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)

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)

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)

Julian Savulescu argues for two principles of reproductive ethics: reproductive autonomy and procreative beneficence, where the principle of procreative beneficence is conceptualised in terms of a duty to have the child, of the possible children that could be had, who will have the best opportunity of the best life. Were it to be accepted, this principle would have significant implications for the ethics of reproductive choice and, in particular, for the use of prenatal testing and other reproductive technologies for the (...) avoidance of disability, and for enhancement. In this paper, it is argued that this principle should be rejected, and it is concluded that while potential parents do have important obligations in relation to the foreseeable lives of their future children, these obligations are not best captured in terms of a duty to have the child with the best opportunity of the best life. (shrink)

Clinical geneticists are increasingly confronted with ethical tensions between their responsibilities to individual patients and to other family members. This paper considers the ethical implications of a “familial” conception of the clinical genetics role. It argues that dogmatic adherence to either the familial or to the individualistic conception of clinical genetics has the potential to lead to significant harms and to fail to take important obligations seriously.Geneticists are likely to continue to be required to make moral judgments in the resolution (...) of such tensions and may find it useful to have access to ethics training and support. (shrink)

The development of human genetics raises a wide range of important ethical questions for us all. The interpersonal dimension of genetic information in particular means that genetics also poses important challenges to the idea of patient-centredness and autonomy in medicine. How ought practical ethical decisions about the new genetics be made given that we appear, moreover, no longer to be able to appeal to unquestioned traditions and widely shared communitarian values? This paper argues that any coherent ethical approach to these (...) questions must be able both to uphold the moral status of the individual and at the same time recognise the communitarian, interpersonal dimensions both of the world in which we live and of personal autonomy itself. The paper then goes on to propose an approach to the resolution of the ethical questions raised by the use of the new genetics in reproductive choice through the development of a coherent and principled process of public reason and justification oriented towards the support and development of personal autonomy. (shrink)

The internet is becoming increasingly important in health care practice. The number of health-related web sites is rising exponentially as people seek health-related information and services to supplement traditional sources, such as their local doctor, friends, or family. The development of e-medicine poses important ethical challenges, both for health professionals and for those who provide clinical ethics support for them. This paper describes some of these challenges and explores some of the ways in which those who provide clinical ethics support (...) might respond creatively to them. By offering ways of responding to such challenges, both electronically and face-to-face, the providers of clinical ethics support can show themselves to be an indispensable part of good quality health care provision. (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)

ZusammenfassungEntscheidungen der Therapiebegrenzung und in der Betreuung am Lebensende sind häufig komplex und von ethischen Problemen begleitet. Im Mittelpunkt der Untersuchung steht die entscheidende Frage, wie hilfreich existierende „Ethik-Richtlinien“, die eine ethische Orientierung bei solchen Entscheidungen geben sollen, in der klinischen Praxis tatsächlich sind. Die Frage, welchen Nutzen „Ethik-Richtlinien“ bei der Entscheidungsfindung haben oder haben können, wird hier exemplarisch an einem klinischen Fallbeispiel aus einer Ethik-Kooperationsstudie in der Intensivmedizin analysiert. Vergleichend werden hierzu „Ethik-Richtlinien“ aus Deutschland, der Schweiz und aus Großbritannien (...) herangezogen, die Gegenstand eines internationalen Projekts zur Analyse von Richtlinien waren. Die Möglichkeiten und Grenzen einer ethischen Orientierung an „Ethik-Richtlinien“ bei Entscheidungsproblemen der Therapiebegrenzung und in der Betreuung am Lebensende werden anhand der Fallstudie diskutiert und illustriert. Abschließend werden Schlussfolgerungen für die Entwicklung ethischer Richtlinien für die klinische Praxis formuliert. (shrink)

More than any other textbook, Moore and Parker's Critical Thinking has defined the structure and content of the critical thinking course at colleges and universities across the country--and has done so with a witty writing style that students enjoy. Now in full-color, the eighth edition brings the concepts of critical thinking to life in vivid detail, with current examples relevant to today's students.

The National Health Service (NHS) was the first healthcare system globally to declare ambitions to become net carbon zero. To achieve this, a shift away from metered-dose inhalers which contain powerful greenhouse gases is necessary. Many patients can use dry powder inhalers which do not contain greenhouse gases and are equally effective at managing respiratory disease. This paper discusses the ethical issues that arise as the NHS attempts to mitigate climate change. Two ethical issues that pose a barrier to moving (...) away from metered-dose inhalers are considered: patients who decline an inhaler with a smaller carbon footprint and increased cost. I argue that while a patient is not morally justified in refusing a more environmentally sustainable inhaler due to the expected harms, a doctor may still prescribe a metered-dose inhaler if they believe that switching without consent might undermine trust or substantially worsen the patient’s health. Turning to cost, I argue that the imperative to combat climate change means the NHS should accept small increased financial costs for lower carbon inhalers, even though this provides no additional direct benefit for the patient. I then go on to consider the implications of the preceding analysis for policy and practice. I argue for a policy that minimises the impact of inhalers on the climate by advocating for a principle of environmental prescribing and explore decision-making in practice. While the arguments here pertain primarily to inhalers, the discussion has broader implications for debates around healthcare’s responsibility to be environmentally sustainable. (shrink)

ZusammenfassungEntscheidungen der Therapiebegrenzung und in der Betreuung am Lebensende sind häufig komplex und von ethischen Problemen begleitet. Im Mittelpunkt der Untersuchung steht die entscheidende Frage, wie hilfreich existierende „Ethik-Richtlinien“, die eine ethische Orientierung bei solchen Entscheidungen geben sollen, in der klinischen Praxis tatsächlich sind. Die Frage, welchen Nutzen „Ethik-Richtlinien“ bei der Entscheidungsfindung haben oder haben können, wird hier exemplarisch an einem klinischen Fallbeispiel aus einer Ethik-Kooperationsstudie in der Intensivmedizin analysiert. Vergleichend werden hierzu „Ethik-Richtlinien“ aus Deutschland, der Schweiz und aus Großbritannien (...) herangezogen, die Gegenstand eines internationalen Projekts zur Analyse von Richtlinien waren. Die Möglichkeiten und Grenzen einer ethischen Orientierung an „Ethik-Richtlinien“ bei Entscheidungsproblemen der Therapiebegrenzung und in der Betreuung am Lebensende werden anhand der Fallstudie diskutiert und illustriert. Abschließend werden Schlussfolgerungen für die Entwicklung ethischer Richtlinien für die klinische Praxis formuliert. (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)

In our paper ‘The ethical case for non-directed postmortem sperm donation’ we argued that it would be ethical for men to donate sperm after death for use by strangers. In their thoughtful response Fredrick and Ben Kroon lay out practical concerns regarding our proposal. They raise issues regarding the quality of sperm collected postmortem based on empirical studies. Second, they claim that concerns about quality would make women unlikely to use sperm collected after death. In this response we explore issues (...) of sperm quality in both living and dead donors. We consider whether there might be ways to ensure quality in both. Finally, we question whether quality should be a barrier to women choosing to use sperm donated after death. (shrink)

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)

The significance of informed consent in research involving humans has been a topic of active debate in the last decade. Much of this debate, we submit, is predicated on an ideology of individualism. We draw on our experiences as anthropologists working in Western and non Western (Iban) health care settings to present ethnographic data derived from diverse scenes in which consent is gained. Employing classical anthropological ritual theory, we subject these observational data to comparative analysis. Our article argues that the (...) individualist assumptions underlying current bioethics guidelines do not have universal applicability, even in Western research settings. This is based on the recognition that the social world is constitutive of personhood in diverse forms, just one of which is individualistic. We submit that greater attention must be paid to the social relations the researcher inevitably engages in when conducting research involving other people, be this in the context of conventional medical research or anthropological field work. We propose, firstly, that the consenting process continues throughout the life of any research project, long after the signature has been secured, and secondly, that both group and individual dimensions of consent, and the sequence in which these dimensions are addressed, should be carefully considered in all cases where consent is sought. (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.

Is it possible for postmodernism to offer viable, coherent accounts of ethics? Or are our social and intellectual worlds too fragmented for any broad consensus about the moral life? These issues have emerged as some of the most contentious in literary and philosophical studies. In Renegotiating Ethics in Literature, Philosophy, and Theory a distinguished international gathering of philosophers and literary scholars address the reconceptualisations involved in this 'turn towards ethics'. An important feature of this has been a renewed interest in (...) the literary text as a focus for the exploration of ethical issues. Exponents of this trend include Charles Taylor, Bernard Williams, Iris Murdoch, Cora Diamond, Richard Rorty and Martha Nussbaum, the latter a contributor and a key figure in this volume. This book assesses the significance of this development for ethical and literary theory and attempts to articulate an alternative postmodern account of ethics which does not rely on earlier appeals to universal truths. (shrink)

Despite having paved the way for face, womb and penis transplants, hand transplantation today remains a small hybrid of reconstructive microsurgery and transplant immunology. An exceptionally limited patient population internationally complicates medical researchers’ efforts to parse outcomes “objectively.” Presumed functional and psychosocial benefits of gaining a transplant hand must be weighed in both patient decisions and bioethical discussions against the difficulty of adhering to post-transplant medications, the physical demands of hand transplant recovery on the patient, and the serious long-term health (...) risks of immunosuppressant drugs. This paper relates five narratives of hand transplantation drawn from an oral history project to show how narrative methods can and should inform ethical evaluations and the clinical process of hand transplantation. The interviews with patients and their partners analyzed here lead us to suggest that qualitative accounts of patient experiences should be used to complement clinical case studies reported in medical journals and to help develop instruments to assess outcomes more systematically. (shrink)

Relativism in psychology unravels the truth-claims and oppressive\npractices of the discipline, but simply relativizing psychological knowledge\nhas not been sufficient to comprehend and combat the discipline\nas part of the ‘psy-complex’. For that, a balanced review of the contribution\nand problems of relativism needs to work dialectically, and so\nthis article reviews four problematic rhetorical balancing strategies in\nrelativism before turning to the contribution of critical realism. Critical\nrealism exposes positivist psychology’s pretensions to model itself\non what it imagines the natural sciences to be, and it grounds (...) discursive\naccounts of mentation in social practices. The problem is that those\nsympathetic to mainstream psychology are also appealing to ‘realism’\nto warrant it as a science and to discredit critical research that situates\npsychological phenomena. Our use of critical realism calls for an\naccount of how psychological facts are socially constructed within\npresent social arrangements and for an analysis of the underlying historical\nconditions that gave rise to the ‘psy-complex’. Only by understanding\nhow the discipline of psychology reproduces notions of\nindividuality and human nature, a critical realist endeavour, will it be\npossible to transform it, and to socially construct it as something different. (shrink)

Autoethnography is a qualitative research method that utilizes data about self and context to gain an understanding of the connectivity between self and others. This introductory article exposes the reader to our own praxis of collaborative autoethnography which we used to interrogate how we navigate the US academy as immigrant women faculty. Before introducing the articles in this special issue, we explore the autoethnography continuum, provide sample areas covered by autoethnographers, and explicate the practice of collaborative autoethnography. We conclude this (...) piece with implications for future use of autoethnography as research method. (shrink)

"This title was first published in 2003.Developments in genetic science are opening up new possibilities for human beings; both the creation and the shaping of human life are now possible in the laboratory. As these techniques develop, questions are increasingly asked about how far everything that is scientifically possible should - morally, legally and socially - be pursued. Whilst much attention and policy-making has focussed on the development of regulation of technologies affecting human reproduction, regulation where plants and animals are (...) concerned is much more limited. In this book, developments in genetics are addressed in the broad sense by an international range of contributors. This includes not only issues such as eugenics and the modification of the human embryo, but also the genetic modification of plants and animals in the pursuit of commerce, agriculture and biomedical research. This book is published in association with the Society for Applied Philosophy"--Provided by publisher. (shrink)

Computer simulation modeling is an important part of contemporary scientific practice but has not yet received much attention from philosophers. The present project helps to fill this lacuna in the philosophical literature by addressing three questions that arise in the context of computer simulation of Earth's climate. Computer simulation experimentation commonly is viewed as a suspect methodology, in contrast to the trusted mainstay of material experimentation. Are the results of computer simulation experiments somehow deeply problematic in ways that the results (...) of material experiments are not? I argue against categorical skepticism toward the results of computer simulation experiments by revealing important parallels in the epistemologies of material and computer simulation experimentation. It has often been remarked that simple computer simulation models---but not complex ones---contribute substantially to our understanding of the atmosphere and climate system. Is this view of the relative contributions of simple and complex models tenable? I show that both simple and complex climate models can promote scientific understanding and argue that the apparent contribution of simple models depends upon whether a causal or deductive account of scientific understanding is adopted. When two incompatible scientific theories are under consideration, they typically are viewed as competitors, and we seek evidence that refutes at least one of the theories. In the study of climate change, however, logically incompatible computer simulation models are accepted as complementary resources for investigating future climate. How can we make sense of this use of incompatible models? I show that a collection of incompatible climate models persists in part because of difficulties faced in evaluating and comparing climate models. I then discuss the rationale for using these incompatible models together and argue that this climate model pluralism has both competitive and integrative components. (shrink)

This paper will investigate how geographic features were recorded on maps in the eighteenth century in order to outline the construction of geographic knowledge by British mapmakers. Due to practical and economic factors, early modern cartography was a conservative practice based on source compilation and comparison. For the Pacific region especially, the paucity of first-hand observations and the conflicting nature of those observations rendered the world's largest ocean difficult to chart and prone to the retention of mythical continents, passages and (...) islands. After a discussion of the practical and economic reasons why geographic features were difficult to revise on maps, the article focuses on a case study to show how geographic enigmas could be placed and persist. It will use Pepys Island to illustrate the ways in which a chimeric feature could become instilled in geographic parlance. (shrink)

With the question “What is ' discourse?' “ as the starting point, this paper addresses ways of identifying particular discourses, and attends to how these discourses should be distinguished from texts. The emergence of discourse analysis within psychology, and the continuing influence of linguistic and post-structuralist ideas on practitioners, provide the basis on which discourse -analytic research can be developed fruitfully. This paper discusses the descriptive, analytic and educative functions of discourse analysis, and addresses the cultural and political questions which (...) arise when discourse analysts reflect on their activity. Suggestions for an adequate definition of discourse are proposed and supported by seven criteria which should be adopted to identify discourses, and which attend to contradictions between and within them. Three additional criteria are then suggested to relate discourse analysis to wider political issues. (shrink)

Unlike some other reproductions of classic texts (1) We have not used OCR(Optical Character Recognition), as this leads to bad quality books with introduced typos. (2) In books where there are images such as portraits, maps, sketches etc We have endeavoured to keep the quality of these images, so they represent accurately the original artefact. Although occasionally there may be certain imperfections with these old texts, we feel they deserve to be made available for future generations to enjoy.

Arguments in environmental ethics often appeal to information from environmental science, such as information about the causes of environmental problems. Contemporary work in philosophy of science can shed light on the practice of environmental science as well as some of the challenges it faces. This chapter surveys some of this work, focusing on three interrelated topics: the nature of scientific evidence, including connections with uncertainty and consensus; the use and evaluation of scientific models; and values and objectivity in scientific practice. (...) A better understanding of these topics can help to ensure that scientific information is used appropriately and effectively in ethical argumentation. (shrink)

At the International Legal Ethics Conference IV held at Stanford Law School between 15 and 17 July 2010, one of the two opening plenary sessions consisted of a panel who debated the proposition that legal ethics should be mandatory in legal education. The panel included leading legal ethics academics from jurisdictions around the world—both those where legal ethics is a compulsory part of the law degree and those where it is not. It comprised Professors Andrew Boon, Brent Cotter, Christine (...) class='Hi'>Parker, Stephen L Pepper and Richard Wu, and was organised and chaired by Professor Kim Economides. This is an edited version of the panel's discussion. It provides a useful summary of the state of legal ethics teaching in the jurisdictions represented as well as a marshalling of the arguments for and against legal ethics as a required course in the university law degree. (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)

The use of video for research purposes is something that has attracted ethical attention and debate. While the usefulness of video as a mechanism to collect data is widely agreed, the ethical sensitivity and impact of recording equipment is more contentious. In some clinical settings the presence of a camera has a dual role, as a portal to a reflecting team and as a recording device to obtain research data. Using data from one such setting, family therapy sessions, this article (...) shows how the role played by recording equipment is negotiated in the course of talk and other activities that constitute sessions. Analysis reveals that members of the therapy interaction orient in different ways and for different purposes to the value of recordings. The article concludes that there are layers of benefit to be derived from recording of clinical interactions, including for members themselves, and this has wider implications for the ways in which qualitative research designs in health sciences are evaluated. (shrink)

The ecohumanist/service-learning approach to environmental education provides a bridge between science and public policy on the one hand, and direct civic action on the other. This pedagogy appears to be a promising way to engage students and to extend the reach of environmental education beyond the classroom. This paper surveys the philosophical context for ecohumanities pedagogy, relates the key moments of teaching such a course, describes specific outcomes, and offers practical advice for those who might wish to try a similar (...) approach to environmental education. (shrink)