Over the past few years, there has been a proliferation of artificial intelligence strategies, released by governments around the world, that seek to maximise the benefits of AI and minimise potential harms. This article provides a comparative analysis of the European Union and the United States’ AI strategies and considers the visions of a ‘Good AI Society’ that are forwarded in key policy documents and their opportunity costs, the extent to which the implementation of each vision is living up to (...) stated aims and the consequences that these differing visions of a ‘Good AI Society’ have for transatlantic cooperation. The article concludes by comparing the ethical desirability of each vision and identifies areas where the EU, and especially the US, need to improve in order to achieve ethical outcomes and deepen cooperation. (shrink)

As China and the United States strive to be the primary global leader in AI, their visions are coming into conflict. This is frequently painted as a fundamental clash of civilisations, with evidence based primarily around each country’s current political system and present geopolitical tensions. However, such a narrow view claims to extrapolate into the future from an analysis of a momentary situation, ignoring a wealth of historical factors that influence each country’s prevailing philosophy of technology and thus their overarching (...) AI strategies. In this article, we build a philosophy-of-technology-grounded framework to analyse what differences in Chinese and American AI policies exist and, on a fundamental level, why they exist. We support this with Natural Language Processing methods to provide an evidentiary basis for our analysis of policy differences. By looking at documents from three different American presidential administrations––Barack Obama, Donald Trump, and Joe Biden––as well as both national and local policy documents (many available only in Chinese) from China, we provide a thorough comparative analysis of policy differences. This article fills a gap in US–China AI policy comparison and constructs a framework for understanding the origin and trajectory of policy differences. By investigating what factors are informing each country’s philosophy of technology and thus their overall approach to AI policy, we argue that while significant obstacles to cooperation remain, there is room for dialogue and mutual growth. (shrink)

In recent years, policymakers, academics, and practitioners have increasingly called for the development of global governance mechanisms for artificial intelligence (AI). This paper considers the prospects for these calls in light of two other geopolitical trends: digital sovereignty and digital expansionism. While calls for global AI governance promote the surrender of some state sovereignty over AI, digital sovereignty and expansionism seek to secure greater state control over digital technologies. To demystify the tensions between these trends and their potential consequences, we (...) undertake a case analysis of digital sovereignty and digital expansionism in China, the European Union, and the United States. We argue that the extraterritoriality embedded in these three actors’ policies and escalatory competitive narratives, particularly those from the US, will likely undermine substantive global AI governance cooperation. However, nascent areas of alignment or compromise, notably in data governance and technical standards, could prove fruitful starting points for building trust in multilateral fora, such as the G20 or United Nations. (shrink)

The US is promoting a new vision of a “Good AI Society” through its recent AI Bill of Rights. This offers a promising vision of community-oriented equity unique amongst peer countries. However, it leaves the door open for potential rights violations. Furthermore, it may have some federal impact, but it is non-binding, and without concrete legislation, the private sector is likely to ignore it.

This commentary examines the challenges faced by metaverse platforms in cross-border content moderation, focusing on the implications for freedom of expression and nondiscrimination. It highlights the difficulties in determining what to remove for which users as well as how to do so, which has serious implications for freedom of expression and our shared sense of reality. Proto-metaverse platforms such as Roblox and Minecraft face similar questions, but have not yet encountered major cross-jurisdictional issues because, as looking at traditional social media (...) platforms reveals, content moderation is not merely a question of law and policy, but also of geopolitics and government priorities. To avoid a “lowest common denominator effect” where freedom of expression is infringed upon worldwide and discrimination is entrenched, this commentary argues that metaverse platforms must clarify their moderation policies, assess their entry into specific markets based on local laws and their own values, and be prepared to exit overly restrictive markets. (shrink)

The SARS-CoV-2 (COVID-19) pandemic has caused social and economic devastation. As the milestone of two years of ‘living with the virus’ approaches, governments and businesses are attempting to develop means of reopening society whilst still protecting public health. However, developing interventions – particularly technological interventions – that find a safe, socially acceptable, and ethically justifiable balance between these two seemingly opposing demands is extremely challenging. There is no one right solution, but the current most popular ‘solution’ is the so-called ‘COVID-19 (...) Vaccine Passport’ (also known as COVID-19 passes or certificates), the use of which may be supported by both human rights and international public health law if they are designed and implemented appropriately. (We use the term ‘Vaccine Passport’ because it has been adopted by the popular press. Though it has been used in many ways, here we use it generically to refer to a document that certifies that an individual has been vaccinated against COVID-19 and on that basis grants the bearer more liberties than to those who have not been vaccinated. Later, we will discuss why it is necessary to move beyond considering only vaccinations, which informs our preferred term of ‘COVID-19 Status Pass’.) We set out to answer the following questions: how should governments and businesses assess the risks in light of human rights, public health ethics, and digital ethics concerns which emerge from developing and deploying COVID-19 Vaccine Passports? What design decisions should businesses make when developing COVID-19 Vaccine Passports to help ensure they respect human rights, and both public health and digital ethics? Do the implications for human rights, public health, and digital ethics vary depending on where and when COVID-19 Vaccine Passports are used? What are the rights and powers of the individual to object to or seek remedy for the use of COVID-19 Vaccine Passports? How can the risks of inequalities and social division derived from the deployment of COVID-19 Vaccine Passports be avoided or mitigated? We conducted a literature review and documentary analysis, supplementing our findings with news articles where appropriate. The following pages report our results, concluding with a series of actionable recommendations for businesses, national governments, and supranational organisations. (shrink)

Background: Nurses encounter complex ethical dilemmas in everyday nursing care. It is important for nurses to have moral courage to act in these situations which threaten patients’ safety or their good care. However, there is lack of research of moral courage. Purpose: This study describes nurses’ experiences of care situations demanding moral courage and their actions in these situations. Method: A qualitative descriptive research design was applied. The data were collected with an open-ended question in the questionnaire used in validation (...) of the Nurses’ Moral Courage Scale. The sample consisted of 286 nurses from four different clinical fields in a major university hospital in Finland, providing a total of 611 answers. Data were analyzed using inductive content analysis. Ethical considerations: The study followed the commonly recognized principles of good scientific practice. The use of data was authorized by the developer of the instrument, the data collector, and the participating hospital. Ethical approval was obtained from the university ethics committee. Findings: Nurses acted morally courageously in most situations but sometimes they failed to do so. Although situations demanding moral courage varied, they could be categorized into seven main domains relating to colleagues, physicians, patients, relatives, nurses themselves, managers, and organizations. Nurses acted in the situations in different ways. The main acts in solving the situations were verbal communication or immediate action, such as interrupting of action. Conclusion: Care situations demanding moral courage focus on good and safe patient care and the patient’s good is at the center of attention. The situations are mostly related to the activities of other healthcare professionals. Findings may be applied in developing ethical nursing care through basic and continuing nursing education. Research is needed on the moral courage of physicians and managers, as well as on patients’ and their relatives’ experiences of care situations demanding moral courage. (shrink)

La didáctica de las ciencias es cada vez más activa, por lo que una metodología ampliamente utilizada es el Aprendizaje Basado en Problemas (ABP). Este método implica la resolución de un problema, la que se recoge en un informe denominado Informe de resolución de problemas (IRP). Para los estudiantes esta tarea representa un gran desafío, ya que implica actuar y expresarse del modo en que lo harían los expertos en el área. Es debido a esta dificultad que se hace imprescindible (...) la orientación de los tutores a través de la retroalimentación. Existen distintos tipos y modos de retroalimentar, lo que generará un impacto en el desempeño de los estudiantes. Analizamos los comentarios evaluativos que entregan las especialistas a los estudiantes que elaboran un IRP, tanto en un borrador como en la versión final del escrito. A partir de la clasificación de comentarios escritos de Arancibia, Tapia-Ladino & Correa (2019), realizamos un análisis de los tipos y modos de comentarios evaluativos y cómo el objeto influencia el modo. Los resultados indican que, a la hora de retroalimentar, en el primer borrador las docentes centran su atención en la superficie más que en el contenido y el modo predominante es a través de órdenes. En la versión final, la retroalimentación se dirige más bien al contenido y las evaluaciones positivas y negativas aumentan. Se infiere que en la medida que los comentarios evaluativos promuevan la adecuación al género, los estudiantes se insertarán más fácilmente en la comunidad a la que han ingresado. (shrink)

This paper analyzes ethnographic and historical data to emphasize the importance of framing health as collective wellbeing. Exploring missionary medical campaigns during the colonial period in East Africa, I connect the institutional legacy of Euro-American Protestant missions on the contemporary frameworks of US global public health provisions at my research site, Mwana Mwema Program. At this network of faith-based, USAID clinics in Kenya that provide treatment for children living with HIV, practitioners care for the wider community within a global health (...) system that bases donor funding on epidemiological criteria. This narrow framing conflicts with practitioners’ notions of healing as collective wellbeing and can exacerbate communal divisions. I argue that Mwana Mwema’s notion of collective wellbeing offers a healthcare framework that faith-based providers can embrace. It yields more holistic care for entire communities and offers an opportunity for those of us in the United States to rethink our notions of health. (shrink)

This paper analyzes ethnographic and historical data to emphasize the importance of framing health as collective wellbeing. Exploring missionary medical campaigns during the colonial period in East Africa, I connect the institutional legacy of Euro-American Protestant missions on the contemporary frameworks of US global public health provisions at my research site, Mwana Mwema Program. At this network of faith-based, USAID clinics in Kenya that provide treatment for children living with HIV, practitioners care for the wider community within a global health (...) system that bases donor funding on epidemiological criteria. This narrow framing conflicts with practitioners’ notions of healing as collective wellbeing and can exacerbate communal divisions. I argue that Mwana Mwema’s notion of collective wellbeing offers a healthcare framework that faith-based providers can embrace. It yields more holistic care for entire communities and offers an opportunity for those of us in the United States to rethink our notions of health. (shrink)

This paper explores the continuing relevance of Karl Rahner’s work on development of doctrine to a church within a world marked by an emerging postmodern consciousness. It focuses primarily on three elements of development as Rahner understands it, theological discussion, the influence of the Spirit and the role of church authority. The discussion of a possible definition of Mary as co-redemptrix and the controversy over the ordination of women are cited as concrete examples of issues of development facing the church (...) today. Rahner’s increasing awareness of the context of irreducible plurality that marks the world-church of today and tomorrow led him to the increasing conviction in the later works that the Spirit is leading the church to a deepening understanding of the central mysteries of faith rather than to a further proliferation of defined dogmas. In the later works especially, he encouraged an attitude of open discussion that reflects the confidence that the Spirit is with the whole church as it struggles to express its faith in ever changing contexts. The paper concludes that Rahner’s understanding of the complex balance of elements involved in authentic doctrinal development continues to offer valuable insight to today’s discussions. (shrink)

A democratic premise is that expert influence should not extend into the political domain of environmental policymaking. This article analyses the relationship between experts and policymakers in the historical development of the National Flood Insurance Program as a flood governance strategy in the United States. The article draws three conclusions. First, while experts asserted great influence on the development of this policy program, underlying values were evaluated and judged by policymakers. Second, as socio-political values changed, new types of experts were (...) involved in the policymaking process. Third, these different types of experts had different implications for how value conflicts were addressed. (shrink)

This investigation develops in three steps. First, we seek to complexify the opioid crisis in a way that helps us to see how the issues of misguided desire and misplaced attachments are fundamentally important for a theological account of opioid addiction.1 Second, acknowledging the connections between pain and opioid addiction, we explore some of the ways in which our understanding of pain can influence our understanding of and responses to opioid use. Finally, we offer some tentative reflections on the theological (...) and ecclesial dimensions of the opioid crisis which hold the potential to influence the nature of a Christian response to the issues. Having laid out these steps, we argue for the church’s calling, where she complexifies the narratives about the opioid crisis and provides individuals suffering from opioid use “homeful” encounters with God and the community. (shrink)

The aim of this study was to explore the note-taking experiences of university students using paper-based and paperless resources. By means of a hermeneutic phenomenological approach, the note-taking experiences of 18 students from an international program at a university in Belgium were examined throughout a semester. In order to document these students’ practices with paper-based and paperless resources, four data collection methods were used: in-depth interviews observations focus group discussions and document analysis of students’ lecture notes. The results showed that (...) students experience note-taking as a complex phenomenon in which lived body, lived human relations, lived space and lived time come into play, and in which they try to find a balance between multiple engagements, between autonomy and authority, between attention and distraction, and between being original and mirroring others. This struggle for balance occurs irrespective of which medium they choose to use. These results provide an in-depth view of the phenomenon, and also highlight the complexity of the note-taking experience. (shrink)

A plethora of studies stress students’ self-regulated learning skills to be conditional for successful learning in school and beyond. In general, self-regulated learners are actively engaged in constructing their own understanding also including the regulation of contextual features in the environment. Within the contextual features, the regulation of peer interaction is necessary, because college courses increasingly require peer learning. This goes along with the increasing interest for online learning settings, due in no small part to the recent COVID-19 pandemic. In (...) the present study we explore how social presence, social space and sociability are essential elements in the regulation of online peer interaction. To shed light in this matter, higher education students were qualitatively followed for 1 year in an online academic writing course by using retrospective interviews and reflective questions. Additionally, for social presence, students’ perceptions were quantitatively measured with a validated questionnaire. The results show that the planning phase is the most important phase for supporting students’ social presence because that is where the regulation of peer interaction becomes important. The sociability has an important role here as well becoming less prominent further on in the self-regulation process. In the SRL follow-up phases, students look for other ways to increase their social presence and social space in order to shape the regulation of peer interaction from a position of trust. In the evaluation phase, students are aware of the importance of social presence but less of social space for the regulation of peer interaction. We conclude with some design principles to facilitate students’ regulation of peer interaction in online settings. (shrink)

In this book, Emmy van Deurzen addresses the taboo subject of the moral role of psychotherapists and counselors.

Lucius Annaeus Seneca was a Roman Stoic philosopher, dramatist, statesman, and advisor to the emperor Nero, all during the Silver Age of Latin literature. The Complete Works of Lucius Annaeus Seneca is a fresh and compelling series of new English-language translations of his works in eight accessible volumes. Edited by world-renowned classicists Elizabeth Asmis, Shadi Bartsch, and Martha C. Nussbaum, this engaging collection helps restore Seneca—whose works have been highly praised by modern authors from Desiderius Erasmus to Ralph Waldo Emerson—to (...) his rightful place among the classical writers most widely studied in the humanities. _Hardship and Happiness_ collects a range of essays intended to instruct, from consolations—works that offer comfort to someone who has suffered a personal loss—to pieces on how to achieve happiness or tranquility in the face of a difficult world. Expertly translated, the essays will be read and used by undergraduate philosophy students and experienced scholars alike. (shrink)

Donald Russell, Emeritus Professor of Classical Literature at the University of Oxford, has been a leading figure in several fields of classical scholarship over the last few decades. The present volume collects essays written in his honour by scholars who have all worked closely with him. They fall into three sections, corresponding to Donald Russell's main work: Latin literature, Greek imperial literature, and ancient literary criticism. They are unified by two of Russell's own pervasive concerns: ethics, the concern of classical (...) literature with moral conduct, and rhetoric, the techniques of effective persuasion. (shrink)

The heme‐containing cytochromes P‐450 are a ubiquitous family of monooxygenase isozymes responsible for the oxidative metabolism of a wide variety of endogenous as well as exogenous compounds. Many of the compounds metabolized by this enzyme system are effectively detoxified and converted to derivatives more easily eliminated from the organism. However, some compounds can be activated to reactive species capable of eliciting a cascade of toxic lesions, including cancer. Since its discovery nearly 30 years ago, the cytochrome P‐450 enzyme system has (...) received a great deal of attention, particularly in the areas of their mechanisms of metabolism, range of substrate specificity, the purification and characterization of the multiple isozymes and, more recently, the regulation of expression of specific forms. This review will discuss current notions concerning the expression of at least one cytochrome P‐450 isozyme and future directions that should lead to a more complete understanding of cytochrome P‐450 gene expression in general, particularly as it impacts upon biochemical pharmacology. (shrink)

Karl Rahner was one of the most significant theological voices of the twentieth century. For many his theology has come to symbolise the Catholic Church's entry into modernity. Part of his enduring appeal lies in his ability to reflect on a whole variety of issues in theology and spirituality and concentrate this plurality into a few basic convictions. This Cambridge Companion provides an accessible introduction to the main themes of Rahner's work. Written by an international array of experts, it will (...) be of interest to both students and scholars alike. Each chapter serves as a guide to its topic and recommends further reading for additional study. The contributors also assess Rahner's significance for contemporary theology by bringing his thought into dialogue with many current concerns including: religious pluralism, spirituality, postmodernism, ecumenism, ethics and developments in political and feminist theologies. (shrink)

Perceived quality of experience for speech listening is influenced by cognitive processing and can affect a listener's comprehension, engagement and responsiveness. Quality of Experience is a paradigm used within the media technology community to assess media quality by linking quantifiable media parameters to perceived quality. The established QoE framework provides a general definition of QoE, categories of possible quality influencing factors, and an identified QoE formation pathway. These assist researchers to implement experiments and to evaluate perceived quality for any applications. (...) The QoE formation pathways in the current framework do not attempt to capture cognitive effort effects and the standard experimental assessments of QoE minimize the influence from cognitive processes. The impact of cognitive processes and how they can be captured within the QoE framework have not been systematically studied by the QoE research community. This article reviews research from the fields of audiology and cognitive science regarding how cognitive processes influence the quality of listening experience. The cognitive listening mechanism theories are compared with the QoE formation mechanism in terms of the quality contributing factors, experience formation pathways, and measures for experience. The review prompts a proposal to integrate mechanisms from audiology and cognitive science into the existing QoE framework in order to properly account for cognitive load in speech listening. The article concludes with a discussion regarding how an extended framework could facilitate measurement of QoE in broader and more realistic application scenarios where cognitive effort is a material consideration. (shrink)

It has been argued that Thomson's defense of abortion, if successful, implies that abortion is permissible only until the point of viability. After that point, if one wanted to end a pregnancy, one must do so by birthing the fetus through induction or cesarean. In this paper, I argue that Thomson's defense of abortion does, in fact, imply that abortion after the point of viability is sometimes permissible. To show this, I point out that the process of birthing a fetus (...) makes use of the body of the pregnant person in significant ways. Indeed, the body of the pregnant person is as much a part of this process as it is a part of the process of carrying a fetus during pregnancy. Thus, just as it is sometimes morally permissible to choose to have an abortion rather than continue a pregnancy, it is sometimes morally permissible to choose to have an abortion rather than undergo an induction or cesarean. Those who support Thomson's defense of abortion, then, have reason not to support the view that induction or cesarean are the only permissible procedures for ending an unwanted pregnancy with a viable fetus. I then use this discussion to suggest that autonomy rights are more complicated than initially thought. Given the extent to which the body is involved in detaching the fetus, it is not merely that one has a right to detach a fetus, but also a right to actualize one's reasonable preferences over the method of detachment. (shrink)

Corporate social responsibility (CSR) has become an increasingly significant managerial concept, yet the manager as an agent of corporate bureaucracy has been substantially missing from both the analytical and conceptual literature dealing with CSR. This article, which is both interpretative in nature and specific in reference to the U.K. cultural context, represents an attempt at addressing this lacuna by utilising qualitative data to explore the perceptions of managers working in corporations with developed CSR programmes. Exploring managerial perceptions of motives for (...) CSR initiatives, methods of stakeholder engagement, organisational integration of CSR and its impact on managerial work, this study concludes that an instrumental approach dominates, which indicates an external-internal organisational paradox in the design and execution of CSR initiatives. (shrink)

It has now become a realistic prospect for smart care to be provided at home for those living with long-term conditions such as dementia. In the contemporary smart care scenario, homes are fitted with an array of sensors for remote monitoring providing data that feed into intelligent systems developed to highlight concerning patterns of behaviour or physiological measurements and to alert healthcare professionals to the need for action. This paper explores some ethical issues that may arise within such smart care (...) systems, focusing on the extent to which ethical issues can be addressed at the system design stage. Artificial intelligence has been widely portrayed as an ethically risky technology, posing challenges for privacy and human autonomy and with the potential to introduce and exacerbate bias and inequality. While broad principles for ethical artificial intelligence have become established, the mechanisms for governing ethical artificial intelligence are still evolving. In healthcare settings the implementation of smart technologies falls within the existing frameworks for ethical review and governance. Feeding into this ethical review there are many practical steps that designers can take to build ethical considerations into the technology. After exploring the pre-emptive steps that can be taken in design and governance to provide for an ethical smart care system, the paper reviews the potential for further ethical challenges to arise within the everyday implementation of smart care systems in the context of dementia, despite the best efforts of all concerned to pre-empt them. The paper concludes with an exploration of the dilemmas that may thus face healthcare professionals involved in implementing this kind of smart care and with a call for further research to explore ethical dimensions of smart care both in terms of general principles and lived experience. (shrink)

This article contains an implicit comparison of the institutions and thought of the Italian city republics in the period from about 1150 to 1350 with medieval and early-modern monarchies and oligarchical republics, the latter being exemplified here by a passage from Bartolo of Sassoferrato. The grammarians, notaries, and jurists treated here are representative of the secular or lay professionalism that first emerged on a large scale in these republics. To these have been added occasional clerks who show the influence of (...) these legal and secular traditions, including Ptolemy of Lucca , whose On Princely Government continued a work by the far more famous Dominican Thomas Aquinas and hence enjoyed wide circulation and great influence. His work shows evidence of the influence of the translation of Aristotle's Politics done c. 1260; the only other author treated here who absorbed part of that tradition is the civilian jurist Bartolo of Sassoferrato. Most of the lawyers and other professionals derived their ideas from Roman law and, to a lesser extent, from Seneca and even Cicero. Readers may be surprised to observe that Marsiglio of Padua, surely Italy's premier political thinker, is not seen here at all or, rather, only once mentioned in passing. A reason for this is that he is much discussed in today's scholarly literature of political theory. A main intention of this author, however, has to do with him. It is to help explain the world he came from. If exaggerated, A. J. Carlyle's observation remains sound. Marsiglio, he said, “is not … setting out some new and revolutionary democratic doctrine, but is rather expressing, even if in rather drastic and unqualified terms, the normal judgement and practice of the [Italian] Middle Ages. (shrink)

There has been considerable debate around the ethical issues raised by data-driven technologies such as artificial intelligence. Ethical principles for the field have focused on the need to ensure...

Journal of Social Philosophy, EarlyView.

The paper draws its inspiration from the provocation which Merton offered sociology both to engage with empirical data and to perform analyses adequate to guide intervention beyond the particular case. Whilst contemporary STS is very different both in its models of theory and its forms of methodology, this paper suggests Merton's concerns with engagement and adequacy provide a useful way to interrogate current approaches. Specifically, the paper explores some recent anthropological conceptions of ethnographic fieldwork that have provided potent models for (...) the study of scientific and technological cultures. These multi-sited approaches have also provided the opportunity to develop new notions of intervention and explore alternative ways of making contributions to development of theory and practice. In the process of pursuing the goals of engagement and adequacy notions of ethnography have however become stretched. This sense of detachment from methodological canons accentuates the need for methodological debate and skill-sharing in STS. (shrink)

This article addresses the issue of moral compunction among a sample of senior managers set against the background of their routine organizational participation. In considering what factors influence their moral sensibilities these managers were interviewed using an approach designed to elicit their perceptions concerning both the ethical and commercially imperative dimensions of their working lives. The qualitative data resulting from this inquiry, while tentative, indicates the primacy of the normative appeal of shareholder value, conditioned by the exigencies of engagement in (...) corporate bureaucracies, including the maintenance of career and livelihood responsibilities. These conclusions indicate the magnitude of the obstacle that the normative business ethics project requires to overcome in order to fulfil its promise. (shrink)

This article addresses the issue of moral compunction among a sample of senior managers set against the background of their routine organizational participation. In considering what factors influence their moral sensibilities these managers were interviewed using an approach designed to elicit their perceptions concerning both the ethical and commercially imperative dimensions of their working lives. The qualitative data resulting from this inquiry, while tentative, indicates the primacy of the normative appeal of shareholder value, conditioned by the exigencies of engagement in (...) corporate bureaucracies, including the maintenance of career and livelihood responsibilities. These conclusions indicate the magnitude of the obstacle that the normative business ethics project requires to overcome in order to fulfil its promise. (shrink)

BackgroundInvolvement of adolescent girls in biomedical HIV research is essential to better understand efficacy and safety of new prevention interventions in this key population at high risk of HIV infection. However, there are many ethical issues to consider prior to engaging them in pivotal biomedical research. In Uganda, 16–17-year-old adolescents can access sexual and reproductive health services including for HIV or other sexually transmitted infections, contraception, and antenatal care without parental consent. In contrast, participation in HIV prevention research involving investigational (...) new drugs requires adolescents to have parental or guardian consent. Thus, privacy and confidentiality concerns may deter adolescent participation. We describe community perspectives on ethical considerations for involving adolescent girls in the MTN 034 study in Uganda.MethodsFrom August 2017 to March 2018, we held five stakeholder engagement meetings in preparation for the MTN 034 study in Kampala, Uganda (NCT03593655): two with 140 community representatives, two with 125 adolescents, and one with 50 adolescents and parents. Discussions were moderated by the study team. Proceedings were documented by notetakers. Summary notes described community perspectives of adolescent participation in HIV research including convergent, divergent or minority views, challenges, and proposed solutions.ResultsMost community members perceived parental or guardian consent as a principal barrier to study participation due to concerns about adolescent disclosure of pre-marital sex, which is a cultural taboo. Of 125 adolescent participants, 119 (95%) feared inadvertent disclosure of sexual activity to their parents. Community stakeholders identified the following critical considerations for ethical involvement of adolescents in HIV biomedical research: (1) involving key stakeholders in recruitment, (2) ensuring confidentiality of sensitive information about adolescent sexual activity, (3) informing adolescents about information to be disclosed to parents or guardians, (4) offering youth friendly services by appropriately trained staff, and (5) partnering with community youth organizations to maximize recruitment and retention.ConclusionsStakeholder engagement with diverse community representatives prior to conducting adolescent HIV prevention research is critical to collectively shaping the research agenda, successfully recruiting and retaining adolescents in HIV clinical trials and identifying practical strategies to ensure high ethical standards during trial implementation. (shrink)

Is our experience of the world 'rich' or 'thin'? In other words, are we aware of unattended sensory stimuli, or are the contents of our consciousness constrained by what we attend to? A recent, ingenious, attempt to address this issue offers us a seemingly unavailable, 'moderate' option; our experience is somewhere between the two. But before we make our minds up about this conclusion, we should see that it resulted from conflating two ways of construing the relevant concepts. I claim (...) that, one way of reading 'rich' vs. 'thin', echoes the psychologists' distinction between 'early' vs. 'late' accounts of selective attention, and I argue that 'perceptual load theory', a recent response to this empirical issue, offers us a satisfying solution to our philosophical problem. Ultimately, we are only aware of what we attend to, so we can conclude that our experience of the world is philosophically 'thin'. Nonetheless, the second way of reading 'rich' vs. 'thin' relates to the range of sensory stimuli that we can be aware of. I claim that this range depends upon the attentional load that our sensory systems are placed under. The 'moderate' position, then, merely marks out one possible degree of sensory awareness on a continuum that runs from 'rich' to 'thin'. (shrink)

A. The Problem: Since A. Gercke's fundamental work, there has been no complete reappraisal of the manuscript tradition of the Natural Questions, yet a reappraisal is long overdue. Gercke divided the manuscripts into two branches, Δ and Φ but this division has been seriously undermined from two quarters. First, H. W. Garrod questioned the status which Gercke assigned to Δ, arguing, quite rightly, that in every case where Δ has the truth against Φ, Δ's reading can reasonably be attributed to (...) conjecture, which is known to be rife in Δ Certainly nothing is proved about Δ's integrity by the passages which Gercke adduced, such as the following :3. (shrink)

The four principles approach to bioethics, an approach most associated with the work of Tom Beauchamp and James Childress, is supposed to provide a framework for reasoning through moral issues in medicine. One might wonder, if one were to guide one’s thinking by the method suggested by principlism, will one identify and perform the objectively morally right action? Will one’s decision making be justified, and consequently, will the action that flows from that decision itself be justified? In this paper, I (...) show that principlism can, and has been, characterized in these two different ways. I also argue that when it is understood according to the first characterization, the view cannot be put into practice. However, when it is understood as an account of justification, there is reason to think that it is indeed action-guiding. Given the problems that confront the first version of the view, perhaps it is best to understand principlism, and biomedical ethical theories generally, not as action-guiding theories of right action, but rather, as procedures by which one’s decisions and actions in medicine can achieve a reasonable degree of moral justification. (shrink)