Payment to recruit research subjects is a common practice but raises ethical concerns relating to the potential for coercion or undue influence. We conducted the first national study of IRB members and human subjects protection professionals to explore attitudes as to whether and why payment of research participants constitutes coercion or undue influence. Upon critical evaluation of the cogency of ethical concerns regarding payment, as reflected in our survey results, we found expansive or inconsistent views about coercion and undue influence (...) that may interfere with valuable research. In particular, respondents appear to believe that coercion and undue influence lie on a continuum; by contrast, we argue that they are wholly distinct: whereas undue influence is a cognitive distortion relating to assessment of risks and benefits, coercion is a threat of harm. Because payment is an offer, rather than a threat, payment is never coercive. (shrink)

How to assess and deal with the claims of millions of displaced people to find refuge and asylum in safe and prosperous countries is one of the most pressing issues of modern political philosophy. In this timely volume, fresh insights are offered into the political and moral implications of refugee crises and the treatment of asylum seekers. The contributions illustrate the widening of the debate over what is owed to refugees, and why it is assumed that national state actors and (...) the international community owe special consideration and protection. Among the specific issues discussed are refugees' rights and duties, refugee selection, whether repatriation can be encouraged or required, and the ethics of sanctuary policies. (shrink)

A proposal by the American Society for Bioethics and Humanities (ASBH) to identify individuals who are qualified to perform ethics consultations neglects case complexity in candidates’ portfolios. To protect patients and healthcare organizations, and to be fair to candidates, a minimum case complexity level must be clearly and publicly articulated. This proof-of-concept study supports the feasibility of assessing case complexity. Using text analytics, we developed a complexity scoring system, and retrospectively analyzed more than 500 ethics summaries of consults performed at (...) an academic medical center during 2013. We demonstrate its use with seven case summaries that range in complexity from uncomplicated to very complicated. We encourage the ASBH to require a minimum level of case complexity, and recommend that attestation portfolios include several cases of moderate complexity and at least one very complex case. (shrink)

This chapter describes the development of a workshop series focused on helping students develop research lab ethics guidelines. The workshop was developed through a National Science Foundation-funded project that situates ethics education within the research environment. Students in four departments at a private research university were recruited to join a Student Ethics Committee that collaboratively developed context-specific codes-of-ethics-based guidelines for their departments. These bottom-up developed guidelines were revised in an iterative process, including feedback from faculty, other graduate students, and the (...) original Student Ethics Committee. The goal of the workshops was to promote the cultivation of an ethical culture in experimental laboratories by integrating research stakeholders in a bottom-up approach to developing context-specific guidelines and to identify factors that students consider relevant to the ethical conduct of research. After describing the workshop series, this chapter presents a qualitative content analysis of the guidelines. The guidelines developed by the Student Ethics Committees reflect the current culture of experimental labs in these departments and the ethical issues that students think are important. The content of these guidelines and the ethical issues the students focused on contrast in some key ways with what ethical issues faculty who head research groups saw as paramount. The chapter describes the first two iterations of the ethics education workshop module, a qualitative analysis of the first draft of these guidelines, and finally reflects on future work in this area of in situ ethics education. (shrink)

Science, technology, engineering, and mathematics (STEM) fields are central to any educational system. The term started with the National Science Foundation as “SMET” and was changed to STEM at a later date due to phonetic reasons. The term was not widely used until Virginia Tech University began offering a “STEM education” degree in 2005 (Friedman 2005). The term STEM covers a broad spectrum of different disciplines. While, in general, STEM is used as an umbrella term for the natural sciences, engineering, (...) mathematics, and technology-related fields, there are some variations in its usage. For example, the US National Science Foundation (NSF) characterizes STEM as including chemistry, computers and information technology, engineering, geoscience, life sciences, mathematical sciences, physics and astronomy, psychology, social sciences, educational research, and STEM education (Gonzalez and Kuezi 2012). Whereas this approach considers the social sciences to be of central importance to STEM and the STEM workforce (Spalter-Roth 2004), in the United Kingdom, STEM is seen to include fields such as medicine, dentistry, and architecture but exclude the social sciences and education (United Kingdom, House of Lords, Science, and Technology, Committee 2012). (shrink)

:In this article, we present an educational intervention that embeds ethics education within research laboratories. This structure is designed to assist students in addressing ethical challenges in a more informed way, and to improve the overall ethical culture of research environments. The project seeks to identify factors that students and researchers consider relevant to ethical conduct in science, technology, engineering, and math and to promote the cultivation of an ethical culture in experimental laboratories by integrating research stakeholders in a bottom-up (...) approach to developing context-specific, ethics-based guidelines. An important assumption behind this approach is that direct involvement in the process of developing laboratory specific ethical guidelines will positively influence researchers’ understanding of ethical research and practice issues, their handling of these issues, and the promotion of an ethical culture in the respective laboratory. The active involvement may increase the sense of ownership and integration of further discussion on these important topics. Based on the project experiences, the project team seeks to develop a module involving the bottom-up building of codes-of-ethics-based guidelines that can be used by a broad range of institutions and that will be distributed widely. (shrink)

Although informed consent is important in clinical research, questions persist regarding when it is necessary, what it requires, and how it should be obtained. The standard view in research ethics is that the function of informed consent is to respect individual autonomy. However, consent processes are multidimensional and serve other ethical functions as well. These functions deserve particular attention when barriers to consent exist. We argue that consent serves seven ethically important and conceptually distinct functions. The first four functions pertain (...) principally to individual participants: (1) providing transparency; (2) allowing control and authorization; (3) promoting concordance with participants' values; and (4) protecting and promoting welfare interests. Three other functions are systemic or policy focused: (5) promoting trust; (6) satisfying regulatory requirements; and (7) promoting integrity in research. Reframing consent around these functions can guide approaches to consent that are context sensitive and that maximize achievable goals. (shrink)

Importance Informed consent is essential to ethical, rigorous research and is important to recruitment and retention in cancer trials.Objective To examine cancer clinical trial (CCT) participants’ perceptions of informed consent processes and variations in perceptions by cancer type.Design and Setting and Participants Cross-sectional survey from mixed-methods study at National Cancer Institute–designated Northeast comprehensive cancer center. Open-ended and forced-choice items addressed: (1) enrollment and informed consent experiences and (2) decision-making processes, including risk-benefit assessment. Eligibility: CCT participant with gastro-intestinal or genitourinary, hematologic-lymphatic (...) malignancies, lung cancer, and breast or gynecological cancer (N = 334).Main Outcome Measures Percentages satisfied with consent process and information provided; and assessing participation’s perceptions of risks/benefits. Multivariable logistic or ordinal regression examined differences by cancer type.Results Most patient-participants felt well informed by the consent process (more than 90% overall and by cancer type) and. most (87.4%) reported that the consent form provided all the information they wanted, although nearly half (44.8%) reported that they read the form somewhat carefully or less. More than half (57.9%) said that talking to research staff (i.e., the consent process) had a greater impact on participation decisions than reading the consent form (2.1%). A third (31.1%) were very sure of joining in research studies before the informed consent process (almost half of lung cancer patients did—47.1%). Most patients personally assessed the risks and benefits before consenting. However, trust in physicians played an important role in the decision to enroll in CCT.Conclusions and Relevance Cancer patients rely less on written features of the informed consent process than on information obtained from the research staff and their own physicians. Research should focus on information and communication strategies that support informed consent from referring physicians, researchers, and others to improve patient risk-benefit assessment and decision-making. (shrink)

Background Clinical ethics consultants are expected to “reduce disparities, discrimination, and inequities when providing consultations,” but few studies about inequities in ethics consultation exist.1 The objectives of this study were (1) to determine if there were racial or gender differences in the timing of requests for ethics consultations related to limiting treatment, and (2) if such differences were found, to identify factors associated with that difference and the role, if any, of ethics consultants in mitigating them. Methods The study was (...) a mixed methods retrospective study of consultation summaries and hospital and ethics center data on 56 age-and gender-matched Caucasian and African American Medicare patients who received ethics consultations related to issues around limiting medical treatment in the period 2011 to 2014. The average age of patients was 70.9. Results Consultation requests for females were made significantly earlier in their stays in the hospital (6.57 days) than were consultation requests made for males (16.07 days). For African American patients, the differences in admission-to-request intervals for female patients (5.93 days) and male patients (18.64 days) were greater than for Caucasian male and female patients. Differences in the timing of a consultation were not significantly correlated with the presence of an advance directive, the specialty of the attending physician, or the reasons for the consult request. Ethics consultants may have mitigated problems that developed during the lag in request times for African American males by spending more time, on average, on those consultations (316 minutes), especially more time, on average, than on consultations with Caucasian females (195 minutes). Most consultations (40 of 56) did result in movement toward limiting treatment, but no statistically significant differences were found among the groups studied in the movement toward limiting treatment. The average number of days from consult to discharge or death were strongly correlated with the intervals between admission to the hospital and request for an ethics consultation. Conclusion Our findings suggest race and gender disparities in the timing of ethics consultations that consultants may have partially mitigated. (shrink)

There are, of course, many important differences between the deployment of cultural authority in the social context of second-century Christianity and that of twentieth-century academia. The editors of the Norton Anthology, for example, do not actively seek to suppress those voices which they exclude, nor are their principles for inclusion so narrowly defined as were the church fathers’. But the literary academy and its institutions developed from those of the Church and continue to wield a derivative, secular version of its (...) social and cultural authority. Since Matthew Arnold, the instutition of literature has been described in terms which liken its authority to that of religion, not only by outsiders—Woolf’s woman “divining the priest”—but by insiders who continue to employ the stances and language of religious authority; see, for instance, J. Hillis Miller’s credo in a recent issue of the ADE Bulletin: “I believe in the established canon of English and American literature and in the validity of the concept of privileged texts. I think it is more important to read Spenser, Shakespeare, or Milton than to read Borges in translation, or even, to say the truth, to read Virginia Woolf.”9 Such rhetoric suggests that the religious resonances in literary texts are not entirely figurative, a point brought out strikingly by revisionary religious figures in feminist texts. In her recent essay “ ‘The Blank Page’ and the Issues of Female Creativity,” Susan Gubar cites as some of the “many parables in an ongoing revisionary female theology” Florence Nightingale’s tentative prophecy that “the next Christ will perhaps be a female Christ,” H. D.’s blessed Lady carrying a “Bible of blank pages,” and Gertrude Stein’s celebration of The Mother of Us All.10 The revisionary female theology promoted in literary writing by women implicitly counters the patriarchal theology which is already inscribed in literature. The prophesied female Christ, blank Bible, and female Creator revise images familiar in the literary tradition, and, in contrast to earlier appropriations of religious imagery by Metaphysical, Pre-Raphaelite, and other poets, make visible the patriarchal preoccupations of literary “theology.” These voices, like the Gnostic voices recovered at Nag Hammadi, are only now being heard in chorus; and Pagels’ study of “the gnostic feminism” helps to illuminate some aspects of a cultural authority predicated on the suppression or domination of other voices. Christine Froula, associate professor of English at Yale University, is the author of A Guide to Ezra Pound’s “Selected Poems” and of the forthcoming “To Write Paradise”: Syle and Error in Pound’s Cantos. She is currently working on a book about literary authority in James Joyce and Virginia Woolf. (shrink)

There are many ways to understand the meanings of the #MeToo movement. Analyses of its significance have proliferated in popular media; some academic analyses have also recently appeared. Commentary on the philosophical and epistemic significance of the #MeToo movement has been less plentiful. The specific moment of the #MeToo movement in which Dr. Christine Blasey Ford’s testimony garnered a widespread social media response from sexual violence survivors highlighted the power of a particular form of epistemic response, what I call (...) ‘epistemic refusal.’ In breaking our silence, those of us who are sexual violence survivors have used this strategy to refuse the dominant epistemic structures that have kept us tightly in check. Mass informal disclosure of survivor status represented in conjunction with hashtags such as #MeToo, #WhyIDidntReport, and #BelieveHer creates space for epistemic, ethical, and political community between survivors of sexual violence by denying hegemonic epistemic discourses of contemporary rape culture. Regarding Dr. Blasey Ford’s testimony and the social media response it garnered, analysis of three main elements proves particularly illuminating: the nature of mass informal disclosure of sexual violence, what the hashtag #WhyIDidntReport reveals about refusing silence, and what the hashtags #BelieveHer and #BelieveSurvivors can show us about what it takes to begin to overcome epistemic gaslighting. (shrink)

In this review, we describe some of the central philosophical issues facing origins-of-life research and provide a targeted history of the developments that have led to the multidisciplinary field of origins-of-life studies. We outline these issues and developments to guide researchers and students from all fields. With respect to philosophy, we provide brief summaries of debates with respect to (1) definitions (or theories) of life, what life is and how research should be conducted in the absence of an accepted theory (...) of life, (2) the distinctions between synthetic, historical, and universal projects in origins-of-life studies, issues with strategies for inferring the origins of life, such as (3) the nature of the first living entities (the “bottom up” approach) and (4) how to infer the nature of the last universal common ancestor (the “top down” approach), and (5) the status of origins of life as a science. Each of these debates influences the others. Although there are clusters of researchers that agree on some answers to these issues, each of these debates is still open. With respect to history, we outline several independent paths that have led to some of the approaches now prevalent in origins-of-life studies. These include one path from early views of life through the scientific revolutions brought about by Linnaeus (von Linn.), Wöhler, Miller, and others. In this approach, new theories, tools, and evidence guide new thoughts about the nature of life and its origin.We also describe another family of paths motivated by a” circularity” approach to life, which is guided by such thinkers as Maturana & Varela, Gánti, Rosen, and others. These views echo ideas developed by Kant and Aristotle, though they do so using modern science in ways that produce exciting avenues of investigation. By exploring the history of these ideas, we can see how many of the issues that currently interest us have been guided by the contexts in which the ideas were developed. The disciplinary backgrounds of each of these scholars has influenced the questions they sought to answer, the experiments they envisioned, and the kinds of data they collected. We conclude by encouraging scientists and scholars in the humanities and social sciences to explore ways in which they can interact to provide a deeper understanding of the conceptual assumptions, structure, and history of origins-of-life research. This may be useful to help frame future research agendas and bring awareness to the multifaceted issues facing this challenging scientific question. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Introduction to the Special SectionFranklin G. MillerHappy is a female elephant who has been confined at the Bronx Zoo for over 40 years. In 2018 the Nonhuman Rights Project sued the Wildlife Conservation Society, which manages the zoo, seeking habeas corpus for Happy in order to release her to an elephant sanctuary. Numerous amicus curiae briefs were filed in favor and against the petition on behalf of Happy. The (...) case reached the highest court in New York State, which denied the petition of the plaintiff in June 2022.This special section includes views on the case of Happy by David DeGrazia, Martha Nussbaum, and Christine Korsgaard, three distinguished moral philosophers who have made significant contributions to animal ethics. The essays by Martha Nussbaum and Christine Korsgaard are drawn from the amicus briefs that they filed in the legal proceedings, which they agreed could be published here.Professor Nussbaum applies her "capabilities approach" as a foundation for promoting wellbeing and recognizing rights to Happy and to elephants in general. She argues that Happy is a being with a meaningful life and is entitled to be treated with respect and dignity, which is incompatible with her conditions of confinement at the zoo. Professor Korsgaard applies her understanding of the moral philosophy of Immanuel Kant to the case of Happy—a "cognitively sophisticated [End Page 1] animal" which, like human beings, should be treated as an end in herself and not merely as a means to the purposes of human beings. Professor DeGrazia, in an invited essay, analyzes the meanings of "person" and examines the pertinent characteristics of elephants that make them at least "borderline persons," with the moral status of possessing basic rights.While Happy remains confined at the Bronx Zoo, these three incisive contributions challenge readers to reflect on the ethical treatment of nonhuman animals, especially those with complex and rich capacities of intelligence and emotion. [End Page 2]Franklin G. MillerWeill Cornell Medical College, New YorkCopyright © 2023 Johns Hopkins University Press... (shrink)

Potential conflicts between the roles of physicians and researchers have been described at the theoretical level in the bioethics literature (Czoli, et al., 2011). Physicians and researchers are generally in mutually distinct roles, responsible for patients and participants respectively. With increasing emphasis on integration of research into clinical settings, however, the role divide is sometimes unclear. Consequently, physician–researchers must consider and negotiate salient ethical differences between clinical– and research–based obligations (Miller et al, 1998). This paper explores the subjective experiences (...) and perspectives of 30 physician–researchers working in three Canadian paediatric settings. Drawing on qualitative interviews, it identifies ethical challenges and strategies used by physician–researchers in managing dual roles. It considers whether competing obligations could have both positive and adverse consequences for both physician–researchers and patients. Finally, we discuss how empirical work, which explores the perspectives of those engaged in research and clinical practice, can lead the way to understanding and promoting best practice. (shrink)

This chapter outlines the main ideas of my book National responsibility and global justice. It begins with two widely held but conflicting intuitions about what global justice might mean on the one hand, and what it means to be a member of a national community on the other. The first intuition tells us that global inequalities of the magnitude that currently exist are radically unjust, while the second intuition tells us that inequalities are both unavoidable and fair once national responsibility (...) is allowed to operate. This conflict might be resolved either by adopting a cosmopolitan theory of justice (which leaves no room for national responsibility) or by adopting a ?political? theory of justice (which denies that questions of distributive justice can arise beyond the walls of the sovereign state). Since neither resolution is satisfactory, the chapter defends the idea of national responsibility and proposes a new theory of global justice, whose main elements are the protection of basic human rights worldwide, and fair terms of interaction between independent political communities. (shrink)

It has been a common assumption that words are substances that instantiate or have properties. In this paper, I question the assumption that our ontology of words requires posting substances by outlining a bundle theory of words, wherein words are bundles of various sorts of properties (such as semantic, phonetic, orthographic, and grammatical properties). I argue that this view can better account for certain phenomena than substance theories, is ontologically more parsimonious, and coheres with claims in linguistics.

Aristotle believes that an agent lacks virtue unless she enjoys the performance of virtuous actions, while Kant claims that the person who does her duty despite contrary inclinations exhibits a moral worth that the person who acts from inclination lacks. Despite these differences, this chapter argues that Aristotle and Kant share a distinctive view of the object of human choice and locus of moral value: that what we choose, and what has moral value, are not mere acts, but actions: acts (...) done for the sake of ends. Morally good actions embody a kind of intrinsic value that inspires us to do them from duty (in Kant) or for the sake of the noble (in Aristotle). The chapter traces the difference in their attitudes about doing one's duty with pleasure to a difference in their attitudes towards pleasure itself: Aristotle sees it as a perception of the good, while Kant thinks of it as mere feeling. (shrink)

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

This paper argues for a particular view about in what metaphysical equivalence consists: namely, that any two metaphysical theories are metaphysically equivalent if and only if those theories are strongly hyperintensionally equivalent. It is consistent with this characterisation that said theories are weakly hyperintensionally distinct, thus affording us the resources to model the content of propositional attitudes directed towards metaphysically equivalent theories in such a way that non-ideal agents can bear different propositional attitudes towards metaphysically equivalent theories.

The Ethics of Need: Agency, Dignity, and Obligation argues for the philosophical importance of the notion of need and for an ethical framework through which we can determine which needs have moral significance. In the volume, Sarah Clark Miller synthesizes insights from Kantian and feminist care ethics to establish that our mutual and inevitable interdependence gives rise to a duty to care for the needs of others. Further, she argues that we are obligated not merely to meet others’ needs (...) but to do so in a manner that expresses "dignifying care," a concept that captures how human interactions can grant or deny equal moral standing and inclusion in a moral community. She illuminates these theoretical developments by examining two cases where urgent needs require a caring and dignifying response: the needs of the elderly and the needs of global strangers. Those working in the areas of feminist theory, women’s studies, aging studies, bioethics, and global studies should find this volume of interest. (shrink)

In this paper, we consider the question of whether there exists an essential relation between emotions and wellbeing. We distinguish three ways in which emotions and wellbeing might be essentially related: constitutive, causal, and epistemic. We argue that, while there is some room for holding that emotions are constitutive ingredients of an individual’s wellbeing, all the attempts to characterise the causal and epistemic relations in an essentialist way are vulnerable to some important objections. We conclude that the causal and epistemic (...) relation between emotions and wellbeing is much less strong than is commonly thought. (shrink)

Abstract Theories are metaphysically equivalent just if there is no fact of the matter that could render one theory true and the other false. In this paper I argue that if we are judiciously to resolve disputes about whether theories are equivalent or not, we need to develop testable criteria that will give us epistemic access to the obtaining of the relation of metaphysical equivalence holding between those theories. I develop such ?diagnostic? criteria. I argue that correctly inter-translatable theories are (...) metaphysically equivalent, and what we need are ways of determining whether a putative translation is correct or not. To that end I develop a number of tools we can employ to discern whether a translation is a correct one. (shrink)

In this article we critique the collectivist approach to collective moral responsibility. According to philosophers of a collectivist persuasion, a central notion of collective moral responsibility is moral responsibility assigned to a collective as a single entity. In our critique, we proceed by way of discussing the accounts and arguments of three prominent representatives of the collectivist approach with respect to collective responsibility: Margaret Gilbert, Russell Hardin, and Philip Pettit. Our aims are mainly critical; however, this should not be taken (...) to imply that we do not ourselves support an alternative account of collective responsibility. We advocate an individualist account of collective responsibility. On this view of collective responsibility as joint responsibility, collective responsibility is ascribed to individuals. Each member of the group is individually morally responsible for the outcome of the joint action, but each is individually responsible jointly with the others. (shrink)

Although evidence of teaching behaviour has been identified in some nonhuman species, human teaching appears to be unique in terms of both the breadth of contexts within which it is observed, and in its responsiveness to needs of the learner. Similarly, cultural evolution is observable in other species, but human cultural evolution appears strikingly distinct. This has led to speculation that the evolutionary origins of these capacities may be causally linked. Here we provide an overview of contrasting perspectives on the (...) relationship between teaching and cultural evolution in humans, and briefly review previous research which suggests that cumulative culture can occur without teaching. We then report the results of a novel experimental study in which we investigated how the benefits of teaching may depend on the complexity of the skill to be acquired. Participants were asked to tie knots of varying complexity. In our Teaching condition, opportunities to interact with an experienced partner aided transmission of the most complex knots, but not simpler equivalents, relative to exposure to completed products alone, and also relative to information about the process of completion. We conclude by considering the plausibility of various accounts of the evolutionary relationship between teaching and cultural evolution in humans. (shrink)

Here are some intuitions we have about the nature of space and time. There is something fundamentally different about the past, present, and future. What is definitive of the past is that the past events are fixed. What is definitive of the future is that future events are not fixed. What is definitive of the present is that it marks the objective ontological border between the past and the future and, by doing so, instantiates a particularly salient phenomenological property of (...) nowness. Call the combination of these intuitions according to which there exists an objective present, a fixed past, and an open future, the intuitive view. I argue that, given the intuitive view, the possibility of backwards causation—and hence, for instance, backwards time travel—is problematic. (shrink)

The natural name theory, recently discussed by Johnson (2018), is proposed as an explanation of pure quotation where the quoted term(s) refers to a linguistic object such as in the sentence ‘In the above, ‘bank’ is ambiguous’. After outlining the theory, I raise a problem for the natural name theory. I argue that positing a resemblance relation between the name and the linguistic object it names does not allow us to rule out cases where the natural name fails to resemble (...) the linguistic object it names. I argue that to avoid this problem, we can combine the natural name theory with a type-realist metaphysics of language, and hold that the name is natural because the name is an instance of the kind that it names. I conclude by reflecting on the importance of the metaphysics of language for questions in the philosophy of language. (shrink)

Richard Miller presents a bold new program for international justice. He argues for new standards of responsible conduct by governments, firms, and individuals in developed countries, to govern trade, investment, environmental policy, and the use of force. He offers an urgently needed strategy for moving humanity toward genuine global co-operation.

Some are concerned about the possibility that offering money for research participation can constitute coercion or undue influence capable of distorting the judgment of potential research subjects and compromising the voluntariness of their informed consent. The author recognizes that more often than not there are multiple influences leading to decisions, including decisions about research participation. The concept of undue influence is explored, as well as the question of whether or not there is something uniquely distorting about money as opposed to (...) a chance for treatment or medical care. An amount of money that is not excessive and is calculated on the basis of time or contribution may, rather than constitute an undue inducement, be an indication of respect for the time and contribution that research subjects make. (shrink)

The concept of brain death as equivalent to cardiopulmonary death was initially conceived following developments in neuroscience, critical care, and transplant technology. It is now a routine part of medicine in Western countries, including the United States. In contrast, Eastern countries have been reluctant to incorporate brain death into legislation and medical practice. Several countries, most notably China, still lack laws recognizing brain death and national medical standards for making the diagnosis. The perception is that Asians are less likely to (...) approve of brain death or organ transplant from brain dead donors. Cultural and religious traditions have been referenced to explain this apparent difference. In the West, the status of the brain as home to the soul in Enlightenment philosophy, combined with pragmatism and utilitarianism, supports the concept of brain death. In the East, the integration of body with spirit and nature in Buddhist and folk beliefs, along with the Confucian social structure that builds upon interpersonal relationships, argues against brain death. However, it is unclear whether these reasoning strategies are explicitly used when families and medical providers are faced with acknowledging brain death. Their decisions are more likely to involve a prioritization of values and a rationalization of intuitive responses. Why and whether there might be differences between East and West in the acceptance of the brain death concept requires further empirical testing, which would help inform policy-making and facilitate communication between providers and patients from different cultural and ethnic backgrounds. (shrink)

Purpose/methods: This study investigated the relationship between ethics education and training, and the use and usefulness of ethics resources, confidence in moral decisions, and moral action/activism through a survey of practicing nurses and social workers from four United States (US) census regions. Findings: The sample (n = 1215) was primarily Caucasian (83%), female (85%), well educated (57% with a master's degree). no ethics education at all was reported by 14% of study participants (8% of social workers had no ethics education, (...) versus 23% of nurses), and only 57% of participants had ethics education in their professional educational program. Those with both professional ethics education and in-service or continuing education were more confident in their moral judgments and more likely to use ethics resources and to take moral action. Social workers had more overall education, more ethics education, and higher confidence and moral action scores, and were more likely to use ethics resources than nurses. Conclusion: Ethics education has a significant positive influence on moral confidence, moral action, and use of ethics resources by nurses and social workers. (shrink)

Many research ethics guidelines now oblige researchers to offer research participants the results of research in which they participated. This practice is intended to uphold respect for persons and ensure that participants are not treated as mere means to an end. Yet some scholars have begun to question a generalised duty to disclose research results, highlighting the potential harms arising from disclosure and questioning the ethical justification for a duty to disclose, especially with respect to individual results. In support of (...) this view, we argue that current rationales for a duty of disclosure do not form an adequate basis for an ethical imperative. We review policy guidance and scholarly commentary regarding the duty to communicate the results of biomedical, epidemiological and genetic research to research participants and show that there is wide variation in opinion regarding what should be disclosed and under what circumstance. Moreover, we argue that there is fundamental confusion about the notion of “research results,” specifically regarding three core concepts: the distinction between aggregate and individual results, amongst different types of research, and across different degrees of result veracity. Even where policy guidance and scholarly commentary have been most forceful in support of an ethical imperative to disclose research results, ambiguity regarding what is to be disclosed confounds ethical action. (shrink)

The concept of moral distress comes from nursing ethics, and was initially defined as ‘…when one knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right course of action’. There is a large body of literature associated with moral distress, yet multiple definitions now exist, significantly limiting its usefulness. We undertook a systematic review of the argument-based bioethics literature on this topic as the basis for a critical appraisal, identifying 55 papers for analysis. (...) We found that moral distress is most frequently framed around individual experiences of distress in relation to local practices and constraints, and understood in terms of power relations and workplace hierarchies. This understanding is directly derived from, and often still seen as specific to, nursing. Frequently the perspective of the morally distressed individual is privileged. Understandings of moral distress have evolved towards an ‘occupational health approach’, with the assumption that moral distress should be measured and prevented. Counter-perspectives were identified, highlighting conceptual problems. Based on our review, we propose a redefinition of moral distress: ‘Ethical unease or disquiet resulting from a situation where a clinician believes they have contributed to avoidable patient or community harm through their involvement in an action, inaction or decision that conflicts with their own values’. This definition is specific enough for research use, anchored in clinicians’ professional responsibilities and concerns about harms to patients, framed relationally rather than hierarchically, and amenable to multiple perspectives on any given morally distressing situation. (shrink)

In this commentary, we discuss Tom Cochrane’s theory of emotions. Cochrane offers an appealingly unified account of valent representations, ranging from simple responses to complex representations within a mechanistic framework. This offers some guidance as to how we might conceive of emotions as simple action-guiding responses in infants and animals, as well as context-sensitive evaluative states. While Cochrane argues for the centrality of bodily feelings, he does not consider his approach to be embodied in the narrower sense. We question his (...) reasons and suggest to think of emotions as embodied action-oriented representations. We, furthermore, suggest developing the approach with regard to the multiple roles that social norms play, and delve further into the nuanced relationship between bodily self-regulation and the formative influence of social norms on emotions. (shrink)

The interdisciplinary field of neurorobotics looks to neuroscience to overcome the limitations of modern robotics technology, to robotics to advance our understanding of the neural system’s inner workings, and to information technology to develop tools that support those complementary endeavours. The development of these technologies is still at an early stage, which makes them an ideal candidate for proactive and anticipatory ethical reflection. This article explains the current state of neurorobotics development within the Human Brain Project, originating from a close (...) collaboration between the scientific and technical experts who drive neurorobotics innovation, and the humanities and social sciences scholars who provide contextualising and reflective capabilities. This article discusses some of the ethical issues which can reasonably be expected. On this basis, the article explores possible gaps identified within this collaborative, ethical reflection that calls for attention to ensure that the development of neurorobotics is ethically sound and socially acceptable and desirable. (shrink)

I develop the foundation for cosmopolitan care, an underexplored variety of moral cosmopolitanism. I begin by offering a characterization of contemporary cosmopolitanism from the justice tradition. Rather than discussing the political, economic or cultural aspects of cosmopolitanism, I instead address its moral dimensions. I then employ a feminist philosophical perspective to provide a critical evaluation of the moral foundations of cosmopolitan justice, with an eye toward demonstrating the need for an alternative account of moral cosmopolitanism as cosmopolitan care. After providing (...) an explanation of how care ethics in connection with Kantian ethics generates a duty to care, I consider one main feature of cosmopolitan care, namely the theory of obligation it endorses. In developing this account, I place special emphasis on the practical ramifications of the theory by using it to analyze gender violence in conflict zones. (shrink)