This paper explores the evolution of the Universal Declaration on Bioethics and Human Rights , which was adopted by the United Nations Educational, Scientific and Cultural Organization in 2005. While the draft UDBHR generated controversy among bioethicists, the process through which it evolved excluded mainstream bioethicists. The absence of peer review affects the declaration’s content and significance. This paper critically analyses its content, commenting on the failure to acknowledge socioeconomic and other factors that impede its implementation. The UDBHR outlines ideal (...) standards but fails to provide guidance that can be readily applied in different settings. It strives for universality but does not contribute to understanding of universal or global bioethics.The Universal Declaration on Bioethics and Human Rights was developed through multinational consultation over several years. It was officially adopted by the United Nations Educational, Scientific and Cultural Organization in October 2005.1 This paper explores the process of drafting the UDBHR, critically analyses its content and considers its status in the context of global bioethics. It comments on the UDBHR’s failure to acknowledge or respond to socioeconomic and other factors that impede attempts to implement it. The paper concludes that the process of drafting the declaration excluded a necessary group of stakeholders and that the UDBHR therefore fails to provide the guidance it aims to offer.Identifying a need to develop universally applicable ethical guidelines within a context of cultural pluralism, Unesco began developing a draft Declaration on Universal Norms on Bioethics. A near final draft was posted on Unesco’s website in February 2005 and replaced in June 2005 with the version subsequently adopted as the UDBHR. Stakeholder consultation on the draft involved hundreds of people in many diverse nations. These were seemingly limited to consultations with Unesco affiliates, however, and public comment was not solicited. …. (shrink)

Biobanking of patient-derived materials is routine in health care, research, and public health emergencies. Ethical guidelines for biobanking address concerns including some about genetic materials, informed consent, confidentiality, regulatory environments, and standards of governance. This chapter identifies some limitations of existing guidelines that were apparent to one author during an Ebola outbreak, and specifies five ethical concerns about biobanking that warrant additional attention: misconceptions about biobanking, unknown consequences for donors, socioeconomic inequities that compound vulnerabilities, lasting and proportional benefits in North-South (...) research, and contextual challenges to disclosure and understanding. These affect patients, donors, health systems, research, and policy, and are amplified during public health emergencies. (shrink)

Jecker et al. (2024) offer seven principles with which to guide conference organizers and assess how ethically a conference is organized. While focused on bioethics, these principles are relevant t...

Changes in earth's atmosphere, oceans, soil, weather patterns, and ecosystems are well documented by countless scientific disciplines. These manifestations of climate change harm public health. Given their goals and social responsibilities, influential health organizations recognize health impacts compounded by geography, social values, social determinants of health, health behaviors, and relationships between humans and environments primarily described in feminist ethics and environmental ethics. Health impacts are relevant to, but seldom addressed in bioethics, global health, public policy, or health or environmental policy. (...) This book is the first to describe cultural, geographic, and socioeconomic factors that influence the regional significance of these impacts and frame them for bioethics and policy analyses. (shrink)

Here are the 18 guidance points contained in the UNAIDS document on Ethical Considerations in HIV Preventive Vaccine Research, reproduced by kind permission of the Joint United Nations Programme on HIV/AIDS.

Visual imagery is a form of sensory imagination, involving subjective experiences typically described as similar to perception, but which occur in the absence of corresponding external stimuli. We used the Activation Likelihood Estimation algorithm (ALE) to identify regions consistently activated by visual imagery across 40 neuroimaging studies, the first such meta-analysis. We also employed a recently developed multi-modal parcellation of the human brain to attribute stereotactic co-ordinates to one of 180 anatomical regions, the first time this approach has been combined (...) with the ALE algorithm. We identified a total 634 foci, based on measurements from 464 participants. Our overall comparison identified activation in the superior parietal lobule, particularly in the left hemisphere, consistent with the proposed ‘top-down’ role for this brain region in imagery. Inferior premotor areas and the inferior frontal sulcus were reliably activated, a finding consistent with the prominent semantic demands made by many visual imagery tasks. We observed bilateral activation in several areas associated with the integration of eye movements and visual information, including the supplementary and cingulate eye fields (SCEFs) and the frontal eye fields (FEFs), suggesting that enactive processes are important in visual imagery. V1 was typically activated during visual imagery, even when participants have their eyes closed, consistent with influential depictive theories of visual imagery. Temporal lobe activation was restricted to area PH and regions of the fusiform gyrus, adjacent to the fusiform face complex (FFC). These results provide a secure foundation for future work to characterise in greater detail the functional contributions of specific areas to visual imagery. (shrink)

ABSTRACT:Planet Earth and its growing human population are challenged by the health impacts of industrial policies that drive global emissions production and cause climate change. The health-care industry has capacity and responsibility to adopt environmentally sustainable policies and practices. Bioethicists have a responsibility to support environmental sustainability through their clinical, research, educational, and policy work. They communicate complex ideas to diverse stakeholders and can communicate similarly to improve understanding about emissions and the value of environmentally sustainable policy. A growing bioethics (...) literature addresses climate change in collaboration with human and veterinary medicine and other disciplines. Pursuing environmental sustainability with the vigor that made autonomy a norm would help to reduce global emissions production in health care and make it a role model for other industries. Making environmental sustainability a health-care norm would be as significant an accomplishment as doing so for individual autonomy. (shrink)

Health promotion involves social and environmental interventions designed to benefit and protect health. It often harmfully impacts the environment through air and water pollution, medical waste, g...

In this concise yet powerful book, one of the twentieth century's most respected political philosophers presents a controversial reassessment of the political ideas and intellectual legacy of Edmund Burke. A practicing politician and powerful writer, full of ideas, Burke was intent on getting those ideas translated into government policies. But he was too much the impatient practitioner to set out his principles in a single book in the manner of Locke or Hume, leaving both admirers and opponents ample scope to (...) reinterpret his work in different ways. Macpherson, however, finds Burke's views on political economy to be the one consistent factor in his thinking. Today Burke is often viewed as one of modern conservatism's founding lights, and in an era of global capitalism unfettered by national borders, Macpherson's reassessment of Burke's ideas is perhaps more timely than ever. (shrink)

Climate change has substantial impacts on public health and safety, disease risks and the provision of health care, with the poor being particularly disadvantaged. Management of the associated health risks and changing health service requirements requires adequate responses at local levels. Health-care providers are central to these responses. While climate change raises ethical questions about its causes, impacts and social justice, medicine and bioethics typically focus on individual patients and research participants rather than these broader issues. We broaden this focus (...) by examining awareness among health-care providers in the Caribbean region, where geographic and socioeconomic features pose particular vulnerabilities to climate change. In focus groups, Caribbean providers described rises in mosquito-borne, flood-related, heat-related, respiratory and mental illnesses, and attributed these to local impacts of climate change. Their discussions showed that the significance of these impacts differs in different Caribbean nations, raising policy and social justice questions. Bioethics and public health ethics are situated to frame, inform and initiate public and policy dialog about values and scientific evidence associated with climate change. We urge readers to initiate such dialog within their own institutions about the context-dependent nature of the burdens of climate change, and values and policies that permit it to worsen. (shrink)

Parsa-Parsi _et al_ bring attention to the World Medical Association (WMA) and transparency to its International Code of Medical Ethics (ICoME) revisions. 1 We value their report and the revised ICoME but explain here that the ICoME cannot reflect consensus among all WMA members, or the wider medical profession, given structural and epistemic injustices that restrain low-income and middle-income country (LMIC) physicians from participating in activities such as WMA revisions. Such injustices overlook experiences and contributions of those from LMICs and (...) marginalised groups, hindering their access to and influence within medicine. 2 They also undermine access to information about, and from, the WMA. Recruiting new members from, and better engaging members in, LMICs would strengthen the WMA and its influence across the medical profession, and better elevate environmental sustainability as a biomedical and bioethical concern. This would be beneficial because there is controversy among physicians, bioethicists and... (shrink)

The _Second Treatise_ is one of the most important political treatises ever written and one of the most far-reaching in its influence. In his provocative 15-page introduction to this edition, the late eminent political theorist C. B. Macpherson examines Locke's arguments for limited, conditional government, private property, and right of revolution and suggests reasons for the appeal of these arguments in Locke's time and since.

One of the twentieth century's most respected political philosophers presents a controversial perspective on the political ideas and intellectual legacy of Edmund Burke. This new edition includes an introduction by Frank Cunningham, placing the book in the broader context of Macpherson's work.

Professions typically formulate codes of ethics. Medical students are exposed to various codes and often are expected to recite some.

Disabling pain or symptoms can occur at any age from many different causes. Pain and palliative specialists are able to relieve most pain and symptoms, although repeated adjustments to modalities, medications and doses may be needed. Because pain and palliative specialists comprise only a small percentage of physicians, many patients find it difficult to access them or obtain pain relief. Globally, there are too few such specialists to meet existing needs. Most are affiliated with hospice and palliative units, so their (...) accessibility to patients without terminal conditions is negligible. Doctors outside pain and palliative specialties are often unfamiliar with pain guidelines and sceptical about patient reports of unrelieved pain. They are therefore likely to undertreat it. Undertreating pain, however, violates respect for persons and beneficence. This paper reviews literature supporting these claims and offers a narrative description of the author’s attempts to find relief from shingles and postherpetic neuralgia. It argues that physicians in most specialties are not, but should be, familiar with palliative evidence and guidelines so that they are equipped to relieve pain and symptoms quickly and effectively. Such information should be routinely introduced in medical curricula to encourage the mastery of knowledge, attitudes and skills necessary to upholding ethical principles and to ensure that more doctors in any discipline are willing to believe and be compassionate to patients whose pain is unresponsive to initial treatments. Routinely exposing students to such information would better prepare them to fulfil their professional duties to patients and society. (shrink)

This article outlines challenges to benefitting developing countries that are hosts of international research. In the context of existing guidance and frameworks for benefit‐sharing, it aims to provoke dialog about socioeconomic factors and other background conditions that influence what constitute benefits in a given host setting, and about the proportionality between benefits to hosts and benefits to sponsors and researchers. It argues that capacity‐building for critical thinking and negotiation in many developing country governments, institutions, and communities is a benefit because (...) it can help to overcome background conditions that impinge on equitable international research negotiations, partnerships, and benefits. Enhancing the capacity for both critical thinking and negotiation can, like other targets of capacity‐building, nurture respectful and trusting partnerships that benefit all stakeholders in international research. (shrink)

In his final book, one of the giants of twentieth-century political philosophy returns to his key themes of state, class, and property to consider such contemporary questions as economic justice, human rights, and the nature of industrial democracy. This new edition includes an introduction by Frank Cunningham, placing the book in the broader context of Macpherson's work.

An unlinked seroprevalence study of HIV and other viruses was conducted on pregnant women on the Caribbean island of Grenada in 1994. Investigators were from both the developed world and the Grenadian Ministry of Health . There was then no board on Grenada to protect research subjects or review ethical aspects of studies. Nurses from the MOH were asked to verbally inform their patients about the study, and request that patients become subjects of the study and give blood for screening. (...) If consent was given nurses took blood and administered a survey about each subjects' knowledge of HIV transmission routes. Nurses shared a spoken dialect and cultural heritage with prospective subjects and were probably more effective than foreign researchers at informing subjects. Informed consent was obtained with a simplified consent form supplemented by conversation with each prospective research subject. Facilitating discussion between people with common cultural backgrounds helps apply the Western approach to informed consent to communities in the developing world. Researchers must disclose all information to nurses or other mediators, and ensure that nurses disclose as much information as possible to prospective subjects. So modified, informed consent maintains respect for persons and becomes applicable and relevant to various cultures. (shrink)

Professionalism is demonstrated through attitudes and behaviors. Medical education is concerned with teaching and evaluating it among students. It is often bioethicists who teach professionalism to medical students. Most bioethics curricula use lectures and group discussions to introduce principles and theories, but there is variation in number of credit and contact hours, placement in the curriculum and alongside which courses bioethics is placed), the extent of individual mentoring, and the emphasis placed on any particular philosophical approach. Bioethics curricula also vary (...) in whether and how explicitly and extensively they address topics, including professionalism, cultural competence, medical humanities, spirituality, death and dying, and community service, and in the number and topics of vignettes, controversies, assignments, and course activities. (shrink)

An unlinked seroprevalence study of HIV and other viruses was conducted on pregnant women on the Caribbean island of Grenada in 1994. Investigators were from both the developed world and the Grenadian Ministry of Health . There was then no board on Grenada to protect research subjects or review ethical aspects of studies. Nurses from the MOH were asked to verbally inform their patients about the study, and request that patients become subjects of the study and give blood for screening. (...) If consent was given nurses took blood and administered a survey about each subjects' knowledge of HIV transmission routes. Nurses shared a spoken dialect and cultural heritage with prospective subjects and were probably more effective than foreign researchers at informing subjects. Informed consent was obtained with a simplified consent form supplemented by conversation with each prospective research subject. Facilitating discussion between people with common cultural backgrounds helps apply the Western approach to informed consent to communities in the developing world. Researchers must disclose all information to nurses or other mediators, and ensure that nurses disclose as much information as possible to prospective subjects. So modified, informed consent maintains respect for persons and becomes applicable and relevant to various cultures. (shrink)

This seminal work by political philosopher C.B. Macpherson was first published by the Clarendon Press in 1962, and remains of key importance to the study of liberal-democratic theory half-a-century later. In it, Macpherson argues that the chief difficulty of the notion of individualism that underpins classical liberalism lies in what he calls its "possessive quality" - "its conception of the individual as essentially the proprietor of his own person or capacities, owing nothing to society for them." Under such (...) a conception, the essence of humanity becomes freedom from dependence on the wills of others; society is little more than a system of economic relations; and political society becomes a means of safeguarding private property and the system of economic relations rooted in property. As the New Statesman declared: "It is rare for a book to change the intellectual landscape. It is even more unusual for this to happen when the subject is one that has been thoroughly investigated by generations of historians.... Until the appearance of Professor Macpherson's book, it seemed unlikely that anything radically new could be said about so well-worn a topic. The unexpected has happened, and the shock waves are still being absorbed." A new introduction by Frank Cunningham puts the work in a twenty-first-century context. (shrink)

C-minimality is a variant of o-minimality in which structures carry, instead of a linear ordering, a ternary relation interpretable in a natural way on set of maximal chains of a tree. This notion is discussed, a cell-decomposition theorem for C-minimal structures is proved, and a notion of dimension is introduced. It is shown that C-minimal fields are precisely valued algebraically closed fields. It is also shown that, if certain specific ‘bad’ functions are not definable, then algebraic closure has the exchange (...) property, and for definable sets dimension coincides with the rank obtained from algebraic closure. (shrink)

We explore analogues of o-minimality and weak o-minimality for circularly ordered sets. Much of the theory goes through almost unchanged, since over a parameter the circular order yields a definable linear order. Working over ∅ there are differences. Our main result is a structure theory for ℵ0-categorical weakly circularly minimal structures. There is a 5-homogeneous example which is not 6-homogeneous, but any example which is k-homogeneous for some k ≥ 6 is k-homogeneous for all k.

While for many years Locke was viewed almost universally as the prophet of liberalism, today a successive reading of C.B. Macpherson's Possessive Individualism, John Dunn's The Political Thought of John Locke and Richard Ashcraft's Revolutionary Politics and Locke's �Two Treatises of Government�, might produce a schizophrenic vision of Locke as simultaneously an accumulative bourgeois villain, an irrelevant Calvinist moralist and a radical egalitarian revolutionary hero. This essay addresses an issue examined to a greater or lesser extent by these and (...) other interpreters: John Locke's thoughts on the conduct of everyday political life. Consideration of this topic can serve to moderate one's impression of Locke, just as currently Ashcraft holds Locke to be less radical and Dunn finds Locke less irrelevant than they did before. The essay seeks to identify the group of persons Locke presumed would govern in a well-ordered nation, to examine the qualities required of these governors in order for them to perform their calling, and to illuminate Locke's personal efforts to promote these qualities in the governors of the next generation. In particular, I will examine the concept of trust, which John Dunn in recent years has found to be of continuing political relevance. In the first section, I will review the use of the word �trust� in Locke's Second Treatise to display the fact that trustworthiness in governors is constituted by possession of the qualities of virtue and prudence in the second section, I will argue that Locke's educational writings ought to be viewed as attempts to encourage the formation of the qualities necessary for good governors. In the following two sections, I will examine the meaning Locke ascribes to both �prudence� and �virtue� in his various political, philosophical, and educational writings. Finally, I will endeavour to show that an understanding of these qualities, along with the importance of status and breeding, are instrumental to an understanding of Locke's conception of the conduct of everday political life. (shrink)