The chapter begins with a brief preliminary investigation of the nature and role of theory in psychotherapy in general. Then, it introduces Gestalt therapy in an institutional and historical context. The distinctive theoretical tenets of Gestalt psychotherapy are outlined next. The chapter looks at some of the philosophical underpinnings of this theory and notes how such underpinnings tend toward subjectivism and an anti‐theory stance. It also suggests some alternative underpinnings, which could lead to a more integrated outlook on the relation (...) of theory to practice and a resolution of the objectivity‐subjectivity tension. (shrink)

This is an exploration and analysis of Aquinas's contribution to the philosophy of religion. It examines Aquinas's contexts, his views on philosophy and theology, as well as faith and reason. His arguments for God's existence, responses to objections against God's existence and his characterization of the nature of God are examined.

"...there is nothing elementary about O'Grady's primer. She pulls off the feat of writing a reliable and accessible introduction to modern philosophy that is also a meaningful contribution to the subject." - London Times Literary Supplement From Descartes' famous line 'I think therefore I am' to Kant's fascinating discussions of morality, the thinkers of the Enlightenment have helped to shape the modern world. Addressing such important subjects as the foundations of knowledge and the role of ethics, the theories of (...) these philosophers continue to have great relevance to our lives. Ranging across Enlightenment thinking from Berkeley to Rousseau, Enlightenment Philosophy in a Nutshell explains important ideas such as Locke's ideas of primary and secondary qualities, Kant's moral rationalism, and Hume's inductive reasoning. Filled with helpful diagrams and simple summaries of complex theories, this essential introduction brings the great ideas of the past to everyone. (shrink)

This concise book brings behavioral insights to the wide array of topics commonly taught in the required professional responsibility course, including admission to the practice of law, confidentiality, conflicts of interest, representing entities, prosecutorial and criminal defense ethics, litigation and negotiation ethics, legal billing, and managerial and subordinate responsibilities. Behavioral legal ethics relies on empirical research to explore how lawyers actually make ethical decisions in context, rather than how they predict they would decide an ethical dilemma. This approach complements the (...) law of lawyering by seeking to understand how various psychological factors and situational pressures explain and influence decision-making and resulting ethical (or unethical) action. Each chapter explores findings from behavioral science that pertain to ethical decision-making such as motivated reasoning, confirmation bias and other cognitive biases, fast thinking, the fundamental attribution error, wrongful obedience, conformity, moral disengagement, and much more. In addition, each chapter contains relevant case studies and reflection questions to deepen and cement students' understanding of the role of behavioral legal ethics in professional responsibility. Finally, the book offers ideas for individual attorneys and legal organizations to improve ethical decision-making."--Publisher's webpage. (shrink)

The Language Dynamic identifies a number of mechanisms that enable the meaning potential of language from the phoneme through grammar and discourse and onto ideological systems. This book, which underpins functional theories of language with concepts from biological and cultural evolution, social semiotics and systems theory, is relevant to all who are interested in how and why we can mean and what it means for us as humans to be semiotic agents.

The late twentieth century has provided both reasons and occasions for reassessing just war theory as an organizing framework for the moral analysis of war. Books by G. Scott Davis, James T. Johnson, and John Kelsay, together with essays by Jeffrey Stout, Charles Butterworth, David Little, Bruce Lawrence, Courtney Campbell, and Tamara Sonn, signal a remarkable shift in war studies as they enlarge the cultural lens through which the interests and forces at play in political violence are identified and evaluated. (...) In his review of the contribution made by these texts, the author focuses on the cohesion of just war theory, the asymmetry between Christian and Islamic attitudes toward holy war, and the need to develop just war theory into a tool adequate to assist in the moral evaluation of violent conflicts within, not just between, nation-states. (shrink)

An accessible guide to philosophy, presenting a collection of 70 essays covering the major themes, theories and arguments of the most prominent thinkers of ancient Greece.

This book offers eleven different philosophical approaches to issues concerning the basis of value, the nature of the good life, and human destiny; important matters in this recession. The essayists featured are professors at Trinity College Dublin.

Research participants' views about investigator financial interests were explored. Reactions ranged from concern to acceptance, indifference, and even encouragement. Although most wanted such information, some said it did not matter, was private, or was burdensome, and other factors were more important to research decisions. Very few said it would affect their research decisions, and many assumed that institutions managed potential conflicts of interest. Although disclosure of investigator financial interest information to research participants is often recommended, its usefulness is limited, especially (...) when participation is desired because of illness. (shrink)

The late twentieth century has provided both reasons and occasions for reassessing just war theory as an organizing framework for the moral analysis of war. Books by G. Scott Davis, James T. Johnson, and John Kelsay, together with essays by Jeffrey Stout, Charles Butterworth, David Little, Bruce Lawrence, Courtney Campbell, and Tamara Sonn, signal a remarkable shift in war studies as they enlarge the cultural lens through which the interests and forces at play in political violence are identified and evaluated. (...) In his review of the contribution made by these texts, the author focuses on the cohesion of just war theory, the asymmetry between Christian and Islamic attitudes toward holy war, and the need to develop just war theory into a tool adequate to assist in the moral evaluation of violent conflicts within, not just between, nation-states. (shrink)

New fetal therapies offer important prospects for improving health. However, having to consider both the fetus and the pregnant woman makes the risk–benefit analysis of fetal therapy trials challenging. Regulatory guidance is limited, and proposed ethical frameworks are overly restrictive or permissive. We propose a new ethical framework for fetal therapy research. First, we argue that considering only biomedical benefits fails to capture all relevant interests. Thus, we endorse expanding the considered benefits to include evidence-based psychosocial effects of fetal therapies. (...) Second, we reject the commonly proposed categorical risk and/or benefit thresholds for assessing fetal therapy research. Instead, we propose that the individual risks for the pregnant woman and the fetus should be justified by the benefits for them and the study’s social value. Studies that meet this overall proportionality criterion but have mildly unfavorable risk–benefit ratios for pregnant women and/or fetuses may be acceptable. (shrink)

Vulnerability is one of the least examined concepts in research ethics. Vulnerability was linked in the Belmont Report to questions of justice in the selection of subjects. Regulations and policy documents regarding the ethical conduct of research have focused on vulnerability in terms of limitations of the capacity to provide informed consent. Other interpretations of vulnerability have emphasized unequal power relationships between politically and economically disadvantaged groups and investigators or sponsors. So many groups are now considered to be vulnerable in (...) the context of research, particularly international research, that the concept has lost force. In addition, classifying groups as vulnerable not only stereotypes them, but also may not reliably protect many individuals from harm. Certain individuals require ongoing protections of the kind already established in law and regulation, but attention must also be focused on characteristics of the research protocol and environment that present ethical challenges. (shrink)

The Covid‐19 pandemic has highlighted many of the difficult ethical issues that health care professionals confront in caring for patients and families. The decisions such workers face on the front lines are fraught with uncertainty for all stakeholders. Our focus is on the implications for nurses, who are the largest global health care workforce but whose perspectives are not always fully considered. This essay discusses three overarching ethical issues that create a myriad of concerns and will likely affect nurses globally (...) in unique ways: the safety of nurses, patients, colleagues, and families; the allocation of scarce resources; and the changing nature of nurses’ relationships with patients and families. We urge policy‐makers to ensure that nurses’ voices and perspectives are integrated into both local and global decision‐making so as to minimize the structural injustices many nurses have faced to date. Finally, we urge nurses to seek sources of support throughout this pandemic. (shrink)

This volume explores numerous themes (including the influence of ethnography on religious education research and pedagogy, the interpretive approach to religious education, the relationship between research and classroom practice in religious education), providing a critique of contemporary religious education and exploring the implications of this critique for initial and continuing teacher education.

Different types of consent are used to obtain human biospecimens for future research. This variation has resulted in confusion regarding what research is permitted, inadvertent constraints on future research, and research proceeding without consent. The National Institutes of Health Clinical Center's Department of Bioethics held a workshop to consider the ethical acceptability of addressing these concerns by using broad consent for future research on stored biospecimens. Multiple bioethics scholars, who have written on these issues, discussed the reasons for consent, the (...) range of consent strategies, and gaps in our understanding, and concluded with a proposal for broad initial consent coupled with oversight and, when feasible, ongoing provision of information to donors. This article describes areas of agreement and areas that need more research and dialogue. Given recent proposed changes to the Common Rule, and new guidance regarding storing and sharing data and samples, this is an important and tim.. (shrink)

Ethically challenging situations routinely arise in the course of illness and healthcare. However, very few studies have surveyed patients and family members about their experiences with ethically challenging situations. To address this gap in the literature, we surveyed patients and family members at three hospitals. We conducted a content analysis of their responses to open-ended questions about their most memorable experience with an ethical concern for them or their family member. Participants described 219 unique ethical experiences that spanned many of (...) the prevailing themes of bioethics, including the patient-physician relationship, end-of-life care, decision-making capacity, healthcare costs, and genetic testing. Participants focused on relational issues in the course of experiencing illness and receiving medical care and concerns regarding the patient-physician encounters. Many concerns arose outside of a healthcare setting. These data indicate areas for improvement for healthcare providers but some concerns may be better addressed outside of the traditional healthcare setting. (shrink)

Concerns about exploiting the poor or economically disadvantaged in clinical research are widespread in the bioethics community. For some, any research that involves economically disadvantaged individuals is de facto ethically problematic. The economically disadvantaged are thought of as “venerable” to exploitation, impaired decision making, or both, thus requiring either special protections or complete exclusion from research. A closer examination of the worries about vulnerabilities among the economically disadvantaged reveals that some of these worries are empirically or logically untenable, while others (...) can be better resolved by improved study designs than by blanket exclusion of poorer individuals from research participation. The scientific objective to generate generalisable results and the ethical objective to fairly distribute both the risks and benefits of research oblige researchers not to unnecessarily bar economically disadvantaged subjects from clinical research participation. (shrink)

IRBs often face dueling values in research: their historically grounded mission to protect research participants from harm conflicts with more recent attention to the importance of including underr...

Using payment to recruit research subjects is a common practice, but it raises ethical concerns that coercion or undue inducement could potentially compromise participants’ informed consent. This is the first national study to explore the attitudes of IRB members and other human subjects protection professionals concerning whether payment of research participants constitutes coercion or undue influence, and if so, why. The majority of respondents expressed concern that payment of any amount might influence a participant’s decisions or behaviors regarding research participation. (...) Respondents expressed greater acceptance of payment as reimbursement or compensation than as an incentive to participate in research, and most agreed that subjects are coerced if the offer of payment makes them participate when they otherwise would not or when the offer of payment causes them to feel that they have no reasonable alternative but to participate . Views about undue influence were similar. We conclude that human subjects protection professionals hold expansive and inconsistent views about coercion and undue influence that may interfere with the recruitment of research participants and impede valuable research. (shrink)

Proponents of two axioms of biological evolutionary theory have attempted to find justification by reference to nonequilibrium thermodynamics. One states that biological systems and their evolutionary diversification are physically improbable states and transitions, resulting from a selective process; the other asserts that there is an historically constrained inherent directionality in evolutionary dynamics, independent of natural selection, which exerts a self-organizing influence. The first, the Axiom of Improbability, is shown to be nonhistorical and thus, for a theory of change through time, (...) acausal. Its perception of the improbability of living states is at least partially an artifact of closed system thinking. The second, the Axiom of Historically Determined Inherent Directionality, is supported evidentially and has an explicit historical component. Historically constrained dynamic populations are inherently nonequilibrium systems. It is argued that living, evolving systems, when considered to be historically constrained nonequilibrium systems, do not appear improbable at all. Thus, the two axioms are not compatible. Instead, the Axiom of Improbability is considered to result from an unjustified attempt to extend the contingent proximal actions of natural selection into the area of historical, causal explanations. It is thus denied axiomatic status, and the effects of natural selection are subsumed as an additional level of constraint in an evolutionary theory derived from the Axiom of Historically Determined Inherent Directionality. (shrink)

Research ethics consultation is increasingly recognized as a potentially valuable mechanism for addressing the depth and breadth of ethical issues that arise in research related to human health and well-being. However, fundamental questions remain, including: What is “research ethics consultation”? And what is its justification beyond the purposes already served by existing entities? We examine how a research ethics consultation service may differ from or complement the role of an institutional review board by offering a definition of research ethics consultation (...) and by exploring the potential scope of a consultation service in terms of types of clients served, questions addressed, and advice provided at various stages of the research process. We then consider the relationship between research ethics consultation services and IRBs, as well as the issues that may arise between them, including possible conflicts of interest. (shrink)

Some are concerned about the possibility that offering money for research participation can constitute coercion or undue influence capable of distorting the judgment of potential research subjects and compromising the voluntariness of their informed consent. The author recognizes that more often than not there are multiple influences leading to decisions, including decisions about research participation. The concept of undue influence is explored, as well as the question of whether or not there is something uniquely distorting about money as opposed to (...) a chance for treatment or medical care. An amount of money that is not excessive and is calculated on the basis of time or contribution may, rather than constitute an undue inducement, be an indication of respect for the time and contribution that research subjects make. (shrink)

Payment to recruit research subjects is a common practice but raises ethical concerns relating to the potential for coercion or undue influence. We conducted the first national study of IRB members and human subjects protection professionals to explore attitudes as to whether and why payment of research participants constitutes coercion or undue influence. Upon critical evaluation of the cogency of ethical concerns regarding payment, as reflected in our survey results, we found expansive or inconsistent views about coercion and undue influence (...) that may interfere with valuable research. In particular, respondents appear to believe that coercion and undue influence lie on a continuum; by contrast, we argue that they are wholly distinct: whereas undue influence is a cognitive distortion relating to assessment of risks and benefits, coercion is a threat of harm. Because payment is an offer, rather than a threat, payment is never coercive. (shrink)

Purpose/methods: This study investigated the relationship between ethics education and training, and the use and usefulness of ethics resources, confidence in moral decisions, and moral action/activism through a survey of practicing nurses and social workers from four United States (US) census regions. Findings: The sample (n = 1215) was primarily Caucasian (83%), female (85%), well educated (57% with a master's degree). no ethics education at all was reported by 14% of study participants (8% of social workers had no ethics education, (...) versus 23% of nurses), and only 57% of participants had ethics education in their professional educational program. Those with both professional ethics education and in-service or continuing education were more confident in their moral judgments and more likely to use ethics resources and to take moral action. Social workers had more overall education, more ethics education, and higher confidence and moral action scores, and were more likely to use ethics resources than nurses. Conclusion: Ethics education has a significant positive influence on moral confidence, moral action, and use of ethics resources by nurses and social workers. (shrink)

Technology has played a central role in development programming since the inception of development assistance. Recent development organizations, like the Bill and Melinda Gates Foundation, believe technological innovation can improve development outcomes. Development ethics, a field of study focused on the ethical questions posed by development policies and practices, has yet to fully appreciate the ethical dimensions of the science and technology. Addressing this important research and policy gap, we contend that science and technology studies (STS) offers important insights that (...) can be used in combination with development ethics to influence development policies and practices. Utilizing a case study of a private development program in Uganda, we illustrate how STS offers important insights for understanding how a sociotechnical ensemble placed pressure on already scarce water resources. Two dimensions of STS scholarship, the power asymmetries of technological development and the incomplete or partial nature of technoscientific knowledge, are examined and help us to understand how sociotechnical ensembles in development increase the likelihood of the emergence of publics who are negatively impacted by sociotechnical ensembles in development programs. Leveraging STS insights, we argue for the importance of situated ethics—a pragmatic approach to ensuring responsiveness to the emergence of these publics. (shrink)

Fuzzy logics are systems of logic with infinitely many truth values. Such logics have been claimed to have an extremely wide range of applications in linguistics, computer technology, psychology, etc. In this note, we canvass the known results concerning infinitely many valued logics; make some suggestions for alterations of the known systems in order to accommodate what modern devotees of fuzzy logic claim to desire; and we prove some theorems to the effect that there can be no fuzzy logic which (...) will do what its advocates want. Finally, we suggest ways to accommodate these desires in finitely many valued logics. (shrink)

Our concept of choice is integral to the way we understand others and ourselves, especially when considering ourselves as free and responsible agents. Despite the importance of this concept, there has been little empirical work on it. In this paper we report four experiments that provide evidence for two concepts of choice—namely, a concept of choice that is operative in the phrase having a choice and another that is operative in the phrase making a choice. The experiments indicate that the (...) two concepts of choice can be differentiated from each other on the basis of the kind of alternatives to which each is sensitive. The results indicate that the folk concept of choice is more nuanced than has been assumed. This new, empirically informed understanding of the folk concept of choice has important implications for debates concerning free will, responsibility, and other debates spanning psychology and philosophy. -/- Specifically, 'having a choice' appears to require genuinely open alternatives, or alternative possibilities that are actually realizable, while 'making a choice' appears to only require psychological open alternatives, or the ability to consider alternatives independent of whether these alternatives are actually realizable. We argue that these findings are relevant to the free will debate because choice is central to the folk concept of free will and many philosophical analysis of free will. The kinds of alternatives required for having a choice appear to be incompatibilist in nature, while the kinds of alternatives required for making a choice appear to be compatibilist in nature. If free will requires having choices, then this is perhaps evidence against compatibilism. If free will requires making choices, then this is perhaps evidence in favor of--or at least consistent with--compatibilism. (shrink)

Well before patient-centered or patient-controlled research became trendy, and earlier than calls to preferentially refer to research subjects as participants, Bob Veatch wrote “The Patient as Partner” Veatch presciently argued that research patients should not be thought of as passive subjects nor material from which to obtain data, but rather as partners in discovery. In this manuscript, I will explore Veatch’s conception of patient as partner in research and how that idea has evolved and been implemented over time and consider (...) some of the remaining challenges. Complexities of patient partnership include: clarifying the types of research in which patient partnership is most appropriate, recognizing the various possible levels of patient engagement in each case, avoiding tokenism and striving for respectful partnership, and keeping in mind the appropriate implementation of protections and safeguards. Bob Veatch would be pleased with the progress that has been made in creating research partnerships with patients, while also undoubtedly pushing us to continue to do better. (shrink)

Psychiatry is rapidly adopting digital phenotyping and artificial intelligence/machine learning tools to study mental illness based on tracking participants’ locations, online activity, phone and text message usage, heart rate, sleep, physical activity, and more. Existing ethical frameworks for return of individual research results (IRRs) are inadequate to guide researchers for when, if, and how to return this unprecedented number of potentially sensitive results about each participant’s real-world behavior. To address this gap, we convened an interdisciplinary expert working group, supported by (...) a National Institute of Mental Health grant. Building on established guidelines and the emerging norm of returning results in participant-centered research, we present a novel framework specific to the ethical, legal, and social implications of returning IRRs in digital phenotyping research. Our framework offers researchers, clinicians, and Institutional Review Boards (IRBs) urgently needed guidance, and the principles developed here in the context of psychiatry will be readily adaptable to other therapeutic areas. (shrink)

Patients and family members (N = 671) were surveyed in five Mid-Atlantic U.S. hospitals to ascertain the number and kinds of ethical concerns they are presently experiencing or have previously experienced while being sick or receiving medical care. Seventy percent of participants had at least one (range 0–14) type of ethical concern or question. The most commonly experienced concerns pertained to being unsure how to plan ahead or complete an advance directive (29.4%), being unsure whether someone in the family was (...) able to make their own decisions (29.2%), deciding about limiting life-sustaining treatments (28.6%), wondering about disclosing personal medical information to others in the family (26.4%) and not being sure whether to undergo treatment because of cost (26.2%). Most were interested to some degree in getting help from ethics consultants in the future (76.6%). Given this prevalence, common concerns might usefully be addressed systematically, rather than exclusively on a case-by-case basis. (shrink)

In their target article, Morain and colleagues (2019) tackle the long-standing and thorny issue of whether and when it might be ethical for a physician-investigator to obtain research consent from...

Development law is an ethos-driven law reform paradigm that examines conditions from within the country and provides a frame of reference in which to evaluate the legal regime in the political, economic, social and cultural context. Moreover, development law provides a fresh approach to assessing existing national laws effectiveness generally; it assesses whether modifications are required to promote economic, political, and social progress, including protecting the rights of minority ethnic groups and disenfranchised peoples. By protecting rights, law can be an (...) instrument of social development and will not be alien to large segments of the population. Development law as a paradigm is the result of decision making within the country after careful examination by trained professionals whose sole interest is political, economical, social, cultural and national development. The enactment of laws and integration of customary norms that are embraced by the ruling authority, political elites, and other stake holders will best advance human rights. (shrink)

Lynch and colleagues describe positive and cautionary lessons learned from recent extraordinary research efforts to develop COVID-19 vaccines and therapeutics and consider whether some of th...

Ethical concerns about randomising persons to a no-treatment arm in the context of Ebola epidemic led to consideration of alternative designs. The stepped wedge design, in which participants or clusters are randomised to receive an intervention at different time points, gained popularity. Common arguments in favour of using this design are when an intervention is likely to do more good than harm, all participants should receive the experimental intervention at some time point during the study and the design might be (...) preferable for practical reasons. We examine these assumptions when considering Ebola vaccine research. First, based on the claim that a stepped wedge design is indicated when it is likely that the intervention will do more good than harm, we reviewed published and ongoing SW trials to explore previous use of this design to test experimental drugs or vaccines, and found that SW design has never been used for trials of experimental drugs or vaccines. Given that Ebola vaccines were all experimental with no prior efficacy data, the use of a stepped wedge design would have been unprecedented. Second, we show that it is rarely true that all participants receive the intervention in SW studies, but rather, depending on certain design features, all clusters receive the intervention. Third, we explore whether the SW design is appealing for feasibility reasons and point out that there is significant complexity. In the setting of the Ebola epidemic, spatiotemporal variation may have posed problematic challenges to a stepped wedge design for vaccine research. Finally, we propose a set of points to consider for scientific reviewers and ethics committees regarding proposals for SW designs. (shrink)