BackgroundLow literacy of study participants in Sub - Saharan Africa has been associated with poor comprehension during the consenting process in research participation. The concerns in comprehension are far greater when consenting to participate in genomic studies due to the complexity of the science involved. While efforts are made to explore possibilities of applying genomic technologies in diseases prevalent in Sub Saharan Africa, we ought to develop methods to improve participants’ comprehension for genomic studies. The purpose of this study was (...) to understand different approaches that can be used to seek consent from individuals with low literacy in Sub-Saharan African countries in genomic research to improve comprehension.MethodsUsing qualitative study design, we conducted focus-group discussions, in-depth interviews and participant observations as data collection methods. This study was embedded in a hospital based genomic study on Sickle Cell Disease at Muhimbili National Hospital in Tanzania. Thematic content analysis was used to analyse the transcripts and field notes.ResultsFindings from this study show that literacy level has little influence on understanding the research details. According to the participants of this study, the methods used to provide information, the language, and time spent with the study participants were the key factors influencing understanding. The availability of group sessions held before individual consent to allow for a detailed questions and answers format was agreed to be the best method to facilitate the comprehension.ConclusionThe quality of the consenting process of participants will be influence by a number of factors. The type of research consented for, where the research will be implemented and who are the potential study participants are amongst the factors that need to be assessed during the consenting. Measures to improve participants’ comprehension need to be developed when consenting participants with low literacy level in genomic studies. (shrink)

Background Continued advances in human microbiome research and technologies raise a number of ethical, legal, and social challenges. These challenges are associated not only with the conduct of the research, but also with broader implications, such as the production and distribution of commercial products promising maintenance or restoration of good physical health and disease prevention. In this article, we document several ethical, legal, and social challenges associated with the commercialization of human microbiome research, focusing particularly on how this research is (...) mobilized within economic markets for new public health uses. Methods We conducted in-depth, semi-structured interviews (2009–2010) with 63 scientists, researchers, and National Institutes of Health project leaders (“investigators”) involved with human microbiome research. Interviews explored a range of ethical, legal, and social dimensions of human microbiome research, including investigators’ perspectives on commercialization. Using thematic content analysis, we identified and analyzed emergent themes and patterns. Results Investigators discussed the commercialization of human microbiome research in terms of (1) commercialization, probiotics, and issues of safety, (2) public awareness of the benefits and risks of dietary supplements, and (3) regulation. Conclusion The prevailing theme of ethical, legal, social concern focused on the need to find a balance between the marketplace, scientific research, and the public’s health. The themes we identified are intended to serve as points for discussions about the relationship between scientific research and the manufacture and distribution of over-the-counter dietary supplements in the United States. (shrink)

The introduction of genomics and biobanking methodologies to the African research context has also introduced novel ways of doing science, based on values of sharing and reuse of data and samples. This shift raises ethical challenges that need to be considered when research is reviewed by ethics committees, relating for instance to broad consent, the feedback of individual genetic findings, and regulation of secondary sample access and use. Yet existing ethics guidelines and regulations in Africa do not successfully regulate research (...) based on sharing, causing confusion about what is allowed, where and when. In order to understand better the ethics regulatory landscape around genomic research and biobanking, we conducted a comprehensive analysis of existing ethics guidelines, policies and other similar sources. We sourced 30 ethics regulatory documents from 22 African countries. We used software that assists with qualitative data analysis to conduct a thematic analysis of these documents. Surprisingly considering how contentious broad consent is in Africa, we found that most countries allow the use of this consent model, with its use banned in only three of the countries we investigated. In a likely response to fears about exploitation, the export of samples outside of the continent is strictly regulated, sometimes in conjunction with regulations around international collaboration. We also found that whilst an essential and critical component of ensuring ethical best practice in genomics research relates to the governance framework that accompanies sample and data sharing, this was most sparingly covered in the guidelines. There is a need for ethics guidelines in African countries to be adapted to the changing science policy landscape, which increasingly supports principles of openness, storage, sharing and secondary use. Current guidelines are not pertinent to the ethical challenges that such a new orientation raises, and therefore fail to provide accurate guidance to ethics committees and researchers. (shrink)

A pragmatic account of scientific understanding is used both to examine and to unify fundamental questions concerning the propensity interpretation of probability and theories of chance, causation, and explanation. One of the most important problems to be addressed is the problem of defining homogeneous reference classes in theories of chance, causation, and explanation. The consistency of the propensity interpretation is defended against traditional criticisms such as "Humphreys's paradox." It is demonstrated that the application of this interpretation to theories of chance (...) and probabilistic causation provides insights into problems common to both theories. Various approaches to causation are examined, including those based on identifying sufficient causal factors, necessary causal factors, and contrastive causes. These insights are applied to quantum mechanics and are presented in terms of a set of controlled experiments. The study of quantum mechanics focuses on the paradox of the two slit experiment and quantum logical and quantum probabilistic attempts to resolve this paradox. Finally, the analysis of chance and causation provides the basis for a version of the contrastive theory of explanation. This theory of explanation provides a unique understanding of the nature of explanation, and lessens the impact of the problems of homogeneity and of explanatory ambiguity. (shrink)

Socrates, Sports, and Students involves a philosophical justification for the inclusion of physical education in the school system. This book will appeal to physical educators and administrators interested in justifying their activity, as well as philosophers and professors in the areas of education and sport.

In maternity care, costly high-technology interventions that have never been shown to be clinically effective continue to be used in the United States, while inexpensive and effective low-technology interventions continue to be underused. Three high-technology approaches to risk reduction—electronic fetal monitoring, cesarean section, and home uterine activity monitoring are contrasted with three low-technology approaches—prenatal care, smoking cessation, and nutrition supplementation. These technologies are examined in terms of current controversies over their safety, efficacy, and cost-effectiveness. Examination of these controversies illustrates how (...) the medical technology industry, the regulatory process, and systems of social stratification contribute to social and cultural constructions of what are regarded as reducible birth risks. (shrink)

A growing literature examines the organizational factors that promote women’s access to positions of organizational power. Fewer studies, however, explore the implications of women in leadership positions for the opportunities and experiences of subordinates. Do women leaders serve to undo the gendered organization? In other words, is women’s greater representation in leadership positions associated with less gender segregation at lower organizational levels? We explore this question by drawing on Cohen and Huffman’s conceptual framework of women leaders as either “change agents” (...) or “cogs in the machine” and analyze a unique multilevel data set of workplaces nested within Fortune 1000 firms. Our findings generally support the “agents of change” perspective. Women’s representation among corporate boards of directors, corporate executives, and workplace managers is associated with less workplace gender segregation. Hence, it appears that women’s access to organizational power helps to undo the gendered organization. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:One Parable, Two Interpretations:Pope Francis and William Langland on the Good Samaritan*Sheryl OvermyerInterpretations of the parable of the Good Samaritan (Luke 10:25–37) focus on its theology, ethics, ecclesiology, and even moral psychology. The parable has much to say regarding holiness. It treats how to become holy and distinct acts of holiness, the exemplar of holiness, and the reality and effects of sin. In the history of interpretation, the (...) parable is taken to offer a model of the relationship between the fallen man and grace, the devil and the garment of virtue, the law and love, Christ and the Church. In short, the parable allegorizes salvation history.1I focus conversation about this parable through two interpretations-Pope Francis's Fratelli Tutti [FT], promulgated October 3, 2020, and William Langland's Piers Plowman [PP] circulating circa 1380. Some might hold that Francis's interpretation of the parable is ethical while Langland's is theological.2 Both interpretations of the parable are works of moral theology that intimate distinct understandings of what it means to embody [End Page 541] the Gospel and answer the universal call to holiness. In this essay, I outline the parable of the Good Samaritan as treated in Fratelli Tutti and Piers Plowman (first section), compare the major figures of the parable (second section), and compare their visions of charity (third section). In sum, I argue the encyclical sidelines crucial elements in the medieval figuration of the parable. Pope Francis elides critical issues of sin, agency, Christology, and the Church traditionally associated with this parable—all center on the Samaritan as Christ.Two Interpretations in OutlineFratelli Tutti's Parable of the Good SamaritanPope Francis's third encyclical, Fratelli Tutti, is unique in its genre. The encyclical includes all brothers and sisters in its scope of fraternity and social friendship and is addressed to all (§1). The inspiration for the encyclical includes St. Francis's visit to the Sultan some eight hundred years ago and the 2019 Document on Human Fraternity for World Peace and Living Together, a statement signed by Pope Francis and Sheikh Ahmed el-Tayeb, Grand Imam of Al-Azhar. Indeed, the joint document plays a critical role in the encyclical, sharing a common framework of a doctrine of creation and doctrine of God (FT §5). Because Pope Francis includes all of humanity in the audience of this encyclical and its sources of inspiration are broadly humanitarian, it is fair to raise a question about distinctively Catholic elements to the encyclical.The encyclical chapter devoted to the parable of the Good Samaritan (chapter 2 [§§56–86], treating Luke 10:25–37) intensifies these theological questions. Just as the encyclical is "addressed to all people of good will, regardless of religious convictions," likewise the parable is of universal relevance as it "is one that any of us can relate to and find challenging" (§56). Francis's interpretation of the parable encapsulates Fratelli Tutti's themes.The subject of the parable is, according to Pope Francis, the age-old problem of neighborly love (§57).3 The parable involves several figures: the wounded man lying on the wayside, the robbers, the passers-by, and the Samaritan.4 The wounded are the subject of the encyclical's first chapter. Francis characterizes the wounded as those members of weaker and poorer regions whom the global economy exploits; the poor, disabled, and elderly [End Page 542] who seem no longer useful; children, women, and men of all ages who live under contemporary forms of slavery such as trafficking; and victims of economically driven violence including war, terrorist attacks, and racial and religious persecution (§§§ 12, 18, 24–25). Francis admits that we feel like the wounded, "helpless because our institutions are neglected and lack resources, or simply serve the interests of a few" (§76). However, the primary identification of the wounded focuses on those pushed to the margins by profit-driven economic, technologically progressive, politically divisive, dehumanizing global forces (§76 briefly suggests our identification with the injured man).The parable of the Good Samaritan brings these vast forces to bear our everyday relationships—we all experience an interior struggle when we encounter anyone who suffers (§69... (shrink)

This article explores how ethics and religion interface in everyday life by drawing on a study examining the negotiation of religious and spiritual plurality in health care. Employing methods of critical ethnography, namely, interviews and participant observation, data were collected from patients, health care providers, administrators and spiritual care providers. The findings revealed the degree to which `lived religion' was intertwined with `lived ethics' for many participants; particularly for people from the Sikh faith. For these participants, religion was woven into (...) everyday life, making distinctions between public and private, secular and sacred spaces improbable. Individual interactions, institutional resource allocation, and social discourses are all embedded in social relationships of power that prevent religion from being a solely personal or private matter. Strategies for the reintegration of religion into nursing ethics are: adjusting professional codes and theories of ethics to reflect the influence of religion; and the contribution of critical perspectives, such as postcolonial feminism, to the understanding of lived ethics. (shrink)

Inside this complete guide you will find: A guide to facilitate conversation with your family; How to create peace when war has been declared on your body; How to alleviate pain and suffering; How to choose your own end; How to use the dying process as a mechanism for personal and family growth. Filled with inspirational and helpful stories, Mortal Dilemmas... is a book that not only will prepare you for the inevitable, but will also give you a sense of (...) satisfaction and control."--P. [4] of cover. (shrink)

Today's conversations in virtue ethics are enflamed with questions of “pagan virtues,” which often designate non-Christian virtue from a Christian perspective. “Pagan virtues,” “pagan vices,” and their historied interpretations are the subject of Jennifer Herdt's book Putting On Virtue: The Legacy of the Splendid Vices (2008). I argue that the questions and language animating Herdt's book are problematic. I offer an alternative strategy to Herdt's for reading Thomas Aquinas's Summa Theologiae. My results are twofold: (1) a different set of conclusions (...) and questions regarding the moral life that lend a fresh perspective to “pagan virtues” and (2) corresponding methodological suggestions for improving Herdt's project that would, to my mind, reaffirm her normative conclusions regarding the most viable ways forward for contemporary discussions of virtue. (shrink)

Socrates, Sports, and Students involves a philosophical justification for the inclusion of physical education in the school system. This book will appeal to physical educators and administrators interested in justifying their activity, as well as philosophers and professors in the areas of education and sport.

This paper reviews and augments important work in philosophy of education on intrinsic aims for education, of knowledge, of knowledge of values, and of rationality. A contemporary conception of knowledge as ``rationality's `data-base''' is proposed and an in-depth section on the intrinsic value of rationality is incorporated.

This essay reviews recent feminist scholarship, autobiographical narrative and fiction which explores nurses' engagement with empire in Africa and elsewhere in this century. Such literature suggests that while nursing work may have improved native health in colonized regions, it also contributed significantly to the establishment and stabilization of the racialized order of colonial rule. Of particular significance was colonial nursing's intervention into the reproductive practices of native women, resulting in the loss of local knowledges and autonomy, the disruption of complex (...) social links and indigenous health strategies, and the expansion of markets for western capitalism. (shrink)

In this paper we comment on the changes in the provision of fertility care in Australia, New Zealand and the UK to illustrate how different funding arrangements of assisted reproductive technologies (ART) shape the delivery of patient care and the position of fertility nursing. We suggest that the routinisation of in vitro fertilisation technology has introduced a new way of managing the fertility patient at a distance, the distal fertility patient. This has resulted in new forms of organisational routines in (...) ART which challenge both traditional forms of nursing and advanced nursing roles. We discuss the consequences of this increasingly globalised approach to infertility through the lens of three national contexts, Australia, New Zealand and the UK to unpack the position of nursing within the new forms of organisational routines. (shrink)

KEY POINTS In Canada, commercial data brokers collect deidentified patient data from pharmacies, private drug insurers, the federal government and medical clinics without patient consent. Although pharmaceutical companies are the data brokers’ primary customers, academics and nonprofit and public entities also use commercial data sets, given the absence of a coordinated public approach to collecting these data across Canada. Risks of commercialized patient data include loss of anonymity, surveillance and marketing, discrimination and violation of Indigenous data sovereignty. Coordinated infrastructure for (...) the collection and coordination of health data across Canada and updated privacy legislation would protect individuals and communities and enable appropriate data uses. (shrink)

Abstract The aim of this paper is to examine the propaganda power of Madison’s Solidarity Sing-Along. To do so, I will modify the Epistemic Merit Model of propaganda so that it can account for a broader spectrum of propaganda. I will show how this is consistent with other accounts of musical pragmatics and the potential political function of songs and music. This will provide the ground for a robust interpretation of the political meanings of the Solidarity Sing-Along. I will assume (...) the Madison protests and the Solidarity Sing-Along can be considered a paradigm case of peaceful protest as it has been claimed that the Madison protest and the role of art within those protests set the stage for the Occupy Movement protests later in the same year. (shrink)

This paper challenges the traditional account of vulnerability in healthcare which conceptualizes vulnerability as a list of identifiable subpopulations. This list of ‘usual suspects’, focusing on groups from lower resource settings, is a narrow account of vulnerability. In this article we argue that in certain circumstances middle-class individuals can be also rendered vulnerable. We propose a relational and layered account of vulnerability and explore this concept using the case study of cord blood (CB) banking. In the first section, two different (...) approaches to ‘vulnerability’ are contrasted: categorical versus layered. In the second section, we describe CB banking and present a case study of CB banking in Argentina. We examine the types of pressure that middle-class pregnant women feel when considering CB collection and storage. In section three, we use the CB banking case study to critique the categorical approach to vulnerability: this model is unable to account for the ways in which these women are vulnerable. A layered account of vulnerability identifies several ways in which middle-class women are vulnerable. Finally, by utilizing the layered approach, this paper suggests how public health policies could be designed to overcome vulnerabilities. (shrink)

The aim of this paper is to distinguish between, and examine, three issues surrounding Humphreys's paradox and interpretation of conditional propensities. The first issue involves the controversy over the interpretation of inverse conditional propensities — conditional propensities in which the conditioned event occurs before the conditioning event. The second issue is the consistency of the dispositional nature of the propensity interpretation and the inversion theorems of the probability calculus, where an inversion theorem is any theorem of probability that makes explicit (...) (or implicit) appeal to a conditional probability and its corresponding inverse conditional probability. The third issue concerns the relationship between the notion of stochastic independence which is supported by the propensity interpretation, and various notions of causal independence. In examining each of these issues, it is argued that the dispositional character of the propensity interpretation provides a consistent and useful interpretation of the probability calculus. (shrink)