The objective of this paper is to explain why certain authors - both popular and academic - are making a mistake when they attribute obligations to uncoordinated groups of persons, and to argue that it is particularly unhelpful to make this mistake given the prevalence of individuals faced with the difficult question of what morality requires of them in a situation in which there's a good they can bring about together with others, but not alone. I'll defend two alternatives to (...) attributing obligations to uncoordinated groups. The first solution has us build better people, who will coordinate their actions willingly and spontaneously when the occasion arises. The second solution has us build better groups, so that when the occasion arises, there is a framework in place for coordinating members into action. (shrink)

Many of the items that humans consume are produced in ways that involve serious harms to persons. Familiar examples include the harms involved in the extraction and trade of conflict minerals (e.g. coltan, diamonds), the acquisition and import of non- fair trade produce (e.g. coffee, chocolate, bananas, rice), and the manufacture of goods in sweatshops (e.g. clothing, sporting equipment). In addition, consumption of certain goods (significantly fossil fuels and the products of the agricultural industry) involves harm to the environment, to (...) future persons, and to current persons in low-lying and developing countries, by way of their impacts on climate change. When it comes to such large-scale harms, it's easy for the individual to feel helpless. Even if she sincerely wishes things were otherwise, she may wonder what she could possibly do to make them so. In this paper I briefly explore several promising avenues for generating duties in individuals to consume ethically, and develop one in particular: that an individual ought to signal her commitments to others, as a first step in collectivizing to act against unjust global labour practices. (shrink)

Climate change appears to be a classic aggregation problem, in which billions of individuals perform actions none of which seem to be morally wrong taken in isolation, and yet which combine to drive the global concentration of greenhouse gases (GHGs) ever higher toward environmental (and humanitarian) catastrophe. When an individual can choose between actions that will emit differing amounts of GHGs―such as to choose a vegan rather than carnivorous meal, to ride a bike to work rather than drive a car, (...) or to take a reusable bag to the supermarket rather than send another plastic bag to landfill―does she have any reason to choose the lower-emitting actions? In this chapter I'll reject the claim that individuals don't make a difference when it comes to climate change. I first discuss making a difference with every action, as a way of getting clearer about how individuals' actions impact causally on the harms resulting from climate change, making a distinction so far overlooked in the climate ethics discussion between 'macro' thresholds like ice-cap melt, and 'micro' thresholds like severe weather events. I set aside making a difference with every action as implausible, and then move on to discuss both low probability of major difference, and high probability of minor difference. I argue that both of these are plausible characterizations of individuals' causal contributions to climate change. I conclude by noting some policy implications of having (probabilistic) individual difference-making back in play. (shrink)

In her ‘On the apparent paradox of ideal theory’, Laura Valentini combines three supposedly plausible premises to derive the paradoxical result that ideal theory is both unable to, and indispensable for, guiding action. Her strategy is to undermine one of the three premises by arguing that there are good and bad kinds of ideal theory, and only the bad kinds are vulnerable to the strongest version of their opponents’ attack. By undermining one of the three premises she releases ideal theorists (...) from the paradox, which is as follows. (1) Any sound theory of justice is action-guiding. (2) Any sound theory of justice is ideal. (3) Any ideal theory fails to be action-guiding. Here I shall respond to Valentini in two ways. First, I shall show that both (1) and (2) are false. The falsity of either is sufficient to release ideal theorists from the paradox. Second, I shall show that Valentini’s response to (3) can be extended, because her bad kinds of ideal theory do not necessarily fail to guide action. The cumulative effect of my arguments further strengthens Valentini’s support of ideal theory. I will deal with premises (1) and (2) in Sections I and II, and (3) in Section III. (shrink)

Enth.: Dugoald Stewart's account of Adam Smith / ed. by I.S. Ross.

Do consumers’ ordinary actions of purchasing certain goods make them complicit in global labour injustice? To establish that they do, two things much be shown. First, it must be established that they are not more than complicit, for example that they are not the principal perpetrators. Second, it must be established that they meet the conditions for complicity on a plausible account. I argue that Kutz’s account faces an objection that makes Lepora and Goodin’s better suited, and defend the idea (...) that consumers are complicit in at least two of the ways distinguished by the latter. In the final section of the paper, I consider whether consumers’ responsibility for complicity in global labour injustice is likely to be as strong as responsibility from another source, namely benefiting from that injustice. (shrink)

Lockdowns in Australia have been strict and lengthy. Policy-makers appear to have given the preservation of quantity of lives strong priority over the preservation of quality of lives. But thought-experiments in population ethics suggest that this is not always the right priority. In this paper, I'll discuss both negative impacts on quantity of lives caused by the lockdowns themselves, including an increase in domestic violence, and negative impacts on quality of lives caused by lockdowns, in order to raise the question (...) of whether we each had reason to choose quantity over quality in our own lives in a way that would justify the lockdowns we had. (shrink)

For all the recent talk of people failing or succeeding as allies to oppressed groups, a well worked out philosophical theory of what it is for someone to be an ally is conspicuously absent. This makes it difficult to evaluate the claims of people failing or succeeding as allies, and consequently diminishes the concept’s usefulness to disadvantaged groups by making it difficult to identify who will genuinely help to further their interests. We aim to rectify this absence by answering the (...) following question: what is an ally? On the view that we develop, allyship is a regrettably hierarchical relationship that holds between a privileged individual and an oppressed group, and is formed through a series of actions taken by the privileged individual in a bid to contribute towards bringing that hierarchy to an end. (shrink)

While experience often affords important knowledge and insight that is difficult to garner through observation or testimony alone, it also has the potential to generate conflicts of interest and unrepresentative perspectives. We call this tension the paradox of experience. In this paper, we first outline appeals to experience made in debates about access to unproven medical products and disability bioethics, as examples of how experience claims arise in bioethics and some of the challenges raised by these claims. We then motivate (...) the idea that experience can be an asset by appealing to themes in feminist and moral epistemology, distinguishing between epistemic and justice-based appeals. Next, we explain the concern that experience may be a liability by appealing to empirical work on cognitive biases and theoretical work about the problem of partial representation. We conclude with preliminary recommendations for addressing the paradox and offer several questions for future discussion. (shrink)

In this paper, we examine the case of psychedelic medicine for Alzheimer’s disease and related dementias (AD/ADRD). These “mind-altering” drugs are not currently offered as treatments to persons with AD/ADRD, though there is growing interest in their use to treat underlying causes and associated psychiatric symptoms. We present a research agenda for examining the ethics of psychedelic medicine and research involving persons living with AD/ADRD, and offer preliminary analyses of six ethical issues: the impact of psychedelics on autonomy and consent; (...) the impact of “ego dissolution” on persons experiencing a pathology of self; how psychedelics might impact caregiving; the potential exploitation of patient desperation; institutional review boards’ orientation to psychedelic research; and methods to mitigate inequity. These ethical issues are magnified for AD/ADRD but bear broader relevance to psychedelic medicine and research in other clinical populations. (shrink)

The central question of the paper is: do women have the right to exclude transwomen from women-only spaces? First I argue that biological sex matters politically, and should be protected legally—at least until such a time as there is no longer sex discrimination. Then I turn to the rationales for women-only spaces, arguing that there are eight independent rationales that together overdetermine the moral justification for maintaining particular spaces as women-only. I address a package of spaces, including prisons, changing rooms, (...) fitting rooms, bathrooms, shelters, rape and domestic violence refuges, gyms, spas, sports, schools, accommodations, shortlists, prizes, quotas, political groups, clubs, events, festivals, and terms. The arguments of these two sections taken together make a strong case against self-identification as the basis for legal sex (because legal sex will generally determine inclusion). In the last part of the paper, I address the objection that my conclusion was obtained through linguistic sleight of hand, which I answer by saying that choices about how to refer to transwomen don’t change the underlying fact that the basis for exclusion is generally sex, not gender identity. (shrink)

International Archives of the History of Ideas Archives internationales d'histoire des idées, Vol. 196. -/- Introduction, S. Hutton; Nicholas of Cusa : Platonism at the Dawn of Modernity, D. Moran; At Variance: Marsilio Ficino Platonism And Heresy, M.J.B. Allen; Going Naked into the Shrine:Herbert, Plotinus and the Consructive Metaphor, S.R.L.Clark; Commenius, Light Metaphysics and Educational Reform, J. Rohls ; Robert Fludd’s Kabbalistic Cosmos, W. Schmidt-Biggeman; Reconciling Theory and Fact:The Problem of ‘Other Faiths’ in Lord Herbert and the Cambridge Platonists, (...) D. Pailin; Trinity, Community and Love: Cudworth’s Platonism and the Idea of God, L. Armour; Chaos and Order in Cudworth’s Thought, J-L. Breteau; Cudworth, Prior and Passmore on the Autonomy of Ethics, R. Attfield; Substituting Aristotle: Platonic Themes In Dutch Cartesianism, H. van Ruler; Soul, Body, And World: Plato’s Timaeus And Descartes’ Meditations, C. Wilson ; Locke, Plato and Platonism, G.A.J. Rogers; Reflections on Locke’s Platonism, V. Nuovo; The Platonism at the Core of Leibniz’s Philosophy, C. Mercer; Leibniz and Berkeley: Platonic Metaphysics and ‘The Mechanical Philosophy’, S. Brown; Which Platonism for which Modernity? A Note on Shaftesbury’s Socratic Sea-Cards, L. Jaffro; Platonism, Aesthetics and the Sublime at the Origins Of Modernity, D. Hedley. (shrink)

The increasing complexity of human subjects research and its oversight has prompted researchers, as well as institutional review boards, to have a forum in which to discuss challenging or novel ethical issues not fully addressed by regulations. Research ethics consultation services provide such a forum. In this article, we rely on the experiences of a national Research Ethics Consultation Collaborative that collected more than 350 research ethics consultations in a repository and published 18 challenging cases with accompanying ethical commentaries to (...) highlight four contexts in which REC can be a valuable resource. REC assists: 1) investigators before and after the regulatory review; 2) investigators, IRBs, and other research administrators facing challenging and novel ethical issues; 3) IRBs and investigators with the increasing challenges of informed consent and risk/benefit analysis; and 4) in providing flexible and collaborative assistance to overcome study hurdles, mediate conflicts within a team, or directly engage with research participants. Institutions that have established, or plan to establish, REC services should work to raise the visibility of their service and engage in open communication with existing clinical ethics consult services as well as the IRB. While the IRB system remains the foundation for the ethical review of research, REC can be a valuable service for investigators, regulators, and research participants aligned with the goal of supporting ethical research. (shrink)

In 1976, Jo Freeman wrote an article for Ms. Magazine, entitled ‘Trashing: The Dark Side of Sisterhood’. It provoked an outpouring of letters from women relating their own experiences of trashing during the course of the second wave feminist movement—more letters than Ms. had received about any previous article. Since then, the technology has improved but the climate among feminists has not; trashing is now conducted on social media platforms like Twitter and Facebook, in front of ever-larger audiences and with (...) the magnified opportunities for destruction that these new platforms bring with them. Women already experience disproportionate harassment on social media; many feel trashing by other feminists to be much harder to accept. It’s one thing for people to hate feminists; resistance from those for whom a social justice movement represents a threat is par for the course. But it’s something else for feminists to hate each other. These are people with shared goals and a common enemy. What are the psychological mechanisms underlying this fact of life for feminist activists? Various explanations might be offered, from internalised misogyny, through volatility caused by histories of oppression, through envy and competitiveness, through ideological purity policing. Which are correct? Is the hatred that motivates trashing within feminism the same in quality and quantity, or different, from the affective dynamics inside other social movements? How does tribalism between warring feminist factions contribute to these dynamics, and to what extent is trashing underwritten by laudable moral goals (such as anti-elitism and anti-hierarchy) even when it goes too far or misfires? Can a liberation movement be successful without ideological purity policing, or is there a tension between achieving social justice outcomes and facilitating a healthy amount of disagreement and constructive criticism within a group? In this paper I’ll focus on potential explanations of the phenomena of trashing, including tribalism, power grabs, and purity policing; and the moral commitments that might lead feminists to trash each other. (shrink)

In the last few years, many countries have introduced (or are proposing to introduce) legislation on ‘conversion therapy’, prohibiting attempts to change or suppress sexual orientation and/or gender identity. This legislation covers ‘aversion therapy’, a form of torture that has already been criminalized in most progressive countries, and also ‘talk therapy’, involving things like counselling, psychoanalysis, and prayer. Focusing on this latter category of practices, I explain what is at stake in the fact that sexual orientation and gender identity have (...) been paired for the purposes of this legislation. I use a particular law reform institute’s approach to this legislation as a case study, and review their literature review in mind to discovering whether they provided sufficient empirical justification for including gender identity in their conversion therapy legislation. I conclude that they did not, and suggest that the pairing of sexual orientation and gender identity may be purely political. (shrink)

From a radical feminist perspective, gender is a cage. Or to be more precise, it’s two cages. If genders are cages, then surely we want to let people out. Being less constrained in our choices is something we all have reason to want: theorists in recent years have emphasized the importance of the capability to do and be many different things. At the very least, we should want an end to sex-based oppression. But what does this entail, when it comes (...) to gender? In this paper, I’ll compare four ‘transitional pathways’, with a view to considering how each relates to the ultimate end of ending sex-based oppression. Should we open the doors to the cages, so that people can move freely between them, but leave the cages themselves in place?. Should we add more cages?. Should we make the cages bigger, so that people have a lot more room to move around inside them? Or should we dismantle the cages, so there are no more genders at all?. Some of these options are ‘gender revisionist’, others are gender abolitionist. I’ll argue in favour of a gender abolitionist pathway. (shrink)

Imagine yourself standing on the edge of a canyon, marveling at the terrain below, wondering about all the sights currently obscured from your view, and lamenting that you just don’t have time to commit to the steep descent in and long trek across, which would give you a perspective from right up close. Being handed Juha Räikkä’s new book Social Justice in Practice is like being told there’s a flying fox you can take: the canyon is applied political theory, and (...) the flying fox allows the reader to see many different issues, at some speed, and always with the wider context in view. Tuck your loose items of clothing away in your bags, and hop on.The book is loosely organized into six sections, with twelve chapters overall. The first two sections (“Theory and Practice” and “Action and Uncertainty”) introduce readers to the issues around the methodology of contemporary political theory, from whether the arguments of political theory should be more sensitive to what is feasible, through the. (shrink)

Women, particularly those in public positions (e.g. journalists, politicians, celebrities, activists) are subject to disproportionate amounts of abuse on social media platforms like Twitter. This abuse occurs in a landscape that those platforms designed, and maintain. Focusing in particular on Twitter, as typical of the kind of platform we’re interested in, we argue that it is the platform not (usually) the individuals who use it, that bears collective responsibility as a corporate agent for misogyny. Social media platforms, however, should not (...) overstep the prevention of misogyny into interference in open political debates. (shrink)

Background Diversity in Institutional Review Board (IRB) membership is important for both intrinsic and instrumental reasons, including fairness, promoting trust, improving decision quality, and responding to systemic racism. Yet U.S. IRBs remain racially and ethnically homogeneous, even as gender diversity has improved. Little is known about IRB chairpersons’ perspectives on membership diversity and barriers to increasing it, as well as current institutional efforts to promote diversity, equity, and inclusion (DEI) within IRB membership.Methods We surveyed IRB chairpersons leading U.S. boards registered (...) with the Office for Human Research Protections. Here, we focus exclusively on responses from a subset of 388 chairpersons of IRBs at universities and academic medical centers (AMCs).Results Board chairs were predominantly white and evenly split between men and women. Only about half reported that their boards had at least one member who is Black or African American (51%), Asian (56%), or Hispanic (48%), with 85% of university/AMC boards comprised entirely (15%) or mostly (70%) of white members. Most IRB chairpersons (64%) reported satisfaction with the current diversity of their membership. Participants largely agreed that considering diversity in the selection of IRB members is important (91%), including to improve the quality of IRB deliberation (80%), with an emphasis on racial/ethnic (85%) and gender diversity (74%). Most participants (80%) reported some type of active DEI effort regarding board membership at their university/AMC and just over half (57%) expressed satisfaction with these efforts.Conclusions Our national survey found that although university/AMC IRB chairpersons report valuing diversity in board membership, it may be lacking in key areas. Going forward, it will be important to specify clear reasons for diversity in the IRB context, as well to establish targets for acceptable levels of board diversity and to match DEI efforts to those targets. (shrink)

We have synthesized a 582,970-base pair Mycoplasma genitalium genome. This synthetic genome, named M. genitalium JCVI-1.0, contains all the genes of wild-type M. genitalium G37 except MG408, which was disrupted by an antibiotic marker to block pathogenicity and to allow for selection. To identify the genome as synthetic, we inserted "watermarks" at intergenic sites known to tolerate transposon insertions. Overlapping "cassettes" of 5 to 7 kilobases (kb), assembled from chemically synthesized oligonucleotides, were joined by in vitro recombination to produce intermediate (...) assemblies of approximately 24 kb, 72 kb ("1/8 genome"), and 144 kb ("1/4 genome"), which were all cloned as bacterial artificial chromosomes in Escherichia coli. Most of these intermediate clones were sequenced, and clones of all four 1/4 genomes with the correct sequence were identified. The complete synthetic genome was assembled by transformation-associated recombination cloning in the yeast Saccharomyces cerevisiae, then isolated and sequenced. A clone with the correct sequence was identified. The methods described here will be generally useful for constructing large DNA molecules from chemically synthesized pieces and also from combinations of natural and synthetic DNA segments. 10.1126/science.1151721. (shrink)

There is limited guidance on how to assess the ethical acceptability of research risks that extend beyond research participants to third parties (or “research bystanders”). Community or stakeholder engagement has been proposed as one way to address potential harms to community members, including bystanders. Despite widespread agreement on the importance of community engagement in biomedical research, this umbrella term includes many different goals and approaches, agreement on which is ethically required or recommended for a particular context. We analyse the case (...) of a potential Zika virus human challenge trial to assess whether and how community engagement can help promote the ethical acceptability of research posing risks to bystanders. We conclude that, in addition to having intrinsic value, community engagement can improve the identification of bystander risks, effective approaches to minimizing them, and transparency about bystander risks for host communities. (shrink)

In the mid-1990s, fairtrade-organic registration data showed that only 9 % of Oaxaca, Mexico’s organic coffee ‘farm operators’ were women; by 2013 the female farmer rate had increased to 42 %. Our research investigates the impact of this significant increase in women’s coffee association participation among 210 members of two coffee producer associations in Oaxaca, Mexico. We find that female coffee organization members report high levels of household decision-making power and they are more likely than their male counterparts to report (...) control over their coffee income. These significant advances in women’s agency within the household are offset by the fact that the women experience significant time poverty as they engage in coffee production while bearing a disproportionate share of domestic labor obligations. The women coffee producers view organizational labor as a third burden on their time, after their reproductive and productive labor. The time poverty they experience limits their ability to fully participate in coffee organizational governance and consequently there are few women leaders at all levels of the coffee producer businesses. This is problematic because it limits women’s ability to fully benefit from organizational membership: when women fully participate in governance they gain valuable business and leadership skills and producer associations with active female members may also be more likely to develop and maintain programs and policies that enhance gender equity. Our findings indicate that targeted agricultural development programs to improve gender equity among agricultural smallholders should involve creative ways to ease women’s labor burdens and reduce their time poverty in order to facilitate full organizational participation. The research findings fill a gap in existing studies of agricultural global value chains by demonstrating how the certified coffee GVC depends on women’s under and un-paid labor not only within the household but also within producer organizations. (shrink)

ABSTRACT:Clinical ethics consultants bear witness to the direct harms of intersecting axes of oppression—such as racism and classism—as they impinge on elucidating and resolving ethical dilemmas in health care. Health Care Ethics Consultation (HCEC) professional guidance supports recognizing and analyzing power dynamics and social-structural obstacles to good care. However, the most relied upon bioethical principles in clinical ethics have been criticized for insufficiency in this regard. While individual ethics consultants have found ways to expand their approaches, they do so in (...) an ad hoc way without frameworks to guide consistency. Motivated by the practical expertise of clinical ethicists, this essay offers a new framework to support openness to analyzing power imbalances and respecting marginalized voices and values. This framework is grounded in transformative justice, where the aim is to take responsibility for oppression by centering and responding to moral perspectives and value systems that are all too often silenced. (shrink)

Rare genetic diseases collectively impact millions of individuals in the United States. These patients and their families share many challenges including delayed diagnosis, lack of knowledgeable providers, and limited economic incentives to develop new therapies for small patient groups. As such, rare disease patients and families often must rely on advocacy, including both self-advocacy to access clinical care and public advocacy to advance research. However, these demands raise serious concerns for equity, as both care and research for a given disease (...) can depend on the education, financial resources, and social capital available to the patients in a given community. In this article, we utilize three case examples to illustrate ethical challenges at the intersection of rare diseases, advocacy and justice, including how reliance on advocacy in rare disease may drive unintended consequences for equity. We conclude with a discussion of opportunities for diverse stakeholders to begin to address these challenges. (shrink)

Conflict over who belongs in women-only spaces is now part of mainstream political debate. Some think women-only spaces should exclude on the basis of sex, and others think they should exclude on the basis of a person’s self-determined gender identity. Many who take the latter view appear to believe that the only reason for taking the former view could be antipathy towards men who identify as women. In this paper, we’ll revisit the second-wave feminist literature on separatism, in order to (...) uncover the reasons for women-only spaces as feminists originally conceived them. Once these reasons are understood, those participating in debates over women-only spaces will be in a better position to adjudicate on whether shifting from sex to gender identity puts any significant interests at stake. (shrink)

Nurses have an important role in preventing and responding to child abuse and neglect. This paper reports on nurses' perceptions of how organisational systems and hierarchies shaped their capacity to respond to child abuse and neglect. This is one of four key themes identified through an inductive analysis of data from a broader qualitative study that explored nurses' perceptions and experiences of keeping children safe. The study was guided by social constructionist theory, and data were collected through in‐depth interviews with (...) nurses working with children in Australia (n = 21). Key findings showed that nurses experienced many challenges to responding to child abuse, including difficulties sharing information, fear of making mistakes and inflexible systems of care. This was underpinned by an organisational ‘rule‐centred’ culture of following policies at the expense of maintaining an explicit focus on children's needs. These findings demonstrate first the importance of creative and flexible thinking from individual professionals, so policies are enacted with a clear child focus. Second, they highlight the need for leadership to enact organisational and systemic cultural change that maintains a genuinely child‐centred approach. (shrink)

Existing research has examined if undergraduate factors influence chemistry and physics, or physical science, doctoral degree entry and whether variables during PhD programs associate with graduation. Yet research on the transition from bachelor’s degree to doctoral degree entry (i.e., PhD entry in less than 6 months, attainment of a master’s degree prior to doctoral degree entry, or working in a science-related job for more than a year prior to doctoral degree entry) on PhD degree graduation remains scarce. Our study examines (...) the transition from bachelor’s to doctoral degrees to see if experiences therein associate with female PhD graduation, after doctoral degree enrollment. Our logistic regression analysis, of female chemistry and physics doctorates (n = 867), indicated that attainment of a master’s degree did not change the likelihood of graduation, when compared to direct entry into physical science doctoral programs. Meanwhile working in a science-related job for a year or more is associated with a significantly lower likelihood of physical science doctoral graduation when compared to women who entered directly into PhD programs or received a master’s degree prior to enrollment. (shrink)

The use of social media as a recruitment tool for research with humans is increasing, and likely to continue to grow. Despite this, to date there has been no specific regulatory guidance and there has been little in the bioethics literature to guide investigators and institutional review boards faced with navigating the ethical issues such use raises. We begin to fill this gap by first defending a nonexceptionalist methodology for assessing social media recruitment; second, examining respect for privacy and investigator (...) transparency as key norms governing social media recruitment; and, finally, analyzing three relatively novel aspects of social media recruitment: the ethical significance of compliance with website “terms of use”; the ethics of recruiting from the online networks of research participants; and the ethical implications of online communication from and between participants. Two checklists aimed at guiding investigators and IRBs through the ethical issues are included as appendices. (shrink)

Racism is a pervasive issue in patient care and a key social determinant of health. Clinical ethicists, like others involved in patient care, have a duty to recognize and respond to racism on both individual and systems-wide levels to improve patient care. Doing so can be challenging and, like other skills in ethics consultation, may benefit from specialized training, standardized tools and approaches, and practice. Learning from existing frameworks and tools, as well as building new ones, can help guide clinical (...) ethicists to systematically approach racism as it affects clinical cases. Here, we propose an expansion of the commonly used four-box method to clinical ethics consultation, where racism is considered as a potential factor in each of the four boxes. We apply this method to two clinical cases to highlight ethically salient information that might be missed using the standard formulation of the four boxes but captured with the expanded version. We argue that this expansion of an existing clinical ethics consultation tool is ethically justified insofar as it (a) creates a more just approach, (b) supports individual consultants and services, and (c) facilitates communication in contexts where racism impinges on effecting good patient care. (shrink)

Previous studies have documented the fallibility of attempts by surrogates and physicians to act in a substituted judgment capacity and predict end-of-life treatment decisions on behalf of patients. We previously reported that physicians misperceive their patients' preferences and substitute their own preferences for those of their patients with respect to four treatments: cardiopulmonary resuscitation (CPR) in the event of cardiac arrest, ventilator for an indefinite period of time, medical nutrition and hydration for an indefinite period of time, and hospitalization in (...) the event of pneumonia. (shrink)

Research leadership in Australian universities takes place against a backdrop of policy reforms concerned with measurement and comparison of institutional research performance. In particular, the Excellence in Research in Australian initiative undertaken by the Australian Research Council sets out to evaluate research quality in Australian universities, using a combination of expert review process, and assessment of performance against ?quality indicators?. Benchmarking exercises of this sort continue to shape institutional policy and practice, with inevitable effects on the ways in which research (...) leadership, mentoring and practice are played out within university faculties and departments. In an exploratory study that interviewed 32 Australian academics in universities in four Australian states, we asked participants, occupying formal or informal research leadership roles, to comment on their perceptions of research leadership as envisioned and enacted in their particular workplaces. We found a pervasive concern amongst participants that coalesced around binaries characterized in metaphoric terms of ?carrots and whips?. Research leadership was seen by many as managerial in nature, and as such, largely tethered to instrumentalist notions of productivity and performativity, while research cultures were seen as languishing under the demoralizing weight of reward and punishment systems. Here, we consider what is at stake for the future of the academic workforce under such conditions, arguing that new models of visionary research leadership are urgently needed in the ?troubled times? of techno-bureaucratic university reforms. (shrink)