This paper examines the points of connection and divergence between critical realism/metaRealism and integral theory, suggesting ways in which they might interact and mutually enrich each other. It highlights the common ground that both metatheories share and also identifies the particular strengths and shortcomings of both, arguing that they stem, in part, from their different emphases: integral theory on individual emancipation and critical realism on social emancipation. It suggests that this different focus has led to different strengths in each that (...) often coincide with an area that needs developing in the other, providing a promising potential for mutual enrichment. (shrink)
To extract quantitative and meaningful relationships between material microstructure and deformation twinning in magnesium, we conduct a statistical analysis on large data sets generated by electron backscattering diffraction (EBSD). The analyses show that not all grains of similar orientation and grain size form twins, and twinning does not occur exclusively in grains with high twin Schmid factors or in the relatively large grains of the sample. The number of twins per twinned grain increases with grain area, but twin thickness and (...) the fraction of grains with at least one visible twin are independent of grain area. On the other hand, an analysis of twin pairs joined at a boundary indicates that grain boundary misorientation angle strongly influences twin nucleation and growth. These results question the use of deterministic rules for twin nucleation and Hall?Petch laws for size effects on twinning. Instead, they encourage an examination of the defect structures of grain boundaries and their role in twin nucleation and growth. (shrink)
Most writing on informed consent in Africa highlights different cultural and social attributes that influence informed consent practices, especially in research settings. This review presents a composite picture of informed consent in Nigeria using empirical studies and legal and regulatory prescriptions, as well as clinical experience. It shows that Nigeria, like most other nations in Africa, is a mixture of sociocultural entities, and, notwithstanding the multitude of factors affecting it, informed consent is evolving along a purely Western model. Empirical studies (...) show that 70–95% of Nigerian patients report giving consent for their surgical treatments. Regulatory prescriptions and adjudicated cases in Nigeria follow the Western model of informed consent. However, adversarial legal proceedings, for a multiplicity of reasons, do not play significant roles in enforcing good medical practice in Nigeria. Gender prejudices are evident, but not a norm. Individual autonomy is recognized even when decisions are made within the family. Consent practices are influenced by the level of education, extended family system, urbanization, religious practices, and health care financing options available. All limitations notwithstanding, consent discussions improved with increasing level of education of the patients, suggesting that improved physician's knowledge and increasing awareness and education of patients can override other influences. Nigerian medical schools should restructure their teaching of medical ethics to improve the knowledge and practices of physicians. More research is needed on the preferences of the Nigerian people regarding informed consent so as to adequately train physicians and positively influence physicians' behaviors. (shrink)
In the field of bioethics, scholars have begun to consider carefully the impact of structural issues on global population health, including socioeconomic and political factors influencing the disproportionate burden of disease throughout the world. Human rights and social justice are key considerations for both population health and biomedical research. In this paper, I will briefly explore approaches to human rights in bioethics and review guidelines for ethical conduct in international health research, focusing specifically on health research conducted in resource-poor settings. (...) I will demonstrate the potential for addressing human rights considerations in international health research with special attention to the importance of collaborative partnerships, capacity building, and respect for cultural traditions. Strengthening professional knowledge about international research ethics increases awareness of ethical concerns associated with study design and informed consent among researchers working in resource-poor settings. But this is not enough. Technological and financial resources are also necessary to build capacity for local communities to ensure that research results are integrated into existing health systems. Problematic issues surrounding the application of ethical guidelines in resource-poor settings are embedded in social history, cultural context, and the global political economy. Resolving the moral complexities requires a commitment to engaged dialogue and action among investigators, funding agencies, policy makers, governmental institutions, and private industry. (shrink)
Some experiences of the natural world bring a sense of unity, knowledge, self-transcendence, eternity, light, and love. This is the first detailed study of these intriguing phenomena. Paul Marshall explores the circumstances, characteristics, and after-effects of this important but relatively neglected type of mystical experience, and critiques explanations that range from the spiritual and metaphysical to the psychoanalytic, contextual, and neuropsychological. The theorists discussed include R. M. Bucke, Edward Carpenter, W. R. Inge, Evelyn Underhill, Rudolf Otto, Sigmund Freud, Aldous Huxley, (...) R. C. Zaehner, W. T. Stace, Steven Katz, and Robert Forman, as well as contemporary neuroscientists. The book makes a significant contribution to current debates about the nature of mystical experience. (shrink)
The emergence of new obstetrical and neonatal technologies, as well as more aggressive clinical management, has significantly improved the survival of extremely low birth weight (ELBW) infants. This development has heightened concerns about the limits of viability. ELBW infants, weighing less than 1,000 grams and no larger than the palm of one's hand, are often described as of late twentieth century technology. Improved survivability of ELBW infants has provided opportunities for long-term follow-up. Information on their physical and emotional development contributes (...) to developing standards of practice regarding their care. (shrink)
Cultural difference has been largely ignored within bioethics, particularly within the end-of-life discourses and practices that have developed over the past two decades in the U.S. healthcare system. Yet how should culturebe taken into account?
The severe shortage of organs for transplantation and the continual reluctance of the public to voluntarily donate has prompted consideration of alternative strategies for organ procurement. This paper explores the development of market approaches for procuring human organs for transplantation and considers the social and moral implications of organ donation as both a gift of life and a commodity exchange. The problematic and paradoxical articulation of individual autonomy in relation to property rights and marketing human body parts is addressed. We (...) argue that beliefs about proprietorship over human body parts and the capacity to provide consent for organ donation are culturally constructed. We contend that the political and economic framework of biomedicine, in western and non-western nations, influences access to transplantation technology and shapes the form and development of specific market approaches. Finally, we suggest that marketing approaches for organ procurement are and will be negotiated within cultural parameters constrained by several factors: beliefs about the physical body and personhood, religious traditions, economic conditions, and the availability of technological resources. (shrink)