HIV/AIDS prevention campaigns have been overshadowed by conflicting, competing, and contradictory views between those who support condom use as a last resort and those who are against it for fear of promoting sexual immorality. We argue that abstinence and faithfulness to one partner are the best available moral solutions to the HIV/AIDS pandemic. Of course, deontologists may argue that condom use might appear useful and effective in controlling HIV/AIDS; however, not everything that is useful is always good. In principle, all (...) schools of thought and faith seem to agree on the question of faithfulness for married couples and abstinence for those who are not married. But they differ on condom use. On the ground, the situation is far more complex. We simply lack a single, entirely reliable way to resolve all disagreements regarding HIV/AIDS prevention strategies. (shrink)

Legal professionals in Malawi rely on a limited number of textbooks, outdated law reports and inadequate library services. Most documents available are in image form, are un-structured, i.e. contain no useful legal meta-data, summaries, keynotes, and do not support a system of citation that is essential to legal research. While advances in document processing and machine learning have benefited many fields, legal research is still only marginally affected. In this interdisciplinary research, the authors build semi-automatic tools for creating a corpus (...) of Malawi criminal law decisions annotated with legal meta-data, case and law citations. We used this corpus to extract legal meta-data, including law and case citations as used in Malawi by employing machine learning tools, spaCy and Gensim LDA. We set the foundation for a new methodology for classifying Malawi criminal case law according to the recently introduced International Classification of Crime for Statistical Purposes (ICCS). (shrink)

Research collaboration beyond national jurisdiction is one aspect of the globalisation of health research. It has potential to complement researchers in terms of research skills, equipment and lack of adequate numbers of potential research subjects. Collaboration at an equal level of partnership though desirable, may not be practicable. Sometimes, human research specimens must be transported from one country to other. Where this occurs, there should be clear understanding between the collaborating research institutions regarding issues of access and control of the (...) specimens as well as the duration of storage of specimens. The researchers have the duty to inform the research participants about specimen storage and transport across national boundaries. While obtaining informed consent from study subjects if specimens are to be stored beyond the life of the present study could be the ideal, there still remains significant challenges in a multi-cultural world. (shrink)

BackgroundThe participant recruitment process is a key ethical pivot point when conducting robust research. There is a need to continuously review and improve recruitment processes in research trials and to build fair and effective partnerships between researchers and participants as an important core element in ensuring the ethical delivery of high-quality research. When participants make a fair, informed, and voluntary decision to enroll in a study, they agree to fulfill their roles. However, supporting study participants to fulfill study requirements is (...) an important ethical obligation for researchers, yet evidenced as challenging to achieve. This paper reports on participants’ motivations to volunteer and remain part of a dietary study conducted in Kasungu District, Malawi.MethodsWe conducted twenty in-depth interviews, five systematic ethnographic observations, and fourteen focus group discussions with trial participants and their partners. Interviews were audio-recorded and transcribed verbatim. We used a grounded theory methodology to analyse data that included coding, detailed memo writing, and data interpretation.FindingsThe findings reveal that many participants had concerns during the trial. Thematically, experiences included anxieties, mistrust of researchers, rumours, fears of exploitation, and misconceptions. Anonymous concerns collected from the participants were reported to the trial team which enabled the researchers to appropriately support participants. Despite initial concerns, participants described being supported and expressed motivation to take up their role.ConclusionThese findings highlight a diverse map of multiple notions of what is ethically relevant and what can impact participation and retention within a study. The study has revealed how embedding a responsive approach to address participants’ concerns and ethical issues can support trust relationships. We argue for the need to employ embedded ethics strategies that enhance informed consent, focus on participants’ needs and positive experiences, and support researchers to fulfill their roles. This work highlights the need for research ethics committees to focus on the risks of undue influence and prevent exploitation especially in settings with a high asymmetry in resources and power between researcher and participant groups.Trial Registration: The Addressing Hidden Hunger with Agronomy trial was registered on 5th March 2019. (shrink)

BackgroundThere have been notable investments in large multi-partner research programmes across the agriculture-nutrition-health nexus. These studies often involve human participants and commonly require research ethics review. These ANH studies are complex and can raise ethical issues that need pre-field work, ethical oversight and also need an embedded process that can identify, characterise and manage ethical issues as the research work develops, as such more embedded and dynamic ethics processes are needed. This work builds on notions of ‘ethics in practice’ by (...) developing an approach to facilitate ethical reflection within large research programmes. This study explores the application of a novel ‘real-time research ethics approach’ and how this can support ethical mindfulness. This involves embedding ethical analysis and decision-making within research implementation, with a continuous dialogue between participants and researchers. The aim is to improve ethical responsiveness and participant experience, which in turn may ethically support adherence and retention. In this case study, a bioethics team was embedded in a community-based randomised, controlled trial conducted in rural Malawi, titled the ‘Addressing Hidden Hunger with Agronomy’. To identify ethical issues, the researchers conducted ten focus group discussions, fourteen in-depth interviews with key informants, two workshops, observed two sensitisation and three activity meetings conducted by the trial team, and analysed fifteen reports from pre-trial to trial implementation.ResultsThe RTREA facilitated the identification of social and ethical concerns and made researchers aware of participants’ ‘lived research experience’. To address concerns and experiences, the BT worked with researchers to facilitate conversation spaces where social and ethical issues were discussed. Conversation spaces were designed to create partnerships and promote participatory methods to capture trial participants’ perspectives and experiences.ConclusionsThe use of RTREA showed the value of real-time and continuous engagement between TPs and researchers. These real-time processes could be embedded to complement traditional ethical guidance and expert opinions. A deeper engagement appeared to support greater operationalising of principles of inclusion, empowerment, and participant autonomy and supported researchers ‘ethical mindfulness’ which in turn may support instrumental outcomes of high recruitment, retention, and adherence levels. (shrink)

Socially responsible business and ethical behaviour of companies have been of interest to academia and practice for decades. But the focus has almost exclusively been on large corporations while small- and medium-sized enterprises (SME) have not received as much attention. Thus, this paper focuses on socially responsible business practices of SME entrepreneurs or owner–managers in Germany. Based on the assumption that decision-makers in SMEs are the central point where all business activities start, members of a German entrepreneurs association were approached (...) in the course of a qualitative and quantitative survey. They were asked to assess in what way their social responsibility is expressed in specific management practices towards selected stakeholder groups. These practices in turn were assumed to result in perceived positive reactions of the respective stakeholders and subsequently to positively influence the firm's financial performance, i.e. cost reductions and increase in profits. In the paper, a research model is presented that elaborates the relationship between an SME executive's social responsibility and the value creation of a firm, i.e. whether (personal) values create (economic) value. It was found that socially responsible management practices towards employees, customers and to a lesser extent society have a positive impact on the firm and its performance. As such, values can create additional value. (shrink)

Southern African countries have the highest HIV infection rates in the world. In most of the countries in the region, the rate among adults is at least 10%. The fight against HIV/AIDS has mostly been inadequate owing to the lack of proper consideration of ethical and cultural issues. In this article, the authors discuss the ethical and cultural dilemmas concerning HIV/AIDS, with Malawi as a case in point. It is argued that increasing financial resources alone, as exemplified by the Global (...) Fund to Fight AIDS, Tuberculosis and Malaria initiative, without proper attention to ethical issues, morals and appropriate legal obligations, are unlikely to reduce the spread of HIV in southern Africa. (shrink)

The principle of individual medical confidentiality is one of the moral principles that Africa inherited unquestioningly from the West as part of Western medicine. The HIV/AIDS pandemic in Southern Africa has reduced the relevance of the principle of individual medical confidentiality. Individual medical confidentiality has especially presented challenges for practitioners among the Bantu communities that are well known for their social inter-connectedness and the way they value their extended family relations. Individual confidentiality has raised several unforeseen problems for persons living (...) with HIV/AIDS, ranging from stigma and isolation to feelings of dejection as it drives them away from their families as a way of trying to keep information about their conditions confidential. The involvement of family members in treatment decisions is in line with the philosophy of Ubuntu and serves to respect patients’ and families’ autonomy while at the same time benefiting the individual patient. (shrink)

There is currently a global shortage of nurses. Developing countries such as Malawi are among those hardest hit by this shortage. The demands on available nurses have increased and at the same time there is a lack of interest in becoming a nurse owing to the poor working conditions among those still employed in the service. It is questionable if developed nations should recruit nurses from countries such as Malawi, where severe human resource constraints are being experienced. We argue in (...) this article that the current phenomenon of nurses leaving developing nations for western countries is complex. Human rights issues of individual autonomy and public interest are at stake. (shrink)

HIV/AIDS is a major public health problem in Africa. Stigmatization, discrimination and lack of appropriate health care are among the commonest challenges that HIV infected persons and their families face. It has been suggested that among the tools available in the fight against stigmatization and discrimination is public disclosure of a person’s HIV seropositive status. While public disclosure of HIV status has a place in the fight against HIV and AIDS, especially by resulting in behavioural change among people who know (...) of an HIV infected person, we argue that such disclosure also has potential attendant harms. The posthumous disclosure of HIV status is particularly problematic. Public disclosure should be accompanied by appropriate individual counselling and preparation of the community to deal with the situation, and should have regard for cultural sensitivity after consideration of the risks and benefits to individuals, families and the community. Health practitioners should keep in mind that their main duty is to the best interest of the patient, the family and the community, in that order. (shrink)

Stanley and Williamson (The Journal of Philosophy 98(8), 411–444 2001 ) reject the fundamental distinction between what Ryle once called ‘knowing-how’ and ‘knowing-that’. They claim that knowledge-how is just a species of knowledge-that, i.e. propositional knowledge, and try to establish their claim relying on the standard semantic analysis of ‘knowing-how’ sentences. We will undermine their strategy by arguing that ‘knowing-how’ phrases are under-determined such that there is not only one semantic analysis and by critically discussing and refuting the positive account (...) of knowing-how they offer. Furthermore, we argue for an extension of the classical ‘knowing-how’/‘knowing-that’-dichotomy by presenting a new threefold framework: Using some core-examples of the recent debate, we will show that we can analyze knowledge situations that are not captured by the Rylean dichotomy and argue that, therefore, the latter has to be displaced by a more fine-grained theory of knowledge-formats. We will distinguish three different formats of knowledge we can have of our actions, namely (1) propositional, (2) practical, and (3) image-like formats of knowledge. Furthermore, we will briefly analyze the underlying representations of each of these knowledge-formats. (shrink)

Is musical practice 'real' - and how is it connected with everyday life? Eva-Maria Houben shows that making music changes as soon as its meaning is not sought in a purpose-oriented production of results, but in performing music as an activity - indeed, as play. Musical practice, Eva-Maria Houben contends, should be understood as open and never finished. Such an emphasis on repetition can free us from perfection, productivity, and purpose, allowing meaning to unfold in specific situations, places, (...) and relationships. Thus understood, musical practice can become a form of life and a reality in its own right. (shrink)

Telepsychiatry has long been discussed as a supplement to or substitute for face-to-face therapeutic consultations. The current pandemic crisis has fueled the development in an unprecedented way. More and more psychiatric consultations are now carried out online as video-based consultations. Treatment results appear to be comparable with those of face-to-face care in terms of clinical outcome, acceptance, adherence and patient satisfaction. However, evidence on videoconferencing in a variety of different fields indicates that there are extensive changes in the communication behaviour (...) in online conversations. We hypothesise that this might impact ethically relevant aspects of the therapeutic relationship, which plays a prominent role in psychiatry. In this paper, we review effects of video-based consultations on communication between therapists and patients in psychiatry. Based on a common understanding of video-based consultations as changing the lived experience of communication, we categorise these effects according to sensory, spatial and technical aspects. Departing from a power-based model of therapeutic relationships, we then discuss the ethical significance of this changed communication situation, based on dimensions of respect for autonomy, lucidity, fidelity, justice and humanity. We conclude that there is evidence for ethically relevant changes of the therapeutic relationship in video-based telepsychiatric consultations. These changes need to be more carefully considered in psychiatric practice and future studies. (shrink)

Infants who suffer severe neglect fail to thrive emotionally as well as bodily. The absence of early coexistential structures that provide well-being leads to a narrowing of the child's perceptual and social developmental horizon. What is the nature of these early structures? In this essay, an ontology of well-being or housedness is elaborated through phenomenological reflections on breast-feeding and infant perception. Merleau-Ponty's ontology of the flesh makes a contribution to the ontology of well-being: it gives us a conceptual and evocative (...) language to describe human existence in its pre-verbal, syncretic, and non-dualistic manifestations. It also allows for a re-evaluation and re-interpretation of the results of current research in infant perception. Through the structures of infant perception we perceive the coexistential fit between infants, other human beings, and the world of things. An infant's fundamental housedness in the flesh is taken up and cultivated or destroyed by the child's social and cultural environment. (shrink)

Do people really fare better if they can rely on many social ties? Research suggests that benefits of interpersonal emotion regulation can be derived from both large and small social networks. Building on the intrapersonal regulatory flexibility model, we propose the emotion regulation repertoire of social support model that views effective socioemotional support as the combination of network size and ER strategies, resulting in a repertoire of ER resources one can draw on. Best outcomes in mental health should follow from (...) both a large network and a diverse repertoire of strategies. ERROSS is applied as an example in the context of bereavement, and specific contributions of the model are highlighted. (shrink)

Goethe belongs to the phenomenological tradition for a number of reasons: He shared Husserl’s deep mistrust of the mathematization of the natural world and the ensuing loss of the qualitative dimension of human existence; he understood that the phenomenological observer must free him/herself from sedimented cultural prejudices, a process which Husserl called the epoche; he experienced and articulated the new and surprising fullness of the world as it reveals itself to the patient and participatory phenomenological observer. Goethe’s phenomenological sensibilities and (...) insights become more apparent when his work is brought into dialogue with Husserl’s thinking. In turn Goethe challenges Husserlian phenomenology to a more careful investigation of the natural world and human participation within its order. Both Goethe and Husserl are searching for a science of the qualitative dimension of being. (shrink)

BackgroundThere is growing interest in the collection, storage and reuse of biological samples for future research. Storage and future use of biological samples raise ethical concerns and questions about approaches that safeguard the interests of participants. The situation is further complicated in Africa where there is a general lack of governing ethical frameworks that could guide the research community on appropriate approaches for sample storage and use. Furthermore, there is limited empirical data to guide development of such frameworks. A qualitative (...) study to address this gap was conducted with key stakeholders in Malawi to understand their experiences and perspectives regarding storage and usage of samples for future research.MethodsThis study conducted 13 in-depth interviews with ethics committee members, regulators and researchers, and five focus group discussions with community representatives and clinical trial participants in Malawi. Interviews and focus group discussions were audio-recorded, transcribed verbatim, and thematically analysed.ResultsOn the current regulatory guidelines that governs the collection, storage and reuse of samples in Malawi, participants highlighted their different understanding of it, with some indicating that it prohibited the reuse and sharing of samples, while others believed it permitted.Views on the informed consent model used in Malawi, some stakeholders expressed that the current model limited options for sample contributors regarding future use. Researchers supported storing samples for future use in order to maximize their value and reduce research costs. However, they expressed concern over the exportation of samples highlighting that it could lead to misuse and would not support the development of research capacity within Malawi. They recommended use of broad consent or tiered consent and establishment of biobanks to address these concerns.ConclusionsStudy findings highlighted the need for a review of the current regulatory guideline and the development of infrastructure to support the use of stored biological samples for future use among the research community in Malawi. At the moment, there are ethical and practical concerns arising from the collection, storage and secondary use of biological samples make it hard to reconcile scientific progress and the protection of participants. (shrink)

This text reconstructs the Kohlberg/Gilligan controversy between a male ethics of justice and a female ethics of care. Using Karl-Otto Apel's transcendental pragmatics, the author argues for a mediation between both models in terms of a reciprocal co-responsibility. Against this backdrop, she defends the circular procedure of an exclusively argumentative-reflexive justification of a normative ethics. From this it follows for feminist ethics that it cannot do without either of the two types of ethics. The goal is to assure the evaluative (...) variety of different types of an ethics of the good without endangering the normative boundaries of a deontological discourse ethics. (shrink)

The ancient Tamil poetic corpus of the Cankam is at the same time a national treasure and a common battle ground for linguists and historians alike. Going back to oral predecessors from about the early first millennium, it became part of a canon, slowly fell into near oblivion and was finally rediscovered and printed in the 19th century. The present study follows up the complex historical process of its transmission through 2000 years.

Empathy as “Feelingly Grasping” Perhaps the central question concerning empathy is if and if so how it combines aspects of thinking and feeling. Indeed, the intellectual tradition of the past centuries has been marked by a dualism. Roughly speaking, there have been two pathways when it comes to understanding each other: 1) thinking or mind reading and 2) feeling or empathy. Nonetheless, one of the ongoing debates in psychology and philosophy concerns the question whether these two abilities, namely, understanding what (...) the other is thinking and “understanding” what the other is feeling, are separate or not. Most of the authors in this volume consider the cognitive and affective dimensions at work within empathy. Each author does this within and beyond their own field. Coming from the humanities, we propose the following definition for empathy: Empathy is a social feeling that consists in feelingly grasping or retracing the present, future, or past emotional state of the other; thus empathy is also called a vicarious emotion. We would like to highlight two aspects of this definition in particular: 1.) the peculiar position of “grasping” which involves a cognitive dimension and 2.) the social dimensions of relating to the emotions of another human being. (shrink)

Maurice Merleau-Ponty beschreibt die Phänomenologie als einen erkennbaren, praktischen Denkstil, der als Bewegung schon bestand bevor er sich als Philosophie bewusst war. Im Folgenden wird gezeigt, wie Goethe’s naturwissenschaftliches Denken in diesen erkennbaren, praktischen Denkstil der phänomenologischen Bewegung hineinpaßt. Diese Studie über Goethe und die Phänomenologie ist auf drei Themenkreise beschränkt: die phänomenologische Weltanschauung, die von Husserl’s Werk geprägt wurde; die phänomenologische Methode, die ihren Ursprung in Husserl, aber ihre Ausarbeitung in neueren Phänomenologen hat; und letztlich die phänomenologische Naturphilosophie, die (...) ihre Ansätze im Spätwerk Merleau-Ponty’s findet. (shrink)

Gibt es eine weibliche bzw. männliche Moral? Orientiert sich das Moralverhalten beider Geschlechter tatsächlich tendenziell an unterschiedlichen Wertvorstellungen? Diese in den letzten Jahren leidenschaftlich und äußerst kontrovers diskutierte Frage beantwortet Eva-Maria Schwickert aus der Perspektive der philosophischen Ethik. Im Blickpunkt des Interesses stehen die begriffliche Bestimmung und die moralische Legitimation beider Orientierungen. Den von Carol Gilligan erhobenen Vorwurf, die "männliche" Gerechtigkeitsmoral sei zu sehr auf Prinzipien konzentriert, findet die Autorin bestätigt und schlägt vor, das Defizit der Gerechtigkeits- durch die (...) Fürsorgeethik auszugleichen. Ziel des gesuchten Ausgleichs ist ein Vermittlungsmodell, das den berechtigten Einwänden Gilligans Rechnung trägt und dennoch nicht auf eine Prinzipienorientierung verzichtet. Das Ergebnis der Studie präsentiert sich als Brückenschlag zwischen der Kantischen Vernunftethik Kohlbergs einerseits und der Aristotelischen Wertethik Gilligans andererseits. Beide Ethiktypen – die der Gerechtigkeit und die der Fürsorge – fordern sich wechselseitig. Gemessen an diesem vertieften Ethikverständnis stellt sich das weibliche Zögern, ein moralisches Urteil zu fällen, nicht mehr als Ausdruck eines unzureichenden Prinzipienbewußtseins, sondern als das eines verantwortungsethisch reflektierten Urteilsvermögens dar. Die Untersuchung spannt einen Bogen zwischen hermeneutischen und ethischen ebenso wie zwischen historischen und systematischen Fragestellungen. Darüber hinaus bietet sie einen Einblick in die aktuelle Diskussion der Diskursethik. (shrink)

Dieser Aufsatz untersucht einige Zusammenhänge zwischen der Zuschreibung von Intuitionen und intuitivem Wissen einerseits und epistemischen Ungerechtigkeiten andererseits. Der Aufsatz gliedert sich in zwei Teile. Ausgangspunkt ist im ersten Teil Frickers Theorie der epistemischen Ungerechtigkeit. Ich zeige auf, dass dem Verweis auf die „weibliche Intuition“ eine Schlüsselrolle in der Etablierung der Konzepte der testimonialen und hermeneutischen Ungerechtigkeit zukommt, da in ihm systematische Vorurteile über gender-codierte Denkmuster und Verhaltensweisen kulminieren, die paradigmatisch für strukturelle epistemische Ungerechtigkeiten sind. Allerdings gilt es zu betonen, (...) dass der Begriff der Intuition nicht nur im Sinne einer epistemischen Abwertung, sondern auch im Sinne einer Aufwertung höchst problematisch ist. Hierdurch wird eine Schwachstelle in Frickers Theorie deutlich, da diese durch die Annahme einer grundlegenden Asymmetrie zwischen Glaubwürdigkeitsdefiziten und -exzessen ihre Perspektive auf epistemische Ungerechtigkeiten zu weit einschränkt. Im zweiten Teil werde ich anhand zweier ausgewählter metaphilosophischer Debatten einige Verbindungen zwischen dem Intuitionsbegriff in der analytischen Philosophie und Fragen nach epistemischen Ungerechtigkeiten aufdecken. Hierbei werde ich in Bezug auf die Debatte um die sog. Expertise-Verteidigung dafür argumentieren, dass diese nicht auf epistemische Fragestellungen begrenzt werden kann, sondern auch auf eine ethische Dimension verweist. Mit Blick auf die Debatte um die Gender-Lücke in der akademischen Philosophie werde ich aufzeigen dass hier zwar epistemische und ethische Perspektiven zusammengeführt werden, dass bestimmte Argumentationsmuster aber so angelegt sind, dass sie sich implizit an eine problematische, dualistische Vorstellung von Intuition binden. (shrink)

This paper focuses on Ernst Mach’s theory of scientific experimentation. As I shall show, Mach presents an extraordinarily wide perspective on scientific experiments, bringing together heuristic, evolutionary, historical and didactical aspects. For Mach, experimentation is not reduced to controlled testing in a laboratory. It rather describes a quite general human, and even animal, activity to explore the world. By relying on such a broad notion of experiment, however, his theory has to deal with a wide range of objections. I shall (...) analyse these objections by confronting Mach’s theory with Franz Brentano’s straightforward criticism. I shall conclude that Mach’s theory entails some unsolvable inconsistencies. These inconsistencies lead to some important questions that still pose challenges to the philosophy of scientific experimentation. (shrink)