Monitoring of clinical trials is important to ensure adherence to protocol, to safeguard the rights of research participants and to achieve compliance with principles of good clinical practice. Recent regulatory changes in India require Ethics Committees to keep an oversight of ongoing clinical trials including on-site monitoring. In this article, we share the experience of on-site monitoring of clinical trials by the Ethics Committee of a tertiary care, academic and research centre in India. We found a large number of shortcomings (...) in the areas of informed consent, adverse events, insurance and reimbursement, which would not have been detected by off-site document review. Interestingly, many shortcomings were also not detected by on-site monitoring arranged by clinical trial sponsors. We therefore conclude that on-site monitoring of ongoing clinical trials is a highly important activity for Indian Ethics Committees. (shrink)

Cognitive enhancement (CE) covers a broad spectrum of methods, including behavioral techniques, nootropic drugs, and neuromodulation interventions. However, research on their use in children has almost exclusively been carried out in high-income countries with limited understanding of how experts working with children view their use in low- and middle- income countries (LMICs). This study examines perceptions on cognitive enhancement, their techniques, neuroethical issues about their use from an LMICs perspective.Seven Indian experts were purposively sampled for their expertise in bioethics, child (...) development and child education. In-depth interviews were conducted using a semi-structured topic guide to examine (1) understanding of CE, (2) which approaches were viewed as cognitive enhancers, (3) attitudes toward different CE techniques and (4) neuroethical issues related to CE use within the Indian context. All interviews were audio recorded and transcribed before thematic analysis.Findings indicate Indian experts view cognitive enhancement as a holistic positive impact on overall functioning and well-being, rather than improvement in specific cognitive abilities. Exogenous agents, and neuromodulation were viewed with skepticism, whereas behavioral approaches were viewed more favorably. Neuroethical concerns included equitable access to CE, limited scientific evidence and over-reliance on technology to address societal problems. This highlights the need for more contextually relevant neuroethics research in LMICs. (shrink)

The main aim of this paper is to analyse David Lewis’ version of contextualism and his solution to the Gettier problem and the lottery problem through the employment of his Rule of Relevance and Stewart Cohen’s response to these problems. Here I analyse whether Stewart Cohen’s response to David Lewis’ solutions to these problems is on the right track or not. Hence, I try to analyse some concept in David Lewis and Stewart Cohen which has remained unanalysed. Cohen tries to (...) show that when we try to solve some variation of the lottery problem and the Gettier problem by applying Lewis’s Rule of Relevance, then it generates some counterintuitive result. So Cohen gives Lewis some alternatives (which are explained in “The Strategy of Biting the Bullet and the Problem of Interference” and “Biting the Bullet Strategy as a Natural Extension of Contextualist Resolution to the Sceptical Problem and the Pity Poor Bill Variation of the Lottery Problem” sections) to avoid this counterintuitive result; this attempt, however, affects some other presuppositions of the contextual theory of David Lewis. My aim in this paper is to show how without taking these alternatives suggested by Cohen, Lewis can apply his Rules of Relevance to solve the lottery problem and the Gettier problem without any counterintuitive result. (shrink)

The development of some COVID-19 vaccines by private companies like Moderna and Sanofi-GSK has been substantially funded by various governments. While the Sanofi CEO has previously suggested that countries that fund this development ought to be given some priority, this suggestion has not been taken seriously in the literature. Considerations of nationalism, sustainability, need, and equitability have been more extensively discussed with respect to whether and how much a country is entitled to advance purchase orders of the vaccine under conditions (...) of absolute scarcity. Yet, little attention has been paid to whether prior investment into developing a vaccine entitles a country to some priority with respect to these orders. Moreover, while not a majority view, some survey results show that a significant minority of the populace does endorse some view like this. This article argues that the minority have a point: recognizing funder countries some priority is justified by the weak Lockean claim (WLC). According to the WLC, the fact that someone has contributed to the development of something gives them some entitlement to the resultant product. This article will defend the WLC, and address objections to the argument, including those pertaining to questions of historical injustice and medical need. This argument does not imply an unconstrained entitlement. Rather, contribution to development is one morally relevant factor that must be tempered by and weighed against potentially more substantial claims to priority based on need, equity, and other considerations. (shrink)

This article explores the extent to which income inequality and income mobility—both considered indicators of economic inequality and conditions of formal regulatory institutions —facilitate or constrain the emergence of social entrepreneurship. Using 77,983 individual-level responses obtained from the Global Entrepreneurship Monitor survey of 26 countries, and supplementing with country-level data obtained from the Global Competitiveness Report of the World Economic Forum, our results from multilevel analyses demonstrate that country-level income inequality increases the likelihood of individual-level engagement in social entrepreneurship, while (...) income mobility decreases this likelihood. Further, income mobility negatively moderates the influence of income inequality on social entrepreneurship, such that the condition of low income mobility and high income inequality is a stronger predictor of social entrepreneurship. We discuss implications and limitations of our study, and we suggest avenues for future research. (shrink)

This paper argues that one problem that besets black-box AI is that it lacks algorithmic justifiability. We argue that the norm of shared decision making in medical care presupposes that treatment decisions ought to be justifiable to the patient. Medical decisions are justifiable to the patient only if they are compatible with the patient’s values and preferences and the patient is able to see that this is so. Patient-directed justifiability is threatened by black-box AIs because the lack of rationale provided (...) for the decision makes it difficult for patients to ascertain whether there is adequate fit between the decision and the patient’s values. This paper argues that achieving algorithmic transparency does not help patients bridge the gap between their medical decisions and values. We introduce a hypothetical model we call Justifiable AI to illustrate this argument. Justifiable AI aims at modelling normative and evaluative considerations in an explicit way so as to provide a stepping stone for patient and physician to jointly decide on a course of treatment. If our argument succeeds, we should prefer these justifiable models over alternatives if the former are available and aim to develop said models if not. (shrink)

The Uniqueness Thesis (U), according to Richard Feldman and Roger White, says that for a given set of evidence E and a proposition P, only one doxastic attitude about P is rational given E. Luis Rosa has recently provided two counterexamples against U which are supposed to show that even if there is a sense in which choosing between two doxastic attitudes is arbitrary, both options are equally and maximally rational. Both counterexamples work by exploiting the idea that ‘ought implies (...) can’ and trying to spell out situations in which some inferences are beyond the capabilities of some reasoners. I argue that on a descriptive account of doxastic rationality, questions of whether ‘epistemic ought implies can’ can be bracketed and that at least one of the inferential moves that Rosa describes in his cases is irrational. I further argue that a descriptive account of doxastic rationality is the appropriate notion of rationality that is to be considered when evaluating U. If my argument for a descriptive account of rationality is successful, then we have reason to revise our use of the term rationality to fit this descriptive understanding. (shrink)

The development of some COVID-19 vaccines by private companies like Moderna and Sanofi-GSK has been substantially funded by various governments. While the Sanofi CEO has previously suggested that countries that fund this development ought to be given some priority, this suggestion has not been taken seriously in the literature. Considerations of nationalism, sustainability, need, and equitability have been more extensively discussed with respect to whether and how much a country is entitled to advance purchase orders of the vaccine under conditions (...) of absolute scarcity. Yet, little attention has been paid to whether prior investment into developing a vaccine entitles a country to some priority with respect to these orders. Moreover, while not a majority view, some survey results show that a significant minority of the populace does endorse some view like this. This article argues that the minority have a point: recognizing funder countries some priority is justified by the weak Lockean claim (WLC). According to the WLC, the fact that someone has contributed to the development of something gives them some entitlement to the resultant product. This article will defend the WLC, and address objections to the argument, including those pertaining to questions of historical injustice and medical need. This argument does not imply an unconstrained entitlement. Rather, contribution to development is one morally relevant factor that must be tempered by and weighed against potentially more substantial claims to priority based on need, equity, and other considerations. (shrink)

Despite global warming and climate change remaining top environmental issues, many people do not prioritize the environment. However, religious and spiritual beliefs can influence pro-environmental behavior. Therefore, we focused on understanding how religiosity and spirituality among Christians, the non-religious, and atheists, influence ecologically conscious consumer behavior (ECCB) through environmental values (i.e. egoistic, altruistic, and biospheric) and issue involvement. Using Qualtrics, we recruited a US sample of Christians ( n = 362), the non-religious ( n = 132), and atheists ( n (...) = 84). Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) analyses confirmed the hypothesized model. Overall, the findings suggest that religiosity is related to the environmental values of Christians and the non-religious. This relationship increased issue involvement and positively impacted participants’ ECCB. More importantly, irrespective of religious affiliation, perceived spiritual connection with nature promoted ECCB. (shrink)

Ethics committees like Institutional Review Boards and Research Ethics Committees are typically empowered to approve or reject proposed studies, typically conditional on certain conditions or revisions being met. While some have argued this power should be primarily a function of applying clear, codified requirements, most institutions and legal regimes allow discretion for IRBs to ethically evaluate studies, such as to ensure a favourable risk-benefit ratio, fair subject selection, adequate informed consent, and so forth. As a result, ethics committees typically make (...) moral demands on researchers: require them to act in a way the committee considers ethically right or appropriate. This paper argues that moral demands are legitimate only if publicly justifiable; and as a result, committee decisions are subject to a public justification requirement. Ethics committees can permissibly request for more information, changes to the research protocol or that the research is delayed or even stopped only if these demands are publicly justifiable. This latter claim is in turn justified on the basis that moral demands to φ are permissible only if we are in a position to know that the addressee ought to φ and that we are in a position to know a proposition only if it is publicly justifiable. This argument suggests that ethics committees must consciously and explicitly appeal to public reasons in their decision-making. In cases where public reasons cannot be offered, committees would not be permitted to reject a given study or make approval conditional on an amendment. (shrink)

In recent years, there have been several high-profile recalls of hybrid products. If consumers perceive a global firm to be responsible for the recall, then it will reduce their brand equity. Therefore, global firms may respond in ethically questionable ways to justify themselves to important stakeholders and avoid blame. Understanding how stakeholders attribute blame for crises involving hybrid products is important to shed light on the unethical manner in which global firms might avoid blame in such situations. The research reported (...) here shows that in a hybrid product crisis, consumers show a bias in favor of the brand company and against the manufacturing company. This bias is more pronounced when the country of manufacture has an unfavorable image or when consumers lack familiarity with the recalled brand. Ambiguous recall announcements by companies that fail to provide a specific and clear reason for the product defect prompt consumers to assume that a manufacturing flaw caused the product defect. As a result, consumers reduce their attribution of blame for the brand company, and thus its brand equity is maintained. (shrink)

On the standard version of political liberalism, the exercise of political power is legitimate only if it is justifiable to all reasonable persons. Correspondingly, reasonable disagreement about the moral doctrines underlying a law makes that law not justifiable to all reasonable persons. In this paper, I argue that political liberals are committed to understanding reasonable disagreement as being rational, rather than praiseworthy disagreement between morally reasonable person because other conceptions of reasonableness commit them to an incoherent triad of claims.

Recently, self-fulfilling cases, that is, ones in which an agent's believing a proposition guarantees its truth, have been offered as counterexamples to uniqueness. According to uniqueness, at most one doxastic attitude is epistemically rational given the evidence. I argue that self-fulfilling cases are not counterexamples to uniqueness because belief-formation is not governed by epistemic rationality in such cases. Specifically, this is because epistemic rationality is not just about forming true beliefs, but about tracking mind-independent truths. In support of the latter (...) claim, I offer three arguments, namely that self-fulfilling and non-self-fulfilling cases differ in their phenomenology, in the norms that guide belief formation, and in the way they relate to the evidence. (shrink)

Study on Mānameyodaya of Nārāyaṇabhaṭṭapāda, treatise on Mimamsa philosophy.

Hastings Center Report, Volume 52, Issue 3, Page 31-33, May–June 2022.

Demands for improved access to innovative therapies have prompted a discourse that claims patients have rights to access treatments that may be of benefit, even if evidence that demonstrates safety and efficacy is lacking. This rights-based discourse is grounded in accounts of autonomy and assertions claiming that the state ought to not interfere with the free choices of patients and clinical decision-making. In this essay, we scrutinise these arguments to defend the ethical and legal permissibility of interference in contexts where (...) the uncertainty of benefit and potential for harm creates vulnerabilities that undermine patient capacity for self-determination. In support of this argument, we draw on two theoretical approaches to explore the limits of autonomy in innovative contexts and analyse the legal bases of the rights-based discourse. We then apply this analysis to the case example of stem cell transplantation as an innovative treatment for multiple sclerosis. (shrink)

Ageing populations are increasing across the world. Many countries are exploring new ways to provide care for the elderly in hospitals, community care and family household settings. Scientific progress in robotics, artificial intelligence integrated systems and increasingly sophisticated software engineering have contributed to innovative developments in care robots in the Asia Pacific regions, Europe and the US. Whilst the use of care robots is not widespread, research is already occurring to integrate wider use of care robots in the elderly population (...) towards improving their quality of life. Developments in care robots for the elderly are valuable yet they give rise to special concerns as they affect peoples’ health and safety. This chapter identifies key ethical and legal issues arising from the use of care robots in the ageing population. Ethical aspects such as deception and trust from care robots are highlighted, which implicate governance concerns ranging from balancing innovations and ensuring user safety to determining the appropriate levels of regulatory oversight and support for developers and market strategies. An examination of these issues provides some guidance for law makers and policy developers in these areas of concern in establishing applicable regulatory direction, responses and governance framework. (shrink)

Maternal morbidity and mortality are high in the Indian context, but the majority of maternal deaths could be avoided by prompt and effective access to intrapartum care (WHO, 1999). Understanding the care seeking responses to intrapartum morbidities is crucial if maternal health is to be effectively improved, and maternal mortality reduced. This paper presents the results of a prospective study of 388 women followed through delivery and traditional postpartum in rural Karnataka in southern India. In this setting, few women use (...) the existing health facilities and most deliveries occur at home. The analysis uses quantitative data, collected via questionnaires administered to women both during pregnancy and immediately after delivery. By virtue of its prospective design, the study gives a unique insight into intentions for intrapartum care during pregnancy as well as events following morbidities during labour. Routine care in the intrapartum period, both within institutions and at home, and impediments to appropriate care are also examined. The study was designed to collect information about health seeking decisions made by women and their families as pregnancies unfolded, rather than trying to capture women’s experience from a retrospective instrument. The data set is therefore a rich source of quantitative information, which incorporates details of event sequences and health service utilization not previously collected in a Safe Motherhood study. Additional qualitative information was also available from concurrent in-depth interviews with pregnant women, their families, health care providers and other key informants in the area. The level of unplanned institutional care seeking during the intrapartum period within the study area was very high, increasing from 11% planning deliveries at a facility to an eventual 35% actually delivering in hospitals. In addition there was a significant move away from planned deliveries with the auxiliary nurse midwive (ANM), to births with a lay attendant or dai. The proportion of women who planned for an ANM to assist was 49%, as compared with the actual occurrence, which was less than half of this proportion. Perceived quality of care was found to be an important factor in health seeking behaviour, as was wealth, caste, education and experience of previous problems in pregnancy. Actual care given by a range of practitioners was found to contain both beneficial and undesirable elements. As a response to serious morbidities experienced within the study period, many women were able to seek care although sometimes after a long delay. Those women who experienced inadequate progression of labour pains were most likely to proceed unexpectedly to a hospital delivery. (shrink)

BackgroundCognitive deficits are one of the core features of major depressive disorder that play crucial role in functional recovery. Studies have explored cognitive deficits in MDD, however, given inconsistent results, especially in mild-moderate MDD. Recently, studies have explored music as cognitive ability in various clinical conditions. In MDD, large focus has been on evaluating emotion deficits and just a handful on music cognition. With growing evidence on use of music based intervention to target cognitive deficits, it is imperative to explore (...) nature of music cognitive ability in MDD.AimTo examine musical and neuro-cognitive deficits in patients with mild-moderate MDD.MethodsPatients diagnosed with mild or moderate MDD and matched healthy controls were evaluated on selected tests from NIMHANS Neuropsychological test battery and Montreal battery for evaluation of amusia.ResultsMDD group performed significantly lower than HC on working memory, verbal learning and retention. Three indices were computed for a comprehensive evaluation. Groups did not differ significantly in any of the indices- focused attention, executive function, learning and memory as well as on music cognition. Focused attention and memory index predicted music cognition in HC and the combined group. Attention alone contributed to 62.1% of variance in music cognition. Similarly, music cognition significantly predicted focused attention.ConclusionIndividuals with mild-moderate MDD show significant deficits in working memory, verbal learning and memory, however, not in music cognition. There exists a significant relationship between music cognition and attention, which could be implicated in use of music interventions to ameliorate cognitive deficits. Limitations of study include small sample size and heterogeneity. Future studies on larger cohort examining musical emotion perception and neurocognition is imperative to have deeper understanding of this debilitating condition. (shrink)

With the increasing use of mobile devices and new technologies, electronic payments, such as near field communication mobile payments, are gaining traction and gradually replacing the currency-based cash payment methods. Despite multiple initiatives by various parties to encourage mobile payments, adoption rates in developing countries have remained low. The purpose of this research is to explore the prime determinants of NFC mobile-payment adoption intention and to develop a model of mobile payment adoption that includes perceived risk as one of the (...) major elements by extending the UTAUT2 theory components. An online survey was used to acquire data from 370 NFC mobile payments users for the current study. To validate the components and their correlations, structural equation modelling was implemented. According to the findings, performance expectancy, hedonic motivation, social influence, and facilitating conditions have substantial impacts on the consumers’ intentions to adopt NFC mobile payments. Effort expectancy and PR were reported to have no considerable effects on the adoption intention. In addition, INFC is revealed to be a major mediator between the associations of the actual adoption of NFC mobile payment with PE, HM, and SI. The findings of the study would assist providers and marketers in better understanding of the consumers’ behavior, designing effective marketing strategies to enhance the consumers’ positive intentions, and achieving the mass adoption of NFC mobile payments in different environmental contexts. (shrink)

The paper titled “Cognitive Enhancement and Social Mobility: Skepticism from India,” written by Jayashree Dasgupta and colleagues (2023) is a very valuable addition to the Western discourse on huma...

In their article “Cognitive Enhancement and Social Mobility: Skepticism from India,” Jayashree Dasgupta, Georgia Lockwood Estrin, Jesse Summers and Ilina Singh (2023) call for further investigation...