Even as public health ethics was developing as a field, major incidents such as 9/11 and the SARS epidemic propelled discourse around public health emergency preparedness and response. Policy and practice shifted to a multidisciplinary approach, recognizing the broad range of potential threats to public health, including biological, physical, radiological, and chemical threats. This propelled the development of surveillance systems to detect incidents, laboratory capacities to rapidly test for potential threats, and therapeutic and social countermeasures to prepare for and respond (...) to a range of hazards. In bringing public health ethics and emergency preparedness together, Emergency Ethics: Public Health Preparedness and Response adds depth and complexity to both fields. As global threats continue to emerge, the book, edited by Bruce Jennings, John D. Arras, Drue H. Barrett, and Barbara A. Ellis, will offer a vital compass. (shrink)
BackgroundWhen conducting research with Indigenous populations consent should be sought from both individual participants and the local community. We aimed to search and summarise the literature about methods for seeking consent for research with Indigenous populations.MethodsA systematic literature search was conducted for articles that describe or evaluate the process of seeking informed consent for research with Indigenous participants. Guidelines for ethical research and for seeking consent with Indigenous people are also included in our review.ResultsOf 1447 articles found 1391 were excluded (...) ; 56 were relevant and included. Articles were categorised into original research that evaluated the consent process or publications detailing the process of seeking consent and guidelines for ethical research. Guidelines were categorised into international ; national and state/regional/local guidelines. In five studies based in Australia, Canada and The United States of America the consent process with Indigenous people was objectively evaluated. In 13 other studies interpreters, voice recording, videos, pictures, flipcharts and “plain language” forms were used to assist in seeking consent but these processes were not evaluated. Some Indigenous organisations provide examples of community-designed resources for seeking consent and describe methods of community engagement, but none are evaluated. International, national and local ethical guidelines stress the importance of upholding Indigenous values but fail to specify methods for engaging communities or obtaining individual consent. In the ‘Grey literature’ concerns about the consent process are identified but no solutions are offered.ConclusionConsultation with Indigenous communities is needed to determine how consent should be sought from the community and the individual, and how to evaluate this process. (shrink)
This article identifies limitations in traditional approaches to engineering ethics pedagogy, reflected in an overreliance on disaster case studies. Researchers in the field have pointed out that these approaches tend to occlude ethically significant aspects of day-to-day engineering practice and thus reductively individualize and decontextualize ethical decision-making. Some have proposed, as a remedy for these defects, the use of research and theory from Science and Technology Studies to enrich our understanding of the ways in which technology and engineering practice are (...) intricated in social and institutional contexts. While endorsing this approach, this article also argues that STS scholarship may not sufficiently address the kinds of questions about normativity and agency that are essential to engineering ethics. It proposes making use of the growing body of research in a field called “postphenomenology,” an approach that combines STS research with the traditional phenomenological concern with the standpoint of lived-experience. Postphenomenology offers a method of inquiry that combines STS’s investigation into social and institutional dimensions of technology with phenomenological reflection on our lived experience of embodied engagement with technical objects and sociotechnical systems, particularly the ways in which these involvements affect our moral perception and agency. The aim in using this approach in engineering ethics is thus to illuminate moral dimensions of everyday professional life of which practitioners may not typically be aware. The article concludes with some concrete curricular interventions for engineering ethics classrooms. (shrink)
The consent and community engagement process for research with Indigenous communities is rarely evaluated. Research protocols are not always collaborative, inclusive or culturally respectful. If participants do not trust or understand the research, selection bias may occur in recruitment, affecting study results potentially denying participants the opportunity to provide more knowledge and greater understanding about their community. Poorly informed consent can also harm the individual participant and the community as a whole. Invited by local Aboriginal community leaders of the Fitzroy (...) Valley, the Kimberley, Western Australia, The Picture Talk project explores the consent process for research. Focus groups of Aboriginal community members were conducted to establish preferences for methods of seeking individual consent. Transcripts were analysed through NVivo10 Qualitative software using grounded theory with inductive and deductive coding. Themes were synthesised with quotes highlighted. Focus groups with Aboriginal community members were facilitated by a Community Navigator as a cultural guide and interpreter and a researcher. Participants were recruited from all main language groups of the Fitzroy Valley – Gooniyandi, Walmajarri, Wangkatjungka, Bunuba and Nikinya. Participants were aged ≥18 years, with 5 female groups and one male group. Themes identified include: Reputation and trust is essential; The Community Navigator is key; Pictures give the words meaning – milli milli versus Pictures; Achieving consensus in circles; Signing for consent; and Research is needed in the Valley. Aboriginal communities of the Fitzroy Valley recommend that researchers collaborate with local leaders, develop trust and foster a good reputation in the community prior to research. Local Aboriginal researchers should be employed to provide cultural guidance throughout the research process and interpret local languages especially for elders. Pictures are preferred to written text to explain research information and most prefer to sign for consent. The Fitzroy Valley welcomes research when collaborative and for the benefit of the community. Future research could include exploring how to support young people, promote health screening and improve understanding of medical knowledge. (shrink)
Objective Standards of care regarding obstetric management of life-threatening anomalies are not defined. It is hypothesised that physicians' management of these pregnancies is variable and influenced by demographic factors. Design A questionnaire was mailed to members of the Society of Maternal–Fetal Medicine with valid US addresses assessing obstetric management of both ‘uniformly lethal’ (eg, anencephaly, renal agenesis) and ‘uniformly severe, commonly lethal’ (eg, trisomy 13 and 18) anomalies. Respondents were asked to answer as if not limited by state/institutional restrictions. Fisher's (...) exact or χ2 tests were used as appropriate and correction made for multiple comparisons in analyses that were not prespecified. Results The response rate was 36% (732/2038). Nearly 100% of respondents discuss termination for both uniformly and commonly lethal anomalies. In continuing pregnancies, with patient request for obstetric non-intervention 99% of providers would comply for either uniformly or commonly lethal anomalies. The majority ‘encourage’ such management, but some were non-directive or discouraged this management. In continuing pregnancies, with patient request for full obstetric intervention the majority of respondents was willing to comply for both uniformly (71%) and commonly (82%) lethal anomalies. While most practitioners ‘discouraged’ full intervention, some were non-directive or encouraged this management. Demographics and severity of anomaly influenced counselling. Conclusion Discrepancies exist regarding the management of life-threatening fetal anomalies. Patients may be offered different options based on practitioner demographics. The majority of physicians comply with patient wishes. Differences were noted when comparing the management of lethal with that of severe commonly lethal anomalies, suggesting that practitioners make a distinction when counselling patients. (shrink)
Social networks play a significant role in learning and thus in farmers’ adoption of new agricultural technologies. This study examined the effects of social network factors on information acquisition and adoption of new seed varieties among groundnut farmers in Uganda and Kenya. The data were generated through face-to-face interviews from a random sample of 461 farmers, 232 in Uganda and 229 in Kenya. To assess these effects two alternative econometric models were used: a seemingly unrelated bivariate probit model and a (...) recursive bivariate probit model. The statistical evaluation of the SUBP shows that information acquisition and adoption decisions are interrelated while tests for the RBP do not support this latter model. Therefore, the analysis is based on the results obtained from the SUBP. These results reveal that social network factors, particularly weak ties with external support, partially influence information acquisition, but do not influence adoption. In Uganda, external support, gender, farm size, and geographic location have an impact on information acquisition. In Kenya, external support and geographic location also have an impact on information acquisition. With regard to adoption, gender, household size, and geographic location play the most important roles for Ugandan farmers, while in Kenya information from external sources, education, and farm size affect adoption choice. The study provides insight on the importance of external weak ties in groundnut farming, and a need to understand regional differences along gender lines while developing agricultural strategies. This study further illustrates the importance of farmer participation in applied technology research and the impact of social interactions among farmers and external agents. (shrink)
Marine Lorrain : Dans votre travesti, est-ce que vous pouviez compter sur une aide quelconque des Tibétains tout au long de votre pèlerinage? Comment faisiez-vous pour subsister? Alexandra David-Néel : Ah, il y avait des villages. Devant les villages, on s’en allait mendier, puisqu’on était des mendiants. On s’en allait mendier et, puis, on chantait des choses religieuses aux portes des villages. Je fais ça très bien, du reste ; mon fils aussi, lui, il est tibétain, naturellement. Et alors,.
As scientific and engineering efforts become increasingly global in nature, the need to understand differences in perceptions of research ethics issues across countries and cultures is imperative. However, investigations into the connection between nationality and ethical decision-making in the sciences have largely generated mixed results. In Study 1 of this paper, a measure of biases and compensatory strategies that could influence ethical decisions was administered. Results from this study indicated that graduate students from the United States and international graduate students (...) studying in the US are prone to different biases. Based on these findings, recommendations are made for developing ethics education interventions to target these decision-making biases. In Study 2, we employed an ethics training intervention based on ethical sensemaking and used a well-established measure of ethical decision-making that more fully captures the content of ethical judgment. Similar to Study 1, the results obtained in this study suggest differences do exist between graduate students from the US and international graduate students in ethical decision-making prior to taking the research ethics training. However, similar effects were observed for both groups following the completion of the ethics training intervention. (shrink)
Health care professionals assigned to critical care are confronted on a daily basis with particularly trying situations. Their hard work conditions can become anxiety-provoking, affect their physical and/or psychological condition, decrease their performance and increase their absenteeism rate at work. To face this particularly stressful and sometimes depressing context, some professionals fall back on “gallows humour”, a sort of black humour with a morbid overtone, which is likely to shock certain people. Although gallows humour is very widespread, its use in (...) critical care is extremely controversial and most of the time reprimanded by professional orders. Based on the codes of ethics that govern them, professional orders assume that gallows humour violates the duties and responsibilities of their members towards their patients, rejecting its use straightaway. In this article, we contest the categorical rejection of gallows humour in critical care. We adopt a consequentialist perspective based on the study of scientific literature on the benefits of using humour in the workplace, to defend its ethical acceptability. By enabling us to be better prepared to provide care despite the tragic events experienced by professionals, we will see how the use of gallows humour can ultimately have a positive effect on patients. A consequentialist ethics is not only interested in maximizing the benefits of gallows humour but also in reducing the risk of harm to others related to its use. This important criterion will therefore lead us to define the terms and suggest certain conditions that must be respected for an ethical use of this important defense mechanism by health care professionals in critical care. (shrink)
Health care professionals assigned to critical care are confronted on a daily basis with particularly trying situations. Their hard work conditions can become anxiety-provoking, affect their physical and/or psychological condition, decrease their performance and increase their absenteeism rate at work. To face this particularly stressful and sometimes depressing context, some professionals fall back on “gallows humour”, a sort of black humour with a morbid overtone, which is likely to shock certain people. Although gallows humour is very widespread, its use in (...) critical care is extremely controversial and most of the time reprimanded by professional orders. Based on the codes of ethics that govern them, professional orders assume that gallows humour violates the duties and responsibilities of their members towards their patients, rejecting its use straightaway. In this article, we contest the categorical rejection of gallows humour in critical care. We adopt a consequentialist perspective based on the study of scientific literature on the benefits of using humour in the workplace, to defend its ethical acceptability. By enabling us to be better prepared to provide care despite the tragic events experienced by professionals, we will see how the use of gallows humour can ultimately have a positive effect on patients. A consequentialist ethics is not only interested in maximizing the benefits of gallows humour but also in reducing the risk of harm to others related to its use. This important criterion will therefore lead us to define the terms and suggest certain conditions that must be respected for an ethical use of this important defense mechanism by health care professionals in critical care. (shrink)
La problématisation freudienne de l’expérience ne consiste pas à s’interroger, de manière classique, sur la façon dont le sujet constitue en un savoir objectif des événements particuliers, mais comment le sujet lui-même est constitué en une identité objective, c’est-à-dire dont il peut avoir une connaissance consciente et qui peut être reconnue comme telle par d’autres, à partir d’événements singuliers qui se produisent dans un contexte en-deçà du champ théorique de la conscience, celui du plaisir. S’il part ainsi d’une problématique empiriste (...) de l’expérience (comment, dans le donné, peut-il se constituer un sujet tel qu’il dépasse le donné ?), il estime qu’il faut également chercher à comprendre, à partir de l’expérience elle-même en tant que vécu, la nécessité du rapport entre expérience et subjectivité : si c’est l’expérience qui « produit » le sujet, celui-ci faisant alors figure de dérivé ou d’ « épiphénomène », comment comprendre la « nécessité » de cette production, ainsi que le fait que, une fois constitué, le sujet se définit en retour comme un élément essentiel à l’expérience ? Le sujet de l’expérience ne fait-il que répéter indéfiniment des événements originaires dont le sens lui échappe, ou participe-t-il effectivement à la réalité des expériences qui l’affectent ? (shrink)
Cet article a déjà paru dans Techniques & Culture en ligne, 48-49 | 2007 Résumé : L'œuvre d'André Leroi-Gourhan est traversée par une anthropologie du rythme. Celle-ci ne part pas d'une socialité constituée, de rythmes dits « sociaux », mais inscrit au contraire l'analyse de la rythmicité dans une approche de l'homme comme être vivant, comme totalité indivise. Elle pose en des termes renouvelés le problème classique du groupement des hommes et des liens entre l'individu et son milieu. Avec la (...) question - Anthropologie. (shrink)
Des collégiens lisaient le contenu d'une brochure ou d'un cédérom afin de répondre à des questions relatives aux caractéristiques de trois professions et devaient ensuite rappeler les informations correspondant aux réponses à ces questions ainsi que des informations proches de ces informations dans le texte. Une moitié des informations à rappeler était signalée par la mise en gras. Les résultats montrent des mécanismes de traitement analogues dans la brochure et le cédérom. Les résultats mettent aussi en évidence deux modalités différentes (...) de traitement de la signalisation des informations. Une modalité est relative à la signalisation perceptive périphérique - la mise en gras des informations -; l'autre modalité concerne le questionnement, c'est-à-dire les questions posées. La modalité relative au questionnement conduit à un meilleur rappel final des informations.The effects of two types of text presentation are studied in a experimental situation similar to vocational guidance. Two groups of junior- high school students with computing skills were examined. The first group received the text in a booklet and the second recieved the text on a CD-ROM. Two tasks were given: a research task examining the selection process and then a memory task examining the integration process. Moreover we measured the influence of typographical cues and the instructional system on these two tasks. As far as the information presentation is concerned, the results show that it did not affect the process of selection and the integration of the information. For the text cues, in both groups , the cueing was found to have an effect on the selection process but not in the integration process of the researched information. Researched information can be recalled more easily than information that is only read but the beneficial effect of typographical cues does not add to the beneficial effect of researched information. We propose future research on the effectiveness of different types of cues in function of differences on domain and computing systems expertises. (shrink)
Dans cette étude, l’auteur veut montrer que le conflit, dans la Phénoménologie de l’esprit, ne se réduit pas à la confrontation des consciences de soi débouchant sur le rapport maître-esclave : en fait, le conflit apparaît, dans chaque section de la Phénoménologie de l’esprit, au moment correspondant à la conscience de soi. Ce sont ces différentes figures qui sont ici résumées. En conclusion, l’auteur suggère que la « philosophie de l’identité » de Schelling pourrait être la source principale de la (...) conception hégélienne du conflit.In this study, the author intends to show that in PhG, conflict is not just the confrontation of self-consciousness leading up to a master-slave relationship : in fact, conflict appears in each section of PhG at the time corresponding to self-consciousness. These different figures are summarized here. In conclusion, the author suggests that Schelling’s « identity philosophy » could be the main root of Hegelian conception of conflict. (shrink)
A growing body of research has demonstrated significant heterogeneity of hospital ethics committee (HEC) size, membership and training requirements, length of appointment, institutional support, clinical and policy roles, and predictors of self identified success. Because these studies have focused on HECs at a single point in time, however, little is known about how the composition of HECs changes over time and what impact these changes have on committee utilization. The current study presents 20 years of data on the evolution of (...) the Massachusetts General Hospital HEC. Between 1993 and 2012, the average number of committee members per year was 38 ± 3 and the average length of membership was 4.8 ± 0.4 years. During that time, the committee performed 934 consults, averaging 47 ± 3 per year. Attendance rates fell from 61.5 to 23.8 % over the study period and were inversely correlated with the total number of members. Between 1993 and 2012, the committee saw substantial growth in the diversity of the professional backgrounds of its members. Multivariate analysis, however, suggests that substantial changes in committee composition did not impact its utilization and that other factors are more likely to explain fluctuations in consultation volume. (shrink)
