The COVID-19 pandemic has undoubtedly become an era-defining challenge for the entire world. It has implications not only in the public health sector but also in the global economy and political landscape. The prevention strategy that has been followed in Sri Lanka is unique. Early action taken by the government and the ministry of health, being one of pre-emptive quarantining and isolation of suspected contacts even before they developed symptoms, was vital to contain the spread of the disease. During the (...) early phase, a nationwide lockdown in the form of a curfew was imposed which helped mitigate the spread of the virus. However, due to several lapses, there was a threat of community transmission; this was swiftly brought under control through ongoing government interventions. Thus, strict social/physical distancing measures enforced by the government, together with an increase in testing capacity, prevented widespread community transmission. Strictly containing the outbreaks as and when they were identified made it easier to bring the spread under control through contact tracing. In this article, we give an account of the strategy taken by Sri Lanka to mitigate the pandemic and comment on the lessons learned concerning the ethical responses to the COVID-19 crisis. (shrink)

Peter Abelard (1079–1142 ce) was the most wide‐ranging philosopher of the twelfth century. He quickly established himself as a leading teacher of logic in and near Paris shortly after 1100. After his affair with Heloise, and his subsequent castration, Abelard became a monk, but he returned to teaching in the Paris schools until 1140, when his work was condemned by a Church Council at Sens. His logical writings were based around discussion of the “Old Logic”: Porphyry's Isagoge, aristotle'S Categories and (...) On Interpretation and boethius'S textbook on topical inference. They comprise a freestanding Dialectica (“Logic”; probably c.1116), a set of commentaries (known as the Logica [Ingredientibus], c. 1119) and a later (c. 1125) commentary on the Isagoge (Logica Nostrorum Petititoni Sociorum or Glossulae). In a work Abelard called his Theologia, issued in three main versions (between 1120 and c.1134), he attempted a logical analysis of trinitarian relations and explored the philosophical problems surrounding God's claims to omnipotence and omniscience. The Collationes (“Debates,” also known as “Dialogue between a Christian, a Philosopher and a Jew”; probably c.1130) present a rational investigation into the nature of the highest good, in which the Christian and the Philosopher (who seems to be modeled on a philosopher of pagan antiquity) are remarkably in agreement. The unfinished Scito teipsum (“Know thyself,” also known as the “Ethics”; c.1138) analyses moral action. (shrink)

Plato is one of the key ancient authors studied by both classicists and philosophers. This long-awaited new edition contains seven of the dialogues of Plato, and is the first in the five-volume complete edition of his works in the Oxford Classical Texts series. The result of many years of painstaking scholarship, the new volume will replace the now nearly 100 year old original edition, and is destined to become just as long-lasting a classic.

It is argued that organ donation from a patient to the patient's physician is ethically dubious because donation decisions will be inappropriately influenced and the negative public perceptions will result in more harm than good. It is suggested that to protect the perception of the physician–patient relationship, avoid cynicism about medicine’s attitude to patient welfare and maintain trust in the medical profession, a new professional boundary should be established to prevent physicians from receiving organs for transplantation donated by their patients.

In the past 40 years, a global shift has taken place towards a constellation of values known as “expansive values”, which de-emphasize pursuits of money, possessions, and status, and instead focus on quality of life and humanistic goals. This study investigated what students holding expansive values desired in business school course content and student quality of life, and how these preferences differed from students holding materialistic values. Results revealed a number of different factors that were associated only with expansive values, (...) though on a few factors the two student values cohorts shared similar preferences or had inverse preferences. One clear implication of this study is that business schools need to consider offering more ethics classes in order to satisfy the growing number of students with expansive values. (shrink)

A critical discussion is provided of three central assumptions underlying Nunez's approach to modeling cortical activity. A plea is made for neurophysiologically realistic models involving nonlinearities, multiple time scales, and stochasticity.

OBJECTIVES: To analyse the attitudes of medical personnel towards terminally ill patients and their right to be fully informed. DESIGN: Self-administered questionnaire composed of 56 closed questions. SETTING: Three general hospitals and eleven health centres in Granada (Spain). The sample comprised 168 doctors and 207 nurses. RESULTS: A high percentage of medical personnel (24.1%) do not think that informing the terminally ill would help them face their illness with greater serenity. Eighty-four per cent think the patient's own home is the (...) best place to die: 8.9% of the subjects questioned state that the would not like to be informed of an incurable illness. CONCLUSION: In our opinion any information given should depend on the patient's personality, the stage of the illness and family circumstances. Our study confirms that a hospital is not the ideal environment for attending to the needs of the terminally ill and their families. (shrink)

Background: Funding organisations and research ethics committees should play a part in strengthening attention to gender equality in clinical research. In the research policy of European Union , funding measures have been taken to realise this, but such measures are lacking in the EU policy regarding RECs.Objective: To explore how RECs in Austria, Germany, Ireland, The Netherlands and Sweden deal with gender equality issues by asking two questions: Do existing procedures promote representation of women and gender expertise in the committee? (...) How are sex and gender issues dealt with in protocol evaluation?Methods: Two RECs were selected from each country. Data were obtained through interviews with key informants and content analysis of relevant documents .Results: All countries have rules to ensure the presence of women on RECs; gender expertise is not required. Drug study protocols are carefully evaluated, sometimes on a formal basis, as regards the inclusion of women of childbearing age. The reason for excluding either one of the sexes or including specific groups of women or making a gender-specific risk–benefit analysis are investigated by some RECs. Such measures are, however, neither defined in the regulations nor integrated in review tools.Conclusions: The RECs investigated in five European member states are found to pay limited attention to gender equality in their working methods and, in particular in protocol evaluation. Policy and regulations of EU are needed to strengthen attention to gender equality in the work of RECs. (shrink)

A novel Protocol Ethics Tool Kit (‘Ethics Tool Kit’) has been developed by a multi-stakeholder group of the Multi-Regional Clinical Trials Center of Brigham and Women9s Hospital and Harvard. The purpose of the Ethics Tool Kit is to facilitate effective recognition, consideration and deliberation of critical ethical issues in clinical trial protocols. The Ethics Tool Kit may be used by investigators and sponsors to develop a dedicated Ethics Section within a protocol to improve the consistency and transparency between clinical trial (...) protocols and research ethics committee reviews. It may also streamline ethics review and may facilitate and expedite the review process by anticipating the concerns of ethics committee reviewers. Specific attention was given to issues arising in multinational settings. With the use of this Tool Kit, researchers have the opportunity to address critical research ethics issues proactively, potentially speeding the time and easing the process to final protocol approval. (shrink)

Girotto and Legrenzi's 1993 facilitation effect for their SARS version of Wason s THOG problem a disjunctive reasoning task was examined. The effect was not replicated when the standard THOG problem instructions were used in Experiments 1 and 2. However, in Experiment 3 when Girotto and Legrenzi's precise instructions were used, facilitation was observed. Experiment 4 further investigated the role of the type of instructions in the observed facilitation. The results suggest that such facilitation may result from attentional factors rather (...) than the use of a combinatorial analysis in the problem. (shrink)

Measuring event-related potentials (ERPs) has been fundamental to our understanding of how language is encoded in the brain. One particular ERP response, the N400 response, has been especially influential as an index of lexical and semantic processing. However, there remains a lack of consensus on the interpretation of this component. Resolving this issue has important consequences for neural models of language comprehension. Here we show that evidence bearing on where the N400 response is generated provides key insights into what it (...) reflects. A neuroanatomical model of semantic processing is used as a guide to interpret the pattern of activated regions in functional MRI, magnetoencephalography and intracranial recordings that are associated with contextual semantic manipulations that lead to N400 effects. (shrink)

Researchers are required to seek consent from Indigenous communities prior to conducting research but there is inadequate information about how Indigenous people understand and become fully engaged with this consent process. Few studies evaluate the preference or understanding of the consent process for research with Indigenous populations. Lack of informed consent can impact on research findings. The Picture Talk Project was initiated with senior Aboriginal leaders of the Fitzroy Valley community situated in the far north of Western Australia. Aboriginal people (...) were interviewed about their understanding and experiences of research and consent processes. Transcripts were analysed using NVivo10 software with an integrated method of inductive and deductive coding and based in grounded theory. Local Aboriginal interpreters validated coding. Major themes were defined and supporting quotes sourced. Interviews with Aboriginal leaders were facilitated by a local Aboriginal Community Navigator who could interpret if necessary and provide cultural guidance. Participants were from all four major local language groups of the Fitzroy Valley; aged 31 years and above; and half were male. Themes emerging from these discussions included Research—finding knowledge; Being respectful of Aboriginal people, Working on country, and Being flexible with time; Working together with good communication; Reciprocity—two-way learning; and Reaching consent. The project revealed how much more there is to be learned about how research with remote Aboriginal communities should be conducted such that it is both culturally respectful and, importantly, meaningful for participants. We identify important elements in community consultation about research and seeking consent. (shrink)

A general practice research project on ethics is underway at the University of New South Wales, funded by GPEP (General Practice Evaluation Program, Commonwealth Department of Human Services and Health, GPEP 386). Ethical issues, as defined and explored by general practitioners and consumers, are being examined across four areas of Sydney.So far, telephone interviews have been conducted (64% response rate) with a random sample of general practitioners (GPs). Face-to-face interviews have been conducted with 107 consumers, randomly sampled using ABS collection (...) district information. Focus groups have been formed to discuss acceptable solutions to GP and consumer identified ethical issues. This report will report on some preliminary findings to date and will explore professional and consumer roles in the formation of ethical solutions. (shrink)

A general practice research project on ethics is underway at the University of New South Wales, funded by GPEP. Ethical issues, as defined and explored by general practitioners and consumers, are being examined across four areas of Sydney.So far, telephone interviews have been conducted with a random sample of general practitioners. Face-to-face interviews have been conducted with 107 consumers, randomly sampled using ABS collection district information. Focus groups have been formed to discuss acceptable solutions to GP and consumer identified ethical (...) issues. This report will report on some preliminary findings to date and will explore professional and consumer roles in the formation of ethical solutions. (shrink)

In this paper, we outline a theory of the nature of self-directed agents. What is distinctive about self-directed agents is their ability to anticipate interaction processes and to evaluate their performance, and thus their sensitivity to context. They can improve performance relative to goals, and can, in certain instances, construct new goals. We contrast self-directedness with reactive action processes that are not modifiable by the agent, though they may be modified by supra-agent processes such as populational adaptation or external design.Self-directedness (...) lies at the nexus of issues concerning the evolution and nature of intentionality, intelligence, and agency. It provides some insight into the evolution of intelligence because it helps explain how organisms are able to manage variable interaction processes, e.g., a hunting strategy that varies with prey type, ground condition, and hunger level. Simple self-directed organisms like bumblebees manage variability in one or a few dimensions. (shrink)

State Medical Boards (SMBs) can take severe disciplinary actions (e.g., license revocation or suspension) against physicians who commit egregious wrongdoing in order to protect the public. However, there is noteworthy variability in the extent to which SMBs impose severe disciplinary action. In this manuscript, we present and synthesize a subset of 11 recommendations based on findings from our team’s larger consensus-building project that identified a list of 56 policies and legal provisions SMBs can use to better protect patients from egregious (...) wrongdoing by physicians. (shrink)

The clinical application of the concept of patient autonomy has centered on the ability to deliberate and make treatment decisions (decisional autonomy) to the virtual exclusion of the capacity to execute the treatment plan (executive autonomy). However, the one-component concept of autonomy is problematic in the context of multiple chronic conditions. Adherence to complex treatments commonly breaks down when patients have functional, educational, and cognitive barriers that impair their capacity to plan, sequence, and carry out tasks associated with chronic care. (...) The purpose of this article is to call for a two-component re-conceptualization of autonomy and to argue that the clinical assessment of capacity for patients with chronic conditions should be expanded to include both autonomous decision-making and autonomous execution of the agreed-upon treatment plan. We explain how the concept of autonomy should be expanded to include both decisional and executive autonomy, describe the biopsychosocial correlates of the two-component concept of autonomy, and recommend diagnostic and treatment strategies to support patients with deficits in executive autonomy. (shrink)

At a time when firms signal their commitment to CSR through online communication, news sources may convey conflicting information, causing stakeholders to perceive firm hypocrisy. Here, we test the effects of conflicting CSR information that conveys inconsistent outcomes (results-based hypocrisy) and ulterior motives (motive-based hypocrisy) on hypocrisy perceptions expressed in social media posts, which we conceptualize as countersignals that reach a broad audience of stakeholders. Across six studies, we find that (1) conflicting CSR information from internal (firm) and external (news) (...) sources elicits hypocrisy perceptions regardless of whether the CSR information reflects inconsistencies in results or motives, (2) individuals respond to conflicting CSR information with countersignals accusing firms of hypocrisy expressed in social media posts, (3) hypocrisy perceptions are linked to other damaging stakeholder consequences, including behavior (divestment, boycotting, lower employment interest), affect (moral outrage), and cognition (moral condemnation), and (4) firms with higher credibility are more likely to experience adverse effects of conflicting CSR information. These findings advance theory regarding the effects of conflicting CSR information as it relates to the role of credibility and different forms of hypocrisy. Importantly, damaging social media posts and stakeholder backlash can arise from hypocrisy perceptions associated with inconsistent CSR results as well as inconsistent motives, and strong firm credibility only makes a firm more vulnerable to this backlash. (shrink)

Genetics and genetic testing raise key issues for insurance and employment. Governmental and public concern galvanised the British insurance industry into developing a code of practice. The history of the development of the code, issues of genetic discrimination, access to medical information, consent and the dangers of withholding information and the impact on the equity of pooled risk are explored. Proactive steps by the Association of British Insurers suggest that moral reflection not legislation is the way forward.

In recent years, we have seen a new concern with ethics training for research and development professionals. Although ethics training has become more common, the effectiveness of the training being provided is open to question. In the present effort, a new ethics training course was developed that stresses the importance of the strategies people apply to make sense of ethical problems. The effectiveness of this training was assessed in a sample of 59 doctoral students working in the biological and social (...) sciences using a pre–post design with follow-up and a series of ethical decision-making measures serving as the outcome variable. Results showed not only that this training led to sizable gains in ethical decision making but also that these gains were maintained over time. The implications of these findings for ethics training in the sciences are discussed. (shrink)

In this article we report the findings of a randomised control clinical trial that assessed the impact of a Philosophy for Children program and replicated a previous study conducted in Scotland by Topping and Trickey. A Cognitive Abilities Test was administered as a pretest and a posttest to randomly selected experimental groups and control groups. The students in the experimental group engaged in philosophy lessons in a setting of structured, collaborative inquiry in their language arts classes for one hour per (...) week for a number of weeks. The control group received the standard language arts curriculum in that one hour. The study found that the seventh grade students who had experienced the P4C program showed significant gains relative to those in the seventh grade control group at a high level of statistical significance, but the eighth grade students in the experimental group did not show such gains over the eighth grade control group. It was discovered that the seventh grade teachers started the program early in the school year and continued it for a period of 22 to 26 weeks, while the eighth grade teachers started much later and used the program for only 4 to 10 weeks. Our findings suggest that the P4C program must involve students in activities for a significant period of time before the program shows results, but that a meaningful impact on students’ cognitive abilities can be achieved in about 24 weeks of lessons, less than half the time evidenced by the study by Topping and Trickey. (shrink)