We propose the ‘patient-worker’ as a theoretical construct that responds to moral problems that arise with the globalization of healthcare and medical research. The patient-worker model recognizes that some participants in global medical industries are workers and are owed worker's rights. Further, these participants are patient-like insofar as they are beneficiaries of fiduciary relationships with healthcare professionals. We apply the patient-worker model to human subjects research and commercial gestational surrogacy. In human subjects research, subjects are usually characterized as either patients (...) or as workers. Through questioning this dichotomy, we argue that some subject populations fit into both categories. With respect to commercial surrogacy, we enrich feminist discussions of embodied labor by describing how surrogates are beneficiaries of fiduciary obligations. They are not just workers, but patient-workers. Through these applications, the patient-worker model offers a helpful normative framework for exploring what globalized medical industries owe to the individuals who bear the bodily burdens of medical innovation. (shrink)

Some accounts of the fiduciary relationship place trust and autonomy at odds with one another, so that trusting a fiduciary to act on one’s behalf reduces one’s ability to be autonomous. In this chapter, we critique this view of the fiduciary relationship (particularly bilateral instances of this relationship) using contemporary work on autonomy and ‘relational autonomy’. Theories of relational autonomy emphasize the role that interpersonal trust and social relationships play in supporting or hampering one’s ability to act autonomously. We argue (...) that fiduciary relationships, understood through the lens of relational autonomy, can provide a means of enhancing, rather than diminishing, beneficiaries’ autonomy. (shrink)

Clinical Labor: Tissue Donors and Research Subjects in the Global Bio-economy presents an impressive and informative exploration of a form of labor that is rarely acknowledged as labor at all: the work performed by surrogates, tissue providers, and research subjects. Authors Melinda Cooper and Catherine Waldby refer to this type of work as clinical labor, which they describe as a form of embodied service work that relies on “in vivo, biological processing and the utilization of the worker’s living substrate as (...) essential elements in the productive process”. Providing historical context together with insightful analysis of the rise of clinical labor, Cooper and Waldby give readers a... (shrink)

Rights of Women attracted much UK media attention in late 2014 by bringing a judicial review that challenged the reduced provisions for family law legal aid available for victims of domestic violence: R v The Lord Chancellor and Secretary of State for Justice [2015] EWHC 35. In June 2015, within Rights of Women’s 40th anniversary year, Hannah Camplin interviewed the organisation’s Director Emma Scott about the decision to bring the judicial review, the advantages and challenges of the judicial review (...) process, and the experience of strategic litigation within the context of Rights of Women’s long history of campaigning for women’s rights. What emerged is a portrait of a feminist organisation in 2015, and, in a fast changing political and financial landscape, the dual importance of collaborative working and the need for flexibility in service provision and campaigning tools. (shrink)

Minimal Semantics asks what a theory of literal linguistic meaning is for - if you were to be given a working theory of meaning for a language right now, what would you be able to do with it? Emma Borg sets out to defend a formal approach to semantic theorising from a relatively new type of opponent - advocates of what she call 'dual pragmatics'. According to dual pragmatists, rich pragmatic processes play two distinct roles in linguistic comprehension: as (...) well as operating in a post-semantic capacity to determine the implicatures of an utterance, they also operate prior to the determination of truth-conditional content for a sentence. That is to say, they have an integral role to play within what is usually thought of as the semantic realm. Borg believes dual pragmatic accounts constitute the strongest contemporary challenge to standard formal approaches to semantics since they challenge the formal theorist to show not merely that there is some role for formal processes on route to determination of semantic content, but that such processes are sufficient for determining content. Minimal Semantics provides a detailed examination of this school of thought, introducing readers who are unfamiliar with the topic to key ideas like relevance theory and contextualism, and looking in detail at where these accounts diverge from the formal approach. Borg's defence of formal semantics has two main parts: first, she argues that the formal approach is most naturally compatible with an important and well-grounded psychological theory, namely the Fodorian modular picture of the mind. Then she argues that the main arguments adduced by dual pragmatists against formal semantics - concerning apparent contextual intrusions into semantic content - can in fact be countered by a formal theory. The defence holds, however, only if we are sensitive to the proper conditions of success for a semantic theory. Specifically, we should reject a range of onerous constraints on semantic theorizing (e.g., that it answer epistemic or metaphysical questions, or that it explain our communicative skills) and instead adopt a quite minimal picture of semantics. (shrink)

Emma Borg examines the relation between semantics and pragmatics, and assesses recent answers to fundamental questions of how and where to draw the divide between the two. She argues for a minimal account of the interrelation between them--a 'minimal semantics'--which holds that only rule-governed appeals to context can influence semantic content.

In this commentary, we highlight a difficulty for metric navigation arising from recent data with grid and place cells: the integration of piecemeal representations of space in environments with repeated boundaries. Put simply, it is unclear how place and grid cells might provide a global representation of distance when their fields appear to represent repeated boundaries within an environment. One implication of this is that the capacity for spatial inferences may be limited.

Microaggressions are seemingly negligible slights that can cause significant damage to frequently targeted members of marginalized groups. Recently, Scott O. Lilienfeld challenged a key platform of the microaggression research project: what’s aggressive about microaggressions? To answer this challenge, Derald Wing Sue, the psychologist who has spearheaded the research on microaggressions, needs to theorize a spectrum of aggression that ranges from intentional assault to unintentional microaggressions. I suggest turning to Bonnie Mann’s “Creepers, Flirts, Heroes and Allies” for inspiration. Building from Mann’s (...) richer theoretical framework will allow Sue to answer Lilienfeld’s objection and defend the legitimacy of the concept, ‘microaggression’. (shrink)

A standard objection to so-called ‘minimal semantics’ is that minimal contents are explanatorily redundant as they play no role in an adequate account of linguistic communication. This paper argues that this standard objection is mistaken. Furthermore, I argue that seeing why the objection is mistaken sheds light both on how we should draw the classic Gricean distinction between saying and implicating, and how we should think about the key philosophical notion of assertion. Specifically, it reveals that these ideas are best (...) understood primarily in socio-linguistic terms. (shrink)

"[N]o matter how much of a coalition space this is, it ain't nothing like the coalescing you've got to do tomorrow, and Tuesday and Wednesday."This essay is a critical reflection on the centrality of coalitional politics for decolonial feminist philosophy. Decolonial feminisms emerge from multisited struggles with colonization and, as a result, are rich and heterogeneous.1 Thus, the starting point for decolonial feminists must be one that centers on coalitional politics. Women of color have long emphasized the importance of coalition (...) to collective struggle against a matrix of systems of oppression.2 However, the work of forging coalitions is just that, work. Indeed, the work of coalition building, as Bernice... (shrink)

In this paper, I argue that a definition of paternalism must meet certain methodological constraints. Given the failings of descriptivist and normatively charged definitions of paternalism, I argue that we have good reason to pursue a normatively neutral definition. Archard's 1990 definition is one such account. It is for this reason that I return to Archard's account with a critical eye. I argue that Archard's account is extensionally inadequate, failing to capture some cases which are clear instances of paternalism. I (...) refine each of his three conditions, ultimately providing an improved definition of paternalistic interference. This revised definition meets specific methodological constraints, offering a definition that is both neutral between anti- and pro-paternalistic intuitions, but that also explains why paternalism is normatively significant. Specifically, this definition captures the conflict between interfering with an individual's choices and treating the individual benevolently, without making paternalism permissible or impermissible by definition. (shrink)

Mirror neurons are neurons which fire in two distinct conditions: (i) when an agent performs a specific action, like a precision grasp of an object using fingers, and (ii) when an agent observes that action performed by another. Some theorists have suggested that the existence of such neurons may lend support to the simulation approach to mindreading (e.g. Gallese and Goldman, 1998, 'Mirror neurons and the simulation theory of mind reading'). In this note I critically examine this suggestion, in both (...) its original and a revised form (due to Iacoboni et al., 2005, 'Grasping the intentions of others with one's own mirror neuron system'), and argue that the existence of mirror neurons can in fact tell us very little about how intentional attribution actually proceeds. (shrink)

Philosophers often assume that folk hold pain to be a mental state – to be in pain is to have a certain kind of feeling – and they think this state exhibits the classic Cartesian characteristics of privacy, subjectivity, and incorrigibility. However folk also assign pains bodily locations: unlike most other mental states, pains are held to exist in arms, feet, etc. This has led some to talk of the ‘paradox of pain’, whereby the folk notion of pain is inherently (...) conflicted. Recently, several authors have rejected the paradox view, arguing instead that folk hold a univocal, bodily view. This paper presents six objections to the bodily view of the folk concept of pain. We then outline a direction for future research – the ‘polyeidic approach’ – whereby the folk notion of pain is held to encompass various divergent strands and we suggest that certain problems surrounding the treatment and communication of pain might be usefully be viewed through the lens of the polyeidic approach. (shrink)

‘Pragmaticist’ positions posit a three-way division within utterance content between: the standing meaning of the sentence, a somewhat pragmatically enhanced meaning which captures what the speaker explicitly conveys, and further indirectly conveyed propositions which the speaker merely implies. Here I re-examine the notion of an explicature, asking how it is defined and what work explicatures are supposed to do. I argue that explicatures get defined in three different ways and that these distinct definitions can and do pull apart. Thus the (...) notion of an explicature turns out to be ill-defined. (shrink)

Scientists, philosophers, and policymakers disagree about how to define microaggression. Here, we offer a taxonomy of existing definitions, clustering around (a) the psychological motives of perpetrators, (b) the experience of victims, and (c) the functional role of microaggression in oppressive social structures. We consider conceptual and epistemic challenges to each and suggest that progress may come from developing novel hybrid accounts of microaggression, combining empirically tractable features with sensitivity to the testimony of victims.

In this book Emma Ruttkamp demonstrates the power of the full-blown employment of the model-theoretic paradigm in the philosophy of science. Within this paradigm she gives an account of sciences as process and product. She expounds the "received statement" and the "non-statement" views of science, and shows how the model-theoretic approach resolves the spurious tension between these views. In this endeavour she also engages the views of a number of contemporary philosophers of science with affinity to model theory. This (...) text can be read by specialists working in philosophy of science or formal semantics, by logicians working on the structure of theories, and by students in philosophy of science - this text offers a thorough introduction to non-statement accounts of sciences as well as a discussion of the traditional statement account of science. (shrink)

It is well established that the temporal proximity of two events is a fundamental cue to causality. Recent research with adults has shown that this relation is bidirectional: events that are believed to be causally related are perceived as occurring closer together in time—the so‐called temporal binding effect. Here, we examined the developmental origins of temporal binding. Participants predicted when an event that was either caused by a button press, or preceded by a non‐causal signal, would occur. We demonstrate for (...) the first time that children as young as 4 years are susceptible to temporal binding. Binding occurred both when the button press was executed via intentional action, and when a machine caused it. These results suggest binding is a fundamental, early developing property of perception and grounded in causal knowledge. (shrink)

In his important recent book, Ethics and the Global Financial Crisis: Why Incompetence is Worse than Greed, Boudewijn de Bruin argues that a key element of the global financial crisis of 2007–2008 was a failure of epistemic virtue. To improve matters, then, de Bruin argues we need to focus on the acquisition and exercise of epistemic virtues, rather than to focus on a more ethical culture for banking per se. Whilst this is an interesting suggestion and it is indeed very (...) plausible that an increased focus on proper knowledge-related behaviour will be part of a solution, we are sceptical both about de Bruin’s overarching theoretical claims and about his practical suggestions for change. Instead we argue that change in this sector is best promoted by reconceiving of the relationship between financial institutions and the societies they serve, and that this is fundamentally not an epistemic but a moral issue. (shrink)

Some demonstrative expressions, those we might term ‘bare demonstratives’, appear without any appended descriptive content (e.g. occurrences of ‘this’ or ‘that’ simpliciter). However, it seems that the majority of demonstrative occurrences do not follow this model. ‘Complex demonstratives’ is the collective term I shall use for phrases formed by adjoining one or more common nouns to a demonstrative expression (e.g. ‘that cat’, ‘this happy man’) and I will call the combination of predicates immediately concatenated with the demonstrative in such phrases (...) the ‘matrix’ of the expression. The question, then, is how we should construe the logical form of such expressions within a semantic theory for our language; and I wish to suggest that some recent answers to this question are, in fact, mistaken. The structure of the paper is as follows: first, I wish to highlight two (often underlying) assumptions about the nature of noun phrases in general, and suggest that, if they are both adopted, they apparently constrain the possible accounts of the logical form of complex demonstratives to just three options. The second and third parts of the paper will be concerned with expanding these options and arguing that none of them are adequate; thus the major part of the paper is concerned with the negative claim that the most obvious moves to make in this area must actually fail on closer inspection. The fourth and final section will then (very briefly) sketch the positive thesis of the paper: that we can deliver a clear and cohesive account of complex demonstratives, armed simply with elements which we will draw from David Kaplan’s theory of demonstratives, but only at the cost of rejecting (or at least refining) one assumption we recognised initially. (shrink)

The biomedical industry relies on the skills of animal technologists to put laboratory animal welfare into practice. This is the first study to explore how this is achieved in relation to their participation in implementing refinement and reduction, two of the three key guiding ethical principles––the “3Rs”––of what is deemed to be humane animal experimentation. The interpretative approach contributes to emerging work within the social sciences and humanities exploring care and ethics in practice. Based on qualitative analysis of participant observation (...) within animal research facilities in UK universities, in-depth interviews with ATs, facility managers, and other stakeholders, and analysis of regulatory guidelines, we draw a contrast between the minimum required of ATs by law and how their care work not only meets but often exceeds these requirements. We outline how ATs constitute a key source of innovation and insight into the refinement of animal care and the reduction of animal use, hitherto not formally acknowledged. Exploring AT care work as an example of ethics in practice makes an original contribution to broader debates within health care and animal welfare about how technology, regulation, and behavior can foster and sustain a “culture of care”. (shrink)

Starting with service robotics and industrial robotics, this paper aims to suggest philosophical reflections about the relationship between body and machine, between man and technology in our contemporary world. From the massive use of the cell phone to the robots which apparently “feel” and show emotions like humans do. From the wearable exoskeleton to the prototype reproducing the artificial sense of touch, technological progress explodes to the extent of embodying itself in our nakedness. Robotics, indeed, is inspired by biology in (...) order to develop a new kind of technology affecting human life. This is a bio-robotic approach, which is fulfilled in the figure of the cyborg and consequently in the loss of human nature. Today, humans have reached the possibility to modify and create their own body following their personal desires. But what is the limit of this achievement? For this reason, we all must question ourselves whether we have or whether we are a body. (shrink)

This article identifies several critical problems with the last 30 years of research into hostile communication on the internet and offers suggestions about how scholars might address these problems and better respond to an emergent and increasingly dominant form of online discourse which I call ‘e-bile’. Although e-bile is new in terms of its prevalence, rhetorical noxiousness, and stark misogyny, prototypes of this discourse—most commonly referred to as ‘flaming’—have always circulated on the internet, and, as such, have been discussed by (...) scholars from a range of disciplines. Nevertheless, my review of this vast body of literature reveals that online hostility has historically posed a number of conceptual, methodological, and epistemological challenges due to which scholars have typically underplayed, overlooked, ignored, or otherwise marginalised its prevalence and serious ethical and material ramifications. Fortunately, lessons learned from my analysis suggests promising approaches for future research into this challenging form of new media discourse. (shrink)

In this article, we redefine classical notions of theory reduction in such a way that model-theoretic preferential semantics becomes part of a realist depiction of this aspect of science. We offer a model-theoretic reconstruction of science in which theory succession or reduction is often better - or at a finer level of analysis - interpreted as the result of model succession or reduction. This analysis leads to 'defeasible reduction', defined as follows: The conjunction of the assumptions of a reducing theory (...) T with the definitions translating the vocabulary of a reduced theory T' to the vocabulary of T, defeasibly entails the assumptions of reduced T'. This relation of defeasible reduction offers, in the context of additional knowledge becoming available, articulation of a more flexible kind of reduction in theory development than in the classical case. Also, defeasible reduction is shown to solve the problems of entailment that classical homogeneous reduction encounters. Reduction in the defeasible sense is a practical device for studying the processes of science, since it is about highlighting different aspects of the same theory at different times of application, rather than about naive dreams concerning a metaphysical unity of science. (shrink)

My model-theoretic realist account of science places linguistic systems and the corresponding non-linguistic structures at different stages of the scientific process. It is shown that science and its progress cannot be analysed in terms of only one of these strata. Philosophy of science literature offers mainly two approaches; to the structure of scientific knowledge analysed in terms of theories and their models, the "statement" and the "non-statement" approaches. In opposition to the statement approach's belief that scientific knowledge is embodied in (...) theories symbolic language) with direct interpretative links---via so-called "bridge principles"---to reality, the defenders of the non-statement approach believe in an analysis where the language in which the theory is formulated plays a much smaller role than the structures which satisfy that theory. ;The model-theoretic realism expounded here retains the notion of a scientific theory as a set of sentences, while simultaneously emphasising the interpretative role of the conceptual models of these theories. My criticism against the non-statement approach is based on the fact that merely "giving" the theory "in terms of" its mathematical structures leaves out any real interpretation of the nature and role of general terms in science. Against the statement approach's "direct" linking of general theoretical terms to reality, my approach interpolates models between theories and reality in the interpretative chain. ;The links between the general terms of scientific theories and their interpretations in the various models of the theory regulate the whole referential process. The terms of a theory are "general" in the sense that they are the result of certain abstractive conceptualisations of the object of scientific investigation and subsequent linguistic formulations of these conceptualisations. Their meanings can be "given back" only by interpreting them in the limited context, of the various conceptual models of their theory and, finally, by finding an isomorphic relation between some substructure of the conceptual model in question and some empirical conceptualisation of relevant experimental data. In this sense the notion of scientific "truth" becomes inextricably linked with that of articulated reference, as it---given its model-dependent nature---should be. (shrink)

Harvey Siegel's epistemologically-informed conception of critical thinking is one of the most influential accounts of critical thinking around today. In this article, I seek to open up an account of critical thinking that goes beyond the one defended by Siegel. I do this by re-reading an opposing view, which Siegel himself rejects as leaving epistemology ‘pretty much as it is’. This is the view proposed by Charles Taylor in his paper ‘Overcoming Epistemology’. Crucially, my aim here is not to defend (...) Taylor's challenge to epistemology per se, but rather to demonstrate how, through its appeal to certain key tropes within Heideggerian philosophy, Taylor's paper opens us towards a radically different conception of thinking and the human being who thinks. Indeed, as will be argued, it is through this that Taylor and Heidegger come to offer us the resources for re-thinking the nature of critical thinking—in a way that exceeds the epistemological, and does more justice to receptive and responsible conditions of human thought. (shrink)

Feminists have long argued that women who offend are judged by who they are, not what they do, with idealised images of femininity and motherhood used as measures of culpability. The ability to meet the expectations of motherhood and femininity are particularly difficult for women who experience a crisis pregnancy, as evident in cases where women have been convicted of concealment of birth. The offence prohibits the secret disposal of the dead body of a child, to conceal knowledge of its (...) birth. Traditionally used to prosecute women suspected of killing their newborn children, analysis of court transcripts suggests the offence is also used to punish women who fail to meet expectations of motherhood. This paper analyses three contemporary cases in light of the historical origins of the offence, illustrating the legacy of prejudice against ‘deviant’ mothers. Finally, it questions the continued existence of this archaic offence. (shrink)

The aim of this paper is to explore the proper content of a formal semantic theory in two respects: first, clarifying which uses of expressions a formal theory should seek to accommodate, and, second, how much information the theory should contain. I explore these two questions with respect to occurrences of demonstratives and pronouns – the so- called ‘deferred’ uses – which are often classified as non-standard or figurative. I argue that, contrary to initial impressions, they must be treated as (...) semantically identical to ordinary, perceptual uses of these expression-types, and that this finding has important repercussions for our view of the scope and limits of a semantic theory. (shrink)

We report the results of a cross-cultural investigation of person-body reasoning in the United Kingdom and northern Brazilian Amazon (Marajó Island). The study provides evidence that directly bears upon divergent theoretical claims in cognitive psychology and anthropology, respectively, on the cognitive origins and cross-cultural incidence of mind-body dualism. In a novel reasoning task, we found that participants across the two sample populations parsed a wide range of capacities similarly in terms of the capacities’ perceived anchoring to bodily function. Patterns of (...) reasoning concerning the respective roles of physical and biological properties in sustaining various capacities did vary between sample populations, however. Further, the data challenge prior ad-hoc categorizations in the empirical literature on the developmental origins of and cognitive constraints on psycho-physical reasoning (e.g., in afterlife concepts). We suggest cross-culturally validated categories of “Body Dependent” and “Body Independent” items for future developmental and cross-cultural research in this emerging area. (shrink)

The network approach to psychopathology posits that mental disorders can be conceptualized and studied as causal systems of mutually reinforcing symptoms. This approach, first posited in 2008, has grown substantially over the past decade and is now a full-fledged area of psychiatric research. In this article, we provide an overview and critical analysis of 363 articles produced in the first decade of this research program, with a focus on key theoretical, methodological, and empirical contributions. In addition, we turn our attention (...) to the next decade of the network approach and propose critical avenues for future research in each of these domains. We argue that this program of research will be best served by working toward two overarching aims: (a) the identification of robust empirical phenomena and (b) the development of formal theories that can explain those phenomena. We recommend specific steps forward within this broad framework and argue that these steps are necessary if the network approach is to develop into a progressive program of research capable of producing a cumulative body of knowledge about how specific mental disorders operate as causal systems. (shrink)

In temporal binding, the temporal interval between one event and another, occurring some time later, is subjectively compressed. We discuss two ways in which temporal binding has been conceptualized. In studies showing temporal binding between a voluntary action and its causal consequences, such binding is typically interpreted as providing a measure of an implicit or pre-reflective “sense of agency”. However, temporal binding has also been observed in contexts not involving voluntary action, but only the passive observation of a cause-effect sequence. (...) In those contexts, it has been interpreted as a top-down effect on perception reflecting a belief in causality. These two views need not be in conflict with one another, if one thinks of them as concerning two separate mechanisms through which temporal binding can occur. In this paper, we explore an alternative possibility: that there is a unitary way of explaining temporal binding both within and outside the context of voluntary action as a top-down effect on perception reflecting a belief in causality. Any such explanation needs to account for ways in which agency, and factors connected with agency, have been shown to affect the strength of temporal binding. We show that principles of causal inference and causal selection already familiar from the literature on causal learning have the potential to explain why the strength of people’s causal beliefs can be affected by the extent to which they are themselves actively involved in bringing about events, thus in turn affecting binding. (shrink)

Uncertainty around the role ‘super-spreaders’ play in the transmission and escalation of infectious disease is compounded by its broad and vague definition. It is a term that has been much used in relation to COVID-19, particularly in social media. On its widest definition, it refers to a propensity to infect a larger than average number of people. Given the biological, behavioural and environmental variables relevant to infectivity, this might be pertinent to almost any infected individual who is not physically isolated (...) from others. Nor is the term confined to individuals with a propensity to spread infectious disease: it can potentially be used to describe events, policies or settings. This article explores the use of the term and considers circumstances in which the wide definition can be problematic. One problem is that it can lead to undeserved apportionment of moral blame to alleged super-spreaders. Another is that it can detract from scientific investigation of the heterogeneity of COVID-19 transmission. The author calls for a clearer epidemiological definition. (shrink)

In this paper I want to explore the arguments for so-called ‘unarticulated constituents’ (UCs). Unarticulated constituents are supposed to be propositional elements, not presented in the surface form of a sentence, nor explicitly represented at the level of its logical form, yet which must be interpreted in order to grasp the (proper) meaning of that sentence or expression. Thus, for example, we might think that a sentence like ‘It is raining’ must contain a UC picking out the place at which (...) the speaker of the sentence asserts it to be raining. In §1 I will explore the nature of UCs a little further, and, in §2, suggest that we can recognise two different forms of argument for them.. (shrink)

relevant to the differences between the two speakings, Odile’s words in the first case said what was false, while in the second case they said what was true. Both spoke of the same state of the world, or the same refrigerator in the same condition. So, in the first case, the words said what is false of a refrigerator with but a milk puddle; in the second case they said what is true of such a refrigerator.

Background A topic of great concern in bioethics is the medical research conducted in poor countries sponsored by wealthy nations. Western drug companies increasingly view Latin America as a proper place for clinical research trials. The region combines a large population, modern medical facilities, and low per capita incomes. Participants from developing countries may have little or non alternative means of treatment other than that offered through clinical trials. Therefore, the provision of a valid informed consent is important. Methods To (...) gain insight about some aspects of the informed consent procedure in a major cancer centre in Mexico, we conducted a three-step evaluation process: 1) a ten point multiple choice survey questionnaires, was used to explore some aspects of the patients' experiences during the informed consent process, 2) researchers' knowledge about specific aspects of the informed consent was evaluated in this study using survey questionnaires; and 3) the comprehensibility, readability and number of pages of the consent forms were analysed. The socioeconomic and educational level of the patients, were also considered. Results were reported using a numerical scale. Results Thirty five patients, 20 doctors, and 10 individuals working at the hospital agreed to participate in the study. Eighty three percent of the patients in the study were classified as living in poverty; education level was poor or non existent, and 31% of the patients were illiterate. The consent forms were difficult to understand according to 49% of the patients, most doctors agreed that the forms were not comprehensible to the patients. The average length of the IC documents analysed was 14 pages, and the readability average score was equivalent to 8TH Grade. Conclusion The results presented in this work describe some relevant characteristics of the population seen at public health care institutions in Mexico. Poverty, limited or no education, and the complexity of the information provided to the patients may question the validity of the informed consent procedure in this group of patients. (shrink)

Medical practitioners are duty-bound to tell their patients the truth about their medical conditions, along with the risks and benefits of proposed treatments. Some patients, however, would rather not receive medical information. A recent response to this tension has been to argue that that the disclosure of medical information is not optional. As such, patients do not have permission to refuse medical information. In this paper I argue that, depending on the context, the disclosure of medical information can undermine the (...) patient’s ability to exercise her autonomy or have therapeutically detrimental effects. In the light of these insights I go on to develop a context-sensitive approach to medical disclosure. The advantage of this account is that it addresses concerns on both sides of the debate; whilst it acknowledges that patients do not have an exercisable ‘right not to know,’ it allows that in some cases medical information ought to be withheld. (shrink)

In medical practice, the doctrine of informed consent is generally understood to have priority over the medical practitioner’s duty of care to her patient. A common consequentialist argument for the prioritisation of informed consent above the duty of care involves the claim that respect for a patient’s free choice is the best way of protecting that patient’s best interests; since the patient has a special expertise over her values and preferences regarding non-medical goods she is ideally placed to make a (...) decision that will protect her interests. In this paper I argue against two consequentialist justifications for a blanket prioritisation of informed consent over the duty of care by considering cases in which patients have imperfect access to their overall best interests. Furthermore, I argue that there are cases where the mere presentation of choice under the doctrine of informed consent is detrimental to patient best interests. I end the paper by considering more nuanced approaches to resolving the conflict between informed consent and the duty of care and consider the option of permitting patients to waive informed consent. (shrink)

Objective: Ethical guidelines are designed to ensure benefits, protection and respect of participants in clinical research. Clinical trials must now be registered on open-access databases and provide details on ethical considerations. This systematic survey aimed to determine the extent to which recently registered clinical trials report the use of standard of care and post-trial obligations in trial registries, and whether trial characteristics vary according to setting. Methods: We selected global randomized trials registered on http://www.clinicaltrials.gov and http://www.controlled-trials.com. We searched for intervention (...) trials of HIV/AIDS, malaria, and tuberculosis from 9 October 2004, the date of the most recent version of the Helsinki Declaration, to 10 April 2007. Results: We collected data from 312 trials. Fifty-eight percent (58%, 95% CI = 53 to 64) of trial protocols report informed consent. Fifty-eight percent (58%, 95% CI = 53 to 64) of trials report active controls. Almost no trials (1%, 95% CI = 0.5 to 3) mention post-trial provisions. Most trials measure surrogate outcomes. Twenty percent (20%, 95% CI = 16 to 25) of trials measure patient-important outcomes, such as death; and the odds that these outcomes are in a low income country are five times greater than for a developed country (odds ratio (OR) 5.03, 95% CI = 2.70 to 9.35, p = < 0.001). Pharmaceutical companies are involved in 28% (CI = 23 to 33) of trials and measure surrogate outcomes more often than nonpharmaceutical companies (OR 2.45, 95% CI = 1.18 to 5.09, p = 0.31). Conclusion: We found a large discrepancy in the quality of reporting and approaches used in trials in developing settings compared to wealthier settings. (shrink)

This study supports the idea that fields form around issues, and describes the roles of various stakeholders in the structuring, shaping, and legitimating of the emerging field of Corporate Social Responsibility (CSR). A model of the institutional history of the CSR field is outlined, of which a key stage is the appearance of CSR rating agencies as the significant players and Institutional Entrepreneurs of the field. We show to which extent the creation and further development of CSR rating agencies, and (...) the activism of other significant stakeholders of the field (typically portrayed as “standard setters” and “regulatory agents”), contribute to the institutionalization of CSR. With this in mind, among various stakeholders that legitimate the field of CSR, we present the efforts of global and local stakeholders such as the European Union, the United Nations, the International Organization for Standardization, and governments and their interactions. We suggest that the different paths of CSR development and institutionalization in France and in the United States depend on the nature of local and global stakeholders’ involvement in this process and their interactions. (shrink)

This article advances the idea that shareholders who seek to influence corporate behaviour can be understood analytically as norm entrepreneurs. These are actors who seek to persuade others to adopt a new standard of appropriateness. The article thus goes beyond studies which focus on the influence of shareholder activism on single instances of corporate conduct, as it recognises shareholders' potential as change agents for more widely shared norms about corporate responsibilities. The article includes the empirical example of US internet technology (...) companies who, in their Chinese operations, face conflicts of norm systems in regard to freedom of expression on the internet. Shareholders have been active in seeking to persuade these companies to adopt a norm of adhering to global standards for human rights over restrictions implied by authoritarian regimes to which they deliver services. (shrink)

The unbridled consumption of clothing threatens the environment. In fashion communities, a discussion is developing around the adoption of new materials and economic models to reduce the impacts of clothing production and use. We discuss these emergent technologies in the wider historical setting of the Anthropocene, a geologic term that denotes the global-scale environmental changes brought about by agricultural and industrial activity. The long history of human-environmental interactions is interwoven with the development of international garment economies that have shaped biological (...) and physical systems. This article provides an account of how changes in clothing manufacturing and consumption patterns have... (shrink)

On the 13th June 2014, the Centre for the Humanities and Health (CHH) at King’s College London hosted a one-day workshop on ‘Parentalism and Trust.’ This workshop was the sixth in a series of workshops whose aim is to provide a new model for high-quality open interdisciplinary engagement between medical professionals and philosophers. The term ‘Parentalism’ rather than paternalism is chosen and used throughout because of some of the derisory and unfortunate gender connotations associated with paternalism (and/or its counterpart ‘maternalism’). (...) Medical Parentalism is the position that unwanted interference with a patient’s choices and actions in order to protect and promote her best interests is morally justified. Whilst there are many problems with its justification and implementation, the workshop addressed how such interference depends on a trusting relationship between the doctor and patient, and the extent to which parentalist interferences might undermine this trust. (shrink)

Despite a recent economic downturn, there is considerable political and industry pressure to retain or even increase the number of scientists in the UK and other developed countries. Claims are made that the supply of scientists (including engineers and mathematicians) is crucial to the economy and the health of the nation, and a large number of initiatives have been funded to address the problem. We consider these claims in light of a re-analysis of existing figures from 1986 to 2009, for (...) young scientists passing through education and into employment. Science graduates are heavily stratified by social origin, and this sorting takes place during initial schooling just as it does with other 'prestige' subjects. The majority of science graduates then move into initial occupations that are not directly related to their degree, suggesting that at this stage of life at least, the demand for scientists trained in specific areas is more than met by existing numbers. We have no reason to believe that the situation is different to other vocational and non-vocational subjects, so perhaps science is not as special as politicians and business leaders imagine. Perhaps young people are put off careers in science by their education. Or perhaps the incentives are not right, leading to the 'wrong' kinds of students in science, and so wastage and inefficiency in the supply process. More pertinently, perhaps this vocational outcome is not how a developed country should assess the value and importance of scientific knowledge among its population. (shrink)