Background: Clinical genomic implementation studies pose challenges for informed consent. Consent forms often include complex language and concepts, which can be a barrier to diverse enrollment, and these studies often blur traditional research-clinical boundaries. There is a move toward self-directed, web-based research enrollment, but more evidence is needed about how these enrollment approaches work in practice. In this study, we developed and evaluated a literacy-focused, web-based consent approach to support enrollment of diverse participants in an ongoing clinical genomic implementation study. (...) Methods: As part of the Cancer Health Assessments Reaching Many (CHARM) study, we developed a web-based consent approach that featured plain language, multimedia, and separate descriptions of clinical care and research activities. CHARM offered clinical exome sequencing to individuals at high risk of hereditary cancer. We interviewed CHARM participants about their reactions to the consent approach. We audio recorded, transcribed, and coded interviews using a deductively and inductively derived codebook. We reviewed coded excerpts as a team to identify overarching themes. Results: We conducted 32 interviews, including 12 (38%) in Spanish. Most (69%) enrolled without assistance from study staff, usually on a mobile phone. Those who completed enrollment in one day spent an average of 12 minutes on the consent portion. Interviewees found the information simple to read but comprehensive, were neutral to positive about the multimedia support, and identified increased access to testing in the study as the key difference from clinical care. Conclusions: This study showed that interviewees found our literacy-focused, web-based consent approach acceptable; did not distinguish the consent materials from other online study processes; and valued getting access to testing in the study. Overall, conducting empirical bioethics research in an ongoing clinical trial was useful to demonstrate the acceptability of our novel consent approach but posed practical challenges. (shrink)

Since Austin’s introduction of the locutionary-illocutionary-perlocutionary distinction, it has been a matter of debate within speech act theory whether illocutionary acts like promising, warning, refusing and telling require audience ‘uptake’ in order to be performed. Philosophers on different sides of this debate have tried to support their positions by appealing to hypothetical scenarios, designed to elicit intuitive judgements about the role of uptake. However, philosophers’ intuitions appeared to remain deadlocked, while laypeople’s intuitions have not yet been probed. To begin rectifying (...) that, we ran two experiments probing lay intuitions about the implications of uptake failure. Overall, we found that participants’ responses were skewed towards agreement that speech acts were performed, despite the lack of uptake. There were, however, significant differences across the four different speech act types we investigated (with the highest levels of agreement found for refusing, followed by warning, then telling, and finally promising). We also obtained evidence of complex effects relating to the (high or low) stakes involved in the scenarios. While this study only represents an initial exploration of intuitions about uptake, our results form a basis for further research into their nature and significance, across a range of speech acts, scenarios, and experimental designs. (shrink)

Many formerly incarcerated people have civil legal needs that can imperil their successful re-entry to society and, consequently, their health. We categorize these needs and assess their association with cardiovascular disease risk factors in a sample of recently released people. We find that having legal needs related to debt, public benefits, housing, or healthcare access is associated with psychosocial stress, but not uncontrolled high blood pressure or high cholesterol, in the first three months after release.

As the health care system transitions to a precision medicine approach that tailors clinical care to the genetic profile of the individual patient, there is a potential tension between the clinical uptake of new technologies by providers and the legal system's expectation of the standard of care in applying such technologies. We examine this tension by comparing the type of evidence that physicians and courts are likely to rely on in determining a duty to recommend pharmacogenetic testing of patients prescribed (...) the oral anti-coagulant drug warfarin. There is a large body of inconsistent evidence and factors for and against such testing, but physicians and courts are likely to weigh this evidence differently. The potential implications for medical malpractice risk are evaluated and discussed. (shrink)

The α‐actinins are an ancient family of actin‐binding proteins that play structural and regulatory roles in cytoskeletal organisation and muscle contraction. α‐actinin‐3 is the most‐highly specialised of the four mammalian α‐actinins, with its expression restricted largely to fast glycolytic fibres in skeletal muscle. Intriguingly, a significant proportion (∼18%) of the human population is totally deficient in α‐actinin‐3 due to homozygosity for a premature stop codon polymorphism (R577X) in the ACTN3 gene. Recent work in our laboratory has revealed a strong association (...) between R577X genotype and performance in a variety of athletic endeavours. We are currently exploring the function and evolutionary history of the ACTN3 gene and other α‐actinin family members. The α‐actinin family provides a fascinating case study in molecular evolution, illustrating phenomena such as functional redundancy in duplicate genes, the evolution of protein function, and the action of natural selection during recent human evolution. BioEssays 26:786–795, 2004. © 2004 Wiley Periodicals, Inc. (shrink)

While it is well known that SME owner–managers’ sustainability values and attitudes impact their company’s sustainability activities, they often face profit-driven institutional orders. In a qualitative study, we investigate which identities are critical for their engagement in sustainability and how these identities interrelate with their institutional environment. We applied a qualitative design with narratives from 29 owner–managers of hospitality businesses who belong to a New Zealand-based sustainability network. Our study revealed no single overarching sustainability identity; instead, six identities could be (...) identified as sustainability-related and be linked to different institutional orders. By analyzing the interplay between the identities and the institutional environment, we also found mechanisms on how SME owner–managers impact on their business’ sustainability. We revealed that an adequate institutional environment can foster the development of sustainability-related identities, which in turn can lead to cultural evolution towards more sustainability. By integrating identity theory with organizational institutionalism, we contribute to theoretical development and to further sustainability research at individual and institutional level. (shrink)

As infancy is characterized by rapid physical growth and critical periods of development, disruptions due to illness or disease reveal vulnerability associated with this period. Spinal cord injury has devastating consequences at any age, but its onset neonatally, at birth, or within the first year of life multiplies its impact. The immediate physical and physiological consequences are obvious and immense, but the effects on the typical trajectory of development are profound. Activity-based restorative therapies capitalize on activity-dependent plasticity of the neuromuscular (...) system below the lesion and when provided to children with SCI aim to improve the child’s neuromuscular capacity, health and quality of life. This is a report of an infant with a cervical SCI at birth resulting in paralysis of leg and trunk muscles and paresis of arm and hands who was enrolled in an ABRT program at 3 years of age. After 59 sessions of ABRT, the child demonstrated significant improvements in trunk control and arm function, as well as social and emotional development. Despite the chronicity of injury and low expectations for improvement with therapeutic interventions, ABRT had a positive impact on the child’s physical capacity and provided benefits across multiple developmental domains. (shrink)

The project we highlight in this article stems from our philosophical work on moral disagreements that appear to be—and sometimes are—intractable. Deliberative democratic theorists tout the merits of dialogue as an effective way to bridge differences of values and opinion, ideally resulting in agreement, or perhaps more often resulting in greater mutual understanding. Could dialogue mitigate disagreements about a controversial education policy such as affirmative action? Could it foster greater understanding? We conceived of a project that would simultaneously fulfill two (...) goals that we had as philosophers, education researchers, and aspiring public intellectuals. First, it would allow us to use philosophy in research, grounding our mixed methods research in a philosophically informed framework. The tools and analytic techniques that are particular to philosophers felt uniquely suited for an empirical study concerning political theory. Second, we aimed to use philosophy in the community. We were able to put our own expertise in philosophy and race-conscious education policy to good use by purposefully creating opportunities for diverse community members in our larger metropolitan area to engage in dialogue and deliberation with each other over the issue of affirmative action. (shrink)

In Moral Passages, Kathryn Pyne Addelson presents an original moral theory suited for contemporary life and its moral problems. Her basic principle is that knowledge and morality are generated in collective action, and she develops it through a critical examination of theories in philosophy, sociology and women's studies, most of which hide the collective nature and as a result hide the lives and knowledge of many people. At issue are the questions of what morality is, and how moral theories (...) (whether traditional or feminist) are implemented. Addelson takes up a large number of historical cases and contemporary social problems, including teen pregnancy, contraception and abortion, and gay rights. These cases allow her to see how the knowledge and lives of some people are declared deviant or immoral, while those of others appear to show the public consensus. One case she uses throughout the book is Margaret Sanger's early work on birth control with the anarcho-syndicalist movement--a revisionist history that reveals rather than hides the collective nature of morality and knowledge. Addelson shows how the usual individualist philosophies promote theories which hide the authority of the professionals who make them. A collectivist approach, she argues, must show the part professionals play in collective action. Her aim is to allow professional knowledge makers to be morally and intellectually responsible. Based on Addelson's twenty years of work in feminist philosophy and interactionist sociology as well as her long-standing involvement in women's community organization, Moral Passages investigates how morality and knowledge are collectively enacted in today's world. (shrink)

This article advances sustainability towards a new logic that favors the flourishing of Sustainable Development Goals (SDGs) and well-being from North to South. It presents a Global Dual-Perspective (GDP) and a Dynamic Equilibrium Framework (DEF) that inform sustainability, management, and international business with a paradoxical view of the SDGs and a strengthened analysis that outlines the role of multinational enterprises (MNEs) in addressing the SDGs within and across the North–South. This article reveals that organizations will effectively unleash virtuous cycles of (...) SDGs and well-being when confronting and juxtaposing environmental, health, social, economic, and law-oriented goals. Furthermore, virtuous cycles will be more successful when splitting and integrating short- and long-term conflicting goals within and across the North–South to fuel systemic resilience and sustainable development. (shrink)

It is argued that the question of whether or not one is required to be or become a strict vegetarian depends, not upon a rule or ideal that endorses vegetarianism on moral grounds, but rather upon whether one's own physical, biological nature is adapted to maintaining health and well-being on a vegetarian diet. Even if we accept the view that animals have rights, we still have no duty to make ourselves substantially worse off for the sake of other rights-holders. Moreover, (...) duties to others, such as fetuses and infants, may require one to consume meat or animal products. Seven classes of individuals who are not required to be or become vegetarians are identified and their examption is related to nutritional facts; these classes comprise most of the earth's population. The rule of vegetarianism defines a special or provisional duty rather than any general or universal rule, since its observance it based upon the biological capacities of individual humans whose genetic constitution and environment makes them suitably herbivorous. It is also argued that generalizing the vegetarian ideal as a social goal for all would be wrongful because it fails to consider the individual nutritional needs of humans at various stages of life, according to biological differences between the sexes, and because it would have the eugenic effect of limiting the adaptability of the human species. The appeal to the natural interests of omnivores will not justify any claim that humans may eat amounts of meat or animal products in excess of a reasonable safety margin since animals have rights-claims against us. (shrink)

Arguing for a pro-democratic approach in authoritarian times, this book challenges the focus on age in identifying children in child rights. It argues that, even for the purposes of a benevolent rights regime, adopting a monist construction of child identity artificially separates the law from reality, potentially foreclosing children's democratic deliberative agency in self-identification. An essential feature of other human rights regimes is the scope for a claimant to argue one's identity, or foundationally 'I am a human being;' but such (...) a contention is foreclosed when identification as a child is decided uniquely by reference to age. Drawing on Critical Race Theory's narrative method and inspired by W.E.B. DuBois' identity construction, Professor Grahn-Farley advocates a new theoretical understanding of the child and of child rights, cognisant of social interaction and democratic participation. This book will appeal to researchers in child and human rights, and to sociologists, legal theorists and activists.__This title is part of the Flip it Open programme and may also be available Open Access. Check our website Cambridge Core for details. (shrink)

Granted that God may exist, how may God be defined in our time? Addressing this issue Benjamin Farley explores a variety of belief systems, Western and Eastern, religious and skeptical. Taking an approach that is both critical of religion as well as sympathetic, Farley refuses to shy away from hard questions or to dismiss constructive answers that speak to the human condition. He distinguishes human "intellectual ascent" towards God from humankind's "innate and inner sense" to know and relate (...) to the living God, demonstrating the efforts and rewards of both approaches in Christianity, as well as in Hinduism, Buddhism, Taoism, and Zen. Alongside these more obviously "religious" approaches, Farley reviews the methodologies and findings of today's greatest scientific minds, including skeptics such as Hawking, Dawkins, and Wilson, as well as their skeptical forerunners of the past. He argues that belief in God can no more ignore the scientific truth about the universe than science can dismiss the spiritual yearnings and hunger of humanity for purpose, meaning, and its inescapable sense of the presence of God. (shrink)

Philosophers of science are increasingly interested in engaging with scientific communities, policy makers, and members of the public; however, the nature of this engagement has not been systematically examined. Instead of delineating a specific kind of engaged philosophy of science, as previous accounts have done, this article draws on literature from outside the discipline to develop a framework for analyzing different forms of broadly engaged philosophy of science according to two key dimensions: social interaction and epistemic integration. Clarifying the many (...) forms of engagement available to philosophers of science can advance future scholarship on engagement and promote more strategic engagement efforts. (shrink)

How Doctors Think defines the nature and importance of clinical judgment. Although physicians make use of science, this book argues that medicine is not itself a science but rather an interpretive practice that relies on clinical reasoning. A physician looks at the patient's history along with the presenting physical signs and symptoms and juxtaposes these with clinical experience and empirical studies to construct a tentative account of the illness. How Doctors Think is divided into four parts. Part one introduces the (...) concept of medicine as a practice rather than a science; part two discusses the idea of causation; part three delves into the process of forming clinical judgment; and part four considers clinical judgment within the uncertain nature of medicine itself. In How Doctors Think, Montgomery contends that assuming medicine is strictly a science can have adverse side effects, and suggests reducing these by recognizing the vital role of clinical judgment. (shrink)

Recently, researchers on organization theory and behavior were challenged by the introduction of cognitive machines in the list of the organization’s participants. Researchers in this field advocated that cognitive machines contribute to improve cognitive abilities in the organization by extending people’s rationality and decision-making capacity and by reducing intra-individual and group dysfunctional conflicts. This paper supports these findings and extends their results to upper layers at managerial and organizational levels of application by proposing the concept of new industrial organizations with (...) structure and processes of Computational Organization Management Networks. In such a new organization type, cognitive machines and cognitive information systems are prominent actors of governance, automation, and control of the whole enterprise. (shrink)

Humans and organizations have limitations of computational capacity and information management. Such constraints are synonymous with bounded rationality. Therefore, in order to extend the human and organizational boundaries to more advanced models of cognition, this research proposes concepts of cognitive machines in organizations. From a micro point of view, what makes this research distinct is that, beyond people, it includes in the list of participants of the organization the cognitive machines. From a macro point of view, this paper relies on (...) the premise that cognitive machines can improve the cognitive abilities of the organization. From such perspectives, it presents rationale and principles of a class of cognitive machines with capabilities to carry out complex cognitive tasks in organizations. It also introduces analyses of the cognitive machines in organizations through theories of bounded rationality, economic decision-making, and conflict resolution. The analyses indicate that these machines can solve or reduce intra-individual and group dysfunctional conflicts which arise from decision-making processes in the organization, and thus they can improve the degree of organizational cognition. From all these backgrounds, this research outlines implications of cognitive machines for organizations. (shrink)

Constitutivist accounts in metaethics explain the normative standards in a domain by appealing to the constitutive features of its members. The success of these accounts turns on whether they can explain the connection between normative standards and the nature of individuals they authoritatively govern. Many such explanations presuppose that any member of a norm-governed kind must minimally satisfy the norms governing its kind. I call this the Threshold Commitment, and argue that constitutivists should reject it. First, it requires constitutivists to (...) restrict the scope of their explanatory ambitions, because it is not plausibly true of social kinds. Second, despite the frequent reliance on physical artifacts in constitutivists’ illustrations of the Threshold Commitment, it counter-intuitively entails that physical artifacts can cease to exist without being physically destroyed. Third, it misconstrues the normative force of authoritative norms on very defective kind-members because it locates this force not in the norm, but in the threat of non-existence. Fortunately, constitutivism can be decoupled from the Threshold Commitment, and I close by sketching a promising alternative account. (shrink)

While acknowledging Hannah Arendt's keen philosophical and political insights, Kathryn T. Gines claims that there are some problematic assertions and oversights regarding Arendt’s treatment of the "Negro question." Gines focuses on Arendt's reaction to the desegregation of Little Rock schools, to laws making mixed marriages illegal, and to the growing civil rights movement in the south. Reading them alongside Arendt's writings on revolution, the human condition, violence, and responses to the Eichmann war crimes trial, Gines provides a systematic analysis (...) of anti-black racism in Arendt’s work. (shrink)

Sometimes form-meaning mappings in language are not arbitrary, but iconic: they depict what they represent. Incorporating iconic elements of language into a compositional semantics faces a number of challenges in formal frameworks as evidenced by the lengthy literature in linguistics and philosophy on quotation/direct speech, which iconically portrays the words of another in the form that they were used. This paper compares the well-studied type of iconicity found with verbs of quotation with another form of iconicity common in sign languages: (...) classifier predicates. I argue that these two types of verbal iconicity can, and should, incorporate their iconic elements in the same way using event modification via the notion of a context dependent demonstration. This unified formal account of quotation and classifier predicates predicts that a language might use the same strategy for conveying both, and I argue that this is the case with role shift in American Sign Language. Role shift is used to report others’ language and thoughts as well as their actions, and recently has been argued to provide evidence in favor of Kaplanian “monstrous” indexical expressions. By reimagining role shift as involving either quotation for language demonstrations or “body classifier” predicates for action demonstrations, the proposed account eliminates one major argument for these monsters coming from sign languages. Throughout this paper, sign languages provide a fruitful perspective for studying quotation and other forms of iconicity in natural language due to their lack of a commonly used writing system which is otherwise often mistaken as primary data instead of speech, the rich existing literature on iconicity within sign language linguistics, and the ability of role shift to overtly mark the scope of a language report. In this view, written language is merely a special case of a more general phenomenon of sign and speech demonstration, which accounts more accurately for natural language data by permitting more strict or loose verbatim interpretations of demonstrations through the context dependent pragmatics. (shrink)

The nature of moral action versus moral judgment has been extensively debated in numerous disciplines. We introduce Virtual Reality (VR) moral paradigms examining the action individuals take in a high emotionally arousing, direct action-focused, moral scenario. In two studies involving qualitatively different populations, we found a greater endorsement of utilitarian responses–killing one in order to save many others–when action was required in moral virtual dilemmas compared to their judgment counterparts. Heart rate in virtual moral dilemmas was significantly increased when compared (...) to both judgment counterparts and control virtual tasks. Our research suggests that moral action may be viewed as an independent construct to moral judgment, with VR methods delivering new prospects for investigating and assessing moral behaviour. (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)

The authors examine the nature of the relationship between social science and philosophy and address the sort of work social science should do, and the role and sorts of claims that an accompanying philosophy should engage in. In particular, the authors reintroduce the question of ontology, an area long overlooked by philosophers of social science, and present a cricital engagement with the work of Roy Bhaskar. The book argues against the excesses of philosophising and commits itself to a philosophical approach (...) more deeply grounded in the social sciences. (shrink)

We present a computational model of dialectical argumentation that could serve as a basis for legal reasoning. The legal domain is an instance of a domain in which knowledge is incomplete, uncertain, and inconsistent. Argumentation is well suited for reasoning in such weak theory domains. We model argument both as information structure, i.e., argument units connecting claims with supporting data, and as dialectical process, i.e., an alternating series of moves by opposing sides. Our model includes burden of proof as a (...) key element, indicating what level of support must be achieved by one side to win the argument. Burden of proof acts as move filter, turntaking mechanism, and termination criterion, eventually determining the winner of an argument. Our model has been implemented in a computer program. We demonstrate the model by considering program output for two examples previously discussed in the artificial intelligence and legal reasoning literature. (shrink)

En el siglo XX y en especial en este momento de transición, algunos artistas han retomado los hechos históricos y en varios casos los horrores de la humanidad para plantearse preguntas sobre el hombre del hoy y del mañana. En el artículo se planteará una reflexión particular, exponiendo la relación entre las artes escénicas y los conflictos humanos, políticos y sociales. Adicionalmente se expondrá la recreación de hechos históricos, temas y personajes, como base para la reflexión y la renovación de (...) la esperanza y de la memoria. (shrink)