Background: Use of patients’ medical data for secondary purposes such as health research, audit, and service planning is well established in the UK. However, the governance environment, as well as public understanding about this work, have lagged behind. We aimed to systematically review the literature on UK and Irish public views of patient data used in research, critically analysing such views though an established biomedical ethics framework, to draw out potential strategies for future good practice guidance and inform ethical and (...) privacy debates. Methods: We searched three databases using terms such as patient, public, opinion, and electronic health records. Empirical studies were eligible for inclusion if they surveyed healthcare users, patients or the public in UK and Ireland and examined attitudes, opinions or beliefs about the use of patient data for medical research. Results were synthesised into broad themes using a framework analysis. Results: Out of 13,492 papers and reports screened, 20 papers or reports were eligible. While there was a widespread willingness to share patient data for research for the common good, this very rarely led to unqualified support. The public expressed two generalised concerns about the potential risks to their privacy. The first of these concerns related to a party’s competence in keeping data secure, while the second was associated with the motivation a party might have to use the data. Conclusions: The public evaluates trustworthiness of research organisations by assessing their competence in data-handling and motivation for accessing the data. Public attitudes around data-sharing exemplified several principles which are also widely accepted in biomedical ethics. This provides a framework for understanding public attitudes, which should be considered in the development in any guidance for regulators and data custodians. We propose four salient questions which decision makers should address when evaluating proposals for the secondary use of data. (shrink)

BackgroundUse of routinely collected patient data for research and service planning is an explicit policy of the UK National Health Service and UK government. Much clinical information is recorded in free-text letters, reports and notes. These text data are generally lost to research, due to the increased privacy risk compared with structured data. We conducted a citizens’ jury which asked members of the public whether their medical free-text data should be shared for research for public benefit, to inform an ethical (...) policy.MethodsEighteen citizens took part over 3 days. Jurors heard a range of expert presentations as well as arguments for and against sharing free text, and then questioned presenters and deliberated together. They answered a questionnaire on whether and how free text should be shared for research, gave reasons for and against sharing and suggestions for alleviating their concerns.ResultsJurors were in favour of sharing medical data and agreed this would benefit health research, but were more cautious about sharing free-text than structured data. They preferred processing of free text where a computer extracted information at scale. Their concerns were lack of transparency in uses of data, and privacy risks. They suggested keeping patients informed about uses of their data, and giving clear pathways to opt out of data sharing.ConclusionsInformed citizens suggested a transparent culture of research for the public benefit, and continuous improvement of technology to protect patient privacy, to mitigate their concerns regarding privacy risks of using patient text data. (shrink)

The leadership development industry regularly claims to aid in developing effective, ethical leaders, using 360-degree psychometric assessments as key tools for so doing. This paper analyses the effects of such tools on those subjected to and subjectivised by them from a Foucauldian perspective. We argue that instead of encouraging ethical leadership such instruments inculcate practices and belief systems that perpetuate falsehoods, misrepresentations and inequalities. ‘Followers’ are presumed compliant, malleable beings needing leaders to determine what is in their interests. Such techniques (...) pursue productivity and profitability, rather than ethical leadership. We examine the Multifactor Leadership Questionnaire, a widely used 360-degree tool that measures transformational leadership, as an illustrative case study to substantiate these criticisms. (shrink)

Archaeological excavations carried out at Pentridge Prison discovered the ruins and foundations of three panopticon exercise yards. This paper details the scope and observations of the excavation program and discusses the influence of Jeremy Bentham’s panopticon model on penal reform and prison design in Australia in the middle of the 19th Century.

In this paper, the theory of syllogistic reasoning proposed by Johnson-Laird is shown to be inadequate and an alternative theory is put forward. Protocols of people attempting to solve syllogistic problems and explaining to another person how they reached their conclusions were obtained. Two main groups of subjects were identified. One group represented the relationship between classes in a spatial manner that was supplemented by a verbal representation. The other group used a primarily verbal representation. A detailed theory of the (...) processes for both groups is given. (shrink)

Complex clinical ethics cases require a blend of compassion, sensitivity, and tenacity in order to navigate the hard work required of stakeholders. Each person comes to the table with rich historie...

The vulnerability of patients receiving significantly innovative neurosurgical procedures, either as research or as non-standard therapy, presents particularly potent challenges for those attempting to substantially advance clinical Neurosurgical practice in the most ethically and efficacious manner. This beginning formulation has built into it several important notions about research participation, balancing values, and clinical advancement in the context of neurological illness. For the time being, allow vulnerability to act as a placeholder for circumstances or states of being wherein the established checks (...) and balances of power and interest are no longer sufficient in promoting the just treatment of persons. Further, the phrase to substantially advance Neurosurgical practice encompasses radical innovation as well as significant research into new procedures. Finally, few of these explorations involve true randomized placebo controlled trials, but rather they enroll patients rightfully hoping for some benefit by means of undergoing the procedure.When a neurosurgeon asks me, as an ethicist, to meet with a patient who has medically refractory disease and no good standard therapy options remaining, he is asking for help concerning whether to offer, as a last chance, an unproven therapy as either innovation or research. (shrink)

Seven specific challenges in patient vulnerability related to neurosurgical advancement highlight needed augmentations for standards in innovation and research that do not unduly inhibit access to potential therapies while assuring just treatment of patients.

The Routledge Handbook of Feminist Bioethics is an outstanding resource for anyone with an interest in feminist bioethics, with chapters covering topics from justice and power to the climate crisis. Comprising 42 chapters by emerging and established scholars, the volume is divided into six parts: Foundations of Feminist Bioethics Identity and Identifications Science, Technology and Research Health and Social Care Reproduction and Making Families Widening the Scope of Feminist Bioethics The volume is essential reading for anyone with an interest in (...) bioethics or feminist philosophy, and will prove an invaluable resource for scholars, teachers, and advanced students. (shrink)

Western societies today are coming unmoored in the face of an earth-shaking ethical and cultural paradigm shift. At its core is the question of what it means to be human and how we are meant to live. The old answers are no longer accepted; a dizzying array of options are offered in their stead. Underpinning this smorgasbord of lifestyles is a thicket of unquestioned assumptions, such as the separation of gender from biological sex, which not so long ago would have (...) been universally rejected as radical notions. In the spring of 2019, a group of Orthodox Christian scholars drawn from a wide variety of academic disciplines met together to offer responses to the moral crisis our generation faces, elaborating upon its various forms and facilitating a fuller understanding of some of its theological and philosophical foundations. In doing so they offer support to all those who question the claims that are so forcefully insisted upon today--a clarity that will aid them in standing up and resisting trends that have already shown to be the cause of great suffering and unhappiness. (shrink)

It’s not uncommon for people to make reference to atmospheres, including in relationship with educational spaces. In this article, we investigate educational atmospheres by turning to Western and Chinese literature on the air and wind. We pursue this task in three phases. First, we examine the Western literature to see the possible strings of thought that would help us reinvigorate the element of air/atmosphere as a foundational component of an educational sphere. Second, we historicize the Chinese notion of wind as (...) a style of reasoning which structures ancient Chinese cosmology, tempo-spatiality, teaching, and governing into a grid of intelligibility. Third, we argue for a bracketing of a trap of philology and a signifier-signified representational logic through reconceptualizing the atmosphere as a thing that blurs the material-figural boundary and that pushes into a new genre of educational life. (shrink)

The US-Australia strategic relationship has evolved from more or less an adversarial position in the 19th century to an Australia largely dependent on the US during the Cold War to the interdependent partnership we see today. Strategic interdependence means that the US-Australia relationship is not merely a one-sided affair; that Australia has something of substance to offer the strategic relationship. Part of the reason that the relationship is strong is because of a shared language, similar social values, and compatible political-legal (...) systems. Moreover, the relationship has been thoroughly institutionalised via intelligence cooperation, defence science collaboration, and extensive personal relationships. But what the US really seems to value is Australia’s reliability as an ally. I argue that Australia best demonstrates its reliability as an ally, however, when it follows US strategic decision-making for the right reasons. This sense of reliability is more akin to trustworthiness than it is to loyalty. History demonstrates that Australia has not always agreed with the US. But agreeing doesn’t matter so much when Australia has established a track record of consistently applying sound reasoning to its strategic decisions and it has made substantive contributions to jointly sought after strategic outcomes. (shrink)

Normally, activity is regarded as discernible, but according to relativity theory whatever is discernible lies in the past of the discernible. Only the present subjective immediacy is properly active. Subjectivity is properly understood as present becoming; objectivity as past being. I propose that we extend the domain of subjective immediacy to include the future as well as the present. This future universal activity is pluralized in the present in terms of the many actualities coming into being. Subjectivity is the individualization (...) of becoming, and so can apply to the future as a whole as well as to particular present subjects. The future as divine grows out of Whitehead's revisions of traditional notions of omnipotence and omniscience. But he separates creativity from the God of Western theism. This separation can be overcome if God is future creativity individualized in its own realm, which is the source of the creativity within each of us. (shrink)

Whitehead’s initial decision to treat actual occasions as unqualifiedly indivisible rendered the notion of succession in becoming highly problematic. Temporal phases would divide the indivisible. Thus Whitehead had originally recourse to genetic analysis. Many have interpreted this as nontemporal becoming, which is not clearly distinguished from the eternity of eternal objects. Besides, Whitehead reserved the term ‘nontemporal’ for the primordial nature. Finally Whitehead came to see that the indivisibility of occasions meant only that they could not be divided into smaller (...) actual occasions (PR 69), which allowed for genetic division. (shrink)

Immanent creativity activates the concrescence of each actual occasion. Transcendent creativity lies beyond all occasions and is the sourceof their creativity. God, here conceived as purely temporal, is the subjectivity of transcendent creativity.

While it has perhaps always accompanied philosophical thought – one immediately thinks of Plato’s Dialogues – the problem of the communication of that thought, and therefore of its capacity to be taught, has acquired a new insistence in the work of post-Kantian thinkers. As evidence of this one could cite Fichte’s repeated efforts to formulate a definitive version of his Wissenschaftslehre, the model of the Bildungsroman that Hegel adopts for his Phenomenology of Spirit, Kierkegaard’s pseudonymous works, Nietzsche’s Thus Spoke Zarathustra, (...) and Heidegger’s uncompleted Being and Time. Certainly each of these thinkers, as well as their projects, are quite distinct from the others, but their works are also signposts. It is not a question here of reducing the puzzles and difficulties of these works to some single element, some trace of a philosophical zeitgeist. Rather, it is enough to indicate this preoccupation with the problem of the communicability of thinking in order to raise the question of the modality of such a communication. How has thinking come to be so fundamentally troubled by its own expression? That Kant’s Critical philosophy has precipitated this preoccupation ought to come as no surprise, for it was Kant, most famously in the Critique of Pure Reason, who sought to definitively set the limits of philosophical thinking. In doing so, however, Kant is unable to remain utterly silent about what he himself sets outside the bounds of meaningful thought and speech: things-in-themselves. The mere fact that this meaningless element is an essential component of Kant’s philosophical exposition is an indication of the paradoxical logic of the limit: to postulate a limit is simultaneously to set out its obverse side. In Kant’s case, then, the demarcation of what can be thought carries with it the implicit thinking of what is ruled out of bounds for thought. Beginning with Fichte, the philosophical project of Kant’s successors and inheritors is then largely determined by an effort to incorporate or at least accommodate this alien element within thinking. The initial phase of this effort is marked by a tragic motif, a conjoining of thought with the experience of loss and suffering that is characteristic of Romanticism, that culminates in the dialectic of Hegel’s Absolute Knowing. In Absolute Knowing, thought has not vanquished its limitations, it has instead discovered the resources with which it can perpetually surmount them. This first phase is followed by a reaction or response to this seeming completion and overcoming of the Kantian limitation. Now, the tragic movement of thought comes to be understood as itself limited, and necessarily so according to the logic of the limit that imposes itself upon every gesture of closure. Tragedy thereby gives way to comedy insofar as the limitation that is incorporated as an obstacle to be overcome by tragic thought is shown to be the external condition of that very thought. Finally, if the comic is the fate of the limitations of tragedy, the thought of comedy itself demands a third mode of thinking, one capable of something more than the mere reiteration of the limit between comedy and tragedy that troubles them both. This third form of expression is parody, an expression appropriate to a thinking that repeats and completes the threefold movement of tragic thought while, in this very repetition, creating a limitless domain of thoughtful expression. (shrink)

IN "THE INCARNATION AS A CONTINUING REALITY," RELIGIOUS STUDIES 6,303-27 (DECEMBER 1970), DAVID PAILIN CLAIMS THAT THE INCARNATION REVEALS THE NECESSARY, EMPIRICALLY NON-FALSIFIABLE CHARACTERISTICS OF GOD’S "ACTIVE ACTUALITY". GOD’S "PASSIVE ACTUALITY," THE WAY HE EXPERIENCES THE WORLD, IS METAPHYSICALLY KNOWN, BUT NOT HIS "ACTIVE ACTUALITY," THE WAY IN WHICH HE RESPONDS TO THE WORLD, FOR HE COULD HAVE RESPONDED OTHERWISE. NEVERTHELESS GOD’S CONCRETE RESPONSE IS EMPIRICALLY NON-FALSIFIABLE, FOR EVERYTHING THAT CAN POSSIBLY HAPPEN IN THE ACTUAL WORLD WILL REFLECT THAT RESPONSE. (...) I REPLY THAT THE METAPHYSICAL PRINCIPLES AS WELL COULD CONCEIVABLY BE OTHERWISE, BUT GOD’S PRIMORDIAL DECISION DETERMINES WHICH MUST BE EXEMPLIFIED BY ALL POSSIBLE ACTUALITIES WHATSOEVER. THE GENERAL CHARACTER OF GOD’S RESPONSE TO THE WORLD IS THEREBY METAPHYSICALLY KNOWABLE. THE INCARNATION OF THE CHRIST REVEALS TO US THE CONTINGENT CHARACTER OF GOD’S RESPONSE TO THE PARTICULARITIES OF HUMAN EXISTENCE, AND THIS. (shrink)

Far from being an unnecessary appendage to Whitehead’s system, temporal atomism is, in my judgment, the basis for pansubjectivity and other fundamental ideas such as becoming, concrescence, and subjectivity.

_ Source: _Volume 9, Issue 2, pp 220 - 239 Art has been crucial for Western philosophy roughly since Kant – that is, for what is becoming known as “correlationist” philosophy – because it has so often had assigned to it a singular ontological status. The artwork, in this view, is material being that has been transfigured and shot through with subjectivity. The work of art, what art does and how it works have all been understood as mediating between the (...) otherwise irreconcilable opposites of historical spirit and the mute material world, between communicative thought and the unresponsiveness otherness of nature. I revisit this aesthetic tradition from the perspective of the Anthropocene, the proposed name of the new geological epoch of the present, distinguished by the fact that collective human action has now acquired the scale of a world-shaping natural force. The Anthropocene is at once a geological epoch and a historical period. What forms of narrative might possibly relate these two temporal orders together? What other aesthetic categories might help us think through the conceptual impasse of the Anthropocene present? How might aesthetic experience illuminate the history of Anthropocene? What natural histories might artworks tell today? My speculative endpoint: the Anthropocene globe is the universal artwork of the contemporary moment. (shrink)