Race and religion are integral parts of bioethics. Harm and oppression, with the aim of social and political control, have been wrought in the name of religion against Blacks and people of color as embodied in the Ten Commandments, the Inquisition, and in the history of the Holy Crusades. Missionaries came armed with Judeo/Christian beliefs went to nations of people of color who had their own belief systems and forced change and caused untold harms because the indigenous belief systems were (...) incompatible with their own. The indigenous people were denounced as ungodly, pagan, uncivilized, and savage. Hence, laws were enacted because of their perceived need to structure a sense of morality and to create and build a culture for these indigenous people of color. To date bioethics continues to be informed by a Western worldview that is Judeo/Christian in belief and orientation. However, missing from bioethical discourse in America is the historical influence of the Black Church as a cultural repository, which continues to influence the culture of Africans and Blacks. Cultural aspects of peoples of color are still largely ignored today. In attempting to deal with issues of race while steering clear of the religious and cultural impact of the Black Church, bioethics finds itself in the middle of a distressing situation: it simply cannot figure out what to do with race. (shrink)
This case note considers the availability in the United Kingdom of the provocation defence in cases of intimate homicide in the context of the recent House of Lords decision in Rv. Smith  3 W.L.R. 654. The note argues that the expansion of the objective component of the defence to encompass the mental infirmities of individual defendants is dangerous for women. Although it has the potential to help some abused women who kill to use the defence, it has, at the (...) same time, exposed women who are abused by sexually possessive, violent men to even greater danger. It is thus argued that the defence should be restricted in the way envisaged by the minority judgement of Lord Millett so that abused women will still be able to use the defence, but by anon-medical route. Alternatively, the defence should be abolished and defences which pose no risk of encompassing violent men should be developed to accommodate abused women. (shrink)
The rapid rise of international collaborative science has enabled access to genomic data. In this article, it is argued that to move beyond mapping genomic variation to understanding its role in complex disease aetiology and treatment will require extending data sharing for the purposes of clinical research translation and implementation.
Background Offering financial incentives to achieve medication adherence in patients with severe mental illness is controversial. Aims To explore the views of different stakeholders on the ethical acceptability of the practice. Method Focus group study consisting of 25 groups with different stakeholders. Results Eleven themes dominated the discussions and fell into four categories: (1) ‘wider concerns’, including the value of medication, source of funding, how patients would use the money, and a presumed government agenda behind the idea; (2) ‘problems requiring (...) clear policies’, comprising of practicalities and assurance that incentives are only one part of a tool kit; (3) ‘challenges for research and experience’, including effectiveness, the possibility of perverse incentives, and impact on the therapeutic relationship; (4) ‘inherent dilemmas’ around fairness and potential coercion. Conclusions The use of financial incentives is likely to raise similar concerns in most stakeholders, only some of which can be addressed by empirical research and clear policies. (shrink)
Randomized controlled clinical trials play an important role in the development of new medical therapies. There is, however, an ethical issue surrounding the use of randomized treatment allocation when the patient is suffering from a life threatening condition and requires immediate treatment. Such patients can only benefit from the treatment they actually receive and not from the alternative therapy, even if it ultimately proves to be superior. We discuss a novel new way to analyse data from such clinical trials based (...) on the use of the recently developed theory of imprecise probabilities. This work draws an explicit distinction between the related but nevertheless distinct questions of inference and decision in clinical trials. The traditional question of scientific interest asks 'Which treatment offers the greater chance of success?' and is the primary reason for conducting the clinical trial. The question of decision concerns the welfare of the patients in the clinical trial, asking whether the accumulated evidence favours one treatment over the other to such an extent that the next patient should decline randomization and instead express a preference for one treatment. Consideration of the decision question within the framework of imprecise probabilities leads to a mathematical definition of equipoise and a method for governing the randomization protocol of a clinical trial. This paper describes in detail the protocol for the conduct of clinical trials based on this new method of analysis, which is illustrated in a retrospective analysis of data from a clinical trial comparing the anti-emetic drugs ondansetron and droperidol in the treatment of postoperative nausea and vomiting. The proposed methodology is compared quantitatively using computer simulation studies with conventional clinical trial designs and is shown to maintain high statistical power with reduced sample sizes, at the expense of a high type I error rate that we argue is irrelevant in some specific circumstances. Particular emphasis is placed on describing the type of medical conditions and treatment comparisons where the new methodology is expected to provide the greatest benefit. (shrink)
Recent advances in basic neuroscience research across a wide range of methodologies have contributed significantly to our understanding of human cortical electrophysiology and functional brain imaging. Translation of this research into clinical neurosurgery has opened doors for advanced mapping of functionality that previously was prohibitively difficult, if not impossible. Here we present the case of a unique individual with congenital blindness and medically refractory epilepsy who underwent neurosurgical treatment of her seizures. Pre-operative evaluation presented the challenge of accurately and robustly (...) mapping the cerebral cortex for an individual with a high probability of significant cortical re-organization. Additionally, a blind individual has unique priorities in one’s ability to read Braille by touch and sense the environment primarily by sound than the non-vision impaired person. For these reasons we employed additional measures to map sensory, motor, speech, language, and auditory perception by employing a number of cortical electrophysiologic mapping and functional magnetic resonance imaging methods. Our data show promising results in the application of these adjunctive methods in the pre-operative mapping of otherwise difficult to localize, and highly variable, functional cortical areas. (shrink)
I argue for three basic classes of nominals, based on the (non)-relation they encode; (i) alienable nouns, which have no inherent relation, but gain an underspecified ‘R’ relation when possessed (Higginbotham, Linguistic Inquiry, 14, 305–420, 1983); (ii) relational nouns, which have an inherent relation, defined as an ‘R’ relation restricted by the lexical meaning of the head noun (Barker, Possessive descriptions. CSLI: California, USA, 1995; Burton, Six issues to consider when choosing a husband. Doctoral Dissertation, Rutgers, New Brunswick, New (...) Jersey, 1995); and (iii) inalienable nouns, which also have an inherent relation, defined as a material part-whole relation (Link, Algebraic semantics for linguistics and philosophy. CSLI: California, USA, 1998). I then consider evidence from the Algonquian language Plains Cree, which overtly distinguishes all three subclasses of nominals. (shrink)
It is well established that retrieval of names is harder than the retrieval of other identity specific information. This paper offers a review of the more influential accounts put forward as explanations of why names are so difficult to retrieve. A series of five experiments tests a number of these accounts. Experiments One to Three examine the claims that names are hard to recall because they are typically meaningless (Cohen 1990), or unique (Burton and Bruce 1992; Brédart, Valentine, Calder, (...) and Gassi 1995). Participants are shown photographs of unfamiliar people (Experiments One and Two) or familiar people (Experiment Three) and given three pieces of information about each: a name, a unique piece of information, and a shared piece of information. Learning follows an incidental procedure, and participants are given a surprise recall test. In each experiment shared information is recalled most often, followed by unique information, followed by name. Experiment Four tests both the ¿uniqueness¿ account and an account based on the specificity of the naming response (Brédart 1993). Participants are presented with famous faces and asked to categorise them by semantic group (occupation). Results indicate that less time is needed to perform this task when the group is a subset of a larger semantic category. A final experiment examines the claim that names might take longer to access because they are less often retrieved than other classes of information. Latencies show that participants remain more efficient when categorising faces by their occupation than by their name even when they have received extra practice of naming the faces. We conclude that the explanation best able to account for the data is that names are stored separately from other semantic information and can only be accessed after other identity specific information has been retrieved. However, we also argue that the demands we make of these explanations make it likely that no single theory will be able to account for all existing data. (shrink)