Background Increase in global health research undertaken in resource poor settings in the last decade though a positive development has raised ethical concerns relating to potential for exploitation. Some of the suggested strategies to address these concerns include calls for providing universal standards of care, reasonable availability of proven interventions and more recently, promoting the overall social value of research especially in clinical research. Promoting the social value of research has been closely associated with providing fair benefits to various stakeholders (...) involved in research. The debate over what constitutes fair benefits; whether those that addresses micro level issues of justice or those focusing on the key determinants of health at the macro level has continued. This debate has however not benefited from empirical work on what stakeholders consider fair benefits. This study explores practical experiences of stakeholders involved in global health research in Kenya, over what benefits are fair within a developing world context. Methods and results We conducted in-depth interviews with key informants drawn from within the broader health research system in Kenya including researchers from the mainstream health research institutions, networks and universities, teaching hospitals, policy makers, institutional review boards, civil society organisations and community representative groups. The range of benefits articulated by stakeholders addresses both micro and macro level concerns for justice by for instance, seeking to engage with interests of those facilitating research, and the broader systemic issues that make resource poor settings vulnerable to exploitation. We interpret these views to suggest a need for global health research to engage with current crises that face people in these settings as well as the broader systemic issues that produce them. Conclusion Global health research should provide benefits that address both the micro and macro level issues of justice in order to forestall exploitation. Embracing the two is however challenging in terms of how the various competing interests/needs should be balanced ethically, especially in the absence of structures to guide the process. This challenge should point to the need for greater dialogue to facilitate value clarification among stakeholders. (shrink)

International health research in malaria-endemic settings may include screening for sickle cell disease, given the relationship between this important genetic condition and resistance to malaria, generating questions about whether and how findings should be disclosed. The literature on disclosing genetic findings in the context of research highlights the role of community consultation in understanding and balancing ethically important issues from participants’ perspectives, including social forms of benefit and harm, and the influence of access to care. To inform research practice locally, (...) and contribute to policy more widely, this study aimed to explore the views of local residents in Kilifi County in coastal Kenya on how researchers should manage study-generated information on sickle cell disease and carrier status. (shrink)

BackgroundCurrent guidelines do not clearly outline when assent should be attained from paediatric research participants, nor do they detail the necessary elements of the assent process. This stems from the fact that the fundamental justification behind the concept of assent is misunderstood. In this paper, we critically assess three widespread ethical arguments used for assent: children’s rights, the best interests of the child, and respect for a child’s developing autonomy. We then outline a newly-developed two-fold justification for the assent process: (...) respect for the parent’s pedagogical role in teaching their child to become an autonomous being and respect for the child’s moral worth.DiscussionWe argue that the ethical grounding for the involvement of young children in medical decision-making does not stem from children’s rights, the principle of best interests, or respect for developing autonomy. An alternative strategy is to examine the original motivation to engage with the child. In paediatric settings there are two obligations on the researcher: an obligation to the parents who are responsible for determining when and under what circumstances the child develops his capacity for autonomy and reasoning, and an obligation to the child himself. There is an important distinction between respecting a decision and encouraging a decision. This paper illustrates that the process of assent is an important way in which respect for the child as an individual can be demonstrated, however, the value lies not in the child’s response but the fact that his views were solicited in the first place.SummaryThis paper demonstrates that the common justifications for the process of assent are incomplete. Assent should be understood as playing a pedagogical role for the child, helping to teach him how specific decisions are made and therefore helping him to become a better decision-maker. How the researcher engages with the child supports his obligation to the child’s parents, yet why the researcher engages with the child stems from the child’s moral worth. Treating a child as having moral worth need not mean doing what they say but it may mean listening, considering, engaging or involving them in the decision. (shrink)

The practice of making datasets publicly available for use by the wider scientific community has become firmly integrated in genomic science. One significant gap in literature around data sharing concerns how it impacts on scientists’ ability to preserve values and ethical standards that form an essential component of scientific collaborations. We conducted a qualitative sociological study examining the potential for harm to ethnic groups, and implications of such ethical concerns for data sharing. We focused our empirical work on the MalariaGEN (...) Consortium, one of the first international collaborative genomics research projects in Africa. (shrink)

BackgroundPromoting the social value of global health research undertaken in resource poor settings has become a key concern in global research ethics. The consideration for benefit sharing, which concerns the elucidation of what if anything, is owed to participants, their communities and host nations that take part in such research, and the obligations of researchers involved, is one of the main strategies used for promoting social value of research. In the last decade however, there has been intense debate within academic (...) bioethics literature seeking to define the benefits, the beneficiaries, and the scope of obligations for providing these benefits. Although this debate may be indicative of willingness at the international level to engage with the responsibilities of researchers involved in global health research, it remains unclear which forms of benefits or beneficiaries should be considered. International and local research ethics guidelines are reviewed here to delineate the guidance they provide.MethodsWe reviewed documents selected from the international compilation of research ethics guidelines by the Office for Human Research Protections under the US Department of Health and Human Services.ResultsAccess to interventions being researched, the provision of unavailable health care, capacity building for individuals and institutions, support to health care systems and access to medical and public health interventions proven effective, are the commonly recommended forms of benefits. The beneficiaries are volunteers, disease or illness affected communities and the population in general. Interestingly however, there is a divide between "global opinion" and the views of particular countries within resource poor settings as made explicit by differences in emphasis regarding the potential benefits and the beneficiaries.ConclusionAlthough in theory benefit sharing is widely accepted as one of the means for promoting the social value of international collaborative health research, there is less agreement amongst major guidelines on the specific responsibilities of researchers over what is ethical in promoting the social value of research. Lack of consensus might have practical implications for efforts aimed at enhancing the social value of global health research undertaken in resource poor settings. Further developments in global research ethics require more reflection, paying attention to the practical realities of implementing the ethical principles in real world context. (shrink)

BackgroundThe concept of benefit sharing to enhance the social value of global health research in resource poor settings is now a key strategy for addressing moral issues of relevance to individuals, communities and host countries in resource poor settings when they participate in international collaborative health research.The influence of benefit sharing framework on the conduct of collaborative health research is for instance evidenced by the number of publications and research ethics guidelines that require prior engagement between stakeholders to determine the (...) social value of research to the host communities. While such efforts as the production of international guidance on how to promote the social value of research through such strategies as benefit sharing have been made, the extent to which these ideas and guidelines have been absorbed by those engaged in global health research especially in resource poor settings remains unclear. We examine this awareness among stakeholders involved in health related research in Kenya.MethodsWe conducted in-depth interviews with key informants drawn from within the broader health research system in Kenya including researchers from the mainstream health research institutions, networks and universities, teaching hospitals, policy makers, institutional review boards, civil society organisations and community representative groups.ResultsOur study suggests that although people have a sense of justice and the moral aspects of research, this was not articulated in terms used in the literature and the guidelines on the ethics of global health research.ConclusionThis study demonstrates that while in theory several efforts can be made to address the moral issues of concern to research participants and their communities in resource poor settings, quick fixes such as benefit sharing are not going to be straightforward. We suggest a need to pay closer attention to the processes through which ethical principles are enacted in practice and distil lessons on how best to involve individuals and communities in promoting ethical conduct of global health research in resource poor settings. (shrink)

This paper considers John Doris, Stephen Stich, Alexandra Plakias, and colleagues’ recent attempts to utilize empirical studies of cross-cultural variation in moral judgment to support a version of the argument from disagreement against moral realism. Crucially, Doris et al. claim that the moral disagreements highlighted by these studies are not susceptible to the standard ‘diffusing’ explanations realists have developed in response to earlier versions of the argument. I argue that plausible hypotheses about the cognitive processes underlying ordinary moral judgment and (...) the acquisition of moral norms, when combined with a popular philosophical account of moral inquiry—the method of reflective equilibrium—undercut the anti-realist force of the moral disagreements that Doris et al. describe. I also show that Stich's recent attempt to provide further theoretical support for Doris et al.'s case is unsuccessful. (shrink)

Advanced directives and living wills have improved our ability to dictate end-of-life care, but even these cannot guarantee that we will be allowed the dignity of a natural death. Designed by two sisters-one a doctor, one a lawyer-and drawing on their decades of experience, the five-step Compassion Protocol outlined in A Better Way of Dying offers a simple and effective framework for leaving caretakers concrete, unambiguous, and legally binding instructions about your wishes for your last days. Meant for people in (...) every walk of life-from the elderly, to those in the early stages of mentally degenerative diseases like Alzheimer's, to healthy young people planning for an unpredictable future-this book creates space for a discussion we all must have if we wish to ensure comfort and control at the end of our lives.." -- from publisher's website. (shrink)

"In Applied Ethics and Social Problems Tony Fitzpatrick presents introductions to the three most influential moral philosophies: consequentialism, Kantianism ...

In this book, Fitzpatrick and May make the case for a reimagined approach to critical ethnography in education. Exploring how critical ethnography works within contemporary inquiries, the authors argue that many researchers already do the kind of critical ethnography that readers imagine, whether they call their studies critical or not. Such studies employ the tenets of ethnography and are grounded in work that attends to, reimagines, troubles, and questions notions of power, in/justice, in/equity, and marginalization. Understanding the tensions and (...) complexities that come with the posts-including poststructuralism, postcolonialism, and posthumanism-Fitzpatrick and May argue that social, theoretical, and political issues in education can be more profoundly viewed through a lens that is personal, embodied, and lived: critical ethnography. Offering a wide-ranging and insightful commentary on approaches and influences on critical ethnography over time, Fitzpatrick and May interrogate how it has moved and engaged with ongoing theoretical developments to now include a wide range of possible analytical approaches. With extensive examples, excerpts, and personal discussions, they demonstrate how critical ethnography is an expansive, eclectic, and inclusive methodology. Linking work across a range of topics, this book highlights the ongoing importance of this methodology in education. It is essential reading for students, scholars, and researchers in qualitative inquiry, ethnography, educational anthropology, educational research methods, sociology of education, and philosophy of education. (shrink)

Time's mysteries seem to resist comprehension and what remains, once the familiar metaphors are stripped away, can stretch even the most profound philosopher. In Of Time and Lamentation, Raymond Tallis rises to this challenge and explores the nature and meaning of time and how best to understand it. The culmination of some twenty years of thinking, writing and wondering about (and within) time, it is a bold, original, and thought-provoking work. With characteristic fearlessness, Tallis seeks to reclaim time from (...) the jaws of physics. For most of us, time is composed of mornings, afternoons, and evenings and expressed in hurry, hope, longing, waiting, enduring, planning, joyful expectation, and grief. Thinking about it is to meditate on our own mortality. Yet, physics has little or nothing to say about this time, the time as it is lived. The story told by caesium clocks, quantum theory, and Lorentz coordinates, Tallis argues, needs to be supplemented by one of moss on rocks, tears on faces, and the long narratives of our human journey. Our temporal lives deserve a richer attention than is afforded by the equations of mathematical physics.The first part of the book, "Killing Time" is a formidable critique of the spatialized and mathematized account of time arising from physical science. Part 2, "Human Time" examines tensed time, the reality of time as it is lived: what we mean by "now", how we make sense of past and future events, and the idea of eternity. (shrink)

This volume explores the relationship between individuals and institutions in scholastic thought and practice across the twelfth and fifteenth centuries, setting an agenda for future debates. Written by leading European experts from numerous fields, this theoretically sophisticated collection analyses a wide range of intellectual practices and disciplines. Avoiding narrow approaches to scholasticism, the book addresses ethics, history, heresy, law, inquisition, metaphysics, pastoral care, poetry, religious orders, saints' cults and theology. A substantial introduction establishes an accessible historiographical context for the volume's (...) agenda, and a final afterword examines implications for future research. The history of individuals and institutions in scholasticism has often been unhelpfully treated either as a simple intellectual genealogy of schools and doctrines, or a constitutional history of particular organizational forms. This volume advances our understanding by reconsidering these fields as a whole and addressing two large questions. What was the relationship between particular intellectuals and their wider networks? How did individuals alter their institutions, and how did those institutions shape their individuality? This volume is of major importance to intellectual, religious and cultural historians as well as historians of knowledge and science. It will engage those working on individuals and institutions in the middle ages as well as in other periods. (shrink)

The sources that we have conveying information about the early Greek philosophers are far removed from the original texts. Manuscripts from the era were disseminated by scribes, making copies of a text. The text that formed the basis for the scribe was more likely than not a copy of a copy of a copy. Scribes are imperfect conduits of information. In addition to the challenges faced in ascertaining accuracy of the base text, there are errors that often occur in transcription (...) of the base text. There are errors of omission: Homeoteleuton occurs when a transcription skips words because a subsequent word has the same or a similar ending. Homeoarchy occurs when the transcriber skips lines, because of the similarity of the beginning of the lines. Haplography occurs when the transcriber copies once a term that appears twice in the base text. There are errors of addition. Dittography occurs when the transcriber writes a term twice that appeared once in the base text. Contamination occurs when a transcriber inserts text that was not in the base text. There are errors of transposition. Metathesis occurs when a transcriber reverses letters, words, or phrases from the base text. Finally, but not exhaustively, there are errors of alteration. These errors occur when a transcriber attempts, deliberately or not, to make sense of the base text in the transcription. (shrink)

Raymond Turner first provides a logical framework for specification and the design of specification languages, then uses this framework to introduce and study ...

A collection of philosophical and aesthetic essays, influenced by Bernard Stiegler, which focuses on the techno-cultural artefact in order to critique, engage, or respond to, an aspect of digital culture.

An entertaining series of logic problems and puzzles of increasing difficulty, and all relating important mathematical and logical concepts, includes mind-benders, paradoxes, metapuzzles, number exercises, and a mathematical novel.

This paper explores the ethical and conceptual implications of the findings from an empirical study (reported elsewhere) of decision-making capacity in anorexia nervosa. In the study, ten female patients aged thirteen to twenty-one years with a diagnosis of anorexia nervosa, and eight sets of parents, took part in semistructured interviews. The purpose of the interviews was to identify aspects of thinking that might be relevant to the issue of competence to refuse treatment. All the patient-participants were also tested using the (...) MacArthur Competence Assessment Tool—Treatment test of competence. This is a formalized, structured, interviewer-administered test of competence, which is a widely accepted clinical tool for determining capacity. The young women also completed five brief, self-administered questionnaires to assess their levels of psychopathology. The issues identified from the interviews are described under two headings: difficulties with thought processing and changes in values. The results suggest that competence to refuse treatment may be compromised in people with anorexia nervosa in ways that are not captured by traditional legal approaches. (shrink)

This work subjects the fundamental ideas of Derrida, Lacan, Barthes and their followers to an examination and demonstrates the baselessness of post-Saussurean claims about the relations between language, reality and self.

Social norms – rules governing which behaviours are deemed appropriate or inappropriate within a given community – are typically taken to be uniquely human. Recently, this position has been challenged by a number of philosophers, cognitive scientists, and ethologists, who have suggested that social norms may also be found in certain non-human animal communities. Such claims have elicited considerable scepticism from norm cognition researchers, who doubt that any non-human animals possess the psychological capacities necessary for normative cognition. However, there is (...) little agreement among these researchers about what these psychological prerequisites are. This makes empirical study of animal social norms difficult, since it is not clear what we are looking for and thus what should count as behavioural evidence for the presence (or absence) of social norms in animals. To break this impasse, we offer an approach that moves beyond contested psychological criteria for social norms. This approach is inspired by the animal culture research program, which has made a similar shift away from heavily psychological definitions of ‘culture’ and to become organized around a cluster of more empirically tractable concepts of culture. Here, we propose an analogous set of constructs built around the core notion of a normative regularity, which we define as a socially maintained pattern of behavioural conformity within a community. We suggest methods for studying potential normative regularities in wild and captive primates. We also discuss the broader scientific and philosophical implications of this research program with respect to questions of human uniqueness, animal welfare and conservation. (shrink)

_Foucault’s Law_ is the first book in almost fifteen years to address the question of Foucault’s position on law. Many readings of Foucault’s conception of law start from the proposition that he failed to consider the role of law in modernity, or indeed that he deliberately marginalized it. In canvassing a wealth of primary and secondary sources, Ben Golder and Peter Fitzpatrick rebut this argument. They argue that rather than marginalize law, Foucault develops a much more radical, nuanced and (...) coherent theory of law than his critics have acknowledged. For Golder and Fitzpatrick, Foucault’s law is not the contained creature of conventional accounts, but is uncontainable and illimitable. In their radical re-reading of Foucault, they show how Foucault outlines a concept of law which is not tied to any given form or subordinated to a particular source of power, but is critically oriented towards alterity, new possibilities and different ways of being. _Foucault’s Law_ is an important and original contribution to the ongoing debate on Foucault and law, engaging not only with Foucault’s diverse writings on law and legal theory, but also with the extensive interpretive literature on the topic. It will thus be of interest to students and scholars working in the fields of law and social theory, legal theory and law and philosophy, as well as to students of Foucault’s work generally. (shrink)

This is a new edition of a classic textbook in health care ethics, one that offers an alternative to the principle-based approach from Beauchamp and Childress (Principles of Biomedical Ethics, now in its seventh edition from OUP) and traditional Catholic approaches of Ashley and O'Rourke. In the early chapters Devettere spells out the meaning of ethics and the importance of prudential reasoning in seeking the good life. The rest of the book deals with issues and cases, including determinations of life (...) and death, reproduction and research and genetics, and the distribution of health care. In this fourth edition Devettere updates all chapters and adds new cases and new sections on the following: neuroscience, social psychology, overriding advance directives, studies on the fetus, the palliative care movement, cardiopulmonary resuscitation, pharmacists and reproductive issues, prenatal life and abortion, neonatal testing and mandatory vaccinations, the US governments' STD research in Guatemala, the emergence of biobanks, facial transplantations, genetic testing, legal issues around the Affordable Care Act, and more. This is an accessible and comprehensive textbook covering all aspects of the field. (shrink)

What is law? Does it have a purpose? What is its relationship with justice? Do we have a moral duty to obey the law? These sorts of questions lie at the heart of jurisprudence. Moreover, every substantive or 'black letter' branch of the law raises questions about its own meaning and function. The law of contract cannot be properly understood without an appreciation of the concepts of rights and duties. The law of tort is directly related to several economic theories (...) of compensation. The criminal law is inextricably linked to philosophies of punishment? Understanding Jurisprudence explores these problems and provides an engaging introduction to the central issues of legal theory. The book navigates the reader through legal philosophy's fundamental concepts, concerns, and controversies. An experienced teacher of jurisprudence and distinguished writer in the field, Professor Wacks adopts an approach that is easy to follow and understand without avoiding the complexities and subtleties of the subject. Students of law, politics, philosophy, and other social sciences will find this an ideal guide to the essential themes of contemporary jurisprudence. Online Resource Centre A free online resource accompanies the book and provides the following resources: Analysis of current controversies of a jurisprudential nature such as current legal and moral controversies and political debates An additional chapter providing guidance and advice on the study of jurisprudence An interactive glossary of key terms relating to legal theory Further reading, including links to full text journal articles Questions and answers Useful Web links to support learning. (shrink)