BackgroundThe potential contribution of community engagement to addressing ethical challenges for international biomedical research is well described, but there is relatively little documented experience of community engagement to inform its development in practice. This paper draws on experiences around community engagement and informed consent during a genetic cohort study in Kenya to contribute to understanding the strengths and challenges of community engagement in supporting ethical research practice, focusing on issues of communication, the role of field workers in 'doing ethics' on (...) the ground and the challenges of community consultation.MethodsThe findings are based on action research methods, including analysis of community engagement documentation and the observations of the authors closely involved in their development and implementation. Qualitative and quantitative content analysis has been used for documentation of staff meetings and trainings, a meeting with 24 community leaders, and 40 large public and 70 small community group meetings. Meeting minutes from a purposive sample of six community representative groups have been analysed using a thematic framework approach.ResultsField workers described challenges around misunderstandings about research, perceived pressure for recruitment and challenges in explaining the study. During consultation, leaders expressed support for the study and screening for sickle cell disease. In community meetings, there was a common interpretation of research as medical care. Concerns centred on unfamiliar procedures. After explanations of study procedures to leaders and community members, few questions were asked about export of samples or the archiving of samples for future research.ConclusionsCommunity engagement enabled researchers to take account of staff and community opinions and issues during the study and adapt messages and methods to address emerging ethical challenges. Field workers conducting informed consent faced complex issues and their understanding, attitudes and communication skills were key influences on ethical practice. Community consultation was a challenging concept to put into practice, illustrating the complexity of assessing information needs and levels of deliberation that are appropriate to a given study. (shrink)
The importance of communities in strengthening the ethics of international collaborative research is increasingly highlighted, but there has been much debate about the meaning of the term ‘community’ and its specific normative contribution. We argue that ‘community’ is a contingent concept that plays an important normative role in research through the existence of morally significant interplay between notions of community and individuality. We draw on experience of community engagement in rural Kenya to illustrate two aspects of this interplay: (i) that (...) taking individual informed consent seriously involves understanding and addressing the influence of communities in which individuals’ lives are embedded; (ii) that individual participation can generate risks and benefits for communities as part of the wider implications of research. We further argue that the contingent nature of a community means that defining boundaries is generally a normative process itself, with ethical implications. Community engagement supports the enactment of normative roles; building mutual understanding and trust between researchers and community members have been important goals in Kilifi, requiring a broad range of approaches. Ethical dilemmas are continuously generated as part of these engagement activities, including the risks of perverse outcomes related to existing social relations in communities and conditions of ‘half knowing’ intrinsic to processes of developing new understandings. (shrink)
It is now some years since Professor D. Daiches Raphael published his interesting book, The Paradox of Tragedy , which represented one of the first serious attempts made by a British philosopher to assess the significance of tragic drama for ethical, and indeed metaphysical theory. Since then we have had a variety of books touching on related topics: for instance, Dr George Steiner's Death of Tragedy and Mr Raymond Williams’ most recent, elusive and interesting essay, Modern Tragedy. To entitle an (...) essay Theology and Tragedy might be thought to invite needless trouble for oneself; to indulge to a dangerous degree the human intellectual obsession of supposing that ‘the meaning of a word is an object’. After all, if one confines one's regard to the Greeks, one has to recognise that between the treatments of their common theme of Electra , Sophocles and Euripides are in fact doing very different things. There is no gainsaying the significance for Euripides of the postponement of the murder of Clytemnestra till after that of Aegisthus, still less of his introduction into the play of the morally upright peasant, who has had the banished Electra in his keeping, and whose simple integrity contrasts both with the corruption of the court and the obsessive preoccupation with a dreadful, supposed duty of brother and sister. The element of propaganda is unmistakable; while in Sophocles’ Electra it is altogether absent, although Dr Victor Ehrenberg in his very interesting monograph on Sophocles and Pericles has argued strongly for an element of subtle political commentary in the treatment of Oedipus in the Oedipus Tyrannus , and of Pocreon in the Antigone. These remarks may serve to show that the title does not express a blind indifference to the multiple complexity of those works which we class together as tragedies. They are inherently complex, and various in emphasis; at best we can discern a family resemblance between them, and, in an essay like this, the author runs the risk not only of selecting examples tailor-made to his thesis, but also of imposing an appearance of similarity of conception where it is at least equally important to stress differences. (shrink)
The purpose of this article should become plain during the reading of it, but perhaps some prior explanation is needed. Almost from the beginning of my study of the paṭiccasamuppāda I have had the notion that it could not have come into existence in the form the usual twelvefold formulation takes. For reasons which I try to make clear this twelvefold formulation is not a satisfactory statement of what it is supposed to explain, namely the reasons for each individual's continued (...) rebirths. I feel - and sadly I have to emphasize, before someone else does it for me, that in the final analysis I am relying more or less on intuition for my attitude towards the twelvefold formulation - that if one person alone had been responsible for the usually referred to formulation, and especially if that one person had been the Buddha, then those anomalies that now prevail would never have existed. (shrink)
In this important study D. M. Armstrong offers a comprehensive system of analytical metaphysics that synthesises but also develops his thinking over the last twenty years. Armstrong's analysis, which acknowledges the 'logical atomism' of Russell and Wittgenstein, makes facts the fundamental constituents of the world, examining properties, relations, numbers, classes, possibility and necessity, dispositions, causes and laws. All these, it is argued, find their place and can be understood inside a scheme of states of affairs. This is a comprehensive and (...) rigorously this-worldly account of the most general features of reality, argued from a distinctive philosophical perspective, and it will appeal to a wide readership in analytical philosophy. (shrink)
Truths are determined not by what we believe, but by the way the world is. Or so realists about truth believe. Philosophers call such theories correspondence theories of truth. Truthmaking theory, which now has many adherents among contemporary philosophers, is the most recent development of a realist theory of truth, and in this book D. M. Armstrong offers the first full-length study of this theory. He examines its applications to different sorts of truth, including contingent truths, modal truths, truths about (...) the past and the future, and mathematical truths. In a clear, even-handed and non-technical discussion he makes a compelling case for truthmaking and its importance in philosophy. His book marks a significant contribution to the debate and will be of interest to a wide range of readers working in analytical philosophy. (shrink)
The central insight of Darwin's Origin of Species is that evolution is an ecological phenomenon, arising from the activities of organisms in the 'struggle for life'. By contrast, the Modern Synthesis theory of evolution, which rose to prominence in the twentieth century, presents evolution as a fundamentally molecular phenomenon, occurring in populations of sub-organismal entities - genes. After nearly a century of success, the Modern Synthesis theory is now being challenged by empirical advances in the study of organismal development and (...) inheritance. In this important study, D. M. Walsh shows that the principal defect of the Modern Synthesis resides in its rejection of Darwin's organismal perspective, and argues for 'situated Darwinism': an alternative, organism-centred conception of evolution that prioritises organisms as adaptive agents. His book will be of interest to scholars and advanced students of evolutionary biology and the philosophy of biology. (shrink)
Background: There is general consensus internationally that unfair distribution of the benefits of research is exploitative and should be avoided or reduced. However, what constitutes fair benefits, and the exact nature of the benefits and their mode of provision can be strongly contested. Empirical studies have the potential to contribute viewpoints and experiences to debates and guidelines, but few have been conducted. We conducted a study to support the development of guidelines on benefits and payments for studies conducted by the (...) KEMRI-Wellcome Trust programme in Kilifi, Kenya. Methods: Following an initial broad based survey of cash, health services and other items being offered during research by all programme studies (n = 38 studies), interviews were held with research managers (n = 9), and with research staff involved in 8 purposively selected case studies (n = 30 interviewees). Interviews explored how these ‘benefits’ were selected and communicated, experiences with their administration, and recommendations for future guidelines. Data fed into a consultative workshop attended by 48 research staff and health managers, which was facilitated by an external ethicist.FindingsThe most commonly provided benefits were medical care (for example free care, and strengthened quality of care), and lunch or snacks. Most cash given to participants was reimbursement of transport costs (for example to meet appointments or facilitate use of services when unexpectedly sick), but these payments were often described by research participants as benefits. Challenges included: tensions within households and communities resulting from lack of clarity and agreement on who is eligible for benefits; suspicion regarding motivation for their provision; and confusion caused by differences between studies in types and levels of benefits. Conclusions: Research staff differed in their views on how benefits should be approached. Echoing elements of international benefit sharing and ancillary care debates, some research staff saw research as based on goodwill and partnership, and aimed to avoid costs to participants and a commercial relationship; while others sought to maximise participant benefits given the relative wealth of the institution and the multiple community needs. An emerging middle position was to strengthen collateral or indirect medical benefits to communities through collaborations with the Ministry of Health to support sustainability. (shrink)
Breaking new ground in the debate about the relation of mind and body, David Armstrong's classic text - first published in 1968 - remains the most compelling and comprehensive statement of the view that the mind is material or physical. In the preface to this new edition, the author reflects on the book's impact and considers it in the light of subsequent developments. He also provides a bibliography of all the key writings to have appeared in the materialist debate.
A wide-ranging study of the central concepts in epistemology - belief, truth and knowledge. Professor Armstrong offers a dispositional account of general beliefs and of knowledge of general propositions. Belief about particular matters of fact are described as structures in the mind of the believer which represent or 'map' reality, while general beliefs are dispositions to extend the 'map' or introduce casual relations between portions of the map according to general rules. 'Knowledge' denotes the reliability of such beliefs as representations (...) of reality. Within this framework Professor Armstrong offers a distinctive account of many of the main questions in general epistemology - the relations between beliefs and language, the notions of proposition, concept and idea, the analysis of truth, the varieties of knowledge, and the way in which beleifs and knowledge are supported by reasons. The book as a whole if offered as a contribution to a naturalistic account of man. (shrink)
This is a study of a crucial and controversial topic in metaphysics and the philosophy of science: the status of the laws of nature. D. M. Armstrong works out clearly and in comprehensive detail a largely original view that laws are relations between properties or universals. The theory is continuous with the views on universals and more generally with the scientific realism that Professor Armstrong has advanced in earlier publications. He begins here by mounting an attack on the orthodox and (...) sceptical view deriving from Hume that laws assert no more than a regularity of coincidence between instances of properties. In doing so he presents what may become the definitive statement of the case against this position. Professor Armstrong then goes on to establish his own theory in a systematic manner defending it against the most likely objections, and extending both it and the related theory of universals to cover functional and statistical laws. This treatment of the subject is refreshingly concise and vivid: it will both stimulate vigorous professional debate and make an excellent student text. (shrink)
Dispositions are essential to our understanding of the world. IDispositions: A Debate is an extended dialogue between three distinguished philosophers - D.M. Armstrong, C.B. Martin and U.T. Place - on the many problems associated with dispositions, which reveals their own distinctive accounts of the nature of dispositions. These are then linked to other issues such as the nature of mind, matter, universals, existence, laws of nature and causation.
In this short text, a distinguished philosopher turns his attention to one of the oldest and most fundamental philosophical problems of all: How it is that we are able to sort and classify different things as being of the same natural class? Professor Armstrong carefully sets out six major theories—ancient, modern, and contemporary—and assesses the strengths and weaknesses of each. Recognizing that there are no final victories or defeats in metaphysics, Armstrong nonetheless defends a traditional account of universals as the (...) most satisfactory theory we have.This study is written for advanced students, but as Armstrong goes considerably beyond his earlier work on this topic, it will interest professional scholars as well. Carefully plotted and clearly written, Universals is both a paradigm of exposition and a case study on the value of careful analysis of fundamental issues in philosophy. (shrink)
David Armstrong (1926-2014) was much the most internationally successful philosopher to come from Sydney. His life moved from a privileged Empire childhood and student of John Anderson to acclaimed elder statesman of realist philosophy. His philosophy developed from an Andersonian realist inheritance to major contributions on materialist theory of mind and the theory of universals. His views on several other topics such as religion and ethics are surveyed briefly.
Plotinus is the first Greek philosopher to hold a systematic theory of consciousness. The key feature of his theory is that it involves multiple layers of experience: different layers of consciousness occur in different levels of self. This layering of higher modes of consciousness on lower ones provides human beings with a rich experiential world, and enables human beings to draw on their own experience to investigate their true self and the nature of reality. This involves a robust notion of (...) subjectivity. However, it is a notion of subjectivity that is unique to Plotinus, and remarkably different from the Post-Cartesian tradition. Behind the plurality of terms Plotinus uses to express consciousness, and behind the plurality of entities to which Plotinus attributes consciousness, lies a theory of human consciousness. It is a Platonist theory shaped by engagement with rival schools of ancient thought. (shrink)