In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 14.1 (2004) 47-54 [Access article in PDF] Ethical Guidelines for Human Embryonic Stem Cell Research*(A Recommended Manuscript) Adopted on 16 October 2001Revised on 20 August 2002 Ethics Committee of the Chinese National Human Genome Center at Shanghai, Shanghai 201203 Human embryonic stem cell (ES) research is a great project in the frontier of biomedical science for the twenty-first century. Be- cause the research (...) involves the use of human embryos, it triggers serious debate on ethical issues. Opponents consider the embryo to be an early form of human life that should be respected and not destroyed. However, the majority of scientists support embryonic stem cell research, believing that it offers good prospects for the treatment of diseases that have remained incurable until now and so will benefit humankind. The Ethics Committee of the Department of Ethical, Legal, and Social Implications of the Chinese National Human Genome Center at Shanghai seriously discussed the ethical debate initiated by embryonic stem cell research. We concluded that we should support the scientists of our country in actively carrying out human embryonic stem cell research for the noble cause of "medicine being a beneficent art." For the healthy and orderly development of human embryonic stem cell research in our country, we put forward the following recommended Ethical Guidelines for Human Embryonic Stem Cell Research as a reference for leaders, administrative departments, and related scientists. Preface Article 1. Human embryonic stem cells are the primitive cells that play the main role in the growth and development of a human body. These [End Page 47] primitive cells have the potential for infinite proliferation, self-renewal, and multi-directional differentiation. If scientists can discover the mechanism of differentiation of human embryonic stem cells, it will be possible to induce differentiation of human embryonic stem cells to form various types of human cells for clinical cell therapy. If human embryonic stem cell research can be integrated with modern biomedical engineering techniques, it also will be possible to make repair and replacement of human tissues and organs a reality. Article 2. There are two ways to classify human embryonic stem cells. One way is to classify them according to their potential for differentiation. There could be three kinds of stem cells: totipotent stem cells, pluripotent stem cells, and unipotent stem cells.A totipotent stem cell has the potential to develop into a whole individual. It can differentiate into the more than 200 cell types in the whole body, construct any tissue or organ of the body, and finally develop into a whole individual. The fertilized egg and the cleavage cells at the very early stage of embryonic development are totipotent stem cells.A pluripotent stem cell has the potential to differentiate into many cell types derived from the three embryonic layers. However, it has lost the capacity to develop into a complete organism.A unipotent stem cell is derived from the further differentiation of the pluripotent stem cell. It can differentiate only into one cell type such as a hematopoietic stem cell, neural stem cell, and others.The other way is to classify human stem cells according to their source. There could be two kinds of human stem cells: embryonic stem cells and tissue stem cells (also called adult stem cells). The former involves experimentation with embryos, which has serious ethical implications. Ethical issues associated with the latter are mainly expressed in the various opinions regarding the allocation of health resources. Article 3. Human embryonic stem cells are the group of cells called the blastocyst inner cell mass during the early stage of embryonic development. They are the main source of totipotent stem cells, and hence the focal and hot point in stem cell research. Studies on the clinical application of embryonic stem cells probably will involve use of the somatic cell nucleus transfer (SCNT) technique, which destroys the early human embryo. At present, the ethical and moral debate is very serious in human embryonic stem cell research regarding whether the research will develop... (shrink)

This book is a comprehensive and unique text and reference in medical ethics. By far the most inclusive set of primary documents and articles in the field ever published, it contains over 100 selections. Virtually all pieces appear in their entirety, and a significant number would be difficult to obtain elsewhere. The volume draws upon the literature of history, medicine, philosophical and religious ethics, economics, and sociology. A wide range of topics and issues are covered, such as law and (...) medicine, truth-telling by the physician, research, population policy, genetics, abortion, dying, and individual rights in medical care. The selections span the centuries, beginning with material from the works of Hippocrates, continuing through Thomas Percival, John Stuart Mill, and Claude Bernard, down to modern commentators like Henry K. Beecher, Walsh McDermott, David L. Bazelon, Paul Freund, H. L. A. Hart, John Rawls, Paul Ramsey, Richard McCormick, Rashi Fein, and Bernard Barber. The text has eight major divisions, beginning with sections on the ethical dimensions of the physician-patient relationship in history; the moral bases of medical ethics; and regulation, compulsion, and protection of the consumer in clinical medicine and public health. Each of these sections includes key essays that appear for the first time. All of the book's major divisions contain primary documents: codes such as the Hippocratic Oath, Medieval Law for the Regulation of Medicine, and the first as well as the most recent code of the American Medical Association; court decisions, including those on Karen Quinlan and on abortion in the United States and West Germany; government documents such as the statement of the National Commission on the Protection of Human Subjects, the Tuskegee Syphilis Report, the British Parliamentary debate on euthanasia, and the Council of Europe on rights of the sick and dying; and various published guidelines such as the Harvard Medical School brain death criteria, the American Hospital Association on patient's rights, and Pope Pius XII on the prolongation of life. Cases that illustrate moral dilemmas are provided for discussion purposes. Each section is preceded by a succinct editor's introduction. The documents and essays are of practical value for practitioners and students in medicine, law, ethics, and counselling, and for individual patients and groups concerned with medical care. Through encompassing divergent viewpoints, the essays and primary documents were selected to encourage humane practices and deepen understanding of the multiple traditions that shaped and do shape the development of medicine. (shrink)

This paper explores ethical debates associated with the UK COVID-19 contact tracing app that occurred in the public news media and broader public policy, and in doing so, takes ethics debate as an object for sociological study. The research question was: how did UK national newspaper news articles and grey literature frame the ethical issues about the app, and how did stakeholders associated with the development and/or governance of the app reflect on this? We examined the (...) predominance of different ethical issues in news articles and grey literature, and triangulated this using stakeholder interview data. Findings illustrate how news articles exceptionalised ethical debate around the app compared to the way they portrayed ethical issues relating to ‘manual’ contact tracing. They also narrowed the debate around specific privacy concerns. This was reflected in the grey literature, and interviewees perceived this to have emerged from a ‘privacy lobby’. We discuss the findings, and argue that this limited public ethics narrative masked broader ethical issues. (shrink)

This paper provides an ethical analysis of the controversy that arose from the CRISPR/Cas9 gene editing research involving human embryos that was conducted by a research team in Guangzhou, China, in 2015. It is argued that the researchers involved did not overstep ethical boundaries. This was confirmed to be the case in an international meeting of experts that was convened following the controversy. It is further argued that the controversy highlights the tension between two fundamentally different policies on (...) developing genome editing technology – one proactionary and the other precautionary. This paper argues for a third approach, based on the policy of “crossing the river by probing stones”. Such an approach is consistent with current international recommendations to prioritise basic and pre-clinical research, and to allow the application of genome editing technology to somatic human cells. However, the application of the technology in germline genetic modification for human reproduction or enhancement for medical purposes should not be allowed at present. This is because the attending risks are not well understood and could be excessive or extraordinary, with little or no prospect of benefit. In addition, this paper calls for norms and regulations to be developed for genetically modifying non-human living things. [End Page 307] Finally, the paper concludes with a letter that was sent by the author to the New York Times, setting out China’s fundamental stance on genetic modification involving humans and human derivatives. (shrink)

Migration and Islamic Ethics, Issues of Residence, Naturalization and Citizenship addresses how Islamic ethical and legal traditions can contribute to current global debates on migration and displacement; how Islamic ethics of muʼakha, ḍiyāfa, ijāra, amān, jiwār, sutra, kafāla, among others, may provide common ethical grounds for a new paradigm of social and political virtues applicable to all humanity, not only Muslims. The present volume more broadly defines the Islamic tradition to cover not only theology but also (...) to encompass ethics, customs and social norms, as well as modern political, humanitarian and rights discourses. The first section addresses theorizations and conceptualizations using contemporary Islamic examples, mainly in the treatment of asylum-seekers and refugees; the second, contains empirical analyses of contemporary case studies; the third provides historical accounts of Muslim migratory experiences. (shrink)

The philosophy of our proposal are as follows: (1) Various ideas of life and death, including that of objecting to brain death as human death, should be guaranteed. We would like to maintain the idea of pluralism of human death; and (2) We should respect a child’s view of life and death. We should provide him/her with an opportunity to think and express their own ideas about life and death.

ABSTRACT Nanotechnologies are an expression of the human ability to control and manipulate matter on a very small scale. Their use will enable an even and constant monitoring of human organisms, in a new and perhaps less invasive way. Debates at all levels – national, European and international – have pointed out the common difficulty of giving a complete, clear definition of nanotechnologies. This is primarily due to the variety of their components, to the fact that there is not (...) just one technology but several. The most significant medical applications of nanotechnologies are in the diagnostic and the therapeutic fields, eg biosensors and molecular imaging, providing diagnosis and drug delivery with no invasive methods involved. Like any other emerging field, such technologies imply new possibilities for improving health but, on the other hand, they are still at an experimental stage and therefore should be implemented under rigorous safety testing before going on general release. For this purpose, the ethical, legal and social implications (ELSI) of nanotechnologies have been elaborated by study groups, in order to develop solutions before the results of the tests are diffused into medical practice. The aim of this paper is to define some of the ethical issues concerning biomedical applications and to evaluate whether there is a need for new or additional guidelines and regulations. (shrink)

Neuromarketing is a recent interdisciplinary field which crosses traditional boundaries between neuroscience, neuroeconomics and marketing research. Since this nascent field is primarily concerned with improving marketing strategies and promoting sales, there has been an increasing public aversion and protest against it. These protests can be exemplified by the reactions observed lately in Baylor School of Medicine and Emory University in the United States. The most recent attempt to stop ongoing neuromarketing research in France is also remarkable. The pertaining ethical (...) issues have been continuously attracting much attention, especially since the number of neuromarketing companies has exceeded 300 world-wide. This paper begins with a brief introduction to the field of neurotechnology by presenting its current capabilities and limitations. Then, it will focus on the ethical issues and debates most related with the recent applications of this technology. The French Parliament’s revision of rules on bioethics in 2004 has an exemplary role in our discussion. The proposal by Murphy et al. has attracted attention to the necessity of ethical codes structuring this field. A code has recently been declared by the Neuromarketing Science and Business Association. In this paper, it is argued that these technologies should be sufficiently discussed in public spheres and its use on humans should be fully carried out according to the ethical principles and legal regulations designed in line with human rights and human dignity. There is an urgent need in the interdisciplinary scientific bodies like ethics committees monitoring the research regarding the scientific and ethical values of nonmaleficence, beneficence, autonomy, confidentiality, right to privacy and protection of vulnerable groups. (shrink)

: This paper examines ethical issues related to medical practices with children and adults who are members of a linguistic and cultural minority known as the DEAF-WORLD. Members of that culture characteristically have hearing parents and are treated by hearing professionals whose values, particularly concerning language, speech, and hearing, are typically quite different from their own. That disparity has long fueled a debate on several ethical issues, most recently the merits of cochlear implant surgery for DEAF (...) children. We explore whether that surgery would be ethical if implants could deliver close to normal hearing for most implanted children, thereby diminishing the ranks of the DEAF-WORLD. The ethical implications of eugenic practices with the DEAF are explored, as are ethical quandaries in parental surrogacy for DEAF children, and their parallels in transracial adoption. (shrink)

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

Controlled human infection challenge studies (CHIs) involve intentionally exposing research participants to, and/or thereby infecting them with, micro‐organisms. There have been increased calls for more CHIs to be conducted in low‐ and middle‐income countries (LMICs) where many relevant diseases are endemic. This article is based on a research project that identified and analyzed ethical and regulatory issues related to endemic LMIC CHIs via (a) a review of relevant literature and (b) qualitative interviews involving 45 scientists and ethicists with (...) relevant expertise. In this article we argue that though there is an especially strong case for conducting CHIs in endemic (LMIC) settings, certain ethical issues related to the design and conduct of such studies (in such settings) nonetheless warrant particularly careful attention. We focus on ethical implications of endemic LMIC CHIs regarding (a) potential direct benefits for participants, (b) risks to participants, (c) third‐party risks, (d) informed consent, (e) payment of participants, and (f) community engagement. We conclude that there is a strong ethical rationale to conduct (well‐designed) CHIs in endemic LMICs, that certain ethical issues warrant particularly careful consideration, and that ethical analyses of endemic LMIC CHIs can inform current debates in research ethics more broadly. (shrink)

ABSTRACT This paper reports on a multidisciplinary meeting held to discuss ethical issues in medical research in the developing world. Many studies, including clinical trials, are conducted in developing countries with a high burden of disease. Conditions under which this research is conducted vary because of differences in culture, public health, political, legal and social contexts specific to these countries. Research practices, including standards of care for participants, may vary as a result. It is therefore not surprising that (...) ethical issues emerge. This meeting sought to identify and discuss these issues from the perspectives of the many actors in such research, including community representatives, with a view to finding ethical and pragmatic solutions to these issues. Dialogue between these actors was also promoted, with a view to identifying the need to develop such dialogue in future. Drawing from the experiences of the speakers, the colloquium attempted to outline some answers to several key questions characterising the field today. Experiences related to epidemiologic research, vaccine trials, drug trials, diagnostic tests and to some fundamental ethical issues in health research. Speakers were from different countries, disciplines and professions. The meeting provided a forum for consultation and debate between different ethics actors. Both encouraging findings and challenges emerged. (shrink)

Wearable and mobile technology has advanced in leaps and bounds in the last decade with technological advances creating a role from enhancing healthy living to monitoring and treating disease. However, the discussion about the ethical use of such commercial technology in the community, especially in minors, is lacking behind. In this paper, we first summarize the major ethical concerns that arise from the usage of commercially available wearable technology in children, with a focus on smart watches, highlighting (...) class='Hi'>issues around the consent process, mitigation of risk and potential confidentiality and privacy issues, as well as the potential for therapeutic misconceptions when used without medical advice. Then through a relevant thought experiment we move on to outline some further ethical concerns that are connected to the use of wearables by minors, to wit the issue of informed consent in the case of minors, forcing them to live in the spotlight, and compromising their right to an open future. We conclude with the view that mitigating potential pitfalls and enhancing the benefits of wearable technology especially for minors requires brave and comprehensive moral debates. (shrink)

The ethical issues associated with germline gene modification and embryo research are some of the most contentious in current international science policy debates. In this paper, we argue that new genetic techniques, such as CRISPR, demonstrate that there is an urgent need for China to develop its own regulatory and ethical framework governing new developments in genetic and embryo research. While China has in place a regulatory framework, it needs to be strengthened to include better compliance (...) oversight and explicit criteria for how different types of research should be reviewed by regulatory authorities. We also document a variety of opinions about the new technologies among the public, scholars, and policy makers. China needs to develop its own regulations in coordination with other countries; but it is unlikely that an international consensus will be achieved in this area, given the existing differences in regulations between countries. We should aim at harmonization, not necessarily complete consensus, and the perspective from China is vital when international norms are developed and harmonized. Chinese policy makers and researchers need to be aware of the international discussions, at the same time as the international community is aware of, and accommodates, Chinese positions on important policy options. (shrink)

This article discusses ethical issues which are raised as a result of the introduction of economic evidence in mental health care in order to rationalise clinical practice. Cost effectiveness studies and guidelines based on such studies are often seen as impartial, neutral instruments which try to reduce the influence of non-scientific factors. However, such rationalising instruments often hide normative assumptions about the goals of treatment, the selection of treatments, the role of the patient, and the just distribution of (...) scarce resources. These issues are dealt with in the context of increased control over clinical practice by third parties. In particular, health insurers have a great interest in economic evidence in clinical care settings in order to control access to and quality of health care. The authors conclude that guideline setting and cost effectiveness analysis may be seen as important instruments for making choices in health care, including mental health care, but that such an approach should always go hand in hand with a social and political debate about the goals of medicine and health care. This article is partly based on the results of a research project on the normative aspects of guideline setting in psychiatry and cardiology which was conducted under the guidance of the Royal Dutch Medical Association. (shrink)

This book explores the philosophical, and in particular ethical, issues concerning the conceptualization, design and implementation of poverty alleviation measures from the local to the global level. It connects these topics with the ongoing debates on social and global justice, and asks what an ethical or normative philosophical perspective can add to the economic, political, and other social science approaches that dominate the main debates on poverty alleviation. Divided into four sections, the volume examines four (...) areas of concern: the relation between human rights and poverty alleviation, the connection between development and poverty alleviation, poverty within affluent countries, and obligations of individuals in regard to global poverty. (shrink)

Three main ethical issues involved in the management of whales and small cetaceans are examined: ethical values concerning extinction and their implications for consumptive management regimes, the humaneness of current and feasible future harvesting techniques, and the ethical propriety of killing cetaceans for various uses. I argue that objections to human-caused extinction are primarily ethical, and that the ethical discussion must be expanded to include greater consideration of acceptable risks and problems associated with extinction (...) due to human-caused genetic selection. Whaling methods are objectively described including death times for whales. I show that the debate on humaneness is not about the facts of the hunt, but about the appropriate standard for judging whether or not a technique ishumane. Economic and ecological arguments which attempt to preempt the ethical questions are discussed and dismissed as specious. Arguments which attempt to distinguish ethically human relations with cetaceans from relations with other wildlife species are reviewed critically. (shrink)

Late-term abortions are an issue of immense debate in India, where the Medical Termination of Pregnancy Act, 1971 permits abortions only up to 20 weeks of gestation. In special situations, such as pregnancy arising out of rape especially in the case of minors and the late diagnosis of congenital anomalies, there are no clear guidelines on the legal protocol that is to be followed, often resulting in a lack of consistency in terms of legal decision-making, as well as undue prolongation (...) of legal procedures. The Medical Termination of Pregnancy Act prohibits late-term abortions on the basis of personhood and viability of the foetus, to reduce sex-selective abortions and as it considers such abortions to be unsafe. However, a legal prohibition of late-term abortions does not prevent them, and this has led to a surge in the number of illegal, unsafe abortions that are detrimental to the health of women. There is also physical, mental and financial distress to women who are forced to continue their pregnancy, coupled with a lack of governmental support for the same. In comparison of India’s abortion laws with Singapore’s, which are more liberal, and Philippines, which are more restrictive, liberalisation of abortion laws appears to have a better outcome in reducing the incidence of unsafe abortions. This paper argues that the way forward is to liberalise the laws in terms of not only extending the gestational limit to at least 24 weeks but also making exceptions allowing no gestational limit in special cases that warrant them, such as rape victims and late foetal anomalies. The laws, drafted and implemented in consultation with medical professionals in the field, must also be lucid and not leave any room for misinterpretation by courts and health care providers. (shrink)

The ethics of artificial intelligence is a widely discussed topic. There are numerous initiatives that aim to develop the principles and guidance to ensure that the development, deployment and use of AI are ethically acceptable. What is generally unclear is how organisations that make use of AI understand and address these ethical issues in practice. While there is an abundance of conceptual work on AI ethics, empirical insights are rare and often anecdotal. This paper fills the gap in (...) our current understanding of how organisations deal with AI ethics by presenting empirical findings collected using a set of ten case studies and providing an account of the cross-case analysis. The paper reviews the discussion of ethical issues of AI as well as mitigation strategies that have been proposed in the literature. Using this background, the cross-case analysis categorises the organisational responses that were observed in practice. The discussion shows that organisations are highly aware of the AI ethics debate and keen to engage with ethical issues proactively. However, they make use of only a relatively small subsection of the mitigation strategies proposed in the literature. These insights are of importance to organisations deploying or using AI, to the academic AI ethics debate, but maybe most valuable to policymakers involved in the current debate about suitable policy developments to address the ethical issues raised by AI. (shrink)

Patients with advanced dementia suffer from severe cognitive and functional impairment, including eating disorders. The focus of our research is on the issue of life-sustaining treatment, specifically on the social and ethical implications of tube feeding. The treatment decision, based on values of life and dignity, involves sustaining lives that many people consider not worth living. We explore the moral approach to caring for these patients and review the history of the debate on artificial nutrition and hydration showing the (...) impact of the varying perceptions of the value of these patients' lives on changing norms. We argue that in light of the value of solidarity, decisions about life-sustaining treatment for patients with advanced dementia should be made on a case by case basis, as with any other patient, in consideration of the medical implications of the intervention which might best serve the goals of care for the individual patient. (shrink)

Acceptance of elderly or marginal health individuals as kidney donors is debated, with practices varying between centres. Transplant recipients, live kidney donors and health-care professionals caring for patients with renal failure were surveyed regarding their views on live donor kidney transplantation (LDKT) of marginal health (diabetes, hypertension, atherosclerosis, obesity, etc.) and elderly donors. Participants were recruited within a tertiary renal and transplant centre and invited to participate in focus groups and structured interviews. They also completed an anonymous questionnaire. Of 464 (...) participants who completed the questionnaire (36% health-care professionals and 64% patients), 49% and 64%, respectively, stated that marginal and elderly donors should be accepted for LDKT. In the structured interviews, emphasis was given to presenting to donor, recipient and their respective families a calculated risk regarding the effect that either a nephrectomy or transplant has on long-term quality of life. Participants stated that an independent third party in addition to the transplant team should discuss involved risks. Issues of ‘how desperate’ the recipient's situation is should also be considered. Health-care professionals stated that regardless of the strength of will of an individual to donate a kidney (despite age, health problems or personal risk), they should always have the right to say ‘no’ if performing a specific LDKT was against their professional and ethical values. About half of those surveyed considered that marginal health and elderly donors were acceptable for LDKT. Emphasis was given to the explanation to donors and recipients of the risks involved in such transplantation. (shrink)

A “cocaine vaccine” is a promising immunotherapeutic approach to treating cocaine dependence which induces the immune system to form antibodies that prevent cocaine from crossing the blood brain barrier to act on receptor sites in the brain. Studies in rats show that cocaine antibodies block cocaine from reaching the brain and prevent the reinstatement of cocaine self administration. A successful phase 1 trial of a human cocaine vaccine has been reported. The most promising application of a cocaine vaccine is to (...) prevent relapse to dependence in abstinent users who voluntarily enter treatment. Any use of a vaccine to treat cocaine addicts under legal coercion raises major ethical issues. If this is done at all, it should be carefully trialled first, and only after considerable clinical experience has been obtained in using the vaccine to treat voluntary patients. There will need to be an informed community debate about what role, if any, a cocaine vaccine may have as a way of preventing cocaine addiction in children and adolescents. (shrink)

Under present accounting rules, lessees frequently structure contracts for leased assets, in situations where they enjoy benefits similar to outright ownership, in a way that keeps both the leased assets and related liabilities off their books. This method of accounting creates off-balance sheet financing and is called operating lease accounting. The paper debates the ethicality of intentionally structuring lease contracts to avoid disclosing leased asset and liability amounts and describes the “slippery slope” of rule-based accounting for synthetic leases and (...) special purpose entities, that, in the author’s opinion, led to the accounting debacles at Enron and other companies. The ethical intent that is implicit in the Securities and Exchange Commission and Financial Accounting Standards Board regulations is discussed and suggestions for improving the ethicality of financial reporting are provided. (shrink)

Background: Ethical frameworks for organ donation following circulatory death (DCD) were established >20 years ago. However, considerable variation exists among these, indicating consensus has not been reached on all issues. Additionally, advances such as cardiac DCD transplants and normothermic regional perfusion (NRP) may have reignited old debates.Methods: We reviewed the English-language literature addressing ethical issues in DCD from 1993 to 2022, examining changes in frequency with which ethical principles and their sub-themes identified within each, (...) were addressed.Results: Non-maleficence was the most frequently addressed principle (192 of 199 articles), as well as the most varied, with 9 subthemes (versus 2-4 within each of the other bioethical principles).Conclusions: There were several changes in the terminology used to refer to DCD over time, and substantial interest in cardiac DCD and NRP in recent publications, arising in 11 and 19 of the 30 publications from 2018 to 2022. (shrink)

Three main ethical issues involved in the management of whales and small cetaceans are examined: ethical values concerning extinction and their implications for consumptive management regimes, the humaneness of current and feasible future harvesting techniques, and the ethical propriety of killing cetaceans for various uses. I argue that objections to human-caused extinction are primarily ethical, and that the ethical discussion must be expanded to include greater consideration of acceptable risks and problems associated with extinction (...) due to human-caused genetic selection. Whaling methods are objectively described including death times for whales. I show that the debate on humaneness is not about the facts of the hunt, but about the appropriate standard for judging whether or not a technique ishumane. Economic and ecological arguments which attempt to preempt the ethical questions are discussed and dismissed as specious. Arguments which attempt to distinguish ethically human relations with cetaceans from relations with other wildlife species are reviewed critically. (shrink)

Background Human Papilloma Virus vaccine was introduced in Bangladesh through the arrangement of a demonstration project in Gazipur district in 2016, targeting grade five female students and non-school going girls. HPV vaccination is expected to be eventually included in the nationwide immunization program if the demonstration project is successful. However, introduction and implementation of such a vaccination program raises various ethical concerns. This review paper illustrates a step by step assessment of the ethical concerns surrounding the HPV vaccination (...) implementation in Bangladesh considering specific elements in administering and conducting the program as well as the intended results. Policy-makers, vaccine implementers, vaccine recipients, and an ethics specialist in Bangladesh were interviewed. Electronic database and websites have also been reviewed for relevant published literature and government statements. Main body of the abstract This program imparted inadequate knowledge about HPV and cervical cancer to the recipients and participants. There was lack of autonomous and informed choice of the girls and their parents about taking the vaccine. The program did not have any follow-up plan for the adverse effects in the long run. The impact of a female-only strategy in the larger societal context was overlooked. There was lack of awareness among the implementers about safeguarding the ethical issues pertaining to HPV vaccination. Conclusion Adolescent health education imparted in the scope of the vaccination program should contain adequate information about HPV, its mode of transmission, risk factors along with the importance of secondary prevention despite primary prevention. Adolescent boys should be given HPV related health education as well. The right of making informed choice should be appreciated and respected. More ethical discussion and debate should be done among the public health professionals of Bangladesh in order to increase awareness about ethical issues related to human health. (shrink)

The Scottish Mental Health Arts and Film Festival has seen hundreds of arts, public and community groups coproduce over 300 events to over 25,000 audience members. Integral to this arts-based approach, in contrast to social marketing or public education models, is the notion that mental health is an essentially contested concept whereby meanings are negotiated and debate encouraged. With emerging evidence that the festival is an ef ective way of engaging people intellectually and emotionally, we explore ethical issues, (...) challenges and paradoxes that have emerged as the festival has developed. Consideration is given to issues of power, purpose, opportunity costs, reach, impact, programming risks, and participation from those with experience of mental ill-health. Throughout, we explore practical implications for funding, managing, programming, marketing and evaluation of this and similar endeavours. (shrink)

This monograph consists of five parts: (1) introductory material including a conference overview; (2) papers presented at an international symposium on the topic of ethical issues in disability and rehabilitation as a section of the Annual Conference of the Society for Disability Studies; (3) responses to the symposium, prepared by four of the participants; (4) selected additional papers which offer views from perspectives or cultures not represented at the Denver conference; and (5) an annotated international bibliography. Representatives from (...) 10 countries discussed ethical issues and decision making in disability and rehabilitation. Conference papers include: "Genetic Engineering--The New Eugenics? Evolving Medical Attitudes towards the Quality of Life" (Hugh Gallagher);"Description of the Decision-Making Project" (Daryl Evans); "Treatment and Nontreatment Decisions with Respect to Extremely Premature, Very Low Birthweight Infants (500-750g)" (Ernle Young); "Allocation of Resources and Distributive Justice" (John Mather); "Quality Assurance as an Aid to Ethical Decision Making in Disability Management: Lessons from Recent Ethical Issues Involving Disadvantaged Groups in New Zealand" (Peter Gow); "Disability and Ethical Issues: A Point of View from the Netherlands" (Yolan Koster-Dreese); "Who Shall Live or How Shall They Live? Consumer and Professional Perspectives on Treatment/Non-Treatment Decisions" (Joseph Kaufert and Patricia Kaufert); and "Debates across Social Movements on Reproductive Technologies, Genetic Engineering, and Eugenics" (Theresia Degener). Conference commentaries include: "The Meeting of Disability and Bioethics: A Beginning Rapprochement" (Adrienne Asch); "A Plea for More Dialogue: Commentary on Ethics Conference" (Robert Slater); "Healing Our Wounds" (Martha Lentz Walker); "Theories and Values: Ethics and Contrasting Perspectives on Disability" (Harlan Hahn); and "Current Example of Ethical Dilemma" (Susan Lacetti). Selected additional papers include: "High-tech Medicine Is Basic Care" (Frederick Abrams); "Prevention of Disabilities as a Medical Question" (G. Schioler); "The Ethics of Disability Prevention: A Parent's Point of View" (Mrs. J. Baker); "A Reference Matrix for Issues of Life and Personhood" (Mike Miles); "Nazi Scientists and Ethics of Today" (Isabel Wilkerson); "Ethical and Policy Issues in Rehabilitation Medicine (Hastings Center Report)" (Arthur Caplan et al.); and "Differing Approaches to Prevention of Disability and Treatment of Impaired Infants Creates Controversies Worldwide" (Barbara Duncan). (JDD). (shrink)

This book is a fascinating exploration of ethical issues in the restoration of extinct species, viewed from multidisciplinary perspectives. It does not, however, include law. Scientific possibilities and experimentation that appear to operate outside of the ethical sphere are explored in detail and various outcomes are considered. Several essays moot the possibility of more public debate, but a nexus will need to be made to know how this feeds into the regulation of science and its progression. An (...) overarching possibility emerging from the conglomeration of essays is that animals may need recognition as legal persons in order to counterbalance their current treatment as property. (shrink)

As a result of the increase in genetic testing and the fear of discrimination by insurance companies, employers, and society as a result of genetic testing, the disciplines of ethics, public health, and genetics have converged. Whether relatives of someone with a positive predictive genetic test should be notified of the results and risks is a matter urgently in need of debate. Such a debate must encompass the moral and ethical obligations of the diagnosing physician and the patient. The (...) decision to inform or not will vary depending on what moral theory is used. Utilising the utilitarian and libertarian theories produces different outcomes. The principles of justice and non-maleficence will also play an important role in the decision. (shrink)

This essay outlines the moral dilemma of funding orphan drug research and development. To date, ethical aspects of priority setting for research funding have not been an issue of discussion in the bioethics debate. Conflicting moral obligations of beneficence and distributive justice appear to demand very different levels of funding for orphan drug research. The two types of orphan disease, rare diseases and tropical diseases, however, present very different ethical challenges to questions about allocation of research funds. The (...) dilemma is analysed considering utilitarian and rights based theories of justice and moral obligations of non-abandonment and a professional obligation to advance medical science. The limitations of standard economic evaluation tools and other priority setting tools used to inform health policy decision makers on research funding decisions are outlined. (shrink)

How do we know right from wrong, good from bad, help from hindrance, and how can we judge the behaviour of others? Ethics are the rules and guidelines that we use to make such judgements. Often there are no clear answers, which make this subject both interesting and potentially frustrating. In this book, the authors offer readers the opportunity to develop and express their own opinions in relation to ethics in psychology. There are many psychological studies that appear to have (...) been harmful or cruel to the people or animals that took part in them. For example, memory researchers carried out studies on a man who had no memory for over forty years, but because he had no memory he was never able to agree to the studies. Is this a reasonable thing to do to someone? Comparative psychologist Harry Harlow found that he could create severe and lasting distress in monkeys by keeping them in social isolation. Is this a reasonable thing to do even if we find out useful things about human distress? If you were able to use psychological techniques to break someone down so that they revealed information that was useful to your government, would you do it? If so, why? If not, why not? These ethical issues are not easy to resolve and the debates continue as we encounter new dilemmas. This book uses examples from psychological research to look at: key ethical issues ethical guidelines of psychologists socially sensitive research ethics in applied psychology the use of animals in research This book is essential reading for undergraduate and pre-undergraduate students of psychology and related subjects such as philosophy and social policy. (shrink)

Sport and physical activity is an area that remains relatively unexplored by contemporary bioethics. It is, however, an area in which important ethical issues arise. This paper explores the case of the participation of people with anorexia nervosa in exercise. Exercise is one of the central features of anorexia. The presence of anorexics in exercise classes is becoming an increasingly sensitive issue for instructors and fitness professionals. The ethics of teaching exercise to anorexics has, however, seldom, if ever, (...) been addressed. Codes of ethics and legislation do not offer guidelines pertinent to the case and it is left unclear whether anorexics should be allowed to participate in exercise classes. It is shown by this paper that there are strong ethical reasons to let anorexics participate in exercise classes. However, the paper also explains why, despite these apparently cogent ethical reasons, there is no moral obligation to allow a person with anorexia to take part in exercise/sports activities. (shrink)

Non-human animal models of human diseases advance our knowledge of the genetic underpinnings of disease and lead to the development of novel therapies for humans. While mice are the most common model organisms, their usefulness is limited. Larger animals may provide more accurate and valuable disease models, but it has, until recently, been challenging to create large animal disease models. Genome editors, such as Clustered Randomised Interspersed Palindromic Repeat, meet some of these challenges and bring routine genome engineering of larger (...) animals and non-human primates well within reach. There is growing interest in creating NHP models of brain disorders such as autism, depression and Alzheimer’s, which are very difficult to model or study in other organisms, including humans. New treatments are desperately needed for this set of disorders. This paper is novel in asking: Insofar as NHPs are being considered for use as model organisms for brain disorders, can this be done ethically? The paper concludes that it cannot. Notwithstanding ongoing debate about NHPs’ moral status, animal welfare concerns, the availability of alternative methods of studying brain disorders and unmet expectations of benefit justify a stop on the creation of NHP model organisms to study brain disorders. The lure of using new genetic technologies combined with the promise of novel therapeutics presents a formidable challenge to those who call for slow, careful, and only necessary research involving NHPs. But researchers should not create macaques with social deficits or capuchin monkeys with memory deficits just because they can. (shrink)

As a scientific, materialist worldview becomes increasingly difficult to repudiate, and as philosophers increasingly uncover and articulate the conceptual nature of morality and distinctively moral normativity, the threat of moral anti-realism becomes more and more real. This perspective is argued in Chapter One. Chapter Two discusses how laws and bioethical trends that pertain to the clinical management of patients in a vegetative coma differ from country to country and continue to give rise to unresolved legal debates and scientific controversy. (...) Chapter Three covers how caregivers in palliative care must be supported to better understand patients hopes and needs, making them comfortable to decide when or how much they want to eat. Chapter Four synthesises findings from four empirical studies conducted in Western Africa (Togo) on topics related to the autonomy (end of life decision-making among terminally-ill patients), benevolence and non-malevolence (breaking bad news to elderly patients and their families), and justice (informal payments to physicians, criminal prosecution in cases of HIV transmission) principles of bioethics. Finally, Chapter Five argues that expert members in Ethics committees have an unfair upper-hand, with their decisions trumping other debates in committee deliberations. Qualitative research is brought to bear which illustrates this and which also notes how expertise dilutes the training given to newly appointed ethics committee members. (shrink)

The cornea was the first human solid tissue to be transplanted successfully, and is now a common procedure in ophthalmic surgery. The grafts come from deceased donors. Corneal therapies are now being developed that rely on tissue from living-related donors. This presents new ethical challenges for ophthalmic surgeons, who have hitherto been somewhat insulated from debates in transplantation and donation ethics. This paper provides the first overview of the ethical considerations generated by ocular tissue donation from living (...) donors and suggests how these might be addressed in practice. These are discussed in the context of a novel treatment for corneal limbal stem cell deficiency. This involves limbal cell grafts which are transplanted, either directly or after ex vivo expansion, onto recipient stem cell-deficient eyes. Where only one eye is diseased, the unaffected eye can be used as a source of graft tissue. Bilateral disease requires an allogenic donation, preferably from a genetically related living donor. While numerous papers have dealt with the theory, surgical approaches and clinical outcomes of limbal stem cell therapies, none has addressed the ethical dimensions of this form of tissue donation. (shrink)

This paper challenges traditional views which oppose health economics and medical ethics by arguing that economic assessment is a necessary complement to medical ethics and can help to improve public participation and democratic processes in choices about resource allocation for health care technologies. In support of this argument, four points are emphasized: (1) Most current biomedical ethical debates implicitly deal with economic issues of resource allocation. (2) Clinical decisions, which usually respect the Hippocratic code of ethics, are (...) nevertheless influenced by economic incentives and constraints. (3) Economic assessment is concerned with both efficiency and equity and potential trade-offs between the two, which means that ethical judgements are always embedded in welfare economics. (4) The real debate is not between economics on the one side and medical ethics on the other. Rather it is between different ethical conceptions of social justice and the contrasting approaches they entail to reconciling individual interests and preferences with collective goods and welfare. (shrink)

Transgender issues and transgender rights have become increasingly a matter of media attention and public policy debates. Reflecting changes in psychiatric perspectives, the diagnosis of “trans‐sexualism” first appeared in the International Statistical Classification of Diseases and Related Health Problems in 1975 and shortly thereafter, in 1980, in the Diagnostic and Statistical Manual of Mental Disorders. Since that time, international standards of care have been developed, and today those standards are followed by clinicians across diverse cultures. In many instances, (...) treatment of older adolescents and adults is covered by national health care systems and, in some cases, by private health insurance. Most recently, the Medicare ban on coverage for gender reassignment surgery was lifted in 2014.In contrast to the relative lack of controversy about treating adolescents and adults, there is no expert clinical consensus regarding the treatment of prepubescent children who meet diagnostic criteria for what was referred to in both DSM‐IV‐TR and ICD‐10 as gender identity disorder in children and now in DSM‐5 as gender dysphoria. One reason for the differing attitudes has to do with the pervasive nature of gender dysphoria in older adolescents and adults: it rarely desists, and so the treatment of choice is gender or sex reassignment. On the subject of treating children, however, as the World Professional Association for Transgender Health notes in their latest Standards of Care, gender dysphoria in childhood does not inevitably continue into adulthood, and only 6 to 23 percent of boys and 12 to 27 percent of girls treated in gender clinics showed persistence of their gender dysphoria into adulthood. Further, most of the boys’ gender dysphoria desisted, and in adulthood, they identified as gay rather than as transgender.In an effort to clarify best treatment practices for transgender individuals, a recent American Psychiatric Association Task Force on the Treatment of Gender Identity outlined three differing approaches to treating prepubescent gender dysphoric children. (shrink)

As a moral philosopher, the perspective I will take in this chapter is one of argumentation and informed judgment about two main questions: whether individuals should ever choose to conduct human embryonic stem cell research, and whether the law should permit this type of research. I will also touch upon a secondary question, that of whether the government ought to pay for this type of research. I will discuss some of the main arguments at stake, and explain how the (...) class='Hi'>ethical conflict over these questions differs from the political conflict over them. I will be guided throughout by the assumption that the unique scientific and clinical promise of human embryonic stem cell research is significant. Those who have doubts about this assumption should consult other chapters in this volume in which the issue is addressed directly. I begin with one of the basic facts relevant to the ethical issue of stem cell research: you and I, along with everybody else we know, developed out of clumps of primordial cells, which happen to be the very same clumps that serve as the source for human embryonic stem cells in the laboratory. Let us call these “source cells” for short, since they can be used in this way. Each individual has developed into whatever she is now out of a one-celled animal, which then became a blastocyst, a multi-celled human embryo. These blastocysts are partly made up of an inner mass of cells, and the body of every adult person has developed out of this inner mass. It is this very same clump from the inner part of the blastocyst that consists of source cells for human embryonic stem 1 cell research. These cells can be extracted and grown into a laboratory specimen of extraordinary interest to scientists. Before discussing the significance of the fact that all humans originate from these source cells, it is useful to begin by asking some perhaps rather simple-minded questions about how any one of us knows this fact to be true in the first place. How do I know that I developed from a single cell, and then a blastocyst? In my own case, the main way I know this is that other people have told me so.. (shrink)

Social experimental research commonly employs media to elicit responses from research subjects. This use of media is broadly protected under fair use exemptions to copyright, and creators of content used in experiments are generally not afforded any formal consideration or protections in existing research ethics frameworks. Online social networking sites are an emerging and important setting for social experiments, and in this context the material used to elicit responses is often content produced by other users. This article argues that users (...) may have a reasonable interest in controlling the use of their content in experiments conducted in online social networks. Matters of risk and autonomy in research ethics are explored by analogy to active debates in law over adhesion contracts, moral rights, and the right to be forgotten. The article concludes by considering practical difficulties in identifying and protecting the interests of creators. (shrink)

In recent years and months, human stem cell research has dominated many scientists' interests, the media, public debate, and social policy. This paper aims to consider, first, the major scientific data on stem cell research that are available. Second, I reflect on them by examining how they shaped policies in Europe and the United States. I also point to current changes in policy-making concerning the creation of ad hoc committees to address this novel issue and how, in a few instances, (...) different ethical positions are part of the documents produced. In other words, diverse approaches are not solved but kept in tension. Finally, I suggest that the current state of research on human stem cell will benefit from an ethics of risk. (shrink)

Purpose – This paper aims to focus on the modern development of bionics and linking new technologies with the human nervous system or other biological systems that cause changes of the human biological structure. Design/methodology/approach – The paper is a discursive evaluation of technological progress and new systems where computers and machines integrate, making a single matrix entity – the cyborg. Here fundamental questions arise, such as what it means to be human and what is and what should be a (...) human being? Findings – The paper argues for the value of twenty-first century human enhancement techniques and other emerging technologies that promised to “help” humans become “more than human”, trying to create human beings with greatly enhanced abilities, to improve human mental and physical characteristics and capacities. Modern man is gradually disappearing as a natural being and increasingly turning into an artificial creature “cyborg” that leads into the question, what will ultimately remain human in a human body? Originality/value – The paper contributes to the existing debates about further development of cyborgisation and examines boundaries that will strictly divide man from a cyborg in the near future. In order to protect man from the omnipotence of technology and its unethical application is necessary to establish cyborgoethics that would determine the implementation of an artificial boundary in the natural body. (shrink)

To discern the ethical issues involved incurrent gene therapy research, to explore theproblems inherent in possible future genetherapies, and to encourage debate within thescientific community about ethical questionsrelevant to both, we surveyed American Societyof Human Genetics scientists who engage inhuman genetics research. This study of theopinions of U.S. scientific experts about theethical issues discussed in the literature ongene therapy contributes systematic data on theattitudes of those working in the field as wellas elaborative comments. Our survey finds (...) thatrespondents are highly supportive of thepotential use of somatic cell gene therapy tocure serious diseases in adults and children aswell as prospective offspring. A clearmajority, however, believe that using suchgenetic techniques for enhancement purposes isunacceptable. Delineating the line betweendisease/disorder and improvement/enhancementposes a problem not easily resolved and oneconducive to the growth of slippery-slopeapprehensions. The majority of respondents alsoadvocate germ-line therapy, in theory at least,and under similar restrictions, but theyrecognize the roadblock that the existence ofunanticipated negative consequences currentlypresents. Another complex matter involvestrying to determine appropriate reasons forchoosing target diseases for research, forwhich the dichotomy between rare single-geneand common multifactorial diseases reveals anongoing dilemma. (shrink)

Transcranial direct current stimulation (tDCS) is a brain stimulation technique known for its relative safety and minimal invasiveness. tDCS has demonstrated efficacy as a potential treatment for certain neurological disorders, such as Parkinson’s disease, and has been shown to enhance a range of cognitive abilities under certain contexts. As a result, this technique has captured the interest of both the research community and the public at large. However, efforts to gather information about the effects of tDCS on the brain are (...) still in their infancy, leading to concerns about informed consent as it pertains to the possible risks associated with tDCS treatment. The ability to purchase tDCS equipment in the form of commercial, direct-to-consumer devices, generates even more cause for ethical concern, given the unknowns surrounding this technology and its potential broader societal impact. Previous research has touched on the many ethical issues raised by the emergence of this technology, including under what circumstances its use is justifiable and appropriate. In this paper, we survey recent normative and empirical works pertaining to the ethics of tDCS with the goal of summarizing the current state of ethical debate surrounding its use in the contexts of both therapy and cognitive enhancement, with a particular emphasis on the latter. Our analysis of the collected research finds that issues pertaining to user safety are paramount within existing scholarship; that tDCS use in children is an emerging area of concern entailing special considerations; and that regulatory bodies and legal agencies have struggled to implement appropriate, impactful regulation pertaining to tDCS and related technologies in order to balance public welfare against individual autonomy. This analysis will facilitate future efforts to develop bioethical approaches to tDCS by highlighting the ethical dimensions of tDCS prioritized in existing literature and identifying areas where further ethical consideration is needed. (shrink)

This paper investigates the ethical issues surrounding the concept of Internet neutrality focusing specifically on the correlation between neutrality and fairness. Moving from an analysis of the many available definitions of Internet neutrality and the heterogeneity of the Internet infrastructure, the common assumption that a neutral Internet is also a fair Internet is challenged. It is argued that a properly neutral Internet supports undesirable situations in which few users can exhaust the majority of the available resources or in (...) which specific types of applications and services cannot be developed or properly deployed. The solution offered to these shortcomings is based on (1) an environmental approach to the Internet, (2) the four guiding principles of Floridi’s Information Ethics and (3) a principle called ‘Information Diversity’. The paper is divided into six sections. Section 1 briefly presents the debate concerning the concepts of network and Internet neutrality. Section 2 poses a general and unifying definition of Internet neutrality based on the critical assessment of several domain-specific approaches to the problem of neutrality. Section 3 is dedicated to the analysis of the relationship between Internet neutrality and the ethical principle of fairness. Section 4 introduces Floridi’s Information Ethics, the definition of Information Diversity and an analysis of how they can be used to address the limitations of Internet neutrality. Section 5 summarises the ethics of Internet neutrality and Information Diversity defining their relationship. Section 6 reviews the arguments presented in the paper clarifying the foundational role played by Information Diversity and Information Ethics in Internet policy-making activity. (shrink)

– Pharmacy sales of over‐the‐counter medicines in the UK represent an economically significant and important mechanism by which customers self‐medicate. Sales are supervised in pharmacies, but this paper seeks to question whether patients' electronic health records – due to be introduced nationally – could be used, ethically, by pharmacists to ensure safe medicines sales., – Using theoretical arguments, three areas of ethical concern are identified and explored in relation to pharmacists' access to EHRs‐consequentialsim, analogies and confidentiality/privacy., – Consequentialist arguments (...) include positive benefits to customer's welfare and control of medicine of abuse, but negative economic healthcare burdens and consequences due to potentially increased or paradoxically, decreased presentation of patients to doctors. Socially accepted analogous practices – credit checks, existing pharmacy access to information and hospital treatment – are then argued to be ethically relevant and supportive of access. Privacy and confidentiality are then considered as reasons not to allow EHR access. A contrasting view is that pharmacy access to EHRs is another form of surveillance and hence the question of pharmacists' assess to EHRs may be answered negatively by empirical research that locates pharmacy customers as expert users and identifies confidentiality and privacy concerns about information technology in healthcare more generally., – This paper offers a unique and valuable contribution to the debate about healthcare professionals' role‐based access to patients' medical records and offers a reflection on the ethical concerns surrounding patient information and the rival concerns of patient qua customer autonomy and safety. (shrink)

Questioning Ethics is a major discussion by some of world's leading thinkers of some of the most important ethical issues confronting us today. New essays including Habermas, MacIntyre, Ricoeur and Kristeva discuss issues such as the nature of politics, women's rights, lying, repressed memory, historical debt and forgiveness, the self and responsibility, revisionism, bioethics and multiculturalism. The contributors organize their discussions along the topics of hermeneutics, deconstruction, critical theory, psychoanalysi and the applications of ethics. Also included in (...) this collection is an interview with Jacques Derrida which provides the most accessible insight into his thinking. Contributors: Karl-Otto Apel, Geoffrey Barash, John Caputo, Maeve Cooke, Simon Critchley, Jacques Derrida, Simon Glendinning, Jean Greish, Jurgen Habermas, Richard Kearney, Peter Kemp, Julia Kristeva, Alasdair MacIntyre, Thomas McCarthy, David Rasmussen, William J. Richardson, Paul Ricoeur, David Wood. (shrink)

United States public health experts have long expressed concern about the prevalence of the human immunodeficiency virus among injection drug users. The United States has the largest reported IDU population in the world: 1.1 to 1.5 million. Recent estimates from the Centers for Disease Control and Prevention suggest that 50 percent of incident HIV infections occur among IDUs, with additional infections occurring among their sex partners and offspring. More than 33 percent of new AIDS cases occur in IDUs, their sexual (...) partners, and their children. Almost one half of all women diagnosed with AIDS in the United States are IDUS. Many of the remaining infected women were infected as a result of sex with a male IDU.While public health agencies, legislators, community leaders, and religious groups have engaged in vigorous debate over the merits of needle exchange programs as an intervention to reduce HIV transmission, the programs, some legal and some illegal, have been implemented in fifty-five cities across the country. (shrink)

United States public health experts have long expressed concern about the prevalence of the human immunodeficiency virus among injection drug users. The United States has the largest reported IDU population in the world: 1.1 to 1.5 million. Recent estimates from the Centers for Disease Control and Prevention suggest that 50 percent of incident HIV infections occur among IDUs, with additional infections occurring among their sex partners and offspring. More than 33 percent of new AIDS cases occur in IDUs, their sexual (...) partners, and their children. Almost one half of all women diagnosed with AIDS in the United States are IDUS. Many of the remaining infected women were infected as a result of sex with a male IDU.While public health agencies, legislators, community leaders, and religious groups have engaged in vigorous debate over the merits of needle exchange programs as an intervention to reduce HIV transmission, the programs, some legal and some illegal, have been implemented in fifty-five cities across the country. (shrink)

Extensive and growing use of electronic performance monitoring in organizations has resulted in considerable debate. Advocates of electronic monitoring approach the debate in teleological terms arguing that monitoring benefits organizations, customers, and society. Its critics approach the issue in deontological terms countering that monitoring is dehumanizing, invades worker privacy, increases stress and worsens health, and decreases work-life quality. In contrast to this win-lose approach, this paper argues that an approach which emphasizes communication in the design and implementation of monitoring systems (...) offers a win-win solution that should satisfy both deontological and teleological ethicists. (shrink)