered were the facilitation of access to health care for individuals in acute medical need and emergency response to natural disasters. Respondents' self‐reported reasons when asked why they provided such benefits fell into 2 general categories: intrinsic importance and instrumental importance. (shrink)

Background: This article describes the types of community-wide benefits provided by investigators conducting public health research in South Asia as well as their self-reported reasons for providing such benefits. Methods: We conducted 52 in-depth interviews to explore how public health investigators in low-resource settings make decisions about the delivery of ancillary care to research subjects. In 39 of the interviews respondents described providing benefits to members of the community in which they conducted their study. We returned to our narrative dataset (...) to find answers to two questions: What types of community-wide benefits do researchers provide when conducting public health intervention studies in the community setting, and what reasons do researchers give when asked why they provided community-wide benefits? Findings: The types of community-wide benefits delivered were directed to the health and well-being of the population. The most common types of benefits delivered were the facilitation of access to health care for individuals in acute medical need and emergency response to natural disasters. Respondents' self-reported reasons when asked why they provided such benefits fell into 2 general categories: intrinsic importance and instrumental importance. (shrink)

Time-limited trials of intensive care have arisen in response to the increasing demand for intensive care treatment for patients with a low chance of surviving their critical illness, and the clinical uncertainty inherent in intensive care decision-making. Intensive care treatment is reported by most patients to be a significantly unpleasant experience. Therefore, patients who do not survive intensive care treatment are exposed to a negative dying experience. Time-limited trials of intensive care treatment in patients with a low chance of surviving (...) have both a small chance of benefiting this patient group and a high chance of harming them by depriving them of a good death. A ‘rule of rescue’ for the critically unwell does not justify time-limiting a trial of intensive care treatment and overlooks the experiential costs that intensive care patients face. Offering time-limited trials of intensive care to all patients, regardless of their chance of survival, overlooks the responsibility of resource-limited intensive care clinicians for suffering caused by their actions. A patient-specific risk–benefit analysis is vital when deciding whether to offer intensive care treatment, to ensure that time-limited trials of intensive care are not undertaken for patients who have a much higher chance of being harmed, rather than benefited by the treatment. The virtue ethics concept of human flourishing has the potential to offer additional ethical guidance to resource-limited clinicians facing these complex decisions, involving the balancing of a quantifiable survival benefit against the qualitative suffering that intensive care treatment may cause. (shrink)

In light of the observations and research design presented in the previous reports, the current technical report is focused on the relationship between the quality and specificity of the content of the gambling sites and the site’s SEO and marketing policy. This relationship is dependent upon the category of the gambling site and the difference in content quality, and the degree to which the mathematical dimension of gambling is reflected in this content is explained by this dependence.

The current technical report presents the partial results of the quantitative analysis of the research project, after the review of 247 gambling websites. It is focused on and discusses the usage of the math terms specific to gambling in the reviewed sample. In particular, the fifth technical report discusses the usage of math terms associated with the game of slots, as found in the reviewed sample.

This study delves into the intricate world of tipping, examining how restaurant chefs and chef-owners account for and morally justify this practice. While previous research has paved the way for understanding several of the nuances of tipping in the dining experience, little attention has been given to chefs’ perspectives on its moral dimensions. In today’s evolving restaurant dining landscape, tipping practices have become increasingly contentious. Therefore, it is imperative to grasp the ethical intricacies of tipping experiences, as they hold significant (...) implications for social and economic interactions. This study focuses on interviews with culinary artisans—the masterminds behind the dining experience, including executive chefs, chef-owners, sous chefs, chefs de cuisine, private chefs, and pop-up chefs. Through these conversations, we explore the moral justifications for tipping, unintended consequences that arise, and the advent of tip coercion. Our findings shed light on the moral reasoning and ethical dynamics behind tipping practices. These findings offer a foundation for shaping theoretical frameworks, informing practical solutions, and guiding policy decisions in this complex realm. (shrink)

Although long touted as an ethical and legal requirement, some clinicians still seem to offer less than fully adequate informed consent processes; similarly the counseling of patients and families, particularly about post-intervention scenarios, is often perfunctory at best. Keyed to a narrative of a patient's experience with surgery for a deviated septum, this article reflects on why such less than adequate clinician behaviors tend to occur and what might be done about them. Certain legal misconceptions about informed consent are highlighted (...) in this reflection, as well as why certain clinicians seem to take such a narrow view of their responsibilities to patients. Further reference in this regard is also made to a recently constructed module on informed consent for medical residents. In it, though legal requirements for informed consent are reviewed, the basic perspective taken regards informed consent as a clinical intervention that pursues certain basic goods and values, only one of which lies in determining when legal closure for such processes has occurred. (shrink)

Philosophical and sociological approaches in technology have increasingly shifted toward describing AI (artificial intelligence) systems as ‘(moral) agents,’ while also attributing ‘agency’ to them. It is only in this way – so their principal argument goes – that the effects of technological components in a complex human-computer interaction can be understood sufficiently in phenomenological-descriptive and ethical-normative respects. By contrast, this article aims to demonstrate that an explanatory model only achieves a descriptively and normatively satisfactory result if the concepts of ‘(moral) (...) agent’ and ‘(moral) agency’ are exclusively related to human agents. Initially, the division between symbolic and sub-symbolic AI, the black box character of (deep) machine learning, and the complex relationship network in the provision and application of machine learning are outlined. Next, the ontological and action-theoretical basic assumptions of an ‘agency’ attribution regarding both the current teleology-naturalism debate and the explanatory model of actor network theory are examined. On this basis, the technical-philosophical approaches of Luciano Floridi, Deborah G. Johnson, and Peter-Paul Verbeek will all be critically discussed. Despite their different approaches, they tend to fully integrate computational behavior into their concept of ‘(moral) agency.’ By contrast, this essay recommends distinguishing conceptually between the different entities, causalities, and relationships in a human-computer interaction, arguing that this is the only way to do justice to both human responsibility and the moral significance and causality of computational behavior. (shrink)

New materialism is one of the most important emerging trends in the humanities and social sciences, but it is also one of the least understood. This is because, as a term of ongoing contest...

Practical implementation of notions such as patient-orientation, client-centredness, and demand-driven care is far from straightforward in care and service supply to elderly clients living independently. This paper aims to provide preliminary insights into how it is possible to bridge the gap between policy intent, which reflects an increasing client orientation, and actual practice of care and service provision. Differences in personal objectives and characteristics generate different sets of needs among elderly clients that must have an appropriate response in the (...) daily routines of care and service providers. From a study of the available literature and by conceptual reasoning, we identify several important operational implications of client-oriented care and service provision. To deal with these implications the authors turn to the field of operations management. This field has deepened the understanding of translating an organisation’s policy into daily activities and working methods. More specifically, we elaborate on the concept of modularity, which stems from the field of operations management. With respect to elderly people who live independently, this concept, among others, seems to be particularly useful in providing options and variation in individual care and service packages. Based on our line of reasoning, we propose that modularity provides possibilities to enhance the provision of demand-based care and services. Furthermore, our findings offer direction on how organisations in housing, welfare and care can be guided in translating demand-based care to their operational processes. (shrink)

A key question has been underexplored in the literature on conscientious objection: if a physician is required to perform ‘medical activities,’ what is a medical activity? This paper explores the question by employing a teleological evaluation of medicine and examining the analogy of military conscripts, commonly cited in the conscientious objection debate. It argues that physicians (and other healthcare professionals) can only be expected to perform and support medical acts – acts directed towards their patients’ health. That is, physicians cannot (...) be forced to provide or support services that are not medical in nature, even if such activities support other socially desirable pursuits. This does not necessarily mean that medical professionals cannot or should not provide non-medical services, but only that they are under no obligation to provide them. (shrink)

Hayek, one of the key thinkers of the twentieth century, has also been much misunderstood. His work has crossed disciplines—economics, philosophy, and political science—as well as national boundaries. He was an early critic of Keynes and became famous in the 1940s for his warnings that the advance of collectivism in Western democracies was the road to serfdom. He was a key figure in the post-war revival of free market liberalism and achieved renewed notoriety and some political influence in the 1970s (...) and 1980s as one of the chief intellectual inspirations for the New Right in Britain and the United States.This book traces Hayek’s intellectual formation in Austrian economics and English liberalism. It analyzes the main themes of his thought such as the idea of market order, the nature of knowledge, the limits of government, and his critiques of socialism and conservatism; assesses the originality and internal coherence of his account of liberalism and modernity; and explores as his interventions in policy debates. Gamble argues that Hayek the social scientist must be disentangled from Hayek the ideologue before you can appreciate the importance and implications of some of his insights into the nature of modern societies.An excellent critical guide to one of the most influential thinkers of our times, this book will be of interest to students in politics, economics, and philosophy, as well as to all those interested in a comprehensive introduction to one of the most controversial thinkers of the twentieth century. (shrink)

While there is a great deal to agree with in the essay Expanded Terminal Sedation in End-of-Life Care there is, we think, a need to more fully appreciate the humanistic side of both palliative and end-of-life care.1 Not only does the underlying philosophy of palliative care arguably differ from that which guides curative medicine,2 dying patients are in a uniquely vulnerable position given our cultural disinclination towards open discussions of death and dying. In this brief response, we critically engage Gilbertson (...) et al ’s essay and seek to contextualise the perspective they put forward. According to Cassell, we should distinguish between pain and suffering.3 The former often gives rise to the latter, but suffering has other causes. This includes existential distress, indicating that, unlike pain, suffering is not simply physiological phenomena. Suffering involves the disintegration of the person, meaning that it can impact patient autonomy. Certainly, that a patient is suffering does not equate to a lack autonomy. Nevertheless, we should take care when making decisions in circumstance where the integrity of our embodied personhood is under threat, something that is clearly the case for those who are dying, particularly those who have refractory symptoms while doing so. Generally speaking, refractory symptoms are those which are intractable. They persist despite attempts at palliation. While this implies that such symptoms—and the suffering they cause—cannot be reversed this is not necessarily the case. Not only can the symptoms experienced by dying patients change …. (shrink)

“Intervention” is not synonymous with “care.” For an intervention to constitute care—which patients should have a right to access—it must be technically feasible and licit. Now these criteria do not prove sufficient; numerous archaic interventions remain feasible and legally permissible, yet are now bywords for spurious care. Therefore, we propound another necessary condition for an intervention to become care: the physician must rationally judge the intervention to be conducive to the patient’s good. Consequently, the right of access-to-care relies on physicians (...) being free to practice medicine in accord with their consciences, conscience being the rational faculty with which they judge the reasonableness of even mundane medical decisions. Since physicians operate as part of a community, it is further necessary to consider when central bodies may reasonably compel physicians to engage in interventions that the physician believes are not consistent with the patient’s good and/or are not congruent with the purposes of medicine. (shrink)

Conscientious Objection has become a highly contested topic in the bioethics literature and public policy. However, when CO is discussed, it is almost universally referred to as a single entity. Reality reveals a more nuanced picture. Healthcare professionals may object to a given action on numerous grounds. They may oppose an action because of its ends, its means, or because of factors that lay outside of both ends and means. Our paper develops a taxonomy of CO, which makes it possible (...) to describe the refusals of healthcare professional with greater finesse. The application of this development will potentially allow for greater subtlety in public policy and academic discussions – some species of CO could be permitted while others could be prohibited. (shrink)

This paper introduces a new typology and associated measure of social and environmental mission integration by conceptually framing a feature of hybrid organizations—the degree of integration of their revenue model and social–environmental mission. The SEMI measure is illustrated using a hand-collected sample of 256 North American Certified B Corporations. We explore the heterogeneity of SEMI scores by identifying external-facing correlates and demonstrate non-congruence with Certified B Corporation’s audit results. Overall, our findings advance existing knowledge of these hybrid organizations and how (...) they balance their social–environmental missions with their economic objectives. (shrink)

Background Ethical reasoning and sensitivity are always important in public health, but it is especially important in the sensitive and complex area of public health emergency preparedness. Here, we explored the ethical challenges, and dilemmas encountered by frontline health workers amid the coronavirus disease-19 (COVID-19) pandemic in Ethiopia. Methods A nationwide survey was conducted amongst the frontline health workers from nineteen public hospitals. Health workers were invited to respond to a self-administered questionnaire. Data were weighted and analyzed using descriptive statistics. (...) Results Of the 285 frontline health workers to whom questionnaires were distributed, 217 of them gave their responses (response rate 76.1%). Respondents frequently reported encountering rationing dilemmas on health commodities directly used for the prevention and treatment of COVID-19. Most (83.9%) of the health workers agreed that they encountered ethical challenges very frequently or frequently. Almost all [215(99.1%)] claimed that the limitation of resources was directly used for the treatment and prevention of COVID-19. The frequency of difficulty in the provision of essential clinical services varied between 77% and 98.7% for different services. More than half of the study participants reported that they had encountered difficulty in the provision of clinical care on a daily or weekly basis. Regarding rationing strategies, isolating COVID-19 treatment units and limiting admission were the most frequent rationing strategies used by two-thirds of health workers on a daily or weekly basis. Conclusion Front-line health workers encountered numerous ethically challenging situations during COVID-19. More than half of health workers reported that they encountered ethical challenges in rationing the resources and delivery of different clinical services such as family planning services, maternal and childcare, immunization, and chronic care. With limited resources such as ventilators and hospital beds, healthcare providers have been faced with the difficult task of deciding who gets access to these resources and who doesn't. Overall, the COVID-19 pandemic has presented numerous ethical challenges for healthcare providers, highlighting the importance of ethical considerations in healthcare delivery. By being aware of these dilemmas and having policies in place to address them, healthcare providers can ensure that they are providing the best possible care to their patients while upholding ethical standards. (shrink)

In mid-2019, the controversy regarding South African runner Caster Semenya’s eligibility to participate in competitions against other female runners culminated in a Court of Arbitration for Sport judgement. Semenya possessed high endogenous testosterone levels (arguably a performance advantage), secondary to a disorder of sexual development. In this commentary, Aristotelean teleology is used to defend the existence of ‘male’ and ‘female’ as discrete categories. It is argued that once the athlete’s sex is established, they should be allowed to compete in the (...) category of their sex without obligatory medical treatment. Indeed, other athletes who possess advantageous genetic or phenotypic traits that fall outside of the human norm have been allowed to compete as humans without restraint. In both cases, if an athlete possesses the essential attributes of being a human or being male or female they should be permitted to compete in those respective categories; athletes’ eligibilities should not be based upon accidental attributes. (shrink)

Wischik presents an extensive reply to our paper on conscientious objection, which explores the implications of distinguishing ‘medical acts’ from ‘socioclinical acts’. He provides an extensive leg...

On the question of whether gambling behavior can be changed as result of teaching gamblers the mathematics of gambling, past studies have yielded contradictory results, and a clear conclusion has not yet been drawn. In this paper, I bring some criticisms to the empirical studies that tended to answer no to this hypothesis, regarding the sampling and laboratory testing, and I argue that an optimal mathematical scholastic intervention with the objective of preventing problem gambling is possible, by (...) providing the principles that would optimize the structure and content of the teaching module. Given the ethical aspects of the exposure of mathematical facts behind games of chance, and starting from the slots case – where the parametric design is missing, we have to draw a line between ethical and optional information with respect to the mathematical content provided by a scholastic intervention. Arguing for the role of mathematics in problem-gambling prevention and treatment, interdisciplinary research directions are drawn toward implementing an optimal mathematical module in cognitive therapies. (shrink)

Disorders of sexual differentiation lead to what is often referred to as an intersex state. This state has medical, as well as some legal, recognition. Nevertheless, the question remains whether intersex persons occupy a state in between maleness and femaleness or whether they are truly men or women. To answer this question, another important conundrum needs to be first solved: what defines sex? The answer seems rather simple to most people, yet when morphology does not coincide with haplotypes, and genetics (...) might not correlate with physiology the issue becomes more complex. This paper tackles both issues by establishing where the essence of sex is located and by superimposing that framework onto the issue of the intersex. This is achieved through giving due consideration to the biology of sexual development, as well as through the use of a teleological framework of the meaning of sex. Using a range of examples, the paper establishes that sex cannot be pinpointed to one biological variable but is rather d... (shrink)

When pandemics hit communities, women are bound to suffer as most of the responsibilities of ensuring food security lie on them. This article assesses the impact of the COVID-19 pandemic on the role that church-going women play in food provision. The qualitative study used interviews and focus group discussions to examine the toll of the pandemic-induced restrictions, especially with regard to their disruption of activities that ensure the provision of food for the family. They sought to identify how (...) an environment as restrictive as the one that was imposed during the COVID-19 pandemic affects those largely responsible for food provision in urban Marondera – the women, in this case. The focus was extended to factor in how disasters and pandemics affect women and detract from their normative food procurement and provision roles in marginal societies and how these effects can be mitigated to allow women to carry on with their roles even in restrictive environments. This research was motivated by the recent COVID-19-imposed regulations that restricted the movement of people, restrictions that have only recently been relaxed and (in some cases) removed. We also sought to establish how gender roles are played out, together with whether they are exacerbated by pandemics, and in what ways these pandemics result in higher workloads on women. By utilising the Africana womanist theory, the study analysed women roles in food provision and food security in their societies within the restrictive environments of the pandemics.Contribution: This study concluded that there are gender inequalities that are exacerbated by these pandemics that result in higher workloads for women. It foregrounded how existing gender inequalities were exacerbated by the pandemic, resulting in higher workloads on women. It therefore recommended that women should form empowerment groups to help focus attention on food provision to mitigate challenges women face in this role. Finally, we averred that there ought to be consultation and participation of women on issues to do with pandemics to allow for their full and productive participation in critical roles of providing food. (shrink)

In Development as Freedom Amartya Sen explains how in a world of unprecedented increase in overall opulence millions of people living in the Third World are still unfree. Even if they are not technically slaves, they are denied elementary freedoms and remain imprisoned in one way or another byeconomic poverty, social deprivation, political tyranny or cultural authoritarianism. The main purpose of development is to spread freedom and its 'thousand charms' to the unfree citizens. Freedom, Sen persuasively argues, is at once (...) the ultimate goal of social and economic arrangements and the most efficient means of realizing general welfare. Social institutions like markets, political parties, legislatures, the judiciary, and the media contribute to development by enhancingindividual freedom and are in turn sustained by social values. Values, institutions, development, and freedom are all closely interrelated, and Sen links them together in an elegant analytical framework. By asking 'What is the relation between our collective economic wealth and our individualability to live as we would like?' and by incorporating individual freedom as a social commitment into his analysis Sen allows economics once again, as it did in the time of Adam Smith, to address the social basis of individual well-being and freedom. (shrink)

Hayek's political theory is directed against coercion, which he defines as the intentional control of one person by another. The element of personal intention ensures a clear conceptual distinction between the freedom from coercion—i.e., the “liberty”—that is exercised in the private sphere, and the freedom of choice and opportunity that may be severely constrained by the impersonal, unintentional operation of market forces. Hayek's narrow definitions of coercion and liberty therefore suggest that he was more intent on defending the benefits conferred (...) on us by market forces than on affirming any value intrinsic in freedom—a suggestion confirmed by his lack of interest in species of freedom, such as autonomy, that might conceivably be fostered by state coercion. Hayek's consequentialist defense of liberty, however, was grounded in economic doctrines such as his own view that prices served a vital epistemic function. Given his strictures against the ignorance of modern electorates, Hayek was driven to propose extravagant limits on democracy and to embrace traditionalism; a different Hayekianism might limit inequalities of wealth and encourage the ability to learn from experimentation. (shrink)

In 2008 UK legislation was amended to enable the use of deferred consent for paediatric emergency care (EC) trials in recognition of the practical and ethical difficulties of obtaining prospective consent in an emergency situation. However, ambiguity about how to make deferred consent acceptable to parents, children and practitioners remains. In particular, little is known about practitioners’ views and experiences of seeking deferred consent in this setting.

Rebecca Skloot's The Immortal Life of Henrietta Lacks received renewed attention in August after the National Institutes for Health reached an agreement with the Lacks family over the use of the HeLa genome. The book details how researchers took cancerous cervical cells from a poor black woman, without even telling Lacks or her family, and how the cells evolved into the scientifically significant and commercially lucrative HeLa cell line while the family continued their hardscrabble existence after her 1951 death. I (...) am not a huge fan. How can I not love a book that has received stellar reviews and become mandatory reading at many colleges? One problem is that it views the history of African Americans in medicine and bioethics exclusively through the lens of exploitation, powerlessness, and victimization. (shrink)

This book explores the lived experiences of six African American female mentors working with African American female youth. Through philosophical and pedagogical lenses, Gamble-Lomax brings new understanding to African American female experiences and how they connect to today’s educational climate.

This book explores the lived experiences of six African American female mentors working with African American female youth. Through philosophical and pedagogical lenses, Gamble-Lomax brings new understanding to African American female experiences and how they connect to today’s educational climate.

Enriched with quotations borrowed from southern writers, a photographic celebration of small-town life draws on subjects from those areas of Alabama that have been bypassed by major highways and left somewhat deserted.