Interventional research on deceased organ donors and donor organs prior to transplant holds the promise of reducing the number of patients who die waiting for an organ by expanding the pool of transplantable organs and improving transplant outcomes. However, one of the key challenges researchers face is an assumption that someone who receives an organ that was part of an interventional research protocol is always a human subject of that same study. The consequences of this assumption include the need for (...) oversight by an institutional review board and for research-level informed consent from transplant recipients, all within the complex practical realities of the organ donation and transplantation process in the United States. The current national focus on this issue provides an opportunity to think critically about the policy goals of the human subjects regulations and their application to the nascent field of deceased organ donor intervention research. We propose that for donor research where the transplant recipient does not fall under the definition of human subject, the clinical consent model—rather than the consent model used for human research subjects—best facilitates the policy objectives of balancing clinical innovation, transparency, and protection of patients in an ethically responsible and legally compliant manner. (shrink)

A novel Protocol Ethics Tool Kit (‘Ethics Tool Kit’) has been developed by a multi-stakeholder group of the Multi-Regional Clinical Trials Center of Brigham and Women9s Hospital and Harvard. The purpose of the Ethics Tool Kit is to facilitate effective recognition, consideration and deliberation of critical ethical issues in clinical trial protocols. The Ethics Tool Kit may be used by investigators and sponsors to develop a dedicated Ethics Section within a protocol to improve the consistency and transparency between clinical trial (...) protocols and research ethics committee reviews. It may also streamline ethics review and may facilitate and expedite the review process by anticipating the concerns of ethics committee reviewers. Specific attention was given to issues arising in multinational settings. With the use of this Tool Kit, researchers have the opportunity to address critical research ethics issues proactively, potentially speeding the time and easing the process to final protocol approval. (shrink)

This essay details the resurgence of wellness program as employed by large corporations with the aim of reducing healthcare costs. The essay narrows in on a discussion of how Big Data collection practices are being utilized in wellness programs and the potential negative impact on the worker in regards to privacy and employment discrimination. The essay offers an ethical framework to be adopted by wellness program vendors in order to conduct wellness programs that would achieve cost-saving goals without undue burdens (...) on the worker. The essay also offers some innovative approaches to wellness that may well better serve the goals of healthcare cost reduction. (shrink)

More than twenty-five years after the first signs of potential harm, the US remains locked in the grip of an opioid epidemic, with more Americans dying from overdoses than ever before.1 Diversion of prescription opioids plays an important role in opioid-related harms. Much of the scientific and public health focus on diversion has been on end-users, given how commonly non-medical prescription opioid use occurs, as well as the proportion of individuals who report that their source of non-medical opioids was friends (...) or family. However, diversion of opioids, as well as their rampant oversupply, can be discerned higher up the supply chain, including among wholesalers, pharmacies and rogue prescribers whose behavior may trigger well-described “flags” warranting further evaluation and action. (shrink)

This open access book offers insights into the development of the ground-breaking Global Code of Conduct for Research in Resource-Poor Settings (GCC) and the San Code of Research Ethics. Using a new, intuitive moral framework predicated on fairness, respect, care and honesty, both codes target ethics dumping – the export of unethical research practices from a high-income setting to a lower- or middle-income setting. The book is a rich resource of information and argument for any research stakeholder who opposes double (...) standards in research. It will be indispensable for applicants to European Union framework programmes, as the GCC is now a mandatory reference document for EU funding. (shrink)

‘@AP: Breaking: Two Explosions in the White House and Barack Obama is injured’. So read a tweet sent from a hacked Associated Press Twitter account @AP, which affected financial markets, wiping out $136.5 billion of the Standard & Poor’s 500 Index’s value. While the speed of the Associated Press hack crash event and the proprietary nature of the algorithms involved make it difficult to make causal claims about the relationship between social media and trading algorithms, we argue that it helps (...) us to critically examine the volatile connections between social media, financial markets, and third parties offering human and algorithmic analysis. By analyzing the commentaries of this event, we highlight two particular currents: one formed by computational processes that mine and analyze Twitter data, and the other being financial algorithms that make automated trades and steer the stock market. We build on sociology of finance together with media theory and focus on the work of Christian Marazzi, Gabriel Tarde and Tony Sampson to analyze the relationship between social media and financial markets. We argue that Twitter and social media are becoming more powerful forces, not just because they connect people or generate new modes of participation, but because they are connecting human communicative spaces to automated computational spaces in ways that are affectively contagious and highly volatile. (shrink)

For decades, psychological research has heavily favored quantitative over qualitative methods. One reason for this imbalance is the perception that quantitative methods follow from a post-positivist paradigm, which guides mainstream psychology, whereas qualitative methods follow from a constructivist paradigm. However, methods and paradigms are independent, and embracing qualitative methods within mainstream psychology is one way of addressing the generalizability crisis.

This study investigated the relative contribution of perception/cognition and language-specific semantics in nonverbal categorization of spatial relations. English and Korean speakers completed a video-based similarity judgment task involving containment, support, tight fit, and loose fit. Both perception/cognition and language served as resources for categorization, and allocation between the two depended on the target relation and the features contrasted in the choices. Whereas perceptual/cognitive salience for containment and tight-fit features guided categorization in many contexts, language-specific semantics influenced categorization where the two (...) features competed for similarity judgment and when the target relation was tight support, a domain where spatial relations are perceptually diverse. In the latter contexts, each group categorized more in line with semantics of their language, that is, containment/support for English and tight/loose fit for Korean. We conclude that language guides spatial categorization when perception/cognition alone is not sufficient. In this way, language is an integral part of our cognitive domain of space. (shrink)

We review the relationships between language, inner speech, and cognitive control in children and young adults, focusing on the domain of cognitive flexibility. We address the role that inner speech plays in flexibly shifting between tasks, addressing whether it is used to represent task rules, provide a reminder of task order, or aid in task retrieval. We also consider whether the development of inner speech in childhood serves to drive the development of cognitive flexibility. We conclude that there is a (...) close association between inner speech and cognitive flexibility in both adults and children. Experimental work has begun to specify in detail the role that inner speech might play in adult performance, suggesting that language plays a facilitative but not essential role in representing and activating the relevant task set, processes that occur on both switch and nonswitch trials. While developmental studies suggest an increase in the spontaneous use of verbal strategies with age, implying an increase in top-down control during shifting, experimental work is needed to specify more precisely the nature and precise role that inner speech plays in the development of cognitive control through childhood. (shrink)

Catharine MacKinnon has pioneered a new brand of anti-pornography argument. In particular, MacKinnon claims that pornography silences women in a way that violates their right to free speech. In what follows, we focus on a certain account of silencing put forward by Jennifer Hornsby and Rae Langton, and we defend that account against two important objections. The first objection contends that this account makes a crucial but false assumption about the necessary role of hearer recognition in successful speech acts. In (...) response, we argue that, as silencing primarily concerns communication, Hornsby and Langton are perfectly correct to treat hearer recognition as they do. The second objection contends that their particular account of silencing has the unacceptable result of undermining the responsibility of rapists. We here argue that no such result follows from their account. (shrink)

Although others have focused on Catharine MacKinnon's claim that pornography subordinates and silences women, I here focus on her claim that pornography constructs women's nature and that this construction is, in some sense, false. Since it is unclear how pornography, as speech, can construct facts and how constructed facts can nevertheless be false, MacKinnon's claim requires elucidation. Appealing to speech act theory, I introduce an analysis of the erroneous verdictive and use it to make sense of MacKinnon's constructionist claims. I (...) also show that the erroneous verdictive is of more general interest. (shrink)

The upstream framework presented in public health and medicine considers health problems from a preventive perspective, seeking to understand and address the root causes of poor health. Medical-legal partnerships (MLPs) have demonstrated the value of this upstream framework in the practice of law and engage in upstream lawyering by utilizing systemic advocacy to address root causes of injustices and health inequities. This article explores upstreaming and its use by MLPs in reframing legal practice.

Inadequate diet is the leading risk factor for morbidity and mortality worldwide. However, approaches to identifying inadequate diets in clinical practice remain inconsistent, and dietary interventions frequently focus on facilitating ‘healthy choices’, with limited emphasis on structural constraints. We examine the ethical implications of introducing a routine question in the medical history about ability to access food. Not collecting data on food security means that clinicians are unable to identify people who may benefit from support on an individual level, unable (...) to consider relevant dietary risk factors for disease and disease progression and unable to monitor population trends and inequalities in dietary access in order to design effective policy interventions. We argue that the current lack of routine screening for food insecurity is inconsistent with our approach to other health behaviours, as well as with doctors’ frequent informal role as gatekeepers to the food aid system, and recent calls for governmental action on food insecurity and health inequalities from individual clinicians and professional bodies. Potential ethical barriers to asking patients about food security are addressed, including concerns about stigma, limiting autonomy, fair resource allocation, unclear professional remits and clinicians’ ability to offer effective interventions. We suggest that there is an ethical imperative for doctors to ask patients about their ability to access healthy food. Gathering this data provides a valuable first step in re-framing the social determinants of health as modifiable risks, rather than inevitable inequities. No data are available. (shrink)

A geographically stratified cross-sectional survey was conducted in 2002 to investigate household-level factors associated with use of mosquito control measures and self-reported malaria in Malindi, Kenya. A total of 629 households were surveyed. Logistic regressions were used to analyse the data. Half of all households (51%) reported all occupants using an insecticide-treated bed net and at least one additional mosquito control measure such as insecticides or removal of standing water. Forty-nine per cent reported a history of malaria in the household. (...) Of the thirteen household factors analysed, low (OR=0·23, CI 0·11, 0·48) and medium (OR=0·50, CI 0·29, 0·86) education, mudcoral (OR=0·0·39, CI 0·24, 0·66) and mud block–plaster (OR=0·47, CI 0·25, 0·87) wall types, farming (OR=1·38, CI 1·01, 1·90) and travel to rural areas (OR=0·48, CI 0·26, 0·91) were significantly associated with the use of mosquito control, while controlling for other covariates in the model. History of reported malaria was not associated with the use of mosquito control (OR=1·22, CI 0·79, 1·88). Of the thirteen covariates analysed in the second model, only two household factors were associated with history of malaria: being located in the well-drained stratum (OR=0·49, CI 0·26, 0·96) and being bitten while in the house (OR=1·22, CI 0·19, 0·49). These results suggest that high socioeconomic status is associated with increased household-level mosquito control use, although household-level control may not be enough, as many people are exposed to biting mosquitoes while away from the house and in areas that are more likely to harbour mosquitoes. (shrink)

Changes in government policy over the last two decades have seen the traditional goals of criminal justice, namely prosecution and punishment, being replaced by an emphasis on prevention, fear reduction, security and harm reduction. During this time domestic abuse has gained a place on the political agenda, which has resulted in legislative initiatives in the form of civil protection orders across the U.K. which primarily focus on prevention but have also more recently begun to rely on the traditional criminal justice (...) responses should they fail to prevent further abuse. Drawing on international evaluations and a recent study conducted in Scotland (the Scottish study), the article examines whether legislation in the form of civil protection orders has the effect of curtailing the actions of abusers and if not, what occurs when the traditional criminal justice response comes into play. The strengths of civil protection orders and some explanations for the weaknesses of these orders are considered alongside the question of whether there is any value in women continuing to engage with the law in response to domestic abuse. (shrink)

Ethics dumping is a global phenomenon involving the ‘off-shoring’of research. Research that would be prohibited, severely restrictedor regarded as highly patronizing in high-income regions is instead conducted inresource-poor settings. Twenty-eight case studies of ethics dumping were examined through inductive thematic analysis to reveal predisposing factors from the perspective of researchers from high-income regions. Six categories were agreed and further illuminated: Patronizing conduct, unfair distribution of benefits and/or burdens, culturally inappropriate conduct, double standards, lack of due diligence and lack of transparency. (...) The ultimate aim of the paper is to deepen understanding of thesehighly unethical practicesamongst academics who stand against poverty, leading to theirfurther reduction. (shrink)

Legal judgment writing mobilises a process of story-telling, drawing on existing judicial discourses, precedents and practices to create a narrative relevant to the specific case that is articulated by the presiding judge. In the Feminist Judgments projects feminist scholars and activists have sought to challenge and reinterpret legal judgments that have disadvantaged, discriminated against or denied women’s experiences. This paper reflects on the process of writing as a feminist judge in the Australian Project, in an intimate homicide case, R v (...) Middendorp. Drawing on the work of Judith Butler on intelligibility, iterability and the communality of violence and vulnerability, this article argues that feminist judgments necessarily require some uncomfortable compromises with unjust gendered institutions. While ‘donning the robes’ may be an uncomfortable process, a feminist re-articulation of the law’s carceral power serves to unsettle and challenge some aspects of gendered oppression, even though it cannot unsettle the operation of the institution. The article concludes that effective feminist interventions by members of the judiciary may require donning robes that are not entirely comfortable in order to persuade and advocate for change. (shrink)

Background: Past research has highlighted the role of trauma in social adjustment problems, but little is known about the underlying process. This is a barrier to developing effective interventions for social adjustment of traumatized individuals. The present study addressed this research gap through a cognitive model.Methods: A total of 604 young adults from different backgrounds were assessed through self-report questionnaires. The data were analyzed through path analysis and multivariate analysis of variance. Two path analyses were conducted separately for migrant and (...) Australian groups.Results: Analyses indicated that cognitive avoidance and social problem solving can significantly mediate the relation between trauma and social adjustment. According to the model, reacting to trauma by cognitive avoidance can disturb the cognitive capacities that are required for social problem solving. Consequently, a lack of effective social problem solving significantly hinders social adjustment. There were no significant differences among the Australian, non-refugee immigrant and refugee participants on the dependent variables. Moreover, the hypothesized links between the variables was confirmed similarly for both migrant and Australian groups.Conclusion: The findings have important implications for interventions targeting the social adjustment of young individuals. We assert that overlooking the processes identified in this study, can hinder the improvement of social adjustment in young adults with a history of trauma. Recommendations for future research and practice are discussed. (shrink)

In humans, there are two skeletal muscle α‐actinins, encoded by ACTN2 and ACTN3, and the ACTN3 genotype is associated with human athletic performance. Remarkably, approximately 1 billion people worldwide are deficient in α‐actinin‐3 due to the common ACTN3 R577X polymorphism. The α‐actinins are an ancient family of actin‐binding proteins with structural, signalling and metabolic functions. The skeletal muscle α‐actinins diverged ∼250–300 million years ago, and ACTN3 has since developed restricted expression in fast muscle fibres. Despite ACTN2 and ACTN3 retaining considerable (...) sequence similarity, it is likely that following duplication there was a divergence in function explaining why α‐actinin‐2 cannot completely compensate for the absence of α‐actinin‐3. This paper focuses on the role of skeletal muscle α‐actinins, and how possible changes in functions between these duplicates fit in the context of gene duplication paradigms. (shrink)

Within academic circles, the “deficit” model of public understanding of science has been subject to increasing critical scrutiny by those who favor more constructivist approaches. These suggest that “the public” can articulate sophisticated ideas about the social and ethical implications of science regardless of their level of technical knowledge. The seminal studies following constructivist approaches have generally involved small-scale qualitative investigations, which have minimized the pre-framing of issues to a greater or lesser extent. This article describes the Gene Week Project, (...) sponsored by the Wellcome Trust, which attempted to extend this work to a large-scale consultation on genetics and health through the medium of a local daily newspaper. Readers were invited to respond to a set of open-ended questions that accompanied stimulus material published each day for five consecutive weekdays. The articles were written with the intention of extending the limited range of discourses around genetics and biotechnology that are usually presented by the popular media. Responses raised overarching issues about the place of emerging health technologies in society reminiscent of previous open-ended consultations in this field. The paper ends with a critical discussion about the potential of this method to contribute to the further development of open-ended public consultations. (shrink)

Webber, Ruth; Jones, Kate This paper is about how three Catholic agencies carved out and adapted over time a role for themselves in assisting in the recovery after the Victorian bushfires of 2009. It tracks the process from the time the Archbishop of Melbourne commissioned Catholic Social Services Victoria to survey the bushfire affected areas and work out where there were gaps in services that the Catholic agencies could fill. A significant amount of funding was allocated to the provision (...) of services by Catholic agencies for a period of up to three years in the bushfire affected regions. This was seen as a Catholic response to an extraordinary natural disaster. This was organisationally difficult because there are in excess of sixty Catholic welfare services in Victoria and it was necessary to determine who would be best able to meet the gaps and deliver appropriate services.1 It was clear that the aim was not to replicate or compete with existing services, it was to meet real needs and to do this in a cooperative and collegial way with existing players. (shrink)

Defining quality of life is a difficult task as it is a subjective and personal experience. However, for the elderly, this definition is necessary for making complicated healthcare-related decisions. Commonly these decisions compare independence against safety or longevity against comfort. These choices are often not made in isolation, but with the help of a healthcare team. When the patient’s concept of quality of life is miscommunicated, there is a risk of harm to the patient whose best interests are not well (...) understood. In order to bridge this gap in understanding and unite seniors with their caretakers as a cohesive team, we need to establish a definition of quality of life. In this paper, my personal experiences with the elderly will be analysed along with five essays on the topic of ageing. These sources provide clear evidence that quality of life for seniors is majorly determined by the ability to preserve one’s lifelong identity. When making difficult decisions in geriatric healthcare, this greater understanding of the determinants of life quality will allow treatments to best serve the elderly. Defining quality of life allows healthcare providers to shift the focus from minimising disability toward maximising ability. I believe this shift would provide seniors with better health outcomes and properly enhance the quality of their years. (shrink)

Expanding buprenorphine access in the United States requires evidence-based decision-making that considers both the drug's potential dangers and its potential benefits. Risks associated with buprenorphine misuse and diversion highlight the need for careful, ongoing evaluation during each stage of increased access.

This article explores the idea that there is a spectrum of individuals who feel compelled to dwell in the past, either due to psychological or social conditions. I analyze both conditions respectively by critically examining two cases: post-traumatic stress disorder and racialized oppression. I propose that individuals with PTSD can feel psychologically compelled to dwell in the past in a dually negative sense: the individual lives in the past but also broods on it, causing them to feel “stuck” in the (...) past. This kind of “dwelling” can cause individuals to suffer disruptions to their sense of self and intersubjectivity. After exploring the psychological case of dwelling in the past, I explore the social sense in which individuals can dwell in the past due to oppressive social structures by examining the case of racialized oppression. The case of racialization is philosophically stimulating because of its intersubjective dimensions—it subverts the idea that dwelling in the past is simply a psychological phenomenon by capturing that others can help or hinder us with maintaining a sense of self and future-directed intentionality. By putting the phenomenological work of Al-Saji into conversation with recent phenomenological research on incarceration, I propose that racialization can be similarly disruptive to one’s sense of self and intersubjectivity. The proposed account is suggestive that traumatic and oppressive experiences may amplify and compound each other in ways not yet well elucidated in the literature. If this account is taken to be persuasive, it is indicative that both psychological and social conditions mediate one’s temporality and well-being. (shrink)

The rapid pace of technological development often outstrips the ability of legislators and regulators to establish proper guardrails on emerging technologies. A solution is for those who develop, deploy, and use these technologies to develop themselves as moral agents—i.e., as agents capable of steering the course of emerging technologies in a direction that will benefit humanity. However, there is a dearth of literature discussing how to foster moral agency in computer science courses, and little if any research on the effectiveness (...) of such courses in computer science. This paper addresses this gap by providing an overview of an undergraduate course on technology ethics. It then shares and discusses a subset of data collected from a mixed-methods study using a pre-post design that sought to examine the course’s effectiveness in developing students’ moral, intellectual, and civic virtues, as well as related dispositions. (shrink)

Résumé Cet article aborde la querelle comme un élément de la stratégie d’un philosophe vis-à-vis de la postérité. On pourrait évidemment penser à des querelleurs invétérés comme Pascal, Voltaire ou Rousseau, mais il sera question ici du cas plus complexe de Diderot et du dernier ouvrage publié de son vivant, l’_Essai sur les règnes de Claude et de Néron et sur les moeurs et les écrits de Sénèque pour servir à l’introduction de la lecture de ce philosophe_ (1782). L’article démontre (...) que celui-ci constitue un cas de « texte-querelle », c’est-à-dire un texte qui met en scène la querelle menée à son propre sujet et qui ainsi la fait redémarrer; il analyse la posture qu’adopte le philosophe-querelleur, surtout dans l’énoncé paradoxal « ne nous engageons point dans les querelles », dont il examine les qualités performatives. (shrink)

"I am a Jew who was born and who grew up in a Catholic country; I never had a religious education; my Jewish identity is in large measure the result of persecution." This brief autobiographical statement is a key to understanding Carlo Ginzburg's interest in the topic of his latest book: distance. In nine linked essays, he addresses the question: "What is the exact distance that permits us to see things as they are?" To understand our world, suggests Ginzburg, it (...) is necessary to find a balance between being so close to the object that our vision is warped by familiarity or so far from it that the distance becomes distorting. Opening with a reflection on the sense of feeling astray, of familiarization and defamiliarization, the author goes on to consider the concepts of perspective, representation, imagery, and myth. Arising from the theme of proximity is the recurring issue of the opposition between Jews and Christians -- a topic Ginzburg explores with an impressive array of examples, from Latin translations of Greek and Hebrew scriptures to Pope John Paul II's recent apology to the Jews for antisemitism. Moving with equal acuity from Aristotle to Marcus Aurelius to Montaigne to Voltaire, touching on philosophy, history, philology, and ethics, and including examples from present-day popular culture, the book offers a new perspective on the universally relevant theme of distance. (shrink)

This paper argue that metaphysical realism is insufficient to solve Goodman's grue paradox.