Clinical research has at least three problematic features: it tends to be redundant, secretive, and isolated.1 Research with these features not only wastes resources and causes harm, it also fails to meet a basic ethical requirement of research: scientific validity. As bioethicists, we should be asking why, if research with these three features is ethically unjustified, it has been so routinely approved by research ethics committees over the past half century. In what follows, I provide one answer to this question. (...) The first section of this paper outlines empirical evidence for the redundant, secretive, and isolated nature of much contemporary clinical research. Next, I argue that a lack of clarity .. (shrink)

A revision of George Kennedy's translation of, introdution to, and commentary on Aristotle's On Rhetoric. His translation is most accurate, his general introduction is the most thorough and insightful, and his brief introductions to sections of the work, along with his explanatory footnotes, are the most useful available.

Michael Martin aims to affirm a certain pattern of first-person thinking by advocating disjunctivism, a theory of perceptual experience which combines naive realism with the epistemic conception of hallucination. In this paper I argue that we can affirm the pattern of thinking in question without the epistemic conception of hallucination. The first part of my paper explains the link that Martin draws between the first-person thinking and the epistemic conception of hallucination. The second part of my paper explains how we (...) can achieve Martin’s ambition without Martin’s theory. One resource that I enlist for this purpose is a naive-realist friendly conception of first-person access to experience. The metaphysical theory that I enlist is a form of naive realism that endorses an intentionalist or representationalist “common-factor” approach to veridical and hallucinatory experience. The third part of my paper briefly develops this theory. (shrink)

In this paper I argue that there is an urgent need for more empirical research into everyday experiences of living with datafication, something that has not been prioritised in the emerging field of data studies to date. As a result of this absence, the knowledge produced within data studies is not as aligned to the aims of data activism as it might be. Data activism seeks to challenge existing, unequal data power relations and to mobilise data in order to enhance (...) social justice, yet data studies has focused primarily on identifying the former and not on imagining the latter. To build a picture of what more just conditions of datafication might look like, I argue that it is important to take account of everyday experiences of datafication, of what people themselves say would enable them to live better with data and would constitute more just data arrangements, based on their experiences. I explore two possible approaches to this endeavour, both of which suggest the need for a vocabulary of emotions in researching everyday living with data. (shrink)

This edited volume evaluates how sport organizations in the public, private, and non-profit sectors define responsible management and sustainability and what these mean in their daily operations. Using country-specific cases, the chapters provide an empirical investigation of sport organizations in each sector, analyzing managerial decisions and policies through a sustainability lens. All chapters are structured in the same way, providing a truly comparative approach. Offering insights for scholars interested in responsibility and sustainability in different context, this volume will be important (...) to undergraduate and postgraduate sport management, event management, sport science, and sport study programs around the globe. (shrink)

Sexual exploitation and abuse (SEA) by United Nations (UN) peacekeepers causes severe physical and psychological consequences. Where SEA leads to pregnancy and childbirth, peacekeepers typically absolve themselves of their paternal responsibilities and paternity suits are largely unsuccessful. The lack of support for peacekeeper-fathered children (PKFC) tarnishes the image of the UN who fails to implement a victim-centred approach to SEA. Analysing shortcomings in the provision of support, this article presents an evaluation of the UN’s accountability system from the perspective of (...) PKFC families. In-depth interviews with thirty-five PKFC and sixty mothers demonstrate local barriers to child support and paternity claims in eastern Democratic Republic of Congo. We discuss PKFC’s need for assistance and their mothers’ attempts to navigate an opaque international legal system. The findings cast light on their limited access to UN subsidies and offer recommendations to better implement existing UN goals of justice and victim-oriented policies. (shrink)

It now seems technically feasible to culture human embryos beyond the “fourteen‐day limit,” which has the potential to increase scientific understanding of human development and perhaps improve infertility treatments. The fourteen‐day limit was adopted as a compromise but subsequently has been considered an ethical line. Does it remain relevant in light of technological advances permitting embryo maturation beyond it? Should it be changed and, if so, how and why? What justifications would be necessary to expand the limit, particularly given that (...) doing so would violate some people's moral commitments regarding human embryos? Robust stakeholder engagement preceded adoption of the fourteen‐day limit and should arguably be part of efforts to reassess it. Such engagement could also consider the need for enhanced oversight of human embryo research. In the meantime, developing and implementing reliable oversight systems should help foster high‐quality research and public confidence in it. (shrink)

Drawing on Sir Ian Kennedy's extensive experience in healthcare law, ethics and public policy-making, this book explores vital issues in the law surrounding healthcare and regulation. The book contains a range of published and unpublished essays and speeches with the addition of notes and commentaries by the author that bring the pieces up to the present day. Those who want to understand developments, from transplants to confidentiality, from COVID-19 to public inquiries to regulation will find a rich seam of (...) rigorous, informed analysis. The author's unique range of experience allows him to share insights on a variety of issues; from the conduct of the disgraced breast surgeon, Ian Paterson, to research at Porton Down, to the economics of innovation in drug development at NICE. His abiding interest in the welfare of children informs his trenchant forensic examination of how children fare in the NHS. Those involved in or with an interest in law, moral philosophy, and public policy will find much food for thought. (shrink)

Body care is considered a key aspect of nursing and imperative for the health, wellbeing, and dignity of older people. In Scandinavian countries, body care as a professional practice has undergone considerable changes, bringing new understandings, values, and dilemmas into nursing. A systematic mapping review was conducted with the aims of identifying and mapping international nursing research on body care of older people in different institutionalized settings in the healthcare system and to critically discuss the dominant assumptions within the research (...) by adapting a problematization approach. Most identified papers reported on empirical research with a biomedical approach focusing on outcome and effectiveness. Conceptual papers, papers with a focus on the perspectives of the older people, or contextual and material aspects were lacking. The research field is dominated by four dominant assumptions: Body care as an evidence‐based practice, body care as a relational ethical practice, the body as a body‐object and a body‐subject, the objects in the body care practices as nonrelational materialities. Given the complexities of professional body care practices, there is a need for other research designs and theoretical perspectives within nursing that expand our understanding of body care taking into consideration the multiple social and material realities. (shrink)

Diagnostic testing can be used for many purposes, including testing to facilitate the clinical care of individual patients, testing as an inclusion criterion for clinical trial participation, and both passive and active surveillance testing of the general population in order to facilitate public health outcomes, such as the containment or mitigation of an infectious disease. As such, diagnostic testing presents us with ethical questions that are, in part, already addressed in the literature on clinical care as well as clinical research (...) (such as the rights of patients to refuse testing or treatment in the clinical setting or the rights of participants in randomized controlled trials to withdraw from the trial at any time). However, diagnostic testing, for the purpose of disease surveillance also raises ethical issues that we do not encounter in these settings, and thus have not been much discussed. In this paper we will be concerned with the similarities and differences between the ethical considerations in these three domains: clinical care, clinical research, and public health, as they relate to diagnostic testing specifically. Via an examination of the COVID-19 case we will show how an appeal to the concept of diagnostic justice helps us to make sense of the (at times competing) ethical considerations in these three domains. (shrink)

Democracy faces threats from an emerging right-wing movement in democratic governments around the world. This may be even more prevalent in the United States because there is an evil that uses rhetorical tropes to undermine the anchor institutions of democracy: press, courts, universities, and Congress. This evil has a personification--former President Donald Trump. All the rhetorical critiques of Trump, that he is a demagogue, an authoritarian, a serial liar, a populist on steroids, fail to take into account the evil that (...) is fomented by his angry and vengeful rhetoric. Pictures of evil in Scripture, philosophy, and rhetoric bear a striking resemblance to Trump. It is not enough to say that he is dangerous to democracy. Kennedy claims that he is the evil seed in democracy that is even now sprouting new versions of the Trump rhetoric as each acolyte attempts to outrage the next. Good and Evil in the Garden of Democracy screams at the evil, fights against the evil, and then attempts to sing the songs of goodness and democracy from poets, prophets, and rhapsodes. For the health of democracy these words have been written. (shrink)

Net Work provides a detailed study of the work of web designers. It draws on empirical research carried out from the birth of web design as an area of work in the 1990s to its professionalization in the twenty-first century and addresses the politics of building an inclusive WWW for people of diverse abilities.

BackgroundIn 2004, patient advocate groups were major players in helping pass and implement significant public policy and funding initiatives in stem cells and regenerative medicine. In the following years, advocates were also actively engaged in Washington DC, encouraging policy makers to broaden embryonic stem cell research funding, which was ultimately passed after President Barack Obama came into office. Many advocates did this because they were told stem cell research would lead to cures. After waiting more than 10 years, many of (...) these same patients are now approaching clinics around the world offering experimental stem cell-based interventions instead of waiting for scientists in the US to complete clinical trials. How did the same groups who were once the strongest supporters of stem cell research become stem cell tourists? And how can scientists, clinicians, and regulators work to bring stem cell patients back home to the US and into the clinical trial process?DiscussionIn this paper, we argue that the continued marketing and use of experimental stem cell-based interventions is problematic and unsustainable. Central problems include the lack of patient protection, US liability standards, regulation of clinical sites, and clinician licensing. These interventions have insufficient evidence of safety and efficacy; patients may be wasting money and time, and they may be forgoing other opportunities for an intervention that has not been shown to be safe and effective. Current practices do not contribute to scientific progress because the data from the procedures are unsuitable for follow-up research to measure outcomes. In addition, there is no assurance for patients that they are receiving the interventions promised or of what dosage they are receiving. Furthermore, there is inconsistent or non-existent follow-up care. Public policy should be developed to correct the current situation.ConclusionThe current landscape of stem cell tourism should prompt a re-evaluation of current approaches to study cell-based interventions with respect to the design, initiation, and conduct of US clinical trials. Stakeholders, including scientists, clinicians, regulators and patient advocates, need to work together to find a compromise to keep patients in the US and within the clinical trial process. Using HIV/AIDS and breast cancer advocate cases as examples, we identify key priorities and goals for this policy effort. (shrink)

This book presents a straightforward account of disease, the problems of practice, and the moral, legal and financial questions in the field.

IN/Search RE/Search' offers a unique insight into the wide range of appearances of the intersection between art, design and research. The book is organized into twelve substantive chapters: The Anthropocene Epoch; The Climate Crisis; The Coexerced Existence, The Limitations of Language; Facts and Fictions; The Fragile Human; The Instrumentalised Identity; Gender and Violence; The Question of Race; Politics of Public Space; Naked Capitalism; The Morality of a Cyborg. These themes are analysed through art and design projects. The projects are further (...) contextualised by journalistic explorations and academic reflections on similar matters, grappled by varied research outlooks. 00By bringing together various practices (arts, design and writing practices and academic research), 'IN/Search RE/Search' shows how artistic research processes are designed and performed. The kaleidoscopic convergence of the featured approaches promises an exciting shift in thinking about how knowledge within the arts comes about, and how this knowledge nurtures daily practice, and vice versa. In this way, this publication discloses methods of thinking and working through which a new generation of artists/designers/researchers is shaping scenarios for the near future.00The core of this publication is formed by various art and design projects by students of the Rietveld Academie and the Sandberg Instituut. Many of these projects confuse, blur and confront what is traditionally relevant in research practices. These young artists demonstrate what happens when ideas and practices that seem to be miles apart within the traditional domain of research, are suddenly allowed touch upon and influence each other. (shrink)

Women are everywhere in Dune, especially the members of the Bene Gesserit Sisterhood. In the Dune universe, the Bene Gesserit give girls so much practice in honing their skills that it almost guarantees they will grow into supremely confident women who trust their bodies to follow through on any action they desire. The Bene Gesserit in Dune represent a fulfillment of the ideal of the liberated women Beauvoir and Young describe. If women were “given the opportunity to use their full (...) bodily capacities in free and open engagement with the world” and encouraged “to develop specific bodily skills,” they could overcome some of the challenges in a sexist society and make their goals a reality. Dualism has cast a long shadow in Western philosophy, making human bodies out to be burdens entrapping the minds within. In particular, the female body has been treated as a nuisance, even by feminists. (shrink)

This Is A New Release Of The Original 1911 Edition.

It now seems technically feasible to culture human embryos beyond the “fourteen‐day limit,” which has the potential to increase scientific understanding of human development and perhaps improve infertility treatments. The fourteen‐day limit was adopted as a compromise but subsequently has been considered an ethical line. Does it remain relevant in light of technological advances permitting embryo maturation beyond it? Should it be changed and, if so, how and why? What justifications would be necessary to expand the limit, particularly given that (...) doing so would violate some people's moral commitments regarding human embryos? Robust stakeholder engagement preceded adoption of the fourteen‐day limit and should arguably be part of efforts to reassess it. Such engagement could also consider the need for enhanced oversight of human embryo research. In the meantime, developing and implementing reliable oversight systems should help foster high‐quality research and public confidence in it. (shrink)

`Being sensitive' in nursing was explored using Schwartz-Barcott and Kim's hybrid model of concept development, producing a tentative definition of the concept. Three phases were employed: theoretical, empirical/fieldwork and analytical. An exploration of the literature identified where the common idea of `being sensitive' as a nurse was embedded and demonstrated that a theoretical development of this fundamental aspect of nursing was absent. The empirical phase was conducted using semistructured interviews with nine expert palliative care and cancer nurses. This method was (...) particularly useful for the exploration of this concept because of its firm grounding in practical example. A definition of what the concept `being sensitive' means in nursing, and subsequent clarification of `being insensitive', have been posed from the research process undertaken. The essential nature of this concept being integral to nursing practice is emphasized. Potential implications for the development of nursing practice through teaching of this concept were identified. (shrink)

Roger Kennedy has written a masterful investigation into the concept of evil. He begins with a general view of the subject before moving into more detailed analysis. First is a review of the science of evil, including evidence from neuroscience and social psychology. This is followed by psychoanalytical studies of the individual and groups before presenting an overview of the philosophy of evil. Also included are historical and social studies which inform an understanding of evil in action. Kennedy (...) goes on to examine the nature of genocide using a main focus on the Holocaust and of slavery. Both of these "journeys to evil" remain relevant for understanding contemporary society and issues. The Nazi past continues to disturb and resonate decades on. The politics and social fabric of Western society was reliant on slavery as a foundation of economic wealth and is haunted by its inability to process the harsh reality of slavery and its continuing after-effects. Kennedy moves from there to a discussion on the genius of Shakespeare and his encapsulation of the essential features of how evil can develop and take over a person's inner world. The book concludes with a summary of the main themes and a look at those who have resisted evil and what we can learn from them if we are to build a society that can resist the forces of evil. The book is informed by a psychoanalytic approach, with its emphasis on the power and influence of unconscious processes underlying human actions, and on the role of inner conflicting and elemental fears and anxieties often driving individual and group behaviours. It brings fresh insight to an eternal discourse. (shrink)

In Science as Social Knowledge in 1990 and The Fate of Knowledge in 2002, Helen Longino develops an epistemological theory known as Critical Contextual Empiricism (CCE). Knowledge production, she argues, is an active, value-laden practice, evidence is context dependent and relies on background assumptions, and science is a social inquiry that, under certain conditions, produces social knowledge with contextual objectivity. While Longino’s work has been generally well-received, there have been a number of criticisms of CCE raised in the philosophical literature (...) in recent years. In this paper I outline the key elements of Longino’s theory and propose modifications to the four norms offered by the account. The version of CCE I defend, which draws on lessons learned by medical researchers in recent years, gives principles of epistemic diversity a central role and also provides greater specification of three of the four norms. Further, it offers additional resources for defending CCE against Alvin Goldman’s suggestion that there is a need for a “healthy dogmatism” in science, as well as a concern about “manufactured uncertainty” arising out of recent work by David Michaels. Finally, the modified version proposed here is also well positioned to respond (negatively) to a suggestion from Kristen Intemann that CCE needs to be adapted to incorporate a central insight from feminist standpoint theory. In light of the variety of social pressures influencing contemporary scientific research, and the role of science in shaping public policy, I argue that a rigorous social epistemology such as CCE is indispensable for understanding and assessing contemporary scientific practice. (shrink)

The articles in this volume offer a fresh perspective on the important role of the concept of law (lex) in the moral and political philosophy of the 'School of Salamanca'.

In their paper, “Think Pragmatically: Investigators’ Obligations to Patient-Subjects When Research is Embedded in Care,” Stephanie Morain and Emily Largent (2023) argue that investigators, and poss...

Offers both theoretical and practical insights into the dialogue between adults and children as a democratic model for schooling.

Offers an interdisciplinary feminist framework for conceptualizing time and temporal justice as a form of reparation.

Most phase III clinical trials today are explanatory. Because explanatory, or efficacy, trials test hypotheses under “ideal” conditions, they are not well suited to providing guidance on decisions made in most clinical care contexts. Pragmatic trials, which test hypotheses under “usual” conditions, are often better suited to this task. Yet, pragmatic, or effectiveness, trials are infrequently carried out. This mismatch between the design of clinical trials and the needs of health care professionals is frustrating for everyone involved, and explains some (...) of the challenges inherent in attempts to enhance knowledge translation and encourage evidence-based practice. The situation is more than simply frustrating, however; it is potentially unethical. Clinical trials must be socially valuable in order to (1) warrant the risks they impose on human research subjects and (2) fairly and efficiently assess new clinical interventions. Most bioethicists would agree that trials that have no social value, for instance, because their results do not have the potential to advance clinical care, should not be performed. What is less widely appreciated is that given limited research resources, trials that are more socially valuable should be preferred to trials that are less socially valuable when all else is equal. With respect to clinical trial design, I argue that while explanatory trials often have some social value, many have less social value than their pragmatic counterparts. On the basis of this general ethical assessment, I provide a preliminary defense of the position that clinical researchers should aim to conduct pragmatic trials, that is, that researchers face a burden of justification related to any idealizing elements added to trial designs. (shrink)

The volume of clinical research is increasing exponentially—far beyond our ability to process and absorb the results. Given this situation, it may be beneficial to consider reducing the flow at its source. In what follows, I will motivate and critically evaluate the following proposal: researchers should conduct fewer clinical trials. More specifically, I c onsider whether researchers should be permitted to conduct only clinical research of very high quality and, in turn, whether research ethics committees should prohibit all other, lower-quality (...) research, even when it might appear to meet some minimal ethical standard. Following a close analysis of the social-value requirement of ethical clinical research, I argue that this proposal is defensible. The problem identified in this paper has two parts, quantity and quality, and some clarification is needed about the latter because “quality” is a highly contested term in the medical literature. When some scholars advocate for high-quality trials, they mean large-scale, simple, explanatory randomized controlled trials. Others, including myself, have defended a different characterization of high-quality research that tends more toward pragmatic trial design and the use of methods other than RCTs. Pragmatic trials aim to provide evidence that directly supports clinical decision-making in “usual” care settings. Unlike explanatory trials, which aim to abstract away from particular settings and patients, in the hopes of creating ideal conditions for the success of an intervention, pragmatic trials deliberately pursue knowledge of high applicability, through the use of representative subjects, clinically important questions, flexible treatment protocols, patient-oriented outcome measures, and so on. I see applicability as a marker of high-quality research. The context in which research is meant to be applied should be the context in which new interventions are evaluated. (shrink)

What can the sounds of today tell us about the future? Can an analysis of sound and sonic practices allow us to make reliable predictions in relation to wider social phenomena? And what might they tell us about technology in a world where futurology is such a frenzied and busy field? In order to answer these questions, this book tests a range of propositions that connect noise, sound and music to political, economic and technological events. Hence it is a book (...) about historical trajectories and conflicting ideas about time and the necessity to re-contextualize and interpret them in the digital age. (shrink)