: Medical research is widely thought to have a fundamentally therapeutic orientation, in spite of the fact that clinical research is thought to be ethically distinct from medical care. We need an entirely new conception of clinical research ethics—one that looks to science instead of the doctor-patient relationship.

Medical research is widely thought to have a fundamentally therapeutic orientation, in spite of the fact that clinical research is thought to be ethically distinct from medical care. We need an entirely new conception of clinical research ethics—one that looks to science instead of the doctor‐patient relationship.

Medical ethics assumes a clear boundary between clinical research and clinical medicine: one produces knowledge for the benefit of future patients, while the other provides optimal care to individuals right now. It also assumes that the two cannot be integrated without sacrificing the needs of the current patient to those of future patients. But integration could allow us to provide better care to everyone, now and in the future.

Drawing the line on physician assistance in physician-assisted death continues to be a contentious issue in many legal jurisdictions across the USA, Canada and Europe. PAD is a medical practice that occurs when physicians either prescribe or administer lethal medication to their patients. As more legal jurisdictions establish PAD for at least some class of patients, the question of the proper scope of this practice has become pressing. This paper presents an argument for restricting PAD to the terminally ill that (...) can be accepted by defenders as well as critics of PAD for the terminally ill. The argument appeals to fairness-based paternalism and the social meaning of medical practice. These two considerations interact in various ways, as the paper explains. The right way to think about the social meaning of medical practice bears on fair paternalism as it relates to PAD and vice versa. The paper contends that these considerations have substantial force when directed against proposals to extend PAD to non-terminally ill patients, but considerably less force when directed against PAD for the terminally ill. The paper pays special attention to the case of non-terminally ill patients who suffer from treatment-resistant depression, as these patients present a potentially strong case for extending PAD beyond the terminally ill. (shrink)

In the midst of the recent Ebola outbreak, scientific developments involving infection challenge experiments on nonhuman primates (NHPs) sparked hope that successful treatments and vaccines may soon become available. Yet these studies pose a stark ethical quandary. On the one hand, they represent an important step in developing novel therapies and vaccines for Ebola and the Marburg virus, with the potential to save thousands of human lives and to protect whole communities from devastation; on the other hand, they intentionally expose (...) sophisticated animals to severe suffering and a high risk of death. Other studies that infect NHPs with a lethal disease in order to test interventions that may prove beneficial for humans pose the same ethical difficulty. Some advocates have argued that all research on primates should be phased out, and ethicists have questioned whether a moral justification of primate research is possible. A 2010 European Union directive banned virtually all research on great apes, and 2013 guidelines from the National Institutes of Health (NIH), based upon recommendations in an influential 2011 Institute of Medicine (IOM) report, eliminated most biomedical research with chimpanzees in the United States. But studies involving other NHPs face no comparable restrictions.Should research on NHPs other than great apes be subject to tighter restrictions than it currently is? In this article, we explore this general question in the context of one particular type of biomedical research: infection challenge studies. We advocate a presumptive prohibition on infection challenge experiments in NHPs, but we also argue that exceptions to this prohibition are permissible, subject to strict substantive and procedural safeguards, when necessary to avert substantial loss of human life or severe morbidity for a substantial number of people. (shrink)

In early March 2014, some of the members of Culture on the Edge—a scholarly research collaboration of seven scholars of religion, interested in more theoretically sophisticated studies of identity, and all of whom are at different career stages and at a variety of North American institutions—had a conversation online on the use of the terms “critique” and “critical,” terms widely used in the field today but employed in such a variety of ways that the members of the group thought it (...) worthwhile to focus some attention on them. What follows is the transcript of their conversation. (shrink)

Statues also die -- Open letter to the enemy : Jean Genet, war, and the exact measure of man -- Mayhem : symbolic violence and the culture of the death drive -- War, word, worst : reading Samuel Beckett's worstward ho -- Translation of a system in deconstruction : Derrida and the war of language against itself.

Since publication of the 1986 Carnegie Commission report, A Nation Prepared: Teachers for the 21st Century, the professional teaching standards movement has gained noticeable momentum. The professional standards movement in teaching has been fueled by national organizations such as the National Council for Accreditation of Teacher Education, the Interstate New Teachers Assessment and Support Consortium, the National Board for Professional Teaching Standards, the National Commission on Teaching and America's Future, and by close collaboration among these four entities. Further, nearly all (...) of the fifty states are embracing the professional standards movement through formal participation in the work of one or more of these organizations. Although the professional standards movement in teaching is strong and growing stronger, its implications are not clear for instructional programs in social foundations of education, either at the teacher preparation or the advanced graduate levels. In response to the standards movement, social foundations educators have a number of options before them, three of which are to (1) largely ignore these developments, as "this too shall pass"; (2) critically interpret and resist these developments through scholarship and collective professional action, as social foundations scholars did with Competency Based Teacher Education in the 1970s; and (3) critically interpret these developments while working to strengthen the potential of the professional teaching standards movement to achieve its stated goal of providing caring and qualified teachers for every classroom in the nation. Of these three options, the last is most advisable, but it presents a considerable challenge to social foundations educators. Although the absence of social foundations skills, perspectives, and understanding should make it very difficult for teacher candidates and teachers to perform well on standards-based teaching assessments, there is no guarantee that these assessments will hold candidates accountable for social foundations learning. Implications for social foundations educators and activists are significant. (shrink)

In this paper, we argue that deliberative democrats have too narrow a conception of the political, but that 'activism' as it is normally understood is not sufficiently broad, either. Politics is not reducible to coercion and contestation, but rather to the constitution of our shared world. We contend that active citizenship more often takes the form of working in a rape crisis center or a domestic violence clinic than participating in marches or town meetings.

The use of brain imaging technology as a common tool of research has spawned concern and debate over how investigators should respond to incidental fndings discovered in the course of research. In this article, we argue that investigators have an obligation to respond to incidental fndings in view of their entering into a professional relationship with research participants in which they are granted privileged access to private information with potential relevance to participants' health. We discuss the scope and limits of (...) this professional obligation to respond to incidental fndings, bearing in mind that the relationship between investigators and research participants differs fundamentally from the doctor-patient relationship. (shrink)

Using data from 1,352 middle-school Israeli adolescents, the current study examines the interface of spirituality and character strengths and its longitudinal contribution to subjective well-being and prosociality. Participants were approached three times over a 14-months period and completed measures of character strengths, spirituality, subjective well-being (positive emotions, life satisfaction), and prosociality. Findings revealed a fourth-factor structure of character strengths that included the typical tripartite classification of intrapersonal, interpersonal, and intellectual strengths together with spirituality emerging as a statistically autonomous factor. Spirituality (...) was stable over time and contributed to higher subjective well-being and prosociality both cross-sectionally and longitudinally. Discussion focuses on spirituality as a fundamental character strength and an important aspect of positive development. (shrink)

The scientific, ethical, and policy issues raised by research involving the engraftment of human neural stem cells into the brains of nonhuman primates are explored by an interdisciplinary working group in this Policy Forum. The authors consider the possibility that this research might alter the cognitive capacities of recipient great apes and monkeys, with potential significance for their moral status.

Critics of evolutionary psychology and sociobiology have advanced an adaptationists-as-right-wing-conspirators (ARC) hypothesis, suggesting that adaptationists use their research to support a right-wing political agenda. We report the first quantitative test of the ARC hypothesis based on an online survey of political and scientific attitudes among 168 US psychology Ph.D. students, 31 of whom self-identified as adaptationists and 137 others who identified with another non-adaptationist meta-theory. Results indicate that adaptationists are much less politically conservative than typical US citizens and no more (...) politically conservative than non-adaptationist graduate students. Also, contrary to the “adaptationists-as-pseudo-scientists” stereotype, adaptationists endorse more rigorous, progressive, quantitative scientific methods in the study of human behavior than non-adaptationists. (shrink)

We argued last year in this journal that extensive integration of research and care is a worthy goal of health system design, and we second the call from Ruth Faden and colleagues to move toward learning health care systems. As they recognize, learning health care systems demand the coordination of research and medical ethics—two sets of normative commitments that have long been considered distinct. In offering a novel ethics framework for such systems, Faden et al. advance the scholarly debate about (...) how best to do this and challenge us to think more deeply about its practical implications. However, we believe that at least three issues they raise require additional attention. First, the research‐care distinction has more normative bite than they are willing to concede. Second, the role for independent oversight requires clarification. Finally, they neglect the concept of stewardship as a guiding obligation of learning health care systems. (shrink)

We argued last year in this journal that extensive integration of research and care is a worthy goal of health system design, and we second the call from Ruth Faden and colleagues to move toward learning health care systems. As they recognize, learning health care systems demand the coordination of research and medical ethics—two sets of normative commitments that have long been considered distinct. In offering a novel ethics framework for such systems, Faden et al. advance the scholarly debate about (...) how best to do this and challenge us to think more deeply about its practical implications. However, we believe that at least three issues they raise require additional attention. First, the research‐care distinction has more normative bite than they are willing to concede. Second, the role for independent oversight requires clarification. Finally, they neglect the concept of stewardship as a guiding obligation of learning health care systems. (shrink)

Cover -- Title -- Copyright -- Contents -- List of Abbreviations -- Introduction: 'We': The Dangerous Thing -- 1 The Sellarsian Ethical Framework -- 2 Josiah Royce's Philosophy of Loyalty -- 3 Richard Rorty's Quasi-Sellarsian We -- 4 On the Prospects of Redescribing Rorty Roycely -- Bibliography -- Index.

Ethical concerns have been raised about the quality of informed consent by participants in phase 1 oncology trials. Interview surveys indicate that substantial proportions of trial participants do not understand the purpose of these trials—evaluating toxicity and dosing for subsequent efficacy studies—and overestimate the prospect of therapeutic benefit that they offer. In this article we argue that although these data suggest the desirability of enhancing the process of information disclosure and assessment of comprehension of the implications of study participation, they (...) do not necessarily invalidate consent by phase 1 trial participants. (shrink)

A twenty‐person working group convened to discuss the ethical and policy considerations of the controversial intervention called “growth attenuation,” and if possible to develop practical guidance for health professionals. A consensus proved elusive, but most of the members did reach a compromise.

A twenty‐person working group convened to discuss the ethical and policy considerations of the controversial intervention called “growth attenuation,” and if possible to develop practical guidance for health professionals. A consensus proved elusive, but most of the members did reach a compromise.

Despite the importance of extrapair copulation (EPC) in human evolution, almost nothing is known about the design features of EPC detection mechanisms. We tested for sex differences in EPC inference-making mechanisms in a sample of 203 young couples. Men made more accurate inferences (φmen = 0.66, φwomen = 0.46), and the ratio of positive errors to negative errors was higher for men than for women (1.22 vs. 0.18). Since some may have been reluctant to admit EPC behavior, we modeled how (...) underreporting could have influenced these results. These analyses indicated that it would take highly sex-differentiated levels of underreporting by subjects with trusting partners for there to be no real sex difference. Further analyses indicated that men may be less willing to harbor unresolved suspicions about their partners’ EPC behavior, which may explain the sex difference in accuracy. Finally, we estimated that women underreported their own EPC behavior (10%) more than men (0%). (shrink)

: The "therapeutic misconception," described by Paul Appelbaum and colleagues more than 20 years ago, refers to the tendency of participants in clinical trials to confuse the design and conduct of research with personalized medical care. Although the "therapeutic misconception" has become a term of art in research ethics, little systematic attention has been devoted to the ethical significance of this phenomenon. This article examines critically the way in which Appelbaum and colleagues formulate what is at stake in the therapeutic (...) misconception, paying particular attention to assumptions and implications that clinical trial participation disadvantages research participants as compared with receiving standard medical care. After clarifying the ethical significance of the therapeutic misconception with respect to the decision making of patients, we offer policy recommendations for obtaining informed consent to participation in clinical trials. (shrink)

Due to the impact of biomedical technologies on human wellbeing, biomedical engineering presents discipline-specific ethical issues that can have global, economic, environmental, and societal consequences. Because ethics instruction is a component of accredited undergraduate engineering programs in the US, we developed an ethics assignment that provided biomedical engineering students with a framework for ethical decision-making and challenged them to critically reflect on ethical issues related to contemporary medical devices. Thematic analysis performed on student reflections (n = 73) addressed two research (...) questions: (i) _what_ considerations do biomedical engineering undergraduates describe when asked to critically reflect on ethical issues related to contemporary medical devices; and (ii) _how_ do students describe their participation in bioethical discussions? Students described design, economic factors, and empathy most frequently as considerations. Further, students reported confidence in their ability to engage in ethical discussion upon assignment completion. Overall, our analysis builds understanding of student attitudes and engagement to help inform future ethics curriculum development. (shrink)

The surge in genetic research and technology, fuelled in large part by the Human Genome Project, has resulted in the continuing expansion of the range of genetic tests and other genetic information available to physicians, insurance companies, employers, and the general public.’ Genetic tests can provide presymptomatic medical information about an individual, including information about an individual's increased risk of future disease, disability, or early death. These tests can reveal information about an individual's carrier status, that is, the likelihood of (...) parents passing on to their children a genetic condition, and about the health of the individual's family members. Although genetic information provides the promise of early detection and treatment of certain illnesses and disorders, it also poses risks. As a result of the increase in genetic testing and information, legal issues regarding employment discrimination on the basis of genetic information are emerging. (shrink)

The surge in genetic research and technology, fuelled in large part by the Human Genome Project, has resulted in the continuing expansion of the range of genetic tests and other genetic information available to physicians, insurance companies, employers, and the general public.’ Genetic tests can provide presymptomatic medical information about an individual, including information about an individual's increased risk of future disease, disability, or early death. These tests can reveal information about an individual's carrier status, that is, the likelihood of (...) parents passing on to their children a genetic condition, and about the health of the individual's family members. Although genetic information provides the promise of early detection and treatment of certain illnesses and disorders, it also poses risks. As a result of the increase in genetic testing and information, legal issues regarding employment discrimination on the basis of genetic information are emerging. (shrink)

Richard Rorty’s writings have long frustrated scholars of classical American philosophy. Robert Brandom’s recent engagements with the history of pragmatism have been met with similar disdain. This essay draws on Larry A. Hickman’s theory of technology and tool-use to find a productive framework for thinking through these interpretations. Foregrounding the purposes that guide their readings, we may find value where many readers have seen only ignorance. This strategy does not embrace interpretive relativism, nor does it preclude all scholarly criticism, but (...) it instead promises a living and engaged approach to working with the history of philosophy. (shrink)

The purpose of this article is to examine the applicability of the theory of projection for Anthropological hypotheses. The claim is made that Goodman's classic statement of the problem does not apply in its entirety to actual Anthropological hypotheses. The recent Freeman-Mead debate is employed as a framework for the discussion, illustrating that the issue of projectibility, while central for the social sciences, is best used as a backdrop to illustrate several important methodological problems. For Anthropology, and other related social (...) sciences, the central methodological problem, which is directly related to the projectibility one, is the development and justification of evidence-rules that can be used for a theory of confirmation. A preliminary attempt is then made to articulate the nature of these rules within the general Hempelian framework of qualitative confirmation. (shrink)

Arthur Miller is one of the most important and enduring playwrights of the last fifty years. This new edition of The Theater Essays has been expanded by nearly fifty percent to include his most significant articles and interviews since the book's initial publication in 1978. Within these pages Miller discusses the roots of modern drama, the nature of tragedy, and the state of contemporary theater; offers illuminating observations on Ibsen, Strindberg, Chekhov, O'Neill, and Williams; probes the different approaches (...) and attitudes toward theater in Russia, China, and at home; and, of course, provides valuable insights into his own vast dramatic corpus. For this edition the literary chronology and cast and production information have been updated, and an extensive new bibliography has been added. The Theater Essays confirms Arthur Miller's standing as a brilliant, eloquent commentator on drama and culture. No one interested in theater should be without this definitive collection. (shrink)

Objective: Caloric vestibular stimulation has traditionally been used as a tool for neurological diagnosis. More recently, however, it has been applied to a range of phenomena within the cognitive neurosciences. Here, we provide an overview of such studies and review our work using CVS to investigate the neural mechanisms of a visual phenomenon - binocular rivalry. We outline the interhemispheric switch model of rivalry supported by this work and its extension to a metarivalry model of interocular-grouping phenomena. In addition, studies (...) showing a slow rate of binocular rivalry in bipolar disorder are discussed, and the relationship between this finding and the interhemispheric switch model is described. We also review the effects of CVS in various clinical contexts, explain how the technique is performed and discuss methodological issues in its application. (shrink)

Is time travel just a confusing plot device deployed by science fiction authors and Hollywood filmmakers to amaze and amuse? Or might empirical data prompt a scientific hypothesis of time travel? Structured on a fascinating dialogue involving  ...

Philosophers of mind have been arguing for decades about the nature of phenomenal consciousness and the relation between brain and mind. More recently, neuroscientists and philosophers of science have entered the discussion. Which neural activities in the brain constitute phenomenal consciousness, and how could science distinguish the neural correlates of consciousness from its neural constitution? At what level of neural activity is consciousness constituted in the brain and what might be learned from well-studied phenomena like binocular rivalry, attention, memory, affect, (...) pain, dreams and coma? What should the science of consciousness want to know and what should explanation look like in this field? How should the constitution relation be applied to brain and mind and are other relations like identity, supervenience, realization, emergence and causation preferable? Building on a companion volume on the constitution of visual consciousness, this volume addresses these questions and related empirical and conceptual territory. It brings together, for the first time, scientists and philosophers to discuss this engaging interdisciplinary topic. (shrink)

The article is an attempt to analyze the central but troublesome term “context.” While the concept has important empirical implications for the special sciences (indeed, they may not be possible without it), the focus here is to identify and assess its meta physical and,especially, ontological status. After reviewing a number of perspectives directed to understanding the origins of the term’s ambiguity and vagueness, it is suggested that the metaphysical domain of “events-theory” may have interesting parallels with what constitutes a “context.” (...) However, although some aspects of context may be assimilated by the events-theory perspective, others are more resistent to such an interpretation. Implications for further investigation are suggested. (shrink)

This paper attempts to clarify the meaning and significance of "qualitative confirmation". The need to do so is related to the fact that, without such a conceptualization, a large portion of the human sciences are relegated to a less than scientific status. Accordingly, "qualitative confirmation" is viewed as a proper subset of traditional confirmation theory. To establish such a case, a general Hempelian framework is utilized, but it is supplemented with two additional levels of confirmation. It is concluded that the (...) final test for adequacy of such confirmation must rest on a subjective probability notion. (shrink)