Traditional forms of farming, herding, and fishing are remarkably adapted to African conditions but these traditional approaches are being overtaken by modern pressures, particularly population growth. According to a report published by the Office of Technology Assessment (OTA), a nonpartisan analytical support agency of the U. S. Congress, one promising way to help African farmers and herders would be for development assistance organizations to focus more attention on the various forms of low-resource agriculture that predominate in Africa.In keeping with OTA's (...) mission and primary audience, “Enhancing Agriculture in Africa: A Role for U. S. Development Assistance” (1988) is a policy-oriented synthesis of available technical information. The report provides Congress with a range of options that, if pursued, could help Africans enhance agriculture, increase their food security, and improve their lives.This paper is drawn from the larger OTA report, and it focuses on the role technology might play in enhancing low-resource agriculture. Readers should see the full assessment (OTA, 1988) for more information on policy considerations; the specific technologies mentioned; or a complete list of advisory panel members, workshops and participants, and commissioned papers.OTA's report comes at a critical time: for a variety of reasons—ranging from changing values to increased budget constraints—U. S. foreign assistance policy is undergoing a fundamental reevaluation. This review of the potential of low-resource agriculture, and options the United States might pursue to enhance this approach, was intended to aid in this reevaluation. (shrink)

Much philosophical attention has been devoted to “The Land Ethic,” especially by Anglo-American philosophers, but little has been paid to A Sand County Almanac as a whole. Read through the lens of continental philosophy, A Sand County Almanac promulgates an evolutionary-ecological world view and effects a personal self- and a species-specific Self-transformation in its audience. It’s author, Aldo Leopold, realizes these aims through descriptive reflection that has something in common with phenomenology-although Leopold was by no stretch of the imagination a (...) phenomenologist. Consideration of human-animal intersubjectivity, thematized in A Sand County Almanac, brings to light the moral problem of hunting and killing animal subjects. Leopold does not confront that problem, but it is confronted and resolved by Jose Ortega y Gassett, Henry Beston, and Paul Shepard in terms of an appropriate human relationship with wild-animal Others. Comparison with the genuinely Other-based Leopold-Ortega-Beston-Shepard wild-animal ethic shows the purportedly Other-based humanand possibly animal ethic of Emmanuel Levinas actually to be Same-based after all. (shrink)

A diagnosis of dementia often comes with difficulties in understanding a conversational context and expressing how one feels. So far, research on how to facilitate advance care planning for people with dementia focused on defining relevant themes and topics for conversations, or on how to formalize decisions made by surrogate decision makers, e.g., family members. The aim of this review is to provide a better scope of the existing research on practical communication aspects related to dementia in ACP conversations. In (...) November 2020, seven databases were searched to select papers for inclusion. This search was updated in December 2021. The search strategy consisted of three tiers, intersected by using the Boolean term “AND,” and resulted in 787 studies. Two researchers followed explicit criteria for two sequential levels of screening, based on titles and abstracts and full papers. A total of 22 studies were included for data analysis. Seven topics emerged clustered around two themes. This scoping review provides practical suggestions for healthcare professionals to improve ACP communication and uncovered gaps in research on communication aspects related to dementia in ACP conversations, such as non-verbal behavior, timing and implementation, and personal preferences. (shrink)

Society and social structures play an important role in the formation and evaluation of concepts and practices in clinical ethics. This is evident in the ways the authors in this issue explore a wide range of arguments and concepts in clinical ethics including moral distress and conscience based practice, phenomenological interview techniques and gender dysphoria, continuous deep sedation (CDS) at the end of life, the notion of patient expertise, ethically permissible medical billing practices, the notion of selfhood and patient centered (...) care in dementia patients, and the definition of minimal risk as used in research regulations. (shrink)

BackgroundCommunity engagement is increasingly promoted as a marker of good, ethical practice in the context of international collaborative research in low-income countries. There is, however, no widely agreed definition of community engagement or of approaches adopted. Justifications given for its use also vary. Community engagement is, for example, variously seen to be of value in: the development of more effective and appropriate consent processes; improved understanding of the aims and forms of research; higher recruitment rates; the identification of important ethical (...) issues; the building of better relationships between the community and researchers; the obtaining of community permission to approach potential research participants; and, the provision of better health care. Despite these diverse and potentially competing claims made for the importance of community engagement, there is very little published evidence on effective models of engagement or their evaluation.MethodsIn this paper, drawing upon interviews with the members of a Community Advisory Board on the Thai-Myanmar border, we describe and critically reflect upon an approach to community engagement which was developed in the context of international collaborative research in the border region.Results and conclusionsDrawing on our analysis, we identify a number of considerations relevant to the development of an approach to evaluating community engagement in this complex research setting. The paper also identifies a range of important ways in which the Community Advisory Board is in practice understood by its members to have morally significant roles and responsibilities beyond those usually associated with the successful and appropriate conduct of research. (shrink)

As customer return rates increase, retailer bottom lines suffer from customers’ misuse of the policies and to the ethics of such practice. The purpose of this study is to explore customers’ orientation toward return behaviors, and to develop a return orientation assessing these dimensions. This research identified three dimensions relevant to consumer return behavior: the planned/unethical returner; the eager returner; and the reluctant/educated returner. A retest with another sample confirmed these three dimensions. Each dimension was analyzed for its relationship with (...) consumer ethical beliefs as measured by the Muncy–Vitell Consumer Ethics Scale, ethical philosophies and shopping behaviors. These relationships supported the ethical and unethical aspects of returner orientation. Results of this research imply that the core aspect of returner orientation is relevant to ethical behavior and misuse of retail return policies. The three return orientations identified partially support the Rosenbaum & Bitner‐Olson research. (shrink)

A model is described for implementing a program in research ethics education in the face of federal and institutional mandates and current resource, disciplinary, and infrastructure limitations. Also discussed are the historical background, content and evaluation process of the workshop at the heart of the program, which reaches a diverse group of over 250 students per year—from first-year graduate students in basic research labs to clinical fellows. The workshop addresses central issues in both everyday laboratory ethics and in larger societal (...) questions. Goals include improving overall awareness of ethics guidelines and philosophy and enhancing skills in identifying and then analyzing the ethical components of situations. Pedagogies used and their effectiveness and that of the overall workshop and extended program are addressed. Programs like these have initiated a shift in the culture of basic research, which is a critical need given the current atmosphere. (shrink)

As customer return rates increase, retailer bottom lines suffer from customers’ misuse of the policies and to the ethics of such practice. The purpose of this study is to explore customers’ orientation toward return behaviors, and to develop a return orientation assessing these dimensions. This research identified three dimensions relevant to consumer return behavior: the planned/unethical returner; the eager returner; and the reluctant/educated returner. A retest with another sample confirmed these three dimensions. Each dimension was analyzed for its relationship with (...) consumer ethical beliefs as measured by the Muncy–Vitell Consumer Ethics Scale, ethical philosophies and shopping behaviors. These relationships supported the ethical and unethical aspects of returner orientation. Results of this research imply that the core aspect of returner orientation is relevant to ethical behavior and misuse of retail return policies. The three return orientations identified partially support the Rosenbaum & Bitner-Olson research. (shrink)

In this paper we discuss ethical implications of the use of mobile phone apps in the control of the COVID-19 pandemic. Contact tracing is a well-established feature of public health practice during infectious disease outbreaks and epidemics. However, the high proportion of pre-symptomatic transmission in COVID-19 means that standard contact tracing methods are too slow to stop the progression of infection through the population. To address this problem, many countries around the world have deployed or are developing mobile phone apps (...) capable of supporting instantaneous contact tracing. Informed by the on-going mapping of ‘proximity events’ these apps are intended both to inform public health policy and to provide alerts to individuals who have been in contact with a person with the infection. The proposed use of mobile phone data for ‘intelligent physical distancing’ in such contexts raises a number of important ethical questions. In our paper, we outline some ethical considerations that need to be addressed in any deployment of this kind of approach as part of a multidimensional public health response. We also, briefly, explore the implications for its use in future infectious disease outbreaks. (shrink)

Emmanuel Levinas’ early essay “Reflections on the Philosophy of Hitlerism” provides us with a clear description what Levinas’ conception of subjectivity as a lived, bodily experience rejects: “the European notion of man”. This paper traces the argument Levinas presents in “Reflections on the Philosophy of Hitlerism,” providing links between this early essay and Levinas’ later, major works: Totality and Infinity and Otherwise than Being or Beyond Essence. The political interrogation of liberalism at the heart of Levinas’ depiction of the subject (...) as creaturely and his discussion of subjectivity as substitution is revealed by orienting the later works towards “Reflections on the Philosophy of Hitlerism.” Levinas’ description of the ethical relation between myself and all the others locates both my freedom and my responsibility to the other in the inseparable unity of body and spirit. As creatures, and as subjects in substitution, we experience our own freedom as dependent upon our responsibility for the others; unlike the subject of liberalism, the Levinasian subject cannot conform to the racist ideology promoted by the philosophy of Hiterlism without renouncing its own freedom. (shrink)

New standards adopted by the Association to Advance Collegiate Schools of Business International (AACSB) stress business curriculum-wide learning objectives, of which ethics is a critical part. “Knowledge and skills” in ethical responsibilities are required as part of institutionalaccreditation. An exploratory study offers insight into ethics integration, perceived comfort in teaching ethics, and methods used. The main tension presented balances calls for ethics across business curricula with the assertion that ethics instruction, in the hands of an untrained professor, may do more (...) damage than good. Results suggest that while faculty include ethics in their courses, only slightly more than half have received some kind of ethics training. We also explore ethics pedagogies and found differences between methods respondents used in the classroom and desired learning methods for themselves. We offer insights about and possible explanations for the gaps we found in our study, contextualizing them in new literature. We finish with a brief discussion of how our findings impact accreditation assessment. (shrink)

As the federal government distributed remdesivir to some of the states COVID-19 hit hardest, policymakers scrambled to develop criteria to allocate the drug to their hospitals. Our state, Michigan, was among those states to receive an initial quantity of the drug from the U.S. government. The disparities in burden of disease in Michigan are striking. Detroit has a death rate more than three times the state average. Our recommendation to the state was that it should prioritize the communities that bear (...) a disproportionate burden of suffering in the allocation of the new potential treatment. This recommendation is justified not only for new drugs with uncertain effects, but also for drugs of certain benefit or vaccines. For states with significant health disparities, such as Michigan, this allocation priority may help to repair them. In fact, any other allocation strategy may make them worse. (shrink)

No consensus yet exists on how to handle incidental fnd-ings in human subjects research. Yet empirical studies document IFs in a wide range of research studies, where IFs are fndings beyond the aims of the study that are of potential health or reproductive importance to the individual research participant. This paper reports recommendations of a two-year project group funded by NIH to study how to manage IFs in genetic and genomic research, as well as imaging research. We conclude that researchers (...) have an obligation to address the possibility of discovering IFs in their protocol and communications with the IRB, and in their consent forms and communications with research participants. Researchers should establish a pathway for handling IFs and communicate that to the IRB and research participants. We recommend a pathway and categorize IFs into those that must be disclosed to research participants, those that may be disclosed, and those that should not be disclosed. (shrink)

Misattributed paternity or ‘false’ paternity is when a man is wrongly thought, by himself and possibly by others, to be the biological father of a child. Nowadays, because of the progression of genetics and genomics the possibility of finding misattributed paternity during familial genetic testing has increased. In contrast to other medical information, which pertains primarily to individuals, information obtained by genetic testing and/or pedigree analysis necessarily has implications for other biologically related members in the family. Disclosing or not a (...) misattributed paternity has a number of different biological and social consequences for the people involved. Such an issue presents important ethical and deontological challenges. The debate centres on whether or not to inform the family and, particularly, whom in the family, about the possibility that misattributed paternity might be discovered incidentally, and whether or not it is the duty of the healthcare professional to disclose the results and to whom. In this paper, we consider the different perspectives and reported problems, and analyse their cultural, ethical and legal dimensions. We compare the position of HCPs from an Italian and British point of view, particularly their role in genetic counselling. We discuss whether the Oviedo Convention of the Council of Europe can be seen as a basis for enriching the debate. (shrink)

Four ethical values — maximizing benefits, treating equally, promoting and rewarding instrumental value, and giving priority to the worst off — yield six specific recommendations for allocating medical resources in the Covid-19 pandemic: maximize benefits; prioritize health workers; do not allocate on a first-come, first-served basis; be responsive to evidence; recognize research participation; and apply the same principles to all Covid-19 and non–Covid-19 patients.

Couples need to make their wishes explicit if we are to allow postmortem gamete donation.

New standards adopted by the Association to Advance Collegiate Schools of Business International (AACSB) stress business curriculum-wide learning objectives, of which ethics is a critical part. “Knowledge and skills” in ethical responsibilities are required as part of institutionalaccreditation. An exploratory study offers insight into ethics integration, perceived comfort in teaching ethics, and methods used. The main tension presented balances calls for ethics across business curricula with the assertion that ethics instruction, in the hands of an untrained professor, may do more (...) damage than good. Results suggest that while faculty include ethics in their courses, only slightly more than half have received some kind of ethics training. We also explore ethics pedagogies and found differences between methods respondents used in the classroom and desired learning methods for themselves. We offer insights about and possible explanations for the gaps we found in our study, contextualizing them in new literature. We finish with a brief discussion of how our findings impact accreditation assessment. (shrink)

A call to advance integrative teaching and learning in higher education. From Parker Palmer, best-selling author of The Courage to Teach, and Arthur Zajonc, professor of physics at Amherst College and director of the academic program of the Center for Contemplative Mind in Society, comes this call to revisit the roots and reclaim the vision of higher education. The Heart of Higher Education proposes an approach to teaching and learning that honors the whole human being--mind, heart, and spirit--an essential (...) integration if we hope to address the complex issues of our time. The book offers a rich interplay of analysis, theory, and proposals for action from two educators and writers who have contributed to developing the field of integrative education over the past few decades. Presents Parker Palmer's powerful response to critics of holistic learning and Arthur Zajonc's elucidation of the relationship between science, the humanities, and the contemplative traditions. Explores ways to take steps toward making colleges and universities places that awaken the deepest potential in students, faculty, and staff. Offers a practical approach to fostering renewal in higher education through collegiality and conversation. The Heart of Higher Education is for all who are new to the field of holistic education, all who want to deepen their understanding of its challenges, and all who want to practice and promote this vital approach to teaching and learning on their campuses. (shrink)

With an overall estimated 5-year survival rate of 67 percent, bone marrow transplant is a potential cure for patients with primary immune regulatory diseases. Given that Sa...

Adorno's philosophical project hinges on two claims about the mimetic impulse: it is a universal impulse, from which we cannot be liberated; and it is historically mediated, which means that, over time, it takes different forms. Western philosophy, according to Adorno, has repressed the role of mimesis in human life. As a result, reified subjectivity is often misrecognized as freedom. Adorno develops a materialist ethic that exposes and counters the Idealist narratives involved in this suppression. Further, this materialist ethic identifies (...) how mimesis itself might be altered to bring about our liberation from coercive social relations, which are themselves perpetuated by mimesis. I argue that Adorno's materialist ethic is an ethic of love: more specifically, an ethic of a love toward things. A love toward things (modeled in part upon Hegel's freedom toward the object and Kierkegaard's sermon on our love for the dead) involves a subject who practices a respectful restraint toward the object. The individual is able to engage in a mimetic relation of love toward the other, while resisting the urge to enter into a seamless unity with it. As a love toward things, mimesis becomes the motor of dialectical mediation between the separate entities of subject and object, consequently contributing to their reconciliation. Freed from the need to dominate or be dominated, the subject is then able to exist peacefully with the object even in their utter difference from each other. (shrink)

This primer on authentic education explores how mind and heart can work together in the learning process. Moving beyond the bankruptcy of our current model of education, Parker Palmer finds the soul of education through a lifelong cultivation of the wisdom each of us possesses and can share to benefit others.

Head transplantation fits within the broader conceptual space occupied by transhumanists and others who seek to extend the lives of human beings indefinitely. It is reasonable to reflect on whether, under what circumstances, and in what ways human immortality would be good. In this paper, I disambiguate the ways in which immortality might be considered a human good and then argue that immortality is neither necessary nor sufficient condition for objective meaning in life. I also argue that mortality is not (...) a necessary condition for objective meaning in life. (shrink)

Clear and careful thinking is an indispensable aid in the pursuit of answers to the difficult ethical question faced by clinicians, patients, and families. In this issue of The Journal of Medicine and Philosophy devoted to issues in clinical ethics, the authors engage in this enterprise by reflecting on morally good medical decision making, conscientious objection, presumed consent in organ donation, the permissibility of surrogate decision making, and the failure of legislative limits on the scope of euthanasia in Belgium.

This special issue arose from a joint conference of the History of Education Society, UK and the Australian and New Zealand History of Education Society, held in Malvern in Worcestershire, England in 2016 on the theme ‘sight, sound and text in the history of education’. The conference drew together media and educational historians, as well as archivists and museum professionals, to examine both methodological issues and a range of examples of sensory and textual histories. The three-day event, as well as (...) being enriching for its international character, proved that although much work has already been done in this area, there is so much more to consider and exploit when it comes to the study of the ‘new’ sonic and visual sources and their intertextual relationship with the documentary, as well as traditional understandings of ‘text’. (shrink)

A clinical ethics consultant may, at times, be called upon to make independent substantive moral judgments and then offer justifications for those judgments. A CEC does not act unprofessionally by utilizing background beliefs that are religious in nature to justify those judgments. It is important, however, for a CEC to make such judgments authentically and, when asked, to offer up one’s reasons for why one believes the judgment is true in a transparent fashion.

Much has been published about the ethical issues encountered by clinicians in genetics/genomics, but those experienced by clinical laboratory scientists are less well described. Clinical laboratory scientists now frequently face navigating ethical problems in their work, but how they should be best supported to do this is underexplored. This lack of attention is also reflected in the ethics tools available to clinical laboratory scientists such as guidance and deliberative ethics forums, developed primarily to manage issues arising within the clinic.We explore (...) what ethical issues are being experienced by clinical scientists, how they think such issues could be best analysed and managed, and whether their practice might be enhanced by more situated approaches to ethics deliberation and practice such as ethical preparedness. From thematic analysis of cases presented by clinical scientists at a specially convened meeting of the UK Genethics Forum, we derived three main ethical themes: (1) the redistribution of labour and responsibilities resulting from the practice of genomic medicine; (2) the interpretation and certainty of results and (3) the proposal that better standardisation and consistency of ethical approaches (for example, more guidelines and policy) could resolve some of the challenges arising.We argue that although standardisation is important for promoting shared understandings of good (including ethical) practice, supplementary approaches to enhance and sustain ethical preparedness will be important to help clinical scientists and others in the recently expanded genetic/genomic medicine environment foster quality ethical thinking. (shrink)

In After God: Morality and Bioethics in a Secular Age, H. Tristram Engelhardt, Jr. explores the broad implications for moral reasoning once a culture has lost a God’s-eye perspective. In this paper, I focus on the implications of Engelhardt’s views for clinical ethics consultation. I begin by examining the question of whether clinical ethics consultants should advocate a particular viewpoint and/or process during consultations or adopt a neutral stance. I then examine the implications of Engelhardt’s views for this question. Finally, (...) I discuss some of Engelhardt’s foundational ontological, metaphysical, meta-ethical, and epistemological commitments and how these commitments connect to his views on clinical ethics consultation. (shrink)

Religions often operate as comprehensive worldviews, attempting to answer the deepest existential questions that human beings can ask: Who am I? Where do I come from? Where am I going after I die? How should I live? Often ethical systems are embedded and justified within these broader narratives. Inevitably, the clinical ethics consultant will encounter and engage with religiously based ethical systems. In this issue, the authors reflect seriously and deeply on the implications of such engagement.

Conceptual clarity is essential when engaging in dialogue to avoid unnecessary disagreement and to promote mutual understanding. In this issue devoted to clinical bioethics, the authors exemplify the virtue of careful conceptual analysis as they explore complex clinical questions regarding the essential nature of medicine, the boundaries of killing and letting die, the meaning of irreversibility in definitions of death, the argument for a right to try experimental medications, the ethical borders in complex medical billing, and the definition and modeling (...) of complex disease states. (shrink)

An important role of the philosopher is to critically reflect on what is often taken for granted, using the tools of argument and analysis. This article engages with six different papers that offer critical reflections on conventional concepts and beliefs in bioethics regarding informed consent, continuous deep sedation, traditional moral theories underlying bioethical thinking, the definition of mental disease, and codes of ethics for particular medical specialties.

This collection of essays, though dealing with different topics from section to section, is unified by the idea that, at least in the English-speaking world, ...

During the WHO-GloPID COVID-19 Global Research and Innovation Forum meeting held in Geneva on the 11th and 12th of February 2020 a number of different ethical concepts were used. This paper briefly states what a number of these concepts mean and how they might be applied to discussions about research during the COVID-19 pandemic and related outbreaks. This paper does not seek to be exhaustive and other ethical concepts are, of course, relevant and important.

Recent debates have led some to question the legitimacy of physicians refusing to provide legally permissible services for reasons of conscience. In this paper, I will explore the question of whether medical professionals have a collective duty to ensure that their profession provides nondiscriminatory access to all medical services. I will argue that they do not. I will also argue for an approach to dealing with intractable moral disagreements between patients and physicians that gives both parties veto power with regards (...) to participation. Finally, I will respond to three objections to allowing physicians broad freedom to act on their consciences: such allowances would violate the conscience of the patient, would lead to unfairness, and would thwart important societal goals. (shrink)

Often lurking below the surface of many clinical ethical issues are questions regarding background metaphysical, epistemological, meta-ethical, and political beliefs. In this issue, authors critically examine the effects of background beliefs on conscientious objection, explore ethical issues through the lenses of particular theoretical approaches like pragmatism and intersectional theory, rigorously explore the basic concepts at play within the patient safety movement, offer new theoretical approaches to old problems involving decision making for patients with dementia, explicate and explore the problems and (...) promises of machine learning in medicine, and offer us a non-rights-based argument for the just distribution of healthcare resources. (shrink)