BackgroundThe potential contribution of community engagement to addressing ethical challenges for international biomedical research is well described, but there is relatively little documented experience of community engagement to inform its development in practice. This paper draws on experiences around community engagement and informed consent during a genetic cohort study in Kenya to contribute to understanding the strengths and challenges of community engagement in supporting ethical research practice, focusing on issues of communication, the role of field workers in 'doing ethics' on (...) the ground and the challenges of community consultation.MethodsThe findings are based on action research methods, including analysis of community engagement documentation and the observations of the authors closely involved in their development and implementation. Qualitative and quantitative content analysis has been used for documentation of staff meetings and trainings, a meeting with 24 community leaders, and 40 large public and 70 small community group meetings. Meeting minutes from a purposive sample of six community representative groups have been analysed using a thematic framework approach.ResultsField workers described challenges around misunderstandings about research, perceived pressure for recruitment and challenges in explaining the study. During consultation, leaders expressed support for the study and screening for sickle cell disease. In community meetings, there was a common interpretation of research as medical care. Concerns centred on unfamiliar procedures. After explanations of study procedures to leaders and community members, few questions were asked about export of samples or the archiving of samples for future research.ConclusionsCommunity engagement enabled researchers to take account of staff and community opinions and issues during the study and adapt messages and methods to address emerging ethical challenges. Field workers conducting informed consent faced complex issues and their understanding, attitudes and communication skills were key influences on ethical practice. Community consultation was a challenging concept to put into practice, illustrating the complexity of assessing information needs and levels of deliberation that are appropriate to a given study. (shrink)

The importance of communities in strengthening the ethics of international collaborative research is increasingly highlighted, but there has been much debate about the meaning of the term ‘community’ and its specific normative contribution. We argue that ‘community’ is a contingent concept that plays an important normative role in research through the existence of morally significant interplay between notions of community and individuality. We draw on experience of community engagement in rural Kenya to illustrate two aspects of this interplay: (i) that (...) taking individual informed consent seriously involves understanding and addressing the influence of communities in which individuals’ lives are embedded; (ii) that individual participation can generate risks and benefits for communities as part of the wider implications of research. We further argue that the contingent nature of a community means that defining boundaries is generally a normative process itself, with ethical implications. Community engagement supports the enactment of normative roles; building mutual understanding and trust between researchers and community members have been important goals in Kilifi, requiring a broad range of approaches. Ethical dilemmas are continuously generated as part of these engagement activities, including the risks of perverse outcomes related to existing social relations in communities and conditions of ‘half knowing’ intrinsic to processes of developing new understandings. (shrink)

There is wide agreement that community engagement is important for many research types and settings, often including interaction with ‘representatives’ of communities. There is relatively little published experience of community engagement in international research settings, with available information focusing on Community Advisory Boards or Groups (CAB/CAGs), or variants of these, where CAB/G members often advise researchers on behalf of the communities they represent. In this paper we describe a network of community members (‘KEMRI Community Representatives’, or ‘KCRs’) linked to a (...) large multi-disciplinary research programme on the Kenyan Coast. Unlike many CAB/Gs, the intention with the KCR network has evolved to be for members to represent the geographical areas in which a diverse range of health studies are conducted through being typical of those communities. We draw on routine reports, self-administered questionnaires and interviews to: 1) document how typical KCR members are of the local communities in terms of basic characteristics, and 2) explore KCR's perceptions of their roles, and of the benefits and challenges of undertaking these roles. We conclude that this evolving network is a potentially valuable way of strengthening interactions between a research institution and a local geographic community, through contributing to meeting intrinsic ethical values such as showing respect, and instrumental values such as improving consent processes. However, there are numerous challenges involved. Other ways of interacting with members of local communities, including community leaders, and the most vulnerable groups least likely to be vocal in representative groups, have always been, and remain, essential. (shrink)

Benefit sharing in health research has been the focus of international debates for many years, particularly in developing countries. Whilst increasing attention is being given to frameworks that can guide researchers to determine levels of benefits to participants, there is little empirical research from developing countries on the practical application of these frameworks, including in situations of extreme poverty and vulnerability. In addition, the voices of those who often negotiate and face issues related to benefits in practice - frontline researchers (...) and fieldworkers - are rarely included in these debates. Against this background, this paper reports on experiences of negotiating research participation and benefits as described by fieldworkers, research participants and researchers in two community based studies. (shrink)

The aim of this study was to explore the existence of moral distress among nurses in Lilongwe District of Malawi. Qualitative research was conducted in selected health institutions of Lilongwe District in Malawi to assess knowledge and causes of moral distress among nurses and coping mechanisms and sources of support that are used by morally distressed nurses. Data were collected from a purposive sample of 20 nurses through in-depth interviews using a semi-structured interview guide. Thematic analysis of qualitative data was (...) used. The results show that nurses, irrespective of age, work experience and tribe, experienced moral distress related to patient/nursing care. The major distressing factors were inadequate resources and lack of respect from patients, guardians, peers and bosses. Nurses desire teamwork and ethics committees in their health institutions as a means of controlling and preventing moral distress. There is a need for creation of awareness for nurses to recognize and manage moral distress, thus optimizing their ability to provide quality and uncompromised nursing care. (shrink)

The "mathematization" of knowledge is a historically inevitable process governed by two circumstances. In the first place there is the need for the further extension of knowledge in all areas of human activity, whether it be the study of natural phenomena or the theory of taking decisions in the economic or social sphere. Marx pointed out long ago that a science reaches its highest levels only when it succeeds in making use of mathematics. The second circumstance rendering the process of (...) deepening and broadening the mathematization of knowledge not only necessary but possible lies in the constant development both of mathematics itself and of the technical means broadening the sphere of its application. (shrink)

The purpose of the article is the analysis of the causes of the systemic crisis that hit modern civilization through the description of its main structures, identifying the relationship between its elements, assessments of their heuristic potential. This will open up opportunities for finding ways to resolve this crisis, new directions of civilizational development. Theoretical basis of the research are the systems analysis, socio-philosophical and philosophical-anthropological approaches as well as the analysis of scientific developments in the field of global studies. (...) Originality lies in the fact that this article is the first to show the connection between the main structural elements of human civilization as a system. Change in one of the parameters leads to a change in all the others, together with a change in civilization as a whole. Conclusions. The reason for the deep crisis that hit modern civilization is its imbalance as a system. The most important elements of this system are population size, resources and technology, and the core is consciousness in its individual and collective forms. The perception, processing, and use of information, which is a defining civilizational resource, as well as the stability of the entire system depend on the state of consciousness. Consciousness, based on old, obsolete principles and stereotypes, is unable to cope with the most acute challenges of time. New consciousness, since it is formed, will mark the transition to a new theoretical picture of the world and a model of human behavior, in which people will act, driven by proven knowledge, and not willfulness and prejudice. The idea of forming a productive information environment where the ideas of constructiveness and creative work will dominate rather than consumerism and destruction, as is the case at present, must become the categorical imperative of the new consciousness. (shrink)

The concept of interpretation is applicable to any forms of knowledge, including systems of religious knowledge, designing the ideal model of the subject of religious veneration. The author analyzes the epistemological features of theology as a form of spiritual culture, its formation in ancient culture. It is shown that the epistemological basis for overcoming mythological consciousness was the decentralization of thinking, i.e. development of the ability of consciousness in the construction of the image, the picture of the world to correct (...) the position of the subject, to take into account the relativity of the reference system, from the standpoint of which the subject perceives the object and transforms it into an operational system of thinking. Decentration of thinking provided the overcoming of the subjective mental boundaries of the field, giving the thinking nature of universality. Historical stages and moments of this process - the transformation of mythology into forms of folk art, mythopoetic epic, in the form of religious consciousness. In line with such transformations of archaic consciousness, cultural and historical prerequisites of theology emergence were formed. They are represented in mythopoetic art, ancient mythography, early traditions of critical and rationalistic interpretation of the myth, etc. The article shows the formation of allegorical theology, which became possible in the era of individualization of artistic creativity, when the visible was the difference between the motive and the purpose of activity, creative idea and its embodiment, figuratively-poetic and rationally-conceptual ways of reflecting the world, when the image of reality and its personal meaning began to be realized as different States of consciousness. The main function of any theology is the interpretation of abstract models of the subject of religious veneration. (shrink)

В монографии рассматривается соотношение индивидуальных и универсальных начал в праве как эффективное средство решения многих правовых проблем, как руководство в законодательной и судебной деятельности.

Questions pertaining to socialist democracy and human rights and freedoms have now been advanced to the front lines of the ideological struggle between the forces of socialism, peace, and democracy, on the one hand, and those of imperialism, war, and reaction, on the other. This is due to the content and features of the worldwide development of societies today, one direction of which is a universal increase in the political self-awareness and social activity of the working class and the entire (...) mass of the toiling population. The final document of the 1976 Conference of Communist and Workers' Parties of Europe emphasizes: "The historical necessity of replacing capitalist society with a socialist society established in accordance with the will of each people is becoming evident to ever broader strata of the public." The great achievements of socialism and the successes of socialist democracy serve as an inspiring example in the heroic struggle of the working class and its allies for peace and social progress. (shrink)

Мета роботи полягає у постметафізичній концептуалізації суб’єкта у клінічному дискурсі філософської антропології. Теоретичний базис дослідження поєднує засоби дискурсивної аналітики і загальні принципи історико-філософської науки. Логіка дослідження збігається із парадигмальним розумінням трансформацій суб’єкта та передбачає перехід від діагностичних стратегій аналізу індивідуального буття як основи патологічності суб’єкта до дослідження терапевтичних моделей концептуалізації комунікації як детермінанти патології та, нарешті, до аналітики суб’єкта в горизонті полісуб’єктної соціальності. Наукова новизна полягає у розкритті основних антропологічних моделей суб’єкта, що відповідають функціям діагностики й терапії. Показано, що, попри (...) революційність певних проектів, що дозволяє їх віднести до постметафізичних, у них залишаються рецидиви метафізичності, які існують в образі суб’єкта, що мислиться як основа справжності. Відповідно до критеріїв практичної імплементації ключовою є трансформація теорій суб’єкта, орієнтованих на самопокладання і автономію, у концепції, сфокусовані на відповідальності, турботі про суще і здійсненні у якості людини. Висновки. Доведено, що образ посткласичного суб’єкта, зосередженого на ідеалі власної автентичності, мусить діагностуватися як патологічний. Показана недоцільність акцентуації виключно на дискурсивності, розмові, результатом якої стає ствердження незалежності внутрішнього, хоч і маргінального світу девіантного суб’єкта. Обґрунтована необхідність доведення проблеми до логіки соціальної взаємодії, у якій виникає та форма смислової організації феноменів, що є нормальною структурою життєвого світу і на основі якої виникає повноцінний суб’єкт із уявленнями про власну самодостатність, і з турботою про суще. (shrink)