The institutional model as delineated by classical Public Administration has limited utility for public administration in the developing countries. There are unlikely to be any uniform structural remedies foradministrative defects in those countries. Similar relationships do not have similar consequences in different contexts. An increased awareness along these lines led to the emergence of Development Administration- an effort to relate structures to goals - and Comparative Public Administration - analysis of administrative structures in their own societal contexts. The basic argument (...) of the present articles is that despite our increased sophistication on these matters the relevance in Development Administration cannot be obtained if one relies only on theoretical knowledge. It is noted that in Development Administration thinking must descend from the heights of systematic theory to the open country of praxis. (shrink)

Joyce Avrech Berkman interprets Edith Stein’s autobiography as time and space bound, yet arrestingly transgressive. She probes the origins, nature, and afterlife of Stein’s work, which sheds light on Stein’s response to Nazi antisemitism and the roots of her key philosophical and spiritual concerns.

Background: Patients today interact with physicians, physician groups, and health plans, each of which may follow distinct ethical guidelines.Method: We systematically compared physician codes of ethics with ethics policies at physician group practices and health plans, using the 1998–99 policies of 38 organisations—18 medical associations , nine physician group practices , and 12 health plans —selected using random and stratified purposive sampling. A clinician and a social scientist independently abstracted each document, using a 397-item health care ethics taxonomy; a reconciled (...) abstraction form was used for analysis. This study focuses on ethics policies regarding professional obligation towards patients, resource allocation, and care for the vulnerable in society.Results: A majority in all three groups mention “fiduciary obligations” of one sort or another, but associations generally address physician/patient relations but not health plan obligations, while plans rarely endorse physicians’ obligations of advocacy, beneficence, and non-maleficence. Except for occasional mentions of cost effectiveness or efficiency, ethical considerations in resource allocation rarely arise in the ethics policies of all three organisational types. Very few associations, groups, or plans specifically endorse obligations to vulnerable populations.Conclusions: With some important exceptions, we found that the ethics policies of associations, groups, and plans are narrowly focused and often ignore important ethical concerns for society, such as resource allocation and care for vulnerable populations. More collaborative work is needed to build integrated sets of ethical standards that address the aims and responsibilities of the major stakeholders in health care delivery. (shrink)

The recent Common Rule revision process took almost a decade and the resulting changes are fairly modest, particularly when compared to the ambitious ideas proposed in the advance notice of proposed rulemaking and notice of proposed rulemaking. Furthermore, the revision process did not even attempt to tackle any of the Common Rule subparts pertaining to vulnerable populations where commentators think the rules unduly restrict important research. We believe that this was a missed opportunity to make desirable changes, and that given (...) the usual process the next opportunity to revisit the Common Rule is unacceptably remote. In this article, we argue that the Common Rule should be regularly reassessed, with a mechanism for making substantive changes. Drawing on lessons learned from the recent revision process, we make recommendations about ways to structure future attempts to maximize the ability to make timely and necessary changes. (shrink)

Medical malpractice has attracted the attention of people and the media all over the world. In Turkey, malpractice cases are tried according to both criminal and civil law. Nurses and midwives in Turkey fulfill important duties in the distribution of health services. The aim of this study was to reveal the legal procedures followed in malpractice allegations and malpractice lawsuits in which nurses and midwives were named as defendants. We reviewed 59 nursing and midwifery lawsuits reported to the Higher Health (...) Council between 1993 and 1998. Health professionals were held liable in 59% of the lawsuits. Midwives had the highest percentage of malpractice liability (52%), followed by physicians (29%) and nurses (19%). To reduce potential liability, nurse education should be improved, a nursing malpractice law should be enacted, and instructions for nursing procedures should be formulated. (shrink)

Much new global genetic research employs whole genome sequencing, which provides researchers with large amounts of data. The quantity of data has led to the generation and discovery of more incidental or secondary findings and to vigorous theoretical discussions about the ethical obligations that follow from these incidental findings. After a decade of debate in the genetic research community, there is a growing consensus that researchers should, at the very least, offer to return incidental findings that provide high‐impact, medically relevant (...) information, when it is not unduly burdensome to the research enterprise to do so. Much as genetic research has been limited to U.S. and European settings, the incidental findings debate has primarily focused on research conducted in high‐income countries. In a 2015 paper, Alberto Ortiz‐Osorno, Linda Ehler, and Judith Brooks note salient differences between the circumstances of research participants in low‐ and high‐resource settings that alter the analysis of when and why incidental findings should be offered to research participants. In this article, we expand on their analysis and present a framework for thinking about how investigators’ obligations to return genomic data might change in low‐resource settings, particularly in settings where participants do not have access to the medical care needed to treat, assess, or monitor incidental findings that are actionable in settings with plentiful resources. (shrink)

Despite their strong transnational links and support in the second half of the 1990s, Turkish NGOs have not yet had a “tremendous” impact on domestic political and social change. But new points of contact have been established in the public sphere between governmental agencies and the IHV and IHD, with both sides engaged in an argumentative process, which may, in the long run, lead to the subscriptive phase of “human rights talk” and deed. The general tenor of this essay may (...) lend itself to suggesting two prerequisites for establishing such a sustainable human rights regime in this geography: the first is “capacity building”, the other is grounding this regime in an accurate perception of the structures of power, domestic and international, so as to “integrate” the human rights bundle into all aspects of life, at all levels, within all traditions and institutions by empowering the community into the language of human rights. Most of all, integration of human rights into a liberal democratic order requires coming to terms with the past.Capacity building can be defined in different terms: in the words of Mary Robinson, the UN High Commissioner for Human Rights, it is “facing-up to the bullies.” It is a cliché that the legalistic entrenchment of human rights is sufficient guarantee against their violation. It is almost unrealistic to expect a system to volunteer to set up a human rights regime that will limit and cripple the power it wields. So, what to do? Mary Robinson suggests a “national plan,” as, opposed to fragmented political notions, building a sustainable model with strong bricks and mortar. As Robinson notes, “even where there are plans, plans without effective strategies for implementation are empty vessels.” We could add more: in contexts like Turkey where “special circumstances” provide the pretext for legitimating an anti-human rights discourse, Mary Robinson's national plan's chances of success depend on building a strong survival capacity for any civilian government that works to bring, itself, the urban middle classes, civil society and the military into the realities embedded in human rights. (shrink)

Prenatal genetic testing is becoming available for an increasingly broad set of diseases, and it is only a matter of time before parents can choose to test for hundreds, if not thousands, of genetic conditions in their fetuses. Should access to certain kinds of fetal genetic information be limited, and if so, on what basis? We evaluate a range of considerations including reproductive autonomy, parental rights, disability rights, and the rights and interests of the fetus as a potential future child. (...) We conclude that parents should be able to access information that could be useful during pregnancy, but that testing for non-medical information should be limited. Next, we argue that the government lacks a compelling state interest in regulating prenatal genetic testing and propose that regulation should occur through medical professional organizations. Finally, we present a framework for determining what testing physicians should recommend, offer neutrally, or not offer at all. (shrink)

Respect for patient autonomy has served as the dominant ethical principle of genetic counselling, but as we move into a genomic era, it is time to actively re-examine the role that this principle plays in genetic counselling practice. In this paper, we argue that the field of genetic counselling should move away from its emphasis on patient autonomy and toward the incorporation of a more balanced set of principles that allows counsellors to offer clear guidance about how best to obtain (...) or use genetic information. We begin with a brief history of how respect for patient autonomy gained such emphasis in the field and how it has taken on various manifestations over time, including the problematic concept of nondirectiveness. After acknowledging the field's preliminary move away from nondirectiveness, we turn to a series of arguments about why the continued dominance of patient autonomy has become untenable given the arrival of the genomic era. To conclude, we describe how a more complete set of bioethical principles can be adapted and used by genetic counsellors to strengthen their practice without undermining patient autonomy. (shrink)

Bu makalede Marmara Denizi’nin Kuzeybatısında yer alan Rodosçuk/Tekirdağ kazasında yaşayan halkın beslenme kültürü ele alınmıştır. Hangi ürünlerin yaygın olarak tüketildiğini belirlemek için başvurulan temel kaynak narh defterleridir. Bilindiği üzere narh, mal ve hizmet fiyatlarının esnaf örgütlerinin görüşü alınarak devlet tarafından belirlenen üst sınırını ifade etmektedir. Piyasada bulunan malların listelerini barındırdığı için ayrı bir önem taşıyan narh defterleri ilgili kazaya ait şer’iyye sicillerinde yer almaktadır. 1638-1730 yıllarına ait narh listelerinde bulunan ürünler türlerine göre sınıflandırılarak başlıklar halinde değerlendirilmiştir. Bu araştırmada ayrıca narh (...) defterlerine yansıdığı kadarıyla Rodosçuk piyasasında bulunan yiyecek maddelerinin çeşitliliği, yakınlığı nedeniyle özellikle İstanbul’da ve Saray’da tüketilen ürünlerle karşılaştırılarak zaman içinde meydan gelen değişimler belirlenmiş ve incelenen dönemin başından sonuna kadar önemli bir dönüşümün yaşanmadığı ortaya çıkmıştır. Varılan sonuçlardan bir diğeri de Amerikan menşeli yiyeceklerin henüz Rodosçuk’ta sahneye çıkmamış olmasıdır. (shrink)

This paper attempts to account for the contrastive discourse connective (tam) tersine (‘on the contrary’) in Turkish discourse. We suggest that this connective evokes a discourse structure which has at least three parts: the material in the prior linguistic context, its refutation, and then rectification in the clause where the connective is hosted. Since negation is obligatory in the discourse context for refutation, we include a discussion of negation and we conclude that the obligatory negative clauses are instances of descriptive (...) negation rather than metalinguistic negation. We show that linguistic and cognitive contexts interact in producing and interpreting the discourse adverbial connective under discussion and the discourse structure in which it is used. It is claimed that (tam) tersine serves to bring closer the cognitive context of the intended audience to that of the writer’s while minimizing any potential discrepancies in the audience’s and the writer’s cognitive context. We argue that this discourse connective and the discourse it evokes are used in the argumentative mode. (shrink)

Different types of consent are used to obtain human biospecimens for future research. This variation has resulted in confusion regarding what research is permitted, inadvertent constraints on future research, and research proceeding without consent. The National Institutes of Health Clinical Center's Department of Bioethics held a workshop to consider the ethical acceptability of addressing these concerns by using broad consent for future research on stored biospecimens. Multiple bioethics scholars, who have written on these issues, discussed the reasons for consent, the (...) range of consent strategies, and gaps in our understanding, and concluded with a proposal for broad initial consent coupled with oversight and, when feasible, ongoing provision of information to donors. This article describes areas of agreement and areas that need more research and dialogue. Given recent proposed changes to the Common Rule, and new guidance regarding storing and sharing data and samples, this is an important and tim.. (shrink)

Shavelson et al. (2023) identify an important problem in their Target article: a significant number of terminally ill patients with impaired motor function are wrongfully excluded from receiving ai...

There is a growing trend of refusal of blood transfusions from COVID-19 vaccinated donors. We highlight three cases where parents have refused blood transfusions from COVID-19 vaccinated donors on behalf of their children in the setting of congenital cardiac surgery. These families have also requested accommodations such as explicit identification of blood from COVID-19 vaccinated donors, directed donation from a COVID-19 unvaccinated family member, or use of a non-standard blood supplier. We address the ethical challenges posed by these issues. We (...) describe the current screening and safety processes for standard blood donation and explore the importance of donor anonymity and challenges with directed donation and non-standard blood suppliers. We present an ethical framework using the Best Interest Standard, the Zone of Parental Discretion, and the Harm Principle when considering these refusals. Finally, we provide recommendations for how to approach these requests as they potentially become more commonplace in pediatrics. (shrink)

The article argues the thesis that institutions have a prima facie obligation to fund the feedback of individual findings in genomic research conducted on the African continent by drawing arguments from an underexplored Afro-communitarian view of distributive justice and rights of researchers to be aided. Whilst some studies have explored how institutions have a duty to support return as a form of ancillary care or additional foreseeable service in research by mostly appealing to dominant principles and theories in the Global (...) North, this mostly normative study explores this question by appealing to underexplored African philosophy. This is a new way of thinking about institutional responsibility to fund feedback and responds to the call to decolonise health research in Africa. Further studies are required to study how this prima facie obligation will interact with social contexts and an institution’s extant relationships to find an actual duty. The research community should also work out procedures, policies and governance structures to facilitate feedback. In our opinion, though the impacts of feeding back can inform how institutions think about their actual duty, these do not obliterate the binding duty to fund feedback. (shrink)

L’enjeu de ce recueil est de contribuer à repenser la notion de limite, en l’envisageant sous les différentes figures, philosophiques, écologiques, politiques, que lui confère notre présent. Comme le montrent, sous des modalités diverses, les contributions de ce collectif, la limite peut et doit être conçue en dehors des valeurs négatives – borne, restriction ou frontière –, qui en affaiblissent la portée. Elle peut alors être pensée sur le fond de cet illimité où s’ouvre la question même du dehors. Si (...) la finitude demeure la condition de l’existence, de l’art et de la pensée, assumer notre condition finie ne consiste donc pas à se murer dans le connu, mais bien à en transgresser les bornes, et ce faisant, à s’illimiter. Au plus loin de la fermeture des frontières que prônent certaines politiques, ou de la certitude dogmatique dans laquelle certains cherchent à réassurer leur pensée, la limite ne vit que de son rapport fécond à l’illimité. Interrogeant l’existence, la politique, l’art – autant dire, la pensée même –, les textes de ce recueil mettent au jour un certain don de l’illimité. (shrink)

Research studies increasingly use genomic sequencing to draw inferences based on comparisons between the genetic data of a set of purportedly related individuals. As use of this method progresses, it will become much more common to discover that the assumed biological relationships between the individuals are mistaken. Consequently, researchers will have to grapple with decisions about whether to return incidental findings of misattributed parentage on a much larger scale than ever before. In this paper we provide an extended argument for (...) the view that the default position for researchers ought to be the non-disclosure of misattributed parentage. (shrink)

Many authors have taken up the challenge of formulating physicalism as a supervenience thesis. These endeavors have met with varying response, but it seems that the general consensus still remains that a supervenience thesis that is both sufficient and necessary for physicalism has yet to be developed. Terence Horgan1 and Jaegwon Kim2 have most famously argued that supervenience theses are not sufficiently strong for physicalism. Nonetheless, several recent articles suggest that there are philosophers who still hold out hope for some (...) type of supervenience of the mental upon the physical being, if not both sufficient and necessary, at least necessary for physicalism.3 In this paper, I will 1) investigate some of the motivation for finding a supervenience thesis that characterizes physicalism, 2) briefly review the types of supervenience theses that have been proposed as necessary (or necessary and sufficient) for physicalism, and 3) investigate in some detail the recent supervenience thesis proposed by Frank Jackson and expounded upon by Gene Witmer. Jackson, in his recent book, claims to have a supervenience thesis that is both necessary and sufficient for physicalism. (shrink)

The rapid growth of next-generation genetic sequencing has prompted debate about the responsibilities of researchers toward genetic incidental findings. Assuming there is a duty to disclose significant incidental findings, might there be an obligation for researchers to actively look for these findings? We present an ethical framework for analyzing whether there is a positive duty to look for genetic incidental findings. Using the ancillary care framework as a guide, we identify three main criteria that must be present to give rise (...) to an obligation to look: high benefit to participants, lack of alternative access for participants, and reasonable burden on researchers. Our analysis indicates that there is no obligation to look for incidental findings today, but during the ongoing translation of genomic analysis from research to clinical care, this obligation may arise. (shrink)

The risk and crisis communication process in public health emergencies (PHERCC, public health emergency risk and crisis communication) matrix, as proposed by Spitale, Germani, and Biller-Andorno (2...

Hundreds of millions of rare biospecimens are stored in laboratories and biobanks around the world. Often, the researchers who possess these specimens do not plan to use them, while other researchers limit the scope of their work because they cannot acquire biospecimens that meet their needs. This situation raises an important and underexplored question: how should scientists allocate biospecimens that they do not intend to use? We argue that allocators should aim to maximise the social value of the research enterprise (...) when allocating scarce biospecimens. We provide an ethical framework for assessing the social value of proposed research projects and describe how the framework could be implemented. (shrink)

The aim of the present study is to evaluate Sonja Foss’s Rhetorical Schema for the Evaluation of Visual Imagery as well as reflect upon several points for further consideration; and finally suggest a renewed triadic approach as a method for analyzing art-relevant visual imagery. The triadic approach to be discussed assumes three correlative layers: the intellectual knowledge, function of the artistic content as the visual representational component, and aesthetics as modality. This study will include the analysis of a print advertisement (...) that used an artwork as its content of visual rhetoric, and this will inform further discussions on the proposed approach. The contribution of this renewed triadic approached to the field of visual rhetoric has the advantage of expanding and possibly improving rhetorical analysis methods of visual imagery. (shrink)

In this volume twenty-three major scholars comment on and critically evaluate In Search of a Universal Ethic, the 2009 document written by the International Theological Commission (ITC) of the Catholic Church. That historic document represents an official Church contribution both to a more adequate understanding of a universal ethic and to Catholicism s own tradition of reflection on natural law. The essays in this book reflect the ITC document s complementary emphases of dialogue across traditions (universal ethic) and reflection on (...) broadly applicable ethical guidance within the Christian tradition (natural law). Among other things, the document situates the natural law ethical tradition within the larger search for a universal ethic. Along with its insightful essays, Searching for a Universal Ethic offers — for the first time in published form — the Vatican s official English translation of In Search of a Universal Ethic. Contributors: John Berkman Serge-Thomas Bonino, O.P. David Burrell, C.S.C. Lisa Sowle Cahill Joseph E. Capizzi David Cloutier Anver M. Emon Robert P. George Sherif Girgis Jennifer A. Herdt Russell Hittinger M. Cathleen Kaveny Anthony J. Kelly, C.Ss.R. Fergus Kerr, O.P. Steven A. Long William C. Mattison III Gilbert Meilaender Livio Melina Michael S. Northcott David Novak Jean Porter Martin Rhonheimer Tracey Rowland. (shrink)

We agree with Berger and Miller that the focus on cultural competence in medical education fails to name or confront key drivers of health inequity such as structural racism, social determin...