Background International collaborators face challenges in the design and implementation of ethical biomedical research. Evaluating community understanding of research and processes like informed consent may enable researchers to better protect research participants in a particular setting; however, there exist few studies examining community perspectives in health research, particularly in resource-limited settings, or strategies for engaging the community in research processes. Our goal was to inform ethical research practice in a biomedical research setting in western Kenya and similar resource-limited settings. Methods (...) We sought to use mabaraza , traditional East African community assemblies, in a qualitative study to understand community perspectives on biomedical research and informed consent within a collaborative, multinational research network in western Kenya. Analyses included manual, progressive coding of transcripts from mabaraza to identify emerging central concepts. Results Our findings from two mabaraza with 108 community members revealed that, while participants understood some principles of biomedical research, they emphasized perceived benefits from participation in research over potential risks. Many community members equated health research with HIV testing or care, which may be explained in part by the setting of this particular study. In addition to valuing informed consent as understanding and accepting a role in research activities, participants endorsed an increased role for the community in making decisions about research participation, especially in the case of children, through a process of community consent. Conclusions Our study suggests that international biomedical research must account for community understanding of research and informed consent, particularly when involving children. Moreover, traditional community forums, such as mabaraza in East Africa, can be used effectively to gather these data and may serve as a forum to further engage communities in community consent and other aspects of research. (shrink)
The Médecins Sans Frontières ethics review board has been solicited in an unprecedented way to provide advice and review research protocols in an ‘emergency’ mode during the recent Ebola epidemic. Twenty-seven Ebola-related study protocols were reviewed between March 2014 and August 2015, ranging from epidemiological research, to behavioural research, infectivity studies and clinical trials with investigational products at early development stages. This article examines the MSF ERB’s experience addressing issues related to both the process of review and substantive ethical issues (...) in this context. These topics include lack of policies regarding blood sample collection and use, and engaging communities regarding their storage and future use; exclusion of pregnant women from clinical and vaccine trials; and the difficulty of implementing timely and high-quality qualitative/anthropological research to consider potential upfront harms. Having noticed different standards across ethics committees, we propose that when multiple ethics reviews of clinical and vaccine trials are carried out during a public health emergency they should be accompanied by transparent communication between the ECs involved. The MSF ERB experience should trigger a broader discussion on the ‘optimal’ ethics review in an emergency outbreak and what enduring structural changes are needed to improve the ethics review process. (shrink)
Informed by evidence from past studies and experiences with epidemics, an intervention combining quarantine, lockdowns, curfews, social distancing, and washing of hands has been adopted as “international best practice” in COVID-19 response. With massive total lockdowns complemented by electronic surveillance, China successfully controlled the pandemic in country within a few months. But would this work for Africa and other communalistic resource-poor settings where social togetherness translates to effective sharing of basic needs? What ethical and practical challenges would this pose? How (...) would communalism be translated in special contexts to be useful in contributing to the ultimate common good? This paper uses examples from the current situation of COVID-19 in Kenya to address these questions. (shrink)
This paper defends what the philosopher Merleau Ponty coins ‘the imaginary texture of the real’. It is suggested that the imagination is at work in the everyday world which we perceive, the world as it is for us. In defending this view a concept of the imagination is invoked which has both similarities with and differences from, our everyday notion. The everyday notion contrasts the imaginary and the real. The imaginary is tied to the fictional or the illusory. Here it (...) will be suggested, following both Kant and Strawson, that there is a more fundamental working of the imagination, present in both perception and the constructions of fictions. What Kant and Strawson failed to make clear, however, was that the workings of the imagination within the perceived world, gives that world, an affective logic. The domain of affect is that of emotions, feelings and desire, and to claim such an affective logic in the world we experience, is to point out that it has salience and significance for us. Such salience suggests and demands the desiring and sometimes fearful responses we make to it; the shape of the perceived world echoed in the shapes our bodies take within it. (shrink)
Using an economic bargaining game, we tested for the existence of two phenomena related to social norms, namely norm manipulation – the selection of an interpretation of the norm that best suits an individual – and norm evasion – the deliberate, private violation of a social norm. We found that the manipulation of a norm of fairness was characterized by a self-serving bias in beliefs about what constituted normatively acceptable behaviour, so that an individual who made an uneven bargaining offer (...) not only genuinely believed it was fair, but also believed that recipients found it fair, even though recipients of the offer considered it to be unfair. In contrast, norm evasion operated as a highly explicit process. When they could do so without the recipient's knowledge, individuals made uneven offers despite knowing that their behaviour was unfair. (shrink)
Quentin Skinner's The Foundations of Modern Political Thought is primarily of interest to philosophers not for its excellent account of European thought about the state but for the self–conscious philosophy which has gone into it. It is a rare historian who pauses to get his philosophy in order before he embarks on a major enterprise, though such a policy is possibly less unusual in intellectual history than in other fields. In Skinner's case, however, this order of doing things has been (...) pushed so far that he counts as a philosopher in his own right, rather than as merely someone who is unusually careful to think about what he is doing. The publication of this major work thus provides a convenient opportunity to make a few remarks about the relation between historical theory and practice. (shrink)
The Aristotelian view that the moral virtues–the virtues of character informed by practical wisdom–are essential to an individual's happiness, and are thus in an individual's self-interest, has been little discussed outside of purely scholarly contexts. With a few exceptions, contemporary philosophers have tended to be suspicious of Aristotle's claims about human nature and the nature of rationality and happiness. But recent scholarship has offered an interpretation of the basic elements of Aristotle's views of human nature and happiness, and of reason (...) and virtue, that brings them more into line with common-sense thinking and with contemporary philosophical and empirical psychology. This makes it fruitful to reexamine the question of the role of virtue in self-interest. (shrink)
Liberal political philosophy presupposes a moral theory according to which the ability to assess and choose conceptions of the good from a universal and impartial moral standpoint is central to the individual's moral identity. This viewpoint is standardly understood by liberals as that of a rational human agent. Such an agent is able to reflect on her ends and pursuits, including those she strongly identifies with, and to understand and take into account the basic interests of others. From the perspective (...) of liberalism as a political morality, the most important of these interests is the interest in maximum, equal liberty for each individual, and thus the most important moral principles are the principles of justice that protect individuals' rights to life and liberty. According to the communitarian critics of liberalism, however, the liberal picture of moral agency is unrealistically abstract. Communitarians object that moral agents in the real world neither choose their conceptions of the good nor occupy a universalistically impartial moral standpoint. Rather, their conceptions of the good are determined chiefly by the communities in which they find themselves, and these conceptions are largely “constitutive” of their particular moral identities. Moral agency is thus “situated” and “particularistic,” and an impartial reflection on the conception of the good that constitutes it is undesirable, if not impossible. Further, communitarians contend, the good is “prior” to the right in the sense that moral norms are derived from, and justified in terms of, the good. An adequate moral and political theory must reflect these facts about moral agency and moral norms. (shrink)
I present an original model in judgment aggregation theory that demonstrates the general impossibility of consistently describing decision-making purely at the group level. Only a type of unanimity rule can guarantee a group decision is consistent with supporting reasons, and even this possibility is limited to a small class of reasoning methods. The key innovation is that this result holds when individuals can reason in different ways, an allowance not previously considered in the literature. This generalizes judgment aggregation to subjective (...) decision situations, implying that the discursive dilemma persists without individual agreement on the logical constraints. Notably, the model mirrors the typical method of choosing political representatives, and thus suggests that no voting procedure other than unanimity rule can guarantee representation that reflects electorate opinion. Finally, I apply the results to a normative argument for unanimity rule in contract theory and juries, as well as to problems posed for deliberative democratic theory and the concept of representation. (shrink)
I begin with a note about moral goodness as a quality, disposition, or trait of a person or human being. This has at least two different senses, one wider and one narrower. Aristotle remarked that the Greek term we translate as justice sometimes meant simply virtue or goodness as applied to a person and sometimes meant only a certain virtue or kind of goodness. The same thing is true of our word “goodness.” Sometimes being a good person means having all (...) the virtues, or at least all the moral ones; then goodness equals the whole of virtue. But sometimes, being a good person has a narrower meaning, namely, being kind, generous, and so forth. Thus, my OED sometimes equates goodness with moral excellence as a whole and sometimes with a particular moral excellence, viz., kindness, beneficence, or benevolence; and the Bible, when it speaks of God as being good sometimes means that God has all the virtues and sometimes only that he is kind, mereiful, or benevolent. When Jesus says, “Why callest thou me good: None is good, save one, that is God,” he seems to be speaking of goodness in the inclusive sense, but when the writer of Exodus has God himself say that he is “merciful and gracious, long-suffering, and abundant in goodness and truth,” God is using “goodness” in the narrower sense in which it means benevolence, for he goes on to make it clear that he is also just and severe. Similarly, “good will” may mean either “morally good will” in general, as it does in Kant, or it may mean only “benevolent will,” as it usually does; in “men of good will” it is perhaps ambiguous. (shrink)
There is wide agreement that community engagement is important for many research types and settings, often including interaction with ‘representatives’ of communities. There is relatively little published experience of community engagement in international research settings, with available information focusing on Community Advisory Boards or Groups (CAB/CAGs), or variants of these, where CAB/G members often advise researchers on behalf of the communities they represent. In this paper we describe a network of community members (‘KEMRI Community Representatives’, or ‘KCRs’) linked to a (...) large multi-disciplinary research programme on the Kenyan Coast. Unlike many CAB/Gs, the intention with the KCR network has evolved to be for members to represent the geographical areas in which a diverse range of health studies are conducted through being typical of those communities. We draw on routine reports, self-administered questionnaires and interviews to: 1) document how typical KCR members are of the local communities in terms of basic characteristics, and 2) explore KCR's perceptions of their roles, and of the benefits and challenges of undertaking these roles. We conclude that this evolving network is a potentially valuable way of strengthening interactions between a research institution and a local geographic community, through contributing to meeting intrinsic ethical values such as showing respect, and instrumental values such as improving consent processes. However, there are numerous challenges involved. Other ways of interacting with members of local communities, including community leaders, and the most vulnerable groups least likely to be vocal in representative groups, have always been, and remain, essential. (shrink)
Francesco Guala has developed some novel and radical ideas on the problem of external validity, a topic that has not received much attention in the experimental economics literature. In this paper I argue that his views on external validity are not justified and the conclusions which he draws from these views, if widely adopted, could substantially undermine the experimental economics enterprise. In rejecting the justification of these views, the paper reaffirms the importance of experiments in economics.
This article considers the differential absorption and integration of refugee physicists into various countries during the 1930s, and the social and intellectual factors responsible for this, focusing particularly on the social functions of the British and American university at that period, as well as continuing ideological struggles in the Soviet Union. More generally, the issue of the relative absorption of refugee physicists is used to examine the nature of the physics communities and other institutions of the host societies.
Fieldworkers (FWs) are community members employed by research teams to support access to participants, address language barriers, and advise on culturally appropriate research conduct. The critical role that FWs play in studies, and the range of practical and ethical dilemmas associated with their involvement, is increasingly recognised. In this paper, we draw on qualitative observation and interview data collected alongside a six month basic science study which involved a team of FWs regularly visiting 47 participating households in their homes. The (...) qualitative study documented how relationships between field workers and research participants were initiated, developed and evolved over the course of the study, the shifting dilemmas FWs faced and how they handled them. Even in this one case study, we see how the complex and evolving relationships between fieldworkers and study participants had important implications for consent processes, access to benefits and mutual understanding and trust. While the precise issues that FWs face are likely to depend on the type of research and the context in which that research is being conducted, we argue that appropriate support for field workers is a key requirement to strengthen ethical research practice and for the long term sustainability of research programmes. (shrink)