Much has changed in maternal-fetal medicine since the early 2000s, when the previous ethical frameworks for fetal therapy trials were established. We applaud Hendriks and colleagues for taking on t...

The target articles in this “Roe v. Wade” special issue of AJOB rightly point to multiple ethical harms of an imminent end to full federal protection for legal abortion in the United States, p...

We were interested to read the current target article, given our admiration for the senior author’s comprehensive coverage of these same topics a decade ago (Donley, Hul...

This book brings together an international collection of experts in reproductive ethics, law, disability studies, and medicine to explore the challenging future of reproduction and children. From the medical to the social and from the financial to the legal, the authors explore the expanding impact of reproductive genetics on our society. New advances in genetic technologies are revolutionizing the practice of reproductive medicine. We have expanded our ability to detect genetic changes in embryos and fetuses in ways that potentially allow (...) to identify, treat, or prevent a growing range of diseases. The development of gene-editing technologies raises questions about the possibility of removing disease-causing variants from embryos before pregnancy implantation. The growing sophistication of prenatal genomic sequencing offers us glimpses into the whole genome of the developing fetus. And, the increasingly sophisticated science of 'gene matching' allows us greater and greater foreknowledge of how the genomes of two individuals will combine in a future child. This is an indispensable book on the newest developments in bioethics caused by the sciences. Chapter 5 is available open access under a Creative Commons Attribution 4.0 International License via link.springer.com. (shrink)

Noninvasive prenatal screening using cell-free DNA, which analyzes placental DNA circulating in maternal blood to provide information about fetal chromosomal disorders early in pregnancy and without risk to the fetus, has been hailed as a potential “paradigm shift” in prenatal genetic screening. Commercial provision of cell-free DNA screening has contributed to a rapid expansion of the tests included in the screening panels. The tests can include screening for sex chromosome anomalies, rare subchromosomal microdeletions and aneuploidies, and most recently, the entire (...) fetal genome. The benefits of this screening tool are generally framed, by both providers and commercial laboratories, as enhancing reproductive autonomy and choice by providing an earlier, simpler, and more accurate screening while potentially reducing the need for invasive follow-up testing. The majority of the literature has explored these issues empirically or conceptually from a European or North American vantage point, one that assumes normative priorities such as individual reproductive autonomy and the clinical availability of maternal health care or prenatal screening programs within which cell-free DNA screening is offered. While its implementation has raised both challenges and opportunities, very little is known about real-world experiences and the implications of the rapid introduction of cell-free DNA screening outside of North America and Europe, especially in low- and middle-income countries. To begin addressing this gap in knowledge, we organized a four-day international workshop to explore the ethical, legal, social, economic, clinical, and practical implications of the global expansion of cell-free DNA screening. We describe eight key insights that arose from the workshop. (shrink)

In much the same way that genomic technologies are changing the complexion of biomedical research, the issues they generate are changing the agenda of IRBs and research ethics. Many of the biggest challenges facing traditional research ethics today — privacy and confidentiality of research subjects; ownership, control, and sharing of research data; return of results and incidental findings; the relevance of group interests and harms; the scope of informed consent; and the relative importance of the therapeutic misconception — have become (...) important policy issues over the last 20 years because of the ways they have been magnified by genomic research efforts. Research that examines the ethical, legal, and social implications of human genomics research has become a burgeoning international field of scholarship over the last 20 years, thanks in part to its support first by the genome research funding bodies in the U.S. and then by national science agencies in other countries. (shrink)

In their target article, Conley et al. (2023) appropriately highlight the ongoing conceptual and practical opacity of public engagement (PE) in the translation of human gene editing (HGE) (Conley e...

Discharge planning for vulnerable infants and children is a collaborative, inter-disciplinary, decision-making activity that is grounded in the ethical complexities of clinical practice. Although it is a psychosocial intervention that frequently causes moral distress for professionals and has the potential to inflict harm on children and their families, the process has received little attention from ethicists. An ongoing study of the transition of technology-dependent children from hospital to home suggests that the ethical issues embedded in the discharge-planning process may be (...) concealed by dominant cultural values, institutional policies, clinical standards, historical precedents, and legal regulations. (shrink)

This important text draws on decades of research, arguing that modern nursing germinated and grew an ethics from its own native soil, that is a rich, fulsome and philosophically informed; grounded in the tradition, and practice of nursing. This systematic and comprehensive book is an essential contribution for students and scholars of nursing ethics.

二〇〇六年三月、富山県の射水市民病院で入院中の末期患者七人の人工呼吸器が取り外され、死亡していたことが明らかになった。実際にはいかなる事態が起きたのか?その後つづいた「尊厳死法制化」をめぐる政府・医療 界・メディア等の動きも踏まえ、今、日本の終末期医療に真に求められていることは何かを渾身で問いかける。.

Drawing on constructionist theory, this study examines how the media portrayed five public reporting events initiated by the Fair Labor Association (FLA), considering whether the coverage encourages or discourages companies from undertaking a reporting initiative as part of their ethical management. Media coverage was limited but generally favorable across all five events. Coverage frequently included claims made by FLA spokespersons and provided basic facts about the organization and its activities. Extensive detail about labor violations found by monitors was often included. (...) Additional media coverage centered around themes of public reporting and transparency, an assessment of the FLA’s work, brand accountability and responsibility of corporations with regard to working conditions and labor standards, and specifics about the factory monitoring and partnering with factories and NGOs that is necessary to achieve change. Counter-claims brought question to the FLA’s efforts. Explanations about why the social condition exists were fairly limited, and thus, provided little insight into how the problems might be resolved. We discuss managerial implications regarding public reporting initiatives and media coverage, particularly regarding the countering effects of positive coverage and diminishing news stories. (shrink)

This paper presents an overview of the key ethical questions of performing gene editing research on military service members. The recent technological advance in gene editing capabilities provided by CRISPR/Cas9 and their path towards first-in-human trials has reinvigorated the debate on human enhancement for non-medical purposes. Human performance optimization has long been a priority of military research in order to close the gap between the advancement of warfare and the limitations of human actors. In spite of this focus on temporary (...) performance improvement, biomedical enhancement is an extension of these endeavours and the ethical issues of such research should be considered. In this paper, we explore possible applications of CRISPR to military human gene editing research and how it could be specifically applied towards protection of service members against biological or chemical weapons. We analyse three normative areas including risk–benefit analysis, informed consent, and inequality of access as it relates to CRISPR applications for military research to help inform and provide considerations for military institutional review boards and policymakers. (shrink)

Sigmund Freud argued that religions originate in the unconscious needs, longings and fantasies of human minds. His work has served to highlight how any analysis of religion must explore mental life, both the cognitive and the unconscious. _Freud on Religion_ examines Freud's complex understanding of religious belief and practice. The book brings together contemporary psychoanalytic theory and case material from Freud's clinical practice to illustrate how the operations of the unconscious mind support various forms of religious belief, from mainstream to (...) occult. _Freud on Religion_ offers a new way of understanding Freud's thinking and demonstrates how valuable psychoanalysis is for the study of religion. (shrink)

Constructing Race on the Borders of Europe investigates the visual imagery (in painting, photography, prints, film, and design) of race construction primarily in Scandinavia and the empires of Austro-Hungary, Germany, and Russia at a time when the disciplines of ethnography and anthropology were expanding and publications on race were debating competing theories of biological, geographic, linguistic, and cultural determinants. These regions, while on the periphery of continental Europe, largely marginalized in the scholarship of nineteenth-century art history, and ignored by Edward (...) Said (Orientalism 1978), have been central locations for theorizing white identity and for containing diverse ethnic populations that have generated substantive ethnographic study and regional conflicts since the eighteenth century. This anthology explores art that engaged with ethnography and anthropology to shape visual representations of subordinate ethnic populations and material cultures, both indigenous (Roma, Sámi, Inuit, and Celts) and migrant or colonial (Muslims and Blacks), chiefly between 1850 and 1930, but extending into the early twenty-first century. The essays in this book contribute to postcolonial research by documenting colonial-style treatment of minority groups and by seeking to qualify binary systems through explorations of anomalies, complexities, and contradictions that emerge when seen from the perspective of the fine and applied arts. This book presents a range of different artistic voices that responded to ethnographic and anthropological information by producing images or objects that adopted, altered, or critiqued that information. The authors seek to uncover instances of connections and variability, to establish the fabricated nature of ethnic identity, and to challenge the certainties of racial categorization. (shrink)

Domestic violence is a growing societal concern that often spills over into the workplace. However, employers are not recognizing the spillover of domestic violence as a workplace issue. This is problematic considering the serious financial, legal, and ethical consequences for organizations. We analyzed six cases involving domestic violence that were litigated under specific legal bases: Violence Against Women Act, discrimination laws including Title VII, Family and Medical Leave Act, Americans with Disabilities Act, Social Security Disability, Occupational Safety and Health Act, (...) and associated state and municipal ordinances. We chose cases that illustrate the problems of companies meeting the legal standards but not necessarily reaching ethical expectations. Our approach is congruent with the perspective that both legal and ethical analyses should be used in organizational decision making. We suggest for future research the analysis of additional litigated cases, other ethical perspectives, and additional sources of data. In addition, we suggest that companies who are striving for corporate social responsibility should integrate the ethical treatment of domestic violence victims. (shrink)

Modern American nursing has an extensive ethical heritage literature that extends from the 1870s to 1965 when the American Nurses Association issued a policy paper that called for moving nursing education out of hospital diploma programs and into colleges and universities. One consequence of this move was the dispersion of nursing libraries and the loss of nursing ethics textbooks, as they were largely not brought over into the college libraries. In addition to approximately 100 nursing ethics textbooks, the nursing ethics (...) heritage literature also includes hundreds of journal articles that are often made less accessible in modern databases that concentrate on the past 20 or 30 years. A second consequence of nursing’s movement into colleges and universities is that ethics was no longer taught by nursing faculty, but becomes separated and placed as a discrete ethics course in departments of philosophy or theology. These courses were medically identified and rarely incorporated authentic nursing content. This shift in nursing education occurs contemporaneously with the rise of the field of bioethics. Bioethics is rapidly embraced by nursing, and as it develops within nursing, it fails to incorporate the rich ethical heritage, history, and literature of nursing prior to the development of the field of bioethics. This creates a radical disjunction in nursing’s ethics; a failure to more adequately explore the moral identity of nursing; the development of an ethics with a lack of fit with nursing’s ethical history, literature, and theory; a neglect of nursing’s ideal of service; a diminution of the scope and richness of nursing ethics as social ethics; and a loss of nursing ethical heritage of social justice activism and education. We must reclaim nursing’s rich and capacious ethics heritage literature; the history of nursing ethics matters profoundly. (shrink)

At least 177 scales are available to researchers who want to measure religiosity, but questions exist as to exactly what these scales are measuring and in whom they are measuring it. A review of these scales found a lack items designed to measure ethical action in society or the world as a prophetic response to the experience of the divine. Instead, the vast majority of scales focus on internal experiences and beliefs or institutional relationships. A review of scale norm groups (...) found that norm groups often are not fully described, particularly in the area of race/ethnicity, and when they are described, they reveal an over-reliance on convenience samples of college students and an under-representation of racial/ethnic minority groups. Examples of scales with more fully described and more representative norm groups are given, and recommendations are offered for researchers using and developing religiosity scales. (shrink)

At least 177 scales are available to researchers who want to measure religiosity, but questions exist as to exactly what these scales are measuring and in whom they are measuring it. A review of these scales found a lack items designed to measure ethical action in society or the world as a prophetic response to the experience of the divine. Instead, the vast majority of scales focus on internal experiences and beliefs or institutional relationships. A review of scale norm groups (...) found that norm groups often are not fully described, particularly in the area of race/ethnicity, and when they are described, they reveal an over-reliance on convenience samples of college students and an under-representation of racial/ethnic minority groups. Examples of scales with more fully described and more representative norm groups are given, and recommendations are offered for researchers using and developing religiosity scales. (shrink)

Uses of stored skill-models to accelerate simulator-based real-time training in a control skill are discussed. A real-time coach must deliver advice at three levels: (1) what to do next, (2) what to watch for, and (3) what went wrong. Human learning and machine learning results are presented using different screen representations of a pole-and-cart balancing task.

An oversize volume celebrates the National Ranching Heritage Center, a museum and historical park located on the northern edge of the Texas Tech University campus in Lubbock, established to preserve the history of ranching, pioneer life, and the development of the livestock industry in North America.

In this introduction, we address some of the complexities associated with the emergence of medicine’s bodies, not least as a means to ‘working with the body’ rather than simply producing a critique of medicine. We provide a brief review of some of the recent discussions on how to conceive of medicine and its bodies, noting the increasing attention now given to medicine as a technology or series of technologies active in constituting a multiplicity of entities – bodies, diseases, experimental objects, (...) the individualization of responsibility for health and even the precarity of life. We contrast what feminist theorists in the tradition of Judith Butler have referred to as the question of matter, and Science and Technology Studies with its focus on practice and the nature of emergence. As such we address tensions that exist in analyses of the ontological status of ‘the body’ – human and non-human – as it is enacted in the work of the laboratory, the randomized controlled trial, public health policy and, indeed, the market that is so frequently entangled with these spaces. In keeping with the recent turns toward ontology and affect, we suggest that we can regard medicine as concerned with the contraction and reconfiguration of the body’s capacities to affect and be affected, in order to allow for the subsequent proliferation of affects that, according to Bruno Latour, marks corporeal life. Treating both contraction and proliferation circumspectly, we focus on the patterns of affects wrought in particular by the abstractions of medicine that are described in the contributions to this special issue. Drawing on the work of A.N. Whitehead, we note how abstractions such as ‘medical evidence’, the ‘healthy human body’ or the ‘animal model’ are at once realized and undercut, mediated and resisted through the situated practices that eventuate medicine’s bodies. Along the way, we touch on the implications of this sort of perspective for addressing the distribution of agency and formulations of the ethical and the political in the medical eventuations of bodies. (shrink)

In Anerkennung der für Gegenwartsgesellschaften konstitutiven Diversität ihrer Bevölkerungen diskutieren Bioethik und Medizin verstärkt die kulturelle Relativität ihrer eigenen Voraussetzungen, die Kulturspezifik „anderer“ Positionen und die Möglichkeiten kulturübergreifender Orientierungen. Dabei kommt häufig ein Kulturbegriff zum Einsatz, der aus der Perspektive der aktuellen Sozial- und Kulturanthropologie zu statisch, zu homogenisierend und zu sehr auf Differenz und Abgrenzung hin orientiert ist. Der Beitrag diskutiert zunächst Konzepte von Kultur, die solche Verkürzungen zu vermeiden suchen. Sie betonen hingegen Verflechtungszusammenhänge unter dem Vorzeichen intensivierter Globalisierung (...) und deuten Kultur aktiv und reflexiv, als Ressource menschlichen Tuns, und nicht deterministisch als Kausalfaktor. Anschließend wird der ethnographische Forschungsstand zu Patientenverfügungen in westlichen Gesundheitssystemen zusammengefasst. Zeitintensive, qualitative Forschung verdeutlicht die Gefahr einer Kulturalisierung sozialer Ungleichheiten, die spezifische Positionalität bioethischer Prämissen und die Vielfalt und Komplexität im Umgang mit Patientenverfügungen. Der Beitrag schließt mit Hinweisen darauf, wie Diversität in Entscheidungsprozessen am Ende des Lebens jenseits von Kultur analysiert werden kann. (shrink)

In Anerkennung der für Gegenwartsgesellschaften konstitutiven Diversität ihrer Bevölkerungen diskutieren Bioethik und Medizin verstärkt die kulturelle Relativität ihrer eigenen Voraussetzungen, die Kulturspezifik „anderer“ Positionen und die Möglichkeiten kulturübergreifender Orientierungen. Dabei kommt häufig ein Kulturbegriff zum Einsatz, der aus der Perspektive der aktuellen Sozial- und Kulturanthropologie zu statisch, zu homogenisierend und zu sehr auf Differenz und Abgrenzung hin orientiert ist. Der Beitrag diskutiert zunächst Konzepte von Kultur, die solche Verkürzungen zu vermeiden suchen. Sie betonen hingegen Verflechtungszusammenhänge unter dem Vorzeichen intensivierter Globalisierung (...) und deuten Kultur aktiv und reflexiv, als Ressource menschlichen Tuns, und nicht deterministisch als Kausalfaktor. Anschließend wird der ethnographische Forschungsstand zu Patientenverfügungen in westlichen Gesundheitssystemen zusammengefasst. Zeitintensive, qualitative Forschung verdeutlicht die Gefahr einer Kulturalisierung sozialer Ungleichheiten, die spezifische Positionalität bioethischer Prämissen und die Vielfalt und Komplexität im Umgang mit Patientenverfügungen. Der Beitrag schließt mit Hinweisen darauf, wie Diversität in Entscheidungsprozessen am Ende des Lebens jenseits von Kultur analysiert werden kann. (shrink)

The ArgumentThis article uses the history of early sound recording technology in the united States between 1878 and 1915 to show how published discourse contributed to the way the talking machine was defined and situated as a commercially viable product. Comparing the published accounts of Edison's phonograph and Berliners gramophone in popular scientific articles between 1878 and 1896 illustrates that technological advances in sound recording technology take on important cultural meanings. Critical to these meanings is the way in which the (...) technological “fidelity” is linguistically transformed into an aesthetic quality, projected and interpreted within demonstrable values of musical culture. Beginning in 1902, the Victor Talking Machine Company, formed to market the gramophone, took advantage of these cultural meanings to claim a technological advantage over Edison's cylinder recorder. Whose voice was recorded became part of the claim to technological superiority. The Victor Company succeeded in capitalizing “Culture” by promoting their recordings of opera stars like Enrico Caruso as technologically and culturally faithful to live musical performance and as a democratically available access to a privileged lifestyle. Thus did the Victor Company use a terrier and a tenor to legitimate their talking machine as an American musical instrument. (shrink)

Ayn Rand argued that “selfish” is the correct designation for a person living according to the Objectivist ethics and that selfishness is a virtue. The accuracy of this claim is examined along with the meaning of “selfish,” the wider implications for the Objectivist ethics, and ethics in general. Alternatives to the term are suggested.

Modern American nursing arose during the Civil War and subsequently adopted the Nightingale educational model in the 1870s. By 1889, the journal Trained Nurse and Hospital Review had been established. It published a six‐part series on ethics in nursing. With the establishment of the American Nurses Association in 1893, the articles of incorporation gave the organization its first charge: “to establish and maintain a code of ethics.” While the rich and enduring tradition of nursing's ethics has been concerned about individual (...) patients and their relational nexus, nursing ethics has from the beginning been a social ethics, intimately concerned both for the shape of society and for social change. This concern has been for health, conceived broadly and not focused specifically on disease and its treatment, but including the social causes of disease. Nightingale herself was an ardent social reformer, instituting a wide range of types of army sanitation reform, sanitation reform in India, and hospital and nursing reform. Despite her gender, her wealth and privilege granted her access to men in power who furthered her policy and reform agenda. From the start, then, modern nursing was imbued with a social reformist bias. (shrink)

Using 20 video recordings of Emergency Room treatment and over 5 years of Emergency Room fieldwork data, this study elucidates how interactional processes serve as resources for generating a cultural script of death in Japan called ‘Mitori’. A sudden death at a hospital, in which a patient is removed from their social network, is often considered as the opposite of a ‘good home death’. This study shows how hospital deaths in Japan are strongly interrelated with family participation. After showing the (...) point where medical professionals decide to terminate resuscitation attempts, the analysis depicts interactional steps that shift the definition of environment from a place for treatment toward a place where ‘Mitori’ occurs; that is, a family encounter occurs with a dying patient. Conversation between a doctor and a family member consists of a step-by-step evidence- building story. The final section displays both conversational and physical resources used to establish ‘Mitori’. (shrink)

The paper makes a strong plea for the health care system itself to strive for better health. It argues that a growing weakness of the health care system is high level psychological stress. This, in turn, is caused by the overuse of memory-linked analytical process thinking in managing the affairs of health care organizations. The author strongly recommends a shift towards a greater use of natural flow thinking which is more supple, spontaneous, creative and stress free. She argues for this (...) shift on the basis of several years of personal engagement with and learning of flow thinking practices in different parts of the world, including India. (shrink)

ability to understand the ongoing dynamic of the research process. This contrasts with the research team, which often spends little ...

INTRODUCTORY REMARKS It is my lot, if not my duty, in presenting these opening remarks at our conference, to take the title of our meeting seriously. ...

The large body of literature labeled “ethics in nursing education” is entirely devoted to curricular matters of ethics education in nursing schools, that is, to what ought to be the ethics content that is taught and what theory or issues ought to be included in all nursing curricula. Where the nursing literature actually focuses on particular ethical issues, it addresses only single topics. Absent from the literature, however, is any systematic analysis and explication of ethical issues or dilemmas that occur (...) within the context of nursing education. The objective of this article is to identify the spectrum of ethical issues in nursing education to the end of prompting a systematic and thorough study of such issues, and to lay the groundwork for research by identifying and provisionally typologizing the ethical issues that occur within the context of academic nursing. (shrink)

This article calls nursing to engage in the study of religions and identifies six considerations that arise in religious studies and the ways in which religious faith is expressed. It argues that whole-person care cannot be realized, neither can there be a complete understanding of bioethics theory and decision making, without a rigorous understanding of religious-ethical systems. Because religious traditions differ in their cosmology, ontology, epistemology, aesthetic, and ethical methods, and because religious subtraditions interact with specific cultures, each religion and (...) subtradition has something distinctive to offer to ethical discourse. A brief example is drawn from Native American religions, specifically their view of `speech' and `words'. Although the example is particular to an American context, it is intended to demonstrate a more general principle that an understanding of religion per se can yield new insights for bioethics. (shrink)

United States law recognizes adult reproductive liberty and many states view surrogacy services through that lens. During the COVID-19 pandemic in March, 2020, New York State enacted the Child–Pare...

Inequality in the family is the most damaging of all forces in women’s lives. It is overtly preserved by religious, customary, and state laws that formally enshrine discrimination against women and is perpetuated by de facto lack of access to nominally protective systems and remedies. International law and its implementation mechanisms provide an arena for confronting resistance to gender equality in the family, calling states to account at the highest level as well as providing a platform for domestic advocacy. CEDAW (...) and the jurisprudence of its monitoring body, the Committee on the Elimination of Discrimination against Women, clearly state the paramount value of protecting the individual human rights of family members rather than maintaining family “protection” and privacy at the expense of the women within it. By ratifying, States theoretically commit themselves to this progressive position. However, the politics of state and community identity make for a more complex picture that includes multiple, sometimes overlapping, levels of acceptance and rejection. Taking as a case study the current initiative to adopt a new General Recommendation to address the economic consequences of family relations and their dissolution, this Article draws on the CEDAW Convention and the CEDAW Committee’s work to suggest a practical application of international standards to address the tangle of legal systems and identity that have disadvantaged women for centuries. Placing this initiative within the context of multiple family law regimes and the multicultural debate, the right to exit and the concept of freedom to associate and to disassociate are emphasized as crucial in confronting the phenomenon of discriminatory identitybased family legal regimes. The Article concludes with an illustration of the harmonization process required by the CEDAW Convention, taking the new General Recommendation as a model approach for meeting the international equality norms while preserving community or State identity. (shrink)