In lieu of an abstract, here is a brief excerpt of the content:Of Being-Two: IntroductionPheng Cheah (bio) and Elizabeth Grosz (bio)The decade or so spanning the later 1970s to the mid-1980s witnessed the growing importance of “sexual difference” in Anglo-American academic discourse in the humanities and the “soft” social sciences. Both as an interpretive principle in textual criticism and literary theory and as a critical framework for the analysis of social and political structures and cultural formations, sexual difference provided (...) a fertile conceptual ground from which the disinterested universalism claimed by patriarchal and phallocentric knowledges could be put into question. However, in the past decade, the primacy of sexual difference as a critical principle has itself been called into question for eliding other collective forms of difference such as race, class, and sexuality.In a sense, this fracturing or fissuring of the conceptual ground of feminist theory can be seen as a logical outcome of the concept of “difference” itself, which endlessly proliferates into a multiplicity of sometimes conflictual forms. Nevertheless, it is important to stress that the fissuring of “sexual difference” within academic discourse also reflects and expresses (albeit a little belatedly) broader sociological and political events: the rise in the 1970s of what the sociologist Immanuel Wallerstein has described as new antisystemic movements or “new social movements.”By the 1970s one began to speak in the plural of the “new social movements.” The shift from the grammatical singular to the plural provides a crucial clue to the nature of the process. For the “movement,” if it was ever organizationally singular, soon became multiple, if not necessarily fractionated. That is to say, there emerged a whole series of movements, each organized around a specific theme or focus—movements of “ethnic minorities” or “immigrants,” womens’ movements, ecology movements, antiwar movements, gay and lesbian movements, movements of the handicapped and of the aged (or pensioners).... The key theme of the new movements in the West was the forgotten people—the ethnic underclasses, the women, the gays, the aged, et cetera.[41–42]Due caution should, of course, be exercised concerning the many mediations between theory and practice. Nevertheless, this connection between the fissuring of sexual difference in academic theoretical critique and the pluralized nature of the new social movements that emerged in the 1970s necessarily raises the question of whether the contemporary political world has become too complex for sexual difference to serve as a primary critical-analytical and practical principle. Put another way, does sexual difference have continuing pertinence as an effective mechanism and/or ideal horizon for ethical and political transformation? What political future(s), if any, does sexual difference have?As editors of this special issue of diacritics, we have chosen to address these questions about the political future of sexual difference through a critical consideration of the work of one of the most intriguing and original of the present generation of European philosophers, Luce Irigaray. The theoretical question of sexual difference is [End Page 3] indissociable from Irigaray’s writing. The initial posing of the question of sexual difference in the Anglo-American academy coincided with, and was given added impetus by, the translation of Irigaray’s early works into English as part of the corpus of writings that became known as “French feminism.” 1 But what makes it especially apposite to center a special issue on the political future of sexual difference around Irigaray is her continuing insistence on the fundamental nature and, indeed, the infrastructural status of sexual difference to human existence as a whole. In An Ethics of Sexual Difference, originally published in 1984, Irigaray suggests that sexual difference is the fundamental ethical question of the contemporary era:Sexual difference is one of the major philosophical issues, if not the issue, of our age. According to Heidegger, each age has one issue to think through, and one only. Sexual difference is probably the issue in our time which could be our “salvation” if we thought it through. But, whether I turn to philosophy, to science, or to religion, I find this underlying issue still cries out in vain for our attention.[ESD 5]In subsequent, more politically oriented texts, Irigaray has not only reaffirmed this initial suggestion. She has made the... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Future of Sexual Difference: An Interview with Judith Butler and Drucilla Cornell*Pheng Cheah (bio) and Elizabeth Grrosz (bio)EG:Luce Irigaray’s writings have always figured strongly in your works, probably more than in the work of other American feminist theorists. Out of all the feminist theorists you both interrogate, she seems to emerge as a kind of touchstone of the feminist ethical, political, and intellectual concerns to which (...) you seem to aspire. Could each of you briefly outline how she figures in your work, whether your relations to her have changed, and if so, how?JB:I think that probably early on, when I started working on French feminism as a graduate student in the early ‘80s, I was not interested in her at all because she seemed to me to be an essentialist and that was a term we used quite easily then, when we thought we knew what it meant. In the late ‘80s, I started to rethink my objections to her on that basis and found that she was, among the feminist theorists I had read, perhaps the most versed in philosophy and that her engagement with philosophy was a curious mixture of both loyalty and aggression. And it became very interesting to me when I started thinking about her whole practice of critical mimesis—what she was doing when she was reading Freud, what was she doing when she was reading Plato—and I read Speculum again and again, frightened by its anger, compelled by the closeness of the reading, confused by the mimetism of the text. Was she enslaved to these texts, was she displacing them radically, was she perhaps in the bind of being in both positions at the same time? And I realized that whatever the feminine was for her, it was not a substance, not a spiritual reality that might be isolated, but it had something to do with this strange practice of reading, one in which she was reading texts that she was not authorized to read, texts from which she was as a woman explicitly excluded or explicitly demeaned, and that she would read them anyway. And then the question is: what would it mean to read from a position of radical deauthorization in order to expose the contingent authority of the text? That struck me as a feminist critical practice, a critical reading practice that I could learn from, and from that point on, highly influenced by both Drucilla’s work and Naomi Schor’s work [see Schor], I started to read her quite thoroughly.PC:Is this kind of relationship that she has with the philosophers she reads a sexual relationship? I am thinking of some of the sexualized terms you just used: loyalty and aggression.JB:Yes, there is no doubt that there is an eros of a certain kind, usually the kind that frightens me, quite frankly. I think Carolyn Burke has made this argument that Irigaray [End Page 19] has a romance with the philosophers [see Burke]. I think she has a certain masochistic-sadistic erotic engagement with the philosophers.EG:Do you think it is sado-masochistic?JB:Well, I think it was much more aggressive in Speculum of the Other Woman than it became in An Ethics of Sexual Difference. There, I think there is an engagement that is still very difficult, but at least there is evidence of a more loving engagement.PC:I hope that we can return to the question of love at the end. Is this the kind of relationship that you have to her texts?JB:No, I’m probably too frightened. [Everybody laughs.] And I don’t engage them that closely, probably because I find it frightening to be in that particular knot. She doesn’t actually have a chapter in any of my books. I think I can’t quite devote a chapter to her....EG:No, but you devote large sections of chapters....JB:That’s true, but I can’t stay there for a prolonged period of time [laughs], whatever that’s worth.EG:I’d like to come back to this later, because I think it is a really interesting... (shrink)

The body of the law is an ambiguous phrase. Conventionally, it designates the law as a determinate corpus; legal codes, statutes, and the rulings of common law. But it can also refer to the subjected body that is produced by and is part of the law. This subjected body is necessary for the law's existence. Thinking Through the Body of the Law reconceives the role of the body in the founding, maintaining, and regulation of our legal systems and social order (...) and elaborates on its implications for issues of legal responsibility and justice. Taking into account and sometimes challenging the tenets of critical legal theory, critical race theory, and feminist jurisprudence, these essays examine the body and the law as they relate to surrogacy, the Holocaust, land-rights for Aboriginals, murder, the media and insanity, taxation, genetic engineering, and sexy dressing and sexual harassment. (shrink)

To such sanguine expectations, Pheng Cheah responds deftly with a sobering account of how the "inhuman" imperatives of capitalism and technology are ...

In lieu of an abstract, here is a brief excerpt of the content:The Future of Sexual Difference: An Interview with Judith Butler and Drucilla Cornell*Pheng Cheah (bio) and Elizabeth Grrosz (bio)EG:Luce Irigaray’s writings have always figured strongly in your works, probably more than in the work of other American feminist theorists. Out of all the feminist theorists you both interrogate, she seems to emerge as a kind of touchstone of the feminist ethical, political, and intellectual concerns to which (...) you seem to aspire. Could each of you briefly outline how she figures in your work, whether your relations to her have changed, and if so, how?JB:I think that probably early on, when I started working on French feminism as a graduate student in the early ‘80s, I was not interested in her at all because she seemed to me to be an essentialist and that was a term we used quite easily then, when we thought we knew what it meant. In the late ‘80s, I started to rethink my objections to her on that basis and found that she was, among the feminist theorists I had read, perhaps the most versed in philosophy and that her engagement with philosophy was a curious mixture of both loyalty and aggression. And it became very interesting to me when I started thinking about her whole practice of critical mimesis—what she was doing when she was reading Freud, what was she doing when she was reading Plato—and I read Speculum again and again, frightened by its anger, compelled by the closeness of the reading, confused by the mimetism of the text. Was she enslaved to these texts, was she displacing them radically, was she perhaps in the bind of being in both positions at the same time? And I realized that whatever the feminine was for her, it was not a substance, not a spiritual reality that might be isolated, but it had something to do with this strange practice of reading, one in which she was reading texts that she was not authorized to read, texts from which she was as a woman explicitly excluded or explicitly demeaned, and that she would read them anyway. And then the question is: what would it mean to read from a position of radical deauthorization in order to expose the contingent authority of the text? That struck me as a feminist critical practice, a critical reading practice that I could learn from, and from that point on, highly influenced by both Drucilla’s work and Naomi Schor’s work [see Schor], I started to read her quite thoroughly.PC:Is this kind of relationship that she has with the philosophers she reads a sexual relationship? I am thinking of some of the sexualized terms you just used: loyalty and aggression.JB:Yes, there is no doubt that there is an eros of a certain kind, usually the kind that frightens me, quite frankly. I think Carolyn Burke has made this argument that Irigaray [End Page 19] has a romance with the philosophers [see Burke]. I think she has a certain masochistic-sadistic erotic engagement with the philosophers.EG:Do you think it is sado-masochistic?JB:Well, I think it was much more aggressive in Speculum of the Other Woman than it became in An Ethics of Sexual Difference. There, I think there is an engagement that is still very difficult, but at least there is evidence of a more loving engagement.PC:I hope that we can return to the question of love at the end. Is this the kind of relationship that you have to her texts?JB:No, I’m probably too frightened. [Everybody laughs.] And I don’t engage them that closely, probably because I find it frightening to be in that particular knot. She doesn’t actually have a chapter in any of my books. I think I can’t quite devote a chapter to her....EG:No, but you devote large sections of chapters....JB:That’s true, but I can’t stay there for a prolonged period of time [laughs], whatever that’s worth.EG:I’d like to come back to this later, because I think it is a really interesting... (shrink)

Going against orthodoxy, Pheng Cheah retraces the universal-rationalist foundations and progressive origins of political organicism in the work of Kant and its development in philosophers in the German tradition such as Fichte, Hegel, and ...

In lieu of an abstract, here is a brief excerpt of the content:Of Being-Two: IntroductionPheng Cheah (bio) and Elizabeth Grosz (bio)The decade or so spanning the later 1970s to the mid-1980s witnessed the growing importance of “sexual difference” in Anglo-American academic discourse in the humanities and the “soft” social sciences. Both as an interpretive principle in textual criticism and literary theory and as a critical framework for the analysis of social and political structures and cultural formations, sexual difference provided (...) a fertile conceptual ground from which the disinterested universalism claimed by patriarchal and phallocentric knowledges could be put into question. However, in the past decade, the primacy of sexual difference as a critical principle has itself been called into question for eliding other collective forms of difference such as race, class, and sexuality.In a sense, this fracturing or fissuring of the conceptual ground of feminist theory can be seen as a logical outcome of the concept of “difference” itself, which endlessly proliferates into a multiplicity of sometimes conflictual forms. Nevertheless, it is important to stress that the fissuring of “sexual difference” within academic discourse also reflects and expresses (albeit a little belatedly) broader sociological and political events: the rise in the 1970s of what the sociologist Immanuel Wallerstein has described as new antisystemic movements or “new social movements.”By the 1970s one began to speak in the plural of the “new social movements.” The shift from the grammatical singular to the plural provides a crucial clue to the nature of the process. For the “movement,” if it was ever organizationally singular, soon became multiple, if not necessarily fractionated. That is to say, there emerged a whole series of movements, each organized around a specific theme or focus—movements of “ethnic minorities” or “immigrants,” womens’ movements, ecology movements, antiwar movements, gay and lesbian movements, movements of the handicapped and of the aged (or pensioners).... The key theme of the new movements in the West was the forgotten people—the ethnic underclasses, the women, the gays, the aged, et cetera.[41–42]Due caution should, of course, be exercised concerning the many mediations between theory and practice. Nevertheless, this connection between the fissuring of sexual difference in academic theoretical critique and the pluralized nature of the new social movements that emerged in the 1970s necessarily raises the question of whether the contemporary political world has become too complex for sexual difference to serve as a primary critical-analytical and practical principle. Put another way, does sexual difference have continuing pertinence as an effective mechanism and/or ideal horizon for ethical and political transformation? What political future(s), if any, does sexual difference have?As editors of this special issue of diacritics, we have chosen to address these questions about the political future of sexual difference through a critical consideration of the work of one of the most intriguing and original of the present generation of European philosophers, Luce Irigaray. The theoretical question of sexual difference is [End Page 3] indissociable from Irigaray’s writing. The initial posing of the question of sexual difference in the Anglo-American academy coincided with, and was given added impetus by, the translation of Irigaray’s early works into English as part of the corpus of writings that became known as “French feminism.” 1 But what makes it especially apposite to center a special issue on the political future of sexual difference around Irigaray is her continuing insistence on the fundamental nature and, indeed, the infrastructural status of sexual difference to human existence as a whole. In An Ethics of Sexual Difference, originally published in 1984, Irigaray suggests that sexual difference is the fundamental ethical question of the contemporary era:Sexual difference is one of the major philosophical issues, if not the issue, of our age. According to Heidegger, each age has one issue to think through, and one only. Sexual difference is probably the issue in our time which could be our “salvation” if we thought it through. But, whether I turn to philosophy, to science, or to religion, I find this underlying issue still cries out in vain for our attention.[ESD 5]In subsequent, more politically oriented texts, Irigaray has not only reaffirmed this initial suggestion. She has made the... (shrink)

In modernity, the concept of cosmopolitanism has changed from an intellectual ethos to a vision of an institutionally embedded global political consciousness. The central problem that troubles cosmopolitanism from its moment of inception in 18th-century philosophy to the globalized present is whether we live in a world that is interconnected enough to generate institutions that have a global regulatory reach and a global form of solidarity that can influence their functioning. Examination of Kant's pre-nationalist cosmopolitanism, Marx's postnationalist cosmopolitanism, and decolonizing (...) socialist nationalism indicates the normative attraction of the nation as a mode of solidarity. Contemporary arguments about new cosmopolitanisms focusing on the rise of transnational networks of global cities, postnational social formations created by migrant and diasporic flows and Habermas's recent revival of Kant's project of cosmopolitan democracy have likewise failed to address the persistence of nationalism as a normative force within the field of uneven globalization. (shrink)

This is a stellar collection. The pieces are diversified, not a commemorative gesture but a critical engagement.

This article explores the implications of Derrida's suggestion in several texts that, while a classic dialectical materialism partakes of logocentrism, other sorts of nondialectical materialism would be possible. The nondialectical materialisms that emerge from the work of Derrida and that of Gilles Deleuze resist or evade the teleology of the dialectic in different ways. Because Derrida understands material force as the reference to the impossible other and Deleuze views materiality in terms of impersonal and preindividual forces, materiality, even if it (...) is not unfigurable as such, is not easily instantiated by concrete figures that are recognizable by political discourse. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Diacritics 29.4 (1999) 3-18 [Access article in PDF] Grounds of Comparison Pheng Cheah Reflection is born of the comparison of ideas, and it is their variety that leads us to compare them. Whoever sees only a single object has no occasion to make comparisons. Whoever sees only a small number and always the same ones from childhood on still does not compare them, because the habit of (...) seeing them deprives him of the attention required to examine them: but as a new object strikes us, we want to know it, we look for relations between it and the objects we do know; this is how we learn to observe what we see before us, and how what is foreign to us leads us to examine what touches us.Apply these ideas to the first men, you will see the reason for their barbarism. Never having seen anything other than what was around them, they did not know even it; they did not know themselves. They had the idea of a Father, a son, a brother, but not of man. --Jean-Jacques Rousseau, Essay on the Origin of LanguagesIn recent years, the comparative study of cultural formations has undergone critical reinvigoration. The quasi-exponential globalization of all aspects of human existence, which has brought territorially divided or geographically bounded units such as states, national economies, and cultures into an unprecedented and jarring proximity to one another, is, no doubt, an important material condition of possibility of this heightened interest in the cultural branch of comparative studies. For comparison is today no longer a matter of intentional choice. The gradual defamiliarization of our daily lives by globalizing processes has made comparison an inevitable and even unconscious perspective.Indeed, the grounds of comparison have changed. Comparative work is generally understood as a mode of analysis that begins from one given national or cultural case of a subject of legitimate interest, X, which is the basis for forming a provisional hypothesis or working idea about this subject that serves as the tertium comparationis. One then proceeds to examine a range of other cases of X. Discovered similarities confirm or amplify the various essential features of X that were initially posited, and recognized differences serve to modify our working idea about X. A ground of comparison is therefore both the empirical or objective basis from which comparison begins as well as the interest or principle of reason that motivates each particular activity of comparison.In the past, the grounds of comparison were undeniably Eurocentric. Not only was the material starting point of comparison always from Europe or the North Atlantic; comparison also had a teleological aim. Whether explicitly or implicitly, the interests of comparison in canonical texts such as Hegel's Aesthetics; his Lectures on the Philosophy of History; and Lectures on the Philosophy of Religion; or Max Weber's sociology of world religions served to affirm a certain idea of Europe as a world historical model. For Hegel and Weber, other cases merely provided the mise-en-scène for the appearance and Bildung of this idealized, universalized figure of Europe. Today, in the humanities [End Page 3] and interpretive social sciences, this old framework for comparison has been challenged by critiques of Eurocentrism and Orientalism, by postcolonial studies, and also from the more parochial perspective of multiculturalism. One can no longer nonchalantly or dogmatically start a comparative endeavor from Europe or the North Atlantic. But the problem goes deeper. Many theorists and some funding bodies, including the Social Sciences Research Council (SSRC) of the USA, have recently suggested that post-Cold War transnationalism has rendered obsolete the traditionally bounded areas of area studies. If this is so, the claim to begin from any area outside the North Atlantic has also become problematic. In other words, if comparison has always presupposed geographical or cultural areas that are a priori distinct and to be compared, how must the grounds of comparison be reenvisioned?The work of Benedict Anderson stands in an oblique relation to such recent trends in humanistic studies. Although Anderson is an area specialist, a Southeast Asianist trained in political studies, his... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:MatteringPheng Cheah (bio)Judith Butler. Bodies That Matter: On the Discursive Limits of “Sex.” New York: Routledge, 1993.Elizabeth Grosz. Volatile Bodies: Toward a Corporeal Feminism. Bloomington: Indiana UP, 1994.Any cursory survey of contemporary cultural-political theory and criticism will indicate that the related concepts of “nature” and “the given” are not highly valued terms. The reason for this disdain and even moral disapprobation of naturalistic accounts of human existence is (...) supposed to be self-evident: simply put, in a post-Newtonian age, nature refers to the totality of objects governed by immutable causal laws. If human existence was merely natural or given, then we would never be able to alter the conditions that bring about human oppression. Antinaturalism in contemporary theory, however, betrays a deep fear in its repetitive tirades against the natural. For if it is so obviously precritical to treat human existence as given, then why does antinaturalism need to be articulated again and again? This obsessive pushing away of nature may well constitute an acknowledgement-in-disavowal that humans may be natural creatures after all. Furthermore, as a theoretical position, antinaturalism itself is produced by the polemical energy that strives to keep nature at bay, in quarantine from the sphere of human life. Consequently, antinaturalism works with a conventional philosophical definition of nature which it may do well to question. We may therefore be justified in claiming that, far from being tired superstitions that savvy discourse analysts and cultural constructionists can leave behind, the concepts of “nature” and “the given” are, in fact, neuralgic points, the contested sites around which any theory of political transformation is organized.In its conventional usage, nature is opposed to a whole host of other terms: history, culture, law, production, and so forth. The slipperiness of nature, however, is seen in the fact that the relation between nature and its others defies characterization as a simple relation of exteriority between two ontologically distinct terms. For instance, the relation of nature to history can be posed not only in terms of the modification of nature by historical agency but also from within the realm of historical agency insofar as the constraints of structure or construction on transformative rational agency seem to replicate the limitations or weightiness of nature. Feminism is an exemplary site for rehearsing this fundamental questioning of the distinction between nature and its others because it must refute biologistic and naturalistic justifications for the oppression of women even as it must affirm women’s bodily specificity as the minimal consensual stuff which grounds feminist practice. As Zillah Eisenstein astutely observes in spite of her own intellectual allegiances, “if the body is already engendered in this way, how can we claim our bodies without reproducing the inequities of the gender-system?... [S]o we become involved in explicating patriarchal relations without knowing where patriarchy begins and ends in the definition of a woman’s or a mother’s body. What aspect of the body constitutes a woman’s potential capacities, and what part articulates her oppression?” [73, 75]. [End Page 108] Philosophically speaking, the giving of body or matter—what I propose to call “mattering”—may be the process where history and nature become uncannily indistinguishable in a manner that is both enabling and disabling for political transformation, its condition of (im)possibility.Thus far, the productive unease in feminist theory occasioned by the body as the ambivalent ground of both oppression and emancipatory transformation has resulted in debates over the sex/gender distinction and the question of essentialism/antiessentialism. 1 Discussion has, however, primarily centered on the strategic deployment of the body as a political resource. Two recent books—Judith Butler’s Bodies That Matter and Elizabeth Grosz’s Volatile Bodies—stand out because they promise to raise discussion to a level where political issues concerning the body can be reevaluated through a rigorous rethinking of the relation between nature and its others: culture, history, and society. The authors of these books share the distinctive aim of articulating a feminist theory that is centered on a philosophical exploration of the status of the body. Both Grosz and Butler are trained in Continental philosophy, where the secondary status of... (shrink)

This article explores the implications of Derrida's suggestion in several texts that, while a classic dialectical materialism partakes of logocentrism, other sorts of nondialectical materialism would be possible. The nondialectical materialisms that emerge from the work of Derrida and that of Gilles Deleuze resist or evade the teleology of the dialectic in different ways. Because Derrida understands material force as the reference to the impossible other and Deleuze views materiality in terms of impersonal and preindividual forces, materiality, even if it (...) is not unfigurable as such, is not easily instantiated by concrete figures that are recognizable by political discourse. (shrink)

This dissertation examines the tribulations and the futures of radical national literary culture as a vehicle of freedom in the postcolonial South within the general context of the vicissitudes of the postcolonial nation-state in contemporary neocolonial globalisation. In philosophical modernity, culture is regarded as the means to overcome finitude and the realm where the ideal of human freedom can be incarnated. Consequently, the modern idea of freedom culminates in a politics of culture. Culture supplies the ontological paradigm for different models (...) of modern political community and even the idea of the political itself in the philosophical cosmopolitanism of Kant and the philosophical nationalisms of Fichte and Hegel. Although Marx presents his materialist cosmopolitanism as an inversion of Hegel's idealist nationalism, the same philosopheme of culture informs his idea of the proletarian world community. This is made evident by the persistence of the national question in Marxism. Insofar as it grants primacy to culture in the struggle against colonial and neocolonial economic and political domination, the project of Third World revolutionary national culture has its conceptual origins in the modern philosopheme of culture. However, the vicissitudes of these projects in neocolonial globalisation as exemplified by the work and lives of Pramoedya Ananta Toer of Indonesia and Ngugi Wa Thiong'o of Kenya cast doubt on the viability of this philosopheme of culture. The inability of revolutionary national culture to transcend the neocolonial forces of domination, death and destruction unleashed by global capital suggests that culture qua incarnational work is plagued by various forms of haunting that are internal to its structure. Hence, instead of regarding postcolonial national culture as the incarnation of human freedom, we ought to understand it as being essentially constituted by spectral negotiations with global capital. It is only from this vantage point that we can better grasp how it in turn haunts and destabilises neocolonial hegemony. (shrink)

Community engagement is increasingly promoted as a marker of good, ethical practice in the context of international collaborative research in low-income countries. There is, however, no widely agreed definition of community engagement or of approaches adopted. Justifications given for its use also vary. Community engagement is, for example, variously seen to be of value in: the development of more effective and appropriate consent processes; improved understanding of the aims and forms of research; higher recruitment rates; the identification of important ethical (...) issues; the building of better relationships between the community and researchers; the obtaining of community permission to approach potential research participants; and, the provision of better health care. Despite these diverse and potentially competing claims made for the importance of community engagement, there is very little published evidence on effective models of engagement or their evaluation. (shrink)

In order to involve children in the decision-making process about participation in medical research it is widely recommended that the child’s assent be sought in addition to parental consent. However, the concept of assent is fraught with difficulties, resulting in confusion among researchers and ethics committees alike.

The use of placebos in randomised controlled trials is a subject of considerable ethical debate. In this paper we present a set of considerations to evaluate the ethics of placebo controlled trials that includes: social value of the study; need for a randomised controlled trial and placebo; standards of care; risks of harm due to administration of placebo and the harm benefit balance; clinical equipoise; and double standards. We illustrate the application of these considerations using a case study of a (...) large ongoing multicentre, placebo-controlled, double-blinded, randomised trial to determine primaquine anti-relapse efficacy in vivax malaria. There is an urgent need for primaquine anti-relapse studies in order to rationalise the management of a potentially fatal disease. An ethical justification for the use of the placebo arm is provided on the grounds that the actual current applied standard of care in most endemic places does not include primaquine. It has also been argued that there is clinical equipoise among the primaquine study arms and that the risk of harms of being in the placebo arm is the risk of having relapse, which is no more than not being included in the trial, and that there are no double standards. Based on our set of considerations, we conclude that a placebo arm is not only justified but imperative in this study. We propose that similar considerations should be prospectively applied to other placebo controlled trials and observational control arms where no treatment is offered. (shrink)

Community engagement is increasingly recognized as a critical element of medical research, recommended by ethicists, required by research funders and advocated in ethics guidelines. The benefits of community engagement are often stressed in instrumental terms, particularly with regard to promoting recruitment and retention in studies. Less emphasis has been placed on the value of community engagement with regard to ethical good practice, with goals often implied rather than clearly articulated. This article outlines explicitly how community engagement can contribute to ethical (...) global health research by complementing existing established requirements such as informed consent and independent ethics review. The overarching and interlinked areas are respecting individuals, communities and stakeholders; building trust and social relationships; determining appropriate benefits; minimizing risks, burdens and exploitation; supporting the consent process; understanding vulnerabilities and researcher obligations; gaining permissions, approvals and building legitimacy and achieving recruitment and retention targets. (shrink)

BackgroundSharing de-identified individual-level health research data is widely promoted and has many potential benefits. However there are also some potential harms, such as misuse of data and breach of participant confidentiality. One way to promote the benefits of sharing while ameliorating its potential harms is through the adoption of a managed access approach where data requests are channeled through a Data Access Committee (DAC), rather than making data openly available without restrictions. A DAC, whether a formal or informal group of (...) individuals, has the responsibility of reviewing and assessing data access requests. Many individual groups, consortiums, institutional and independent DACs have been established but there is currently no widely accepted framework for their organization and function.Main textWe propose that DACs, should have the role of both promotion of data sharing and protection of data subjects, their communities, data producers, their institutions and the scientific enterprise. We suggest that data access should be granted by DACs as long as the data reuse has potential social value and provided there is low risk of foreseeable harms. To promote data sharing and to motivate data producers, DACs should encourage secondary uses that are consistent with the interests of data producers and their own institutions. Given the suggested roles of DACs, there should be transparent, simple and clear application procedures for data access. The approach to review of applications should be proportionate to the potential risks involved. DACs should be established within institutional and legal frameworks with clear lines of accountability, terms of reference and membership. We suggest that DACs should not be modelled after research ethics committees (RECs) because their functions and goals of review are different from those of RECs. DAC reviews should be guided by the principles of public health ethics instead of research ethics.ConclusionsIn this paper we have suggested a framework under which DACs should operate, how they should be organised, and how to constitute them. (shrink)

Research funders, regulatory agencies, and journals are increasingly expecting that individual-level data from health research will be shared. Broad consent to such sharing is considered appropriate, feasible and acceptable in low- and middle-income settings, but to date limited empirical research has been conducted to inform the design of such processes. We examined stakeholder perspectives about how best to seek broad consent to sharing data from the Mahidol Oxford Tropical Medicine Research Unit, which implemented a data sharing policy and broad consent (...) to data sharing in January 2016. Between February and August 2017 qualitative data were collected at two sites, Bangkok and the Thai-Myanmar border town of Mae Sot. We conducted eighteen semi-structured interviews. We also conducted four focus group discussions with a total of nineteen people. Descriptive and thematic coding informed analysis of aspects of data sharing that are considered most important to inform participants about, and the best ways to explain complex and abstract topics relating to data sharing. The findings demonstrated that clinical trial participants prioritise information about the potential benefits and harms of data sharing. Stakeholders made multiple suggestions for clarifying information provided about data sharing on such topics. There was significant variation amongst stakeholders’ perspectives about how much information should be provided about data sharing, and it was clear that effective information provision should be responsive to the study, the study population, the individual research participant and the research context. Effectively communicating about data sharing with research participants is challenging in practice, highlighting the importance of robust and effective data sharing governance in this context. Broad consent should incorporate effective and efficient explanations of data sharing to promote informed decision-making, without impeding research participants’ understandings of key aspects of the research from which data will be shared. Further work is required to refine both the development of core information about data sharing to be provided to all research participants, and appropriate solutions for context specific-challenges arising when explaining data sharing. (shrink)

Since January 2016, the Mahidol Oxford Tropical Medicine Research Unit has trialled a data-sharing policy where requests to access research datasets are processed through a Data Access Committee. In this paper, we share our experiences establishing data management systems and data-sharing infrastructure including a data-sharing policy, data access committee and related procedures. We identified a number of practical and ethical challenges including requests for datasets collected without specific or broad consent to data sharing and requests from pharmaceutical companies for data (...) to support drug registration applications. We also encountered significant resource constraints which required the development of appropriate human resources and infrastructure. We suggest a research agenda to promote responsible and equitable data sharing while safeguarding the rights and interests of research participants and researchers. (shrink)

Background The ownership status of individual-level health data affects the manner in which it is used. In this paper we analyze two competing models of the ownership status of the data discussed in the literature recently: private ownership and public ownership. Main body In this paper we describe the limitations of these two models of data ownership with respect to individual-level health data, in particular in terms of ethical principles of justice and autonomy, risk mitigation, as well as technological, economic, (...) and conceptual issues. We argue that undifferentiated application of neither private ownership nor public ownership will allow us to resolve all the problems associated with effective, equitable, and ethical use of data. We suggest that, instead of focusing on data ownership, we should focus on the institutional and procedural aspects of data governance, such as using Data Access Committees (DACs) or equivalent managed access processes, which can balance the elements of these two ownership frameworks. Conclusion Undifferentiated application of the ownership concept (private or public) is not helpful in resolving problems associated with sharing individual-level health data. DACs or equivalent managed access processes should be an integral part of data governance. They can approve or disapprove data access requests after considering the potential benefits and harms to data subjects, their communities, primary researchers, and the wider society. (shrink)

Community engagement (CE) is gaining prominence in global health research. A number of ethical goals–spanning the instrumental, intrinsic, and transformative–have been ascribed to CE in global health research. This paper draws attention to an additional transformative value that CE is not typically linked to but that seems very relevant: solidarity. Both are concerned with building relationships and connecting parties that are distant from one another. This paper first argues that furthering solidarity should be recognized as another ethical goal for CE (...) in global health research. It contends that, over time, CE can build the bases of solidaristic relationships—moral imagination, recognition, understanding, empathy—between researchers and community members. Applying concepts from existing accounts of solidarity, the paper develops preliminary ideas about who should be engaged and how to advance solidarity. The proposed approach is compared to current CE practice in global health research. Finally, the paper briefly considers how solidaristic CE could affect how global health research is performed. (shrink)

The notion of ‘wise mother and good wife (WMGW)’ (Hyonmo Yangcho) is the traditional idealized image of Korean womanhood as one who serves her country and others through her roles as a mother and wife. This ideology may continue to have some significance in the lives of many first‐generation Korean immigrant women, but its potential role in the adjustment challenges these women may face while acculturating to the immigrant context in the United States has received little attention. In this paper, (...) we briefly review the historical background of the WMGW ideology and discussed the significance of focusing research attention on the role of this notion in contemporary first‐generation Korean immigrant women in the United States. We focus on the intersecting influences of gender, ethnicity, and immigrants’ generation status, which may further marginalize some first‐generation Korean immigrant mothers. We then outline possible unique challenges faced by some of these mothers due to the WMGW gender ideology, highlighting potential immigration‐related difficulties including changes in their social support networks, parenting burden, mental health, and language issues. Finally, we provide suggestions for researchers and practitioners working with U.S. Korean immigrant women. (shrink)

The pressure on companies to practice corporate social responsibility (CSR) has gained momentum in recent times as a means of sustaining competitive advantage in business. The pharmaceutical industry has been acutely affected by this trend. While pharmaceutical product recalls have become rampant and increased dramatically in recent years, no comprehensive study has been conducted to study the effects of announcements of recalls on the shareholder returns of pharmaceutical companies. As product recalls could significantly damage a company's reputation, profitability and brand (...) integrity, this paper investigates the effect on shareholder wealth and the extent to which the adoption of CSR practices by pharmaceutical companies in the United Kingdom (U.K.) and the United States (U.S.), the two largest markets for pharmaceutical products in the world, affected market reactions surrounding product recall announcements. The analysis of product recall announcements from 1998 to 2004 compiled from The Pharmaceutical Journal and U.S. Food and Drug Administration enforcement reports revealed marked differences in the way market participants in the two countries responded to news of product recalls. U.S. investors penalised firms according to the severity of product defects while U.K. investors were indifferent. While U.K. investors rewarded product recalls by firms which were not usually CSR-active, U.S. investors punished non-CSR active firms that performed recalls. These observations could pose strategic challenges to pharmaceutical firms operating in both countries. (shrink)

BackgroundCommunity engagement is increasingly promoted as a marker of good, ethical practice in the context of international collaborative research in low-income countries. There is, however, no widely agreed definition of community engagement or of approaches adopted. Justifications given for its use also vary. Community engagement is, for example, variously seen to be of value in: the development of more effective and appropriate consent processes; improved understanding of the aims and forms of research; higher recruitment rates; the identification of important ethical (...) issues; the building of better relationships between the community and researchers; the obtaining of community permission to approach potential research participants; and, the provision of better health care. Despite these diverse and potentially competing claims made for the importance of community engagement, there is very little published evidence on effective models of engagement or their evaluation.MethodsIn this paper, drawing upon interviews with the members of a Community Advisory Board on the Thai-Myanmar border, we describe and critically reflect upon an approach to community engagement which was developed in the context of international collaborative research in the border region.Results and conclusionsDrawing on our analysis, we identify a number of considerations relevant to the development of an approach to evaluating community engagement in this complex research setting. The paper also identifies a range of important ways in which the Community Advisory Board is in practice understood by its members to have morally significant roles and responsibilities beyond those usually associated with the successful and appropriate conduct of research. (shrink)

Volume 20, Issue 8, August 2020, Page W14-W16.

ABSTRACTThis article describes our experience using art and theatre to engage rural communities in western Cambodia to understand malaria and support malaria control and elimination. The project was a pilot science–arts initiative to supplement existing engagement activities conducted by local authorities. In 2016, the project was conducted in 20 villages, involved 300 community members and was attended by more than 8000 people. Key health messages were to use insecticide-treated bed-nets and repellents, febrile people should attend village malaria workers, and to (...) raise awareness about the risk of forest-acquired malaria. Building on the experience and lessons learnt in the year prior, the 2017 project which was conducted in 15 villages involved 600 community members and attracted more than 12,000 people. In addition to the malaria theme, upon discussion with local health authorities, secondary theme was added to the 2017 project. We learnt the following lessons from our experience in... (shrink)

Nipah virus is a priority pathogen that is receiving increasing attention among scientists and in work on epidemic preparedness. Despite this trend, there has been almost no bioethical work examining ethical considerations surrounding the epidemiology, prevention, and treatment of Nipah virus or research that has already begun into animal and human vaccines. In this paper, we advance the case for further work on Nipah virus disease in public health ethics due to the distinct issues it raises concerning communication about the (...) modes of transmission, the burdens of public health surveillance, the recent use of stringent public health measures during epidemics, and social or religious norms intersecting with preventive measures. We also advance the case for further work on Nipah virus disease in research ethics, given ethical issues surrounding potential vaccine trials for a high-fatality disease with sporadic spillover events, the different local contexts where trials may occur, and the potential use of unproven therapeutics during outbreaks. Further bioethics work may help to ensure that research and public health interventions for Nipah virus disease are ethically acceptable and more likely to be effective. (shrink)

Shopping cart abandonment remains a challenge for many e-retailers despite the continued growth of the e-commerce industry worldwide. However, the issue of online shopping cart abandonment has not been explored extensively in the literature. Grounded by the stimulus-organism-response model, this study explores a sequential mediation model comprising consumers' wait for lower prices as an antecedent, hesitation at checkout and OSCA as mediators, perceived transaction inconvenience as a moderator, and decision to buy from a land-based retailer as an outcome. An online (...) questionnaire was designed and distributed to 883 online consumers in Mainland China. Partial least squares-structural equation modeling was employed to analyze the survey data. The results show that waiting for lower prices positively influences hesitation at checkout, and subsequently, impacts both OSCA and DBLR. Hesitation at checkout and OSCA play sequential mediating roles in the framework path. In addition, perceived transaction inconvenience strengthens the relationship between waiting for lower prices and hesitation at checkout. Overall, this study contributes to theory and serves as a guideline for e-retailers in reducing the OSCA rate. (shrink)

The precarious rights of senior citizens, especially those who are highly educated and who are expected to counsel and guide the younger generations, has stimulated the creation internationally of advocacy associations and opinion leader groups. The strength of these groups, however, varies from country to country. In some countries, they are supported and are the focus of intense interest; in others, they are practically ignored. For this is reason we believe that the creation of a network of all these associations (...) is essential. The proposed network would act as a support for the already-existing policies of the United Nations’ High Commission for Human Rights, of independent experts, and of the Global Alliance for the Rights of Older People. All three have long ago recommended the creation of a recognized instrument for uniting presently scattered efforts. The proposed network, therefore, will seek to promote the international exchange of relevant expertise, and it will reinforce the commitments and actions that single countries are currently taking to meet these objectives. For example, informative public events can be organised to promote particular support initiatives and to provide an opportunity for new members of the network to be presented. The network will promote health for senior citizens, disease prevention, senior mobility, safe free time for seniors, alimentary education, protection against new risks and dangers, as well as equity in the services necessary for seniors to adopt new information and communication technologies. In the case of retired academic members, the network will promote equality with respect to continuing use of digital technologies (particularly email), continuing access to research libraries, and the guaranteed ability for seniors to fund their own research programs and to deliver free seminars. (shrink)

Background Achieving meaningful consent can be challenging, particularly in contexts of diminished literacy, yet is a vital part of participant protection in global health research. Method We explored the challenges and potential solutions of achieving meaningful consent through a qualitative study in a predominantly hill tribe ethnic minority population in northern Thailand, a culturally distinctive population with low literacy. Semi-structured interviews were conducted with 37 respondents who had participated in scrub typhus clinical research, their family members, researchers and other key (...) informants. A thematic analysis was conducted. Results Our analysis identified four interrelated themes surrounding participants’ ability to give consent: varying degrees of research understanding, limitations of using informal translators, issues impacting decisions to join research, and voluntariness of consent. Suggestions for achieving more meaningful consent included the use of formal translators and community engagement with research populations. Conclusions Participant’s agency in decision making to join research should be supported, but research information needs to be communicated to potential participants in a way that they can understand. We found that improved understanding about the study and its potential benefits and harms goes beyond literacy or translation and requires attention to social and cultural factors. (shrink)

It has been suggested that community advisory boards can play a role in minimising exploitation in international research. To get a better idea of what this requires and whether it might be achievable, the paper first describes core elements that we suggest must be in place for a CAB to reduce the potential for exploitation. The paper then examines a CAB established by the Shoklo Malaria Research Unit under conditions common in resource-poor settings – namely, where individuals join with a (...) very limited understanding of disease and medical research and where an existing organisational structure is not relied upon to serve as the CAB. Using the Tak Province Border Community Ethics Advisory Board as a case study, we assess the extent to which it might be able to take on a role minimising exploitation were it to decide to do so. We investigate whether, after two years in operation, T-CAB is capable of assessing clinical trials for exploitative features and addressing those found to have them. The findings show that, although T-CAB members have gained knowledge and developed capacities that are foundational for one-day taking on a role to reduce exploitation, their ability to critically evaluate studies for the presence of exploitative elements has not yet been strongly demonstrated. In light of this example, we argue that CABs may not be able to perform such a role for a number of years after initial formation, making it an unsuitable responsibility for many short-term CABs. (shrink)