The ethics of conducting research in epidemic situations have yet to account fully for differences in the proportion and acuteness of epidemics, among other factors. While epidemics most often arise from infectious diseases, not all infectious diseases are of epidemic proportions, and not all epidemics occur acutely. These and other variations constrain the generalization of ethical decision‐making and impose ethical demands on the individual researcher in a way not previously highlighted. This paper discusses a number of such constraints and impositions. (...) It applies the ethical principles enunciated by Emmanuel et al.1 to the controversial Pfizer study in Nigeria in order to highlight the particular ethical concerns of acute epidemic research, and suggest ways of meeting such challenges.The paper recommends that research during epidemics should be partly evaluated on its own merits in order to determine its ethical appropriateness to the specific situation. Snap decisions to conduct research during acute epidemics should be resisted. Community engagement, public notification and good information management are needed to promote the ethics of conducting research during acute epidemics. Individual consent is most at risk of being compromised, and every effort should be made to ensure that it is maintained and valid. Use of data safety management boards should be routine. Acute epidemics also present opportunities to enhance the social value of research and maximize its benefits to communities.Ethical research is possible in acute epidemics, if the potential challenges are thought of ahead of time and appropriate precautions taken. (shrink)

We address the moral importance of fish, invertebrates such as crustaceans, snails and insects, and other animals about which there is qualified scientific uncertainty about their sentience. We argue that, on a sentientist basis, one can at least say that how such animals fare make ethically significant claims on our character. It is a requirement of a morally decent person that she at least pays attention to and is cautious regarding the possibly morally relevant aspects of such animals. This involves (...) having a moral stance, in the sense of patterns of perception, such that one notices such animals as being morally relevant in various situations. For the person who does not already consider these animals in this way, this could be a big change in moral psychology, and can be assumed to have behavioural consequences, albeit indeterminate. Character has been largely neglected in the literature, which focuses on act-centred approaches. We see our character-centred approach as complementary to, not superior to, act-centred approaches. Our approach has the advantage of allowing us to make ethically interesting and practically relevant claims about a wider range of cases, but it has the drawback of providing less specific action guidance. (shrink)

Many cultural competency efforts in healthcare stress the importance of cultural diversity and difference. This emphasis is necessary and well justified. It has helped sensitize healthcare systems to the differences among people and their health-related attitudes, preferences, and behaviors. However, the emphasis on diversity and difference has, unfortunately, also detracted from serious consideration of the things that cultures have in common and the possibility that socioeconomic differences are today far more important than cultural ones in determining healthcare outcomes.

We argue that the lack of large cross-cultural differences in many games with student subjects from developed countries may be due to the nature of the games studied. These games tap primarily basic psychological reactions, like fairness and reciprocity. Once we look at norm-enforcement, in particular punishment, we find large differences even among culturally rather homogeneous student groups from developed countries.

Few studies have considered in detail the ethical issues surrounding research in which investigators ask community members to engage in research subject recruitment within their own communities. Peer-driven recruitment and its variants are useful for accessing and including certain populations in research, but also have the potential to undermine the ethical and scientific integrity of community-based research. This paper examines the ethical implications of utilizing community members as recruiters of human subjects in the context of PDR, as well as the (...) authors' experience with a variant of PDR in a research project in South Africa. The importance of situating PDR in a comprehensive community engagement process that is responsive to the constraints of science and local needs and interests is emphasized. The paper will have relevance to bioethicists, health researchers, and research regulators concerned about the appropriate use of peer-driven recruitment strategies in health research. (shrink)

Scholars have debated the role that altruistic considerations play—and should play—in recruitment and decision-making processes for clinical trials. Little empirical data are available to support their various perspectives. We analyzed 140 audiotaped pediatric informed consent sessions, of which 95 (68%) included at least one discussion of how participation in a cancer clinical trial might benefit: 1) the pursuit of scientific knowledge generally; 2) other children with cancer specifically; and 3) “the future” and other vaguely defined recipients. Clinicians initiated most (80%) (...) of these discussions of altruism. The enrollment rate of children in the clinical trial was high (83%) overall, but not higher among children whose parents were involved in an altruism-oriented discussion. These findings suggest that: (1) clinicians invoke a spectrum of altruistic considerations rather than a single monothematic notion of altruism, and (2) the effect of altruistic considerations on subsequent enrollment decisions is marginal. While further research on this topic is warranted, bioethical debate should strive to reflect the diversity of altruistic discourse in clinical research encounters and to place this discourse in the context of other, including nonaltruistic, considerations. (shrink)

‘Researcher identity’ affects global health research in profound and complex ways. Anthropologists in particular have led the way in portraying the multiple, and sometimes tension-generating, identities that researchers ascribe to themselves, or have ascribed to them, in their places of research. However, the central importance of researcher identity in the ethical conduct of global health research has yet to be fully appreciated. The capacity of researchers to respond effectively to the ethical tensions surrounding their identities is hampered by lack of (...) conceptual clarity, as to the nature and scope of the issues involved. This paper strives to provide some clarification of these ethical tensions by considering researcher identity from the perspective of (1) Guillemin and Heggen's (2009) key distinction between procedural ethics and ethics in practice, and (2) our own distinction between perceptions of identity that are either symmetrical or asymmetrical, with the potential to shift research relationships toward greater or lesser ethical harmony. Discussion of these concepts is supported with ethnographic examples from relevant literature and from our own (United States (US) Government-funded) research in South Africa. A preliminary set of recommendations is provided in an effort to equip researchers with a greater sense of organization and control over the ethics of researcher identity. The paper concludes that the complex construction of researcher identity needs to be central among the ethical concerns of global health researchers, and that the conceptual tools discussed in the paper are a useful starting point for better organizing and acting on these ethical concerns. (shrink)

This article examines the responsibilities of researchers who conduct exploratory research to provide a service to vulnerable respondents. The term “service” is used to denote the provision of a tangible benefit in relation to the research question that is apart from the altruistic research benefits. This article explores what this “service” could look like, who might be responsible for providing it, and the challenges associated with such a service. The article argues that not providing a tangible benefit to vulnerable research (...) participants is inconsistent with the principle of social justice that undergirds much of the rationale for conducting health disparities research. (shrink)

Background Genomic research is challenging the tradition of informed consent. Genomic researchers in the USA, Canada and parts of Europe are encouraged to use informed consent to address the prospect of disclosing individual research results (IRRs) to study participants. In the USA, no national policy exists to direct this use of informed consent, and it is unclear how local institutional review boards (IRBs) may want researchers to respond. Objective and methods To explore publicly accessible IRB websites for guidance in this (...) area, using summative content analysis. Findings Three types of research results were addressed in 45 informed consent templates and instructions from 20 IRBs based at centres conducting genomic research: (1) IRRs in general, (2) incidental findings (IFs) and (3) a broad and unspecified category of ‘significant new findings’ (SNFs). IRRs were more frequently referenced than IFs or SNFs. Most documents stated that access to IRRs would not be an option for research participants. These non-disclosure statements were found to coexist in some documents with statements that SNFs would be disclosed to participants if related to their willingness to participate in research. The median readability of template language on IRRs, IFs and SNFs exceeded a ninth-grade level. Conclusion IRB guidance may downplay the possibility of IFs and contain conflicting messages on IRR non-disclosure and SNF disclosure. IRBs may need to clarify why separate IRR and SNF language should appear in the same consent document. The extent of these issues, nationally and internationally, needs to be determined. (shrink)

Few studies have considered in detail the ethical issues surrounding research in which investigators ask community members to engage in research subject recruitment within their own communities. Peer-driven recruitment and its variants are useful for accessing and including certain populations in research, but also have the potential to undermine the ethical and scientific integrity of community-based research. This paper examines the ethical implications of utilizing community members as recruiters of human subjects in the context of PDR, as well as the (...) authors' experience with a variant of PDR in a research project in South Africa. The importance of situating PDR in a comprehensive community engagement process that is responsive to the constraints of science and local needs and interests is emphasized. The paper will have relevance to bioethicists, health researchers, and research regulators concerned about the appropriate use of peer-driven recruitment strategies in health research. (shrink)

Turco-Sogdian Documents from 9th–10th Century Dunhuang. By Nicholas Sims-Williams and James Hamilton. Translated by Nicholas Sims-Williams, with an appendix by Wen Xin. Corpus Inscriptionum Iranicarum, pt. II, vol. III/3. London: School of Oriental and African Studies, 2015. Pp. 120, 50 pl. £40.

The ethics of conducting research in epidemic situations have yet to account fully for differences in the proportion and acuteness of epidemics, among other factors. While epidemics most often arise from infectious diseases, not all infectious diseases are of epidemic proportions, and not all epidemics occur acutely. These and other variations constrain the generalization of ethical decision-making and impose ethical demands on the individual researcher in a way not previously highlighted. This paper discusses a number of such constraints and impositions. (...) It applies the ethical principles enunciated by Emmanuel et al.1 to the controversial Pfizer study in Nigeria in order to highlight the particular ethical concerns of acute epidemic research, and suggest ways of meeting such challenges. The paper recommends that research during epidemics should be partly evaluated on its own merits in order to determine its ethical appropriateness to the specific situation. Snap decisions to conduct research during acute epidemics should be resisted. Community engagement, public notification and good information management are needed to promote the ethics of conducting research during acute epidemics. Individual consent is most at risk of being compromised, and every effort should be made to ensure that it is maintained and valid. Use of data safety management boards should be routine. Acute epidemics also present opportunities to enhance the social value of research and maximize its benefits to communities. Ethical research is possible in acute epidemics, if the potential challenges are thought of ahead of time and appropriate precautions taken. (shrink)

The “smart village” flourishes – at least in policy papers that envision the revitalization of rural areas through the civic deployment of networked media and telecommunications. Yet, while such aspirations are widespread, little is known about the views of those tasked with supervising and supporting digitally driven public participation for rural progress. To address the lack of insight into what these intermediary administrators conceive as catalysts and challenges for the realization of smart village conceptions, we surveyed representatives of regions in (...) Germany who oversee rural development schemes, most notably within the European LEADER framework. For these key actors, digital participation does not mainly hinge on broadband access and IT availability. Instead, they emphasize the importance of human and administrative resources as well as multi-actor collaboration, which we discuss in terms of digital readiness, digital willingness, and digital activity. Building the smart village, we conclude, seems not so much a matter of technological infrastructure, but rather of sociotechnical infrastructuring. (shrink)

Neuroenhancement involves the use of neurotechnologies to improve cognitive, affective or behavioural functioning, where these are not judged to be clinically impaired. Questions about enhancement have become one of the key topics of neuroethics over the past decade. The current study draws on in-depth public engagement activities in ten European countries giving a bottom-up perspective on the ethics and desirability of enhancement. This informed the design of an online contrastive vignette experiment that was administered to representative samples of 1000 respondents (...) in the ten countries and the United States. The experiment investigated how the gender of the protagonist, his or her level of performance, the efficacy of the enhancer and the mode of enhancement affected support for neuroenhancement in both educational and employment contexts. Of these, higher efficacy and lower performance were found to increase willingness to support enhancement. A series of commonly articulated claims about the individual and societal dimensions of neuroenhancement were derived from the public engagement activities. Underlying these claims, multivariate analysis identified two social values. The Societal/protective highlights counter normative consequences and opposes the use enhancers. The Individual/proactionary highlights opportunities and supports use. For most respondents these values are not mutually exclusive. This suggests that for many neuroenhancement is viewed simultaneously as a source of both promise and concern. (shrink)

The normative dimensions of Internet use among patients and their families have not been studied in much depth in the field of clinical ethics. This study considers cancer-related Internet use among families and friends of cancer patients, and how that use of the Internet may affect patients and patient care. Interviews were conducted with 120 cancer patients, most of whom (76%) reported that family, friends, and others in their social network used the Internet in some way related to the patient’s (...) cancer. Many patients (73%) did not request this online help from their social networks, yet found it helpful and comforting nonetheless. Other patients were less positive about the helpfulness of the online efforts of friends and relatives. A significant proportion of patients (39%) also felt that the online information they received was prescreened or edited in some way. Very few patients recalled that their clinicians ever discussed these and other issues with them. The study illustrates that indirect Internet use is a central feature of the cancer experience. In contrast to other literature in this area, the study suggests that indirect Internet use may have normatively positive and negative implications for patients. These implications point towards the importance of studying and understanding indirect Internet use—and Internet use in general—in the field of clinical ethics. (shrink)

Neuroenhancement involves the use of neurotechnologies to improve cognitive, affective or behavioural functioning, where these are not judged to be clinically impaired. Questions about enhancement have become one of the key topics of neuroethics over the past decade. The current study draws on in-depth public engagement activities in ten European countries giving a bottom-up perspective on the ethics and desirability of enhancement. This informed the design of an online contrastive vignette experiment that was administered to representative samples of 1000 respondents (...) in the ten countries and the United States. The experiment investigated how the gender of the protagonist, his or her level of performance, the efficacy of the enhancer and the mode of enhancement affected support for neuroenhancement in both educational and employment contexts. Of these, higher efficacy and lower performance were found to increase willingness to support enhancement. A series of commonly articulated claims about the individual and societal dimensions of neuroenhancement were derived from the public engagement activities. Underlying these claims, multivariate analysis identified two social values. The Societal/Protective highlights counter normative consequences and opposes the use enhancers. The Individual/Proactionary highlights opportunities and supports use. For most respondents these values are not mutually exclusive. This suggests that for many neuroenhancement is viewed simultaneously as a source of both promise and concern. (shrink)

This book is the first treatment at length of negative, or apophatic, theology within the analytic tradition. Apophatic theology holds that there is a significant sense in which we cannot say what God is. Important negative theological elements are present in a host of Christian thinkers, from Gregory of Nyssa to Aquinas, and yet apophaticism is neglected in philosophical theology as practiced within the analytic tradition. By contrast, Hewitt shows how apophatic theology is integral to how Christians have thought (...) about God, and how it can be defended against standard attacks in the philosophical literature. Hewitt diagnoses the unease with apophaticism amongst contempory philosophical theologicans as rooted in a certain picture of how language functions, here called referentialism. Arguing that this picture is not compulsory, an account of language which sits more comfortably with negative theology (originating from work of later Wittgenstein) is invoked, and applied to key themes in philosophical theology including divine personhood, the Trinity, the Incarnation and the afterlife. (shrink)

Biological evolution provides a creative fount of complex and subtle adaptations, often surprising the scientists who discover them. However, because evolution is an algorithmic process that transcends the substrate in which it occurs, evolution’s creativity is not limited to nature. Indeed, many researchers in the field of digital evolution have observed their evolving algorithms and organisms subverting their intentions, exposing unrecognized bugs in their code, producing unexpected adaptations, or exhibiting outcomes uncannily convergent with ones in nature. Such stories routinely reveal (...) creativity by evolution in these digital worlds, but they rarely fit into the standard scientific narrative. Instead they are often treated as mere obstacles to be overcome, rather than results that warrant study in their own right. The stories themselves are traded among researchers through oral tradition, but that mode of information transmission is inefficient and prone to error and outright loss. Moreover, the fact that these stories tend to be shared only among practitioners means that many natural scientists do not realize how interesting and lifelike digital organisms are and how natural their evolution can be. To our knowledge, no collection of such anecdotes has been published before. This paper is the crowd-sourced product of researchers in the fields of artificial life and evolutionary computation who have provided first-hand accounts of such cases. It thus serves as a written, fact-checked collection of scientifically important and even entertaining stories. In doing so we also present here substantial evidence that the existence and importance of evolutionary surprises extends beyond the natural world, and may indeed be a universal property of all complex evolving systems. (shrink)

Taking regular walks when living with Parkinson’s disease has beneficial effects on movement and quality of life. Yet, patients usually show reduced physical activity compared to healthy older adults. Using auditory stimulation such as music can facilitate walking but patients vary significantly in their response. An individualized approach adapting musical tempo to patients’ gait cadence, and capitalizing on these individual differences, is likely to provide a rewarding experience, increasing motivation for walk-in PD. We aim to evaluate the observance, safety, tolerance, (...) usability, and enjoyment of a new smartphone application. It was coupled with wearable sensors and delivered individualized musical stimulation for gait auto-rehabilitation at home. Forty-five patients with PD underwent a 1-month, outdoor, uncontrolled gait rehabilitation program, using the BeatWalk application. The music tempo was being aligned in real-time to patients’ gait cadence in a way that could foster an increase up to +10% of their spontaneous cadence. Open-label evaluation was based on BeatWalk use measures, questionnaires, and a six-minute walk test. Patients used the application 78.8% of the prescribed duration and enjoyed it throughout the program. The application was considered “easy to use” by 75% of the patients. Pain, fatigue, and falls did not increase. Fear of falling decreased and quality of life improved. After the program, patients improved their gait parameters in the six-minute walk test without musical stimulation. BeatWalk is an easy to use, safe, and enjoyable musical application for individualized gait rehabilitation in PD. It increases “walk for exercise” duration thanks to high observance.Clinical Trial Registration: ClinicalTrials.gov Identifier: NCT02647242. (shrink)

Simone Weil is one of the most profound thinkers of the twentieth century. Her writings encompass an extraordinary breadth of subjects, including philosophy, religion, sociology, and politics. A political activist and resistance fighter, her accomplishments are even more astonishing in light of her death in 1943 at the age of thirty-four. Whilst Weil was concerned with deep philosophical questions - the nature of human thought and human faculties, the limits of language, and thought's contact with reality through mediation, science and (...) beauty - the full significance of her work has frequently been obscured by her categorization as a purely religious writer or Christian mystic. Simone Weil: Basic Writings is an expertly edited anthology of her most important writings, presenting Weil's philosophy as it relates to politics, the nature of work, human nature in its duality, necessity, beauty and goodness. D. K. Levy and Marina Barabas have translated all the extracts anew, including translations of important notes and references missing from existing English language editions of Weil's work. Following an extensive introduction by D. K. Levy which places Weil's life and thought in context, each section opens with a short introduction situating the chosen passages within Weil's oeuvre. Simone Weil: Basic Writings is an outstanding starting point for anyone seeking an introduction to Weil's philosophy, and also essential reading for students and scholars of Weil's thought in related disciplines. (shrink)

Developing countries face numerous barriers to conducting effective and efficient ethics reviews of international collaborative research. In addition to potentially overlooking important scientific and ethical considerations, inadequate or insufficiently trained ethics committees may insist on unwarranted changes to protocols that can impair a study's scientific or ethical validity. Moreover, poorly functioning review systems can impose substantial delays on the commencement of research, which needlessly undermine the development of new interventions for urgent medical needs. In response to these concerns, the Drugs (...) for Neglected Diseases Initiative, an independent nonprofit organization founded by a coalition of public sector and international organizations, developed a mechanism to facilitate more effective and efficient host country ethics review for a study of the use of fexinidazole for the treatment of late stage African Trypanosomiasis. The project involved the implementation of a novel ‘pre-review’ process of ethical oversight, conducted by an ad hoc committee of ethics committee representatives from African and European countries, in collaboration with internationally recognized scientific experts. This article examines the process and outcomes of this collaborative process. (shrink)

Many people don’t know how to reconcile the spiritual with the reality of where they are psychologically, so their psychological issues are not submitted to the spirit. Thus, followers of Christ are often living with shame, oppression, or even hatred. It should not be this way. The good news is that there is a way to wholeness. Evangelizing the Depths calls us to listen closely to the Word of God as, very practically, Simone Pacot explains how the grace of the (...) Triune God can restore us to life in every facet of our being, even those that have been deeply wounded by events of the past. As the entwining of the spiritual and psychological levels is explored, this book will help establish us in the love and the truth of God. As this happens, it becomes possible to identify the paths of death that we have taken in the past and then leave them behind as we choose to follow Christ along the way of true life. (shrink)

This essay describes and critically evaluates a co-operative educational program to train Ugandan health care workers in bioethics. It describes one bottom-up effort, a week-long intensive workshop in bioethics provided by the authors to health care professionals in a developing country—Uganda. We will describe the background and circumstances that led to the organization of the workshop, and review its planning, design, curriculum, and outcome. We will focus especially on measures taken to make the workshop relevant for the audience of Ugandan (...) professionals, and describe lessons learned after two presentations of the workshop. Finally, we will discuss the strengths and weaknesses of such a format, and its potential value in raising bioethical expertise in developing countries. (shrink)

Pre-Socratics, physiologists, sages and sophists -- Platonists, Cyrenaics, Aristotelians and cynics -- Sceptics, stoics and epicureans -- Classical Chinese philosophers -- Romans (serious and ridiculous) and neoplatonists -- The deaths of Christian saints -- Medieval philosophers: Christian, Islamic, and Judaic -- Philosophy in the Latin Middle Ages -- Renaissance, Reformation and scientific revolution -- Rationalists (material and immaterial), empiricists and religious dissenters -- Philosophes, materialists and sentimentalists -- Many Germans and some non-Germans -- The masters of suspicion and (...) some unsuspicious Americans -- The long twentieth century I: philosophy in wartime -- The long twentieth century II: analytics, continentals, a few moribunds and a near-death experience. (shrink)

'Dialogue' was invented as a written form in democratic Athens and made a celebrated and popular literary and philosophical style by Plato. Yet it almost completely disappeared in the Christian empire of late antiquity. This book, the first general and systematic study of the genre in antiquity, asks: who wrote dialogues and why? Why did dialogue no longer attract writers in the later period in the same way? Investigating dialogue goes to the heart of the central issues of power, (...) authority, openness and playfulness in changing cultural contexts. This book analyses the relationship between literary form and cultural authority in a new and exciting way, and encourages closer reflection about the purpose of dialogue in its wider social, cultural and religious contexts in today's world. (shrink)

Simone Weil (1909-1943) was a defining figure of the twentieth century; a philosopher, Christian, resistance fighter, anarchist, feminist, labor activist and teacher. She was described by T. S. Eliot as "a woman of genius, of a kind of genius akin to that of the saints," and by Albert Camus as "the only great spirit of our time." Originally published posthumously in two volumes, these newly reissued notebooks, are among the very few unedited personal writings of Weil's that still survive (...) today. Containing her thoughts on art, love, science, God and the meaning of life, they give context and meaning to Weil's famous works, revealing a unique philosophy in development and offering a rare private glimpse of her singular personality. (shrink)

Biography of the paleontologist, priest, writer, and co-discoverer of Peking man who developed a theory claiming to unify cosmic evolution and Christianity.

Bezeichnet man im deutschsprachigen Raum eine kulturelle Veranstaltung als 'Spektakel', geht damit oft eine negative Wertung einher. Im Gegensatz dazu zeigt der Band die vielfältigen Begriffsdimensionen, medialen Charakteristika und Funktionen dieser zentralen ästhetischen Kategorie in künstlerischen, epistemischen und politischen Kontexten auf. Beiträge aus Kunstgeschichte, Philosophie, Film-, Literatur-, Medien-, Tanz- und Theaterwissenschaft setzen sich mit ästhetischen Theorien und Praktiken des Spektakels von der Antike bis zur Gegenwart auseinander. Die behandelten Beispiele reichen von der christlichen Liturgie bis zur Barockoper, von Paulinus von (...) Nola bis Christoph Schlingensief, vom populären Wissenschaftstheater des 19. Jahrhunderts bis zu politischen Funktionen des Spektakulären im südkoreanischen Kino oder dem italienischen Roman, in Alltag und Kunst des Sozialismus sowie der globalen Medienkultur. Mit Beiträgen von: Micha Braun, Simon Frisch, Elisabeth Fritz, Antje Géra, Nicola Gess, Martin Hähnel, Sarah Hegenbart, Teresa Hiergeist, Carsten Juwig, Katherina Keller-Grein, Kirsten Maar, Astrid Matron, Kassandra Nakas, Ulf Otto, Rita Rieger, Ivo Ritzer, Tanja Schwan und Christiane Voss"--Back cover. (shrink)