Moral rights feature prominently and are relied on substantially in debates in bioethics. Conceptually, however, duties can perform the logical work of rights, but not vice versa, and reference to rights is therefore inessential. Normatively, rights, like duties, depend on more basic moral values or principles, and attempts to establish the logical priority of rights over duties or the reverse are misguided. In practical decision making, however, an analysis in terms of duties is more fruitful than one based on rights. (...) A right may function as a proxy term for a consequentialist rule, or for a deontological constraint, but does not thereby enrich these concepts. Rights may also help in a purely expressive sense and may assist an initial focusing on a moral conflict. However, their role in bioethics discourse is more one of convenience than of necessity. Moreover, unless rights are firmly founded on fundamental moral values, their use encourages rhetoric rather than argument. (shrink)

This paper elucidates and rationalizes the ethical governance system for healthcare AI research, as outlined in the ‘Research Ethics Guidelines for AI Researchers in Healthcare’ published by the South Korean government in August 2023. In developing the guidelines, a four-phase clinical trial process was expanded to six stages for healthcare AI research: preliminary ethics review (stage 1); creating datasets (stage 2); model development (stage 3); training, validation, and evaluation (stage 4); application (stage 5); and post-deployment monitoring (stage 6). Researchers identified (...) similarities between clinical trials and healthcare AI research, particularly in research subjects, management and regulations, and application of research results. In the step-by-step articulation of ethical requirements, this similarity benefits from a reliable and flexible use of existing research ethics governance resources, research management, and regulatory functions. In contrast to clinical trials, this procedural approach to healthcare AI research governance effectively highlights the distinct characteristics of healthcare AI research in research and development process, evaluation of results, and modifiability of findings. The model exhibits limitations, primarily in its reliance on self-regulation and lack of clear delineation of responsibilities. While formulated through multidisciplinary deliberations, its application in the research field remains untested. To overcome the limitations, the researchers’ ongoing efforts for educating AI researchers and public and the revision of the guidelines are expected to contribute to establish an ethical research governance framework for healthcare AI research in the South Korean context in the future. (shrink)

Outcome-adaptive randomization has been proposed as a corrective to certain ethical difficulties inherent in the traditional randomized clinical trial using fixed-ratio randomization. In particular, it has been suggested that OAR redresses the balance between individual and collective ethics in favour of the former. In this paper, I examine issues of welfare and autonomy arising in relation to OAR. A central issue in discussions of welfare in OAR is equipoise, and the moral status of OAR is crucially influenced by the way (...) in which this concept is construed. If OAR is based on a model of equipoise that demands strict indifference between competing interventions throughout the trial, such equipoise is disturbed by accruing data favouring one treatment over another; OAR seeks to redress this by weighting randomization to the seemingly superior treatment. However, this is a partial response, as patients continue to be allocated to the inferior therapy. Moreover, it rests upon considerations of aggregate harms and benefits, and does not therefore uphold individual ethics. Issues of fairness also arise, as early and late enrollees are randomized on a different basis. Fixed-ratio randomization represents a fuller and more consistent response to a loss of equipoise, as so construed. With regard to consent, the complexity of OAR poses challenges to adequate disclosure and comprehension. Additionally, OAR does not offer a remedy to the therapeutic misconception—participants’ tendency to attribute treatment allocation in an RCT to individual clinical judgments, rather than to scientific considerations—and, if anything, accentuates rather than alleviates this misconception. In relation to these issues, OAR fails to offer ethical advantages over fixed-ratio randomization. More broadly, the ethical basis of OAR can be seen to lie more in collective than in individual ethics, and overall it fares worse in this territory than fixed-ratio randomization. (shrink)

States commonly employ education policy to build a strong sense of citizenship within young people and to create types of citizens appropriate to the country. In Singapore the government created a policy to build citizenship through both policy statements and social studies in the school curriculum. In the context of a tightly controlled state regulating schooling through a highly controlled educational system, the government expected teachers to obey these policy documents, political statements and the prescribed curriculum. What do teachers understand (...) about citizenship in this context? In schools do teachers demonstrate independence of thought on citizenship education or do they acquiesce to government policy? This article reports on a small group of social studies teachers' understandings of citizenship and explores the nature of these understandings in the context of government policy. The study showed an unexpected diversity of conceptualization amongst Singaporean teachers with their understandings of citizenship located in four themes, namely a sense of identity, rights and responsibilities, participation, and national history. This response was unintended by government and reflects an independence of citizenship education landscape in schools, despite the tight policy and bureaucratic controls over teachers by the Singapore state. (shrink)

This interesting book is a compilation of the lectures and discussions held during a four-day event "Grand Challenges for Science in the 21st Century" organized by Para Limes at the Nanyang Technological University in Singapore. The elite group of speakers included Nobel laureate Sydney Brenner who called on all scientists to adopt a truth-seeking approach and not be afraid of challenging assumptions. The other panellists were Martin Rees, Astronomer Royal and past President of the Royal Society, the much-cited Terrence Sejnowski (...) from the renowned Salk Institute for Biological Studies, the well-known keynote speaker in economics and complexity sciences Brian Arthur, the former President of the European Research Council Helga Nowotny and the Director of the Parmenides Center for the Conceptual Foundations of Science Eors Szathmary. The lively sessions were moderated by the Danish writer Tor Norretranders. The panel tackled topics from evolution and the origin of the universe to modern technologies and artificial intelligence. The challenges presented during the event are bound to get the reader thinking about what may lie ahead in our future. (shrink)

Medical law is not new in medical literature and can constitute an imperative component in medical education. Some medical schools include medical law as a compulsory component of the curriculum. In line with curriculum re-structuring at the University of Malaya, medical law was integrated in the medical curriculum and the feasibility of this integration into the Year 1 undergraduate curriculum was evaluated. Following implementation of a 4-week medical law module, an evaluation of the suitability of early integration of this module (...) was conducted using a ten-item, 4-point Likert scale questionnaire. Two open-ended questions were also included to gauge insights of the integration. All items were scored 3 points or more from the students’ responses. Using the open-ended questions, recommendations for future directions as well as constraints and issues related to the integration of medical law into teaching and learning was revealed. Overall, findings of the study indicated that integrating medical law into medical curriculum at an early stage was beneficial for the medical students. (shrink)

During the COVID-19 pandemic, questions have been raised about the impact of face masks on communication in classroom settings. However, it is unclear to what extent visual obstruction of the speaker’s mouth or changes to the acoustic signal lead to speech processing difficulties, and whether these effects can be mitigated by semantic predictability, i.e., the availability of contextual information. The present study investigated the acoustic and visual effects of face masks on speech intelligibility and processing speed under varying semantic predictability. (...) Twenty-six children and twenty-six adults performed an internet-based cued shadowing task, in which they had to repeat aloud the last word of sentences presented in audio-visual format. The results showed that children and adults made more mistakes and responded more slowly when listening to face mask speech compared to speech produced without a face mask. Adults were only significantly affected by face mask speech when both the acoustic and the visual signal were degraded. While acoustic mask effects were similar for children, removal of visual speech cues through the face mask affected children to a lesser degree. However, high semantic predictability reduced audio-visual mask effects, leading to full compensation of the acoustically degraded mask speech in the adult group. Even though children did not fully compensate for face mask speech with high semantic predictability, overall, they still profited from semantic cues in all conditions. Therefore, in classroom settings, strategies that increase contextual information such as building on students’ prior knowledge, using keywords, and providing visual aids, are likely to help overcome any adverse face mask effects. (shrink)

Using Ang Lee’s Lust, Caution (2007), this article illustrates how an affective mode of address is encouraged when one attends to the ways in which on-screen cinematic audio-visual spectacles are produced through the interaction of different bodies on-screen. Affective cinematic encounters open up other ways of understanding the female body as productive assemblages of everyday affective interactions and relationalities with other bodies within material culture. Particularly, I demonstrate an affective mode of address that attends to the interaction of cinematic objects (...) and how they are constructed, arranged, and engaged with on-screen to reveal hidden dynamics to characters’ relationship and overarching narratives off-screen. (shrink)

The text is extensively referenced, but practical in its approach, giving real life examples and cases based on therapeutic practice.

This paper explores the nature of rights, and their implications for the ethics of nursing. A right is seen as an entitlement which is justified on moral and/or legal grounds, and which may take the form of a right of action or a right of recipience, or both; in either case, correlative duties are generally imposed on others. Some of the conflicts which can occur among two or more conflicting rights are examined through three hypothetical scenarios, and approaches to their (...) resolution are suggested. The question of whether nurses, as nurses, possess rights is then considered, and it is suggested that they do not. In conclusion, it is argued that, if rights are to be a helpful concept, they must be carefully defined and analysed, and their relationship to one another, and to duties, must be clarified. Cet article étudie la nature des droits et leur implications pour l'éthique des soins infirmiers. Un droit reste sur des bases morales et légales et peut prendre la forme d'un droit d'action ou d'un droit de récipience ou des deux formes ensembles. En chaque instant, des devoirs corrélatifs sont normalement imposés à d'autres personnes. Quelques uns des conflits qui peuvent arriver entre deux (ou plusieurs) droits opposés sont considérés ici par trois possibilités hypothétiques et des possibilités de résoudre les problèmes sont proposées. Enfin, la question est considérée si les infirmiers/ères possèdent des droits en tels qu'infirmiers/ères, et il est proposé qu'ils/elles ne les possèdent pas. En conclusion, il est proposé que pour les droits d'être utiles, ils doivent être bien définis et analysés et les relations entre eux et envers les devoirs doivent être bien claires. Dieser Artikel erforscht des Wesen der Rechte und deren Auswirkungen in der Krankenpflegeethik. Ein Recht hat moralische oder legale Gründe und nimmt die Form entweder eines Rechtes der Aktion oder eines Rechtes des Empfanges, oder beider Arten. In allen Fällen sind entsprechende Pflichten anderen aufgelegt. Einige Konflikte, die unter zwei (oder mehreren) Rechten entstehen können, sind hier untersucht an Hilfe von drei hypothetischen Szenarien. Möglichkeiten für die Lösung der Probleme sind vorgeschlagen. Anschliessend wird die Frage, ob das Krankenpflegepersonal Rechte hat - als Personal - betrachtet, und es ist vorgeschlagen, dass solche Rechte nicht bestehen. Zum Abschluss wird vorgeschlagen dass Rechte hilfreich sind wenn sie sorgfältig analysiert und festgelegt sind und wenn deren Beziehung zu einander und zu Pflechten klar ist. (shrink)

Bioethics Education in the Anglo-European context developed since 1970 and was incorporated into the undergraduate and postgraduate education, residency training, and continuous education. In the Asia-Pacific region, bioethics education is less structured and often dependent on contextual constraints. This paper provides a cross-sectional analysis, describing institutional experiences in developing bioethics curriculum at two medical schools in Malaysia and Hong Kong. The medical programmes of the two institutions are distinctive in terms curriculum framework, teaching approach, and topic selection, and common challenges (...) include implementation of bioethics courses, students’ resistance to bioethics, and limited teaching capacity, emerged as they evolve. The reported experiences revealed that there is room for improvement regarding how medical schools integrate bioethics education in regions where curriculum development remains at an early stage. At least, a bioethics education requires both top-down support from the faculty to improve teaching and educational quality, as well as from the bottom-up approach to empower students to raise awareness and concerns toward bioethics, and helps students developing reasoning through challenging issues. (shrink)

This book is the outcome of a European Commission-funded project on resource allocation in health care. It is co-authored by a philosopher, an epidemiologist, a public health medicine specialist and a health economist. Its range is broad, covering the historical, economic, methodological and philosophical aspects of healthrelated quality of life and its measurement.