One recurring criticism of the best interests standard concerns its vagueness, and thus the inadequate guidance it offers to care providers. The lack of an agreed definition of ‘best interests’, together with the fact that several suggested considerations adopted in legislation or professional guidelines for doctors do not obviously apply across different groups of persons, result in decisions being made in murky waters. In response, bioethicists have attempted to specify the best interests standard, to reduce the indeterminacy surrounding medical decisions. (...) In this paper, we discuss the bioethicists’ response in relation to the state's possible role in clarifying the best interests standard. We identify and characterise two clarificatory strategies employed by bioethicists —elaborative and enumerative—and argue that the state should adopt the latter. Beyond the practical difficulties of the former strategy, a state adoption of it would inevitably be prejudicial in a pluralistic society. Given the gravity of best interests decisions, and the delicate task of respecting citizens with different understandings of best interests, only the enumerative strategy is viable. We argue that this does not commit the state to silence in providing guidance to and supporting healthcare providers, nor does it facilitate the abuse of the vulnerable. Finally, we address two methodological worries about adopting this approach at the state level. The adoption of the enumerative strategy is not defeatist in attitude, nor does it eventually collapse into (a form of) the elaborative strategy. (shrink)

Singapore, a highly affluent island city-state located in Southeast Asia, has increasingly leveraged new assisted reproductive technologies (ART) to overcome its dismal fertility rates in recent years. A new frontier in ART is preimplantation genetic testing (PGT) for polygenic risk scores (PRS) to predict complex multifactorial traits in IVF (in vitro fertilisation) embryos, such as type 2 diabetes, cardiovascular diseases and various other characteristics like height, intelligence quotient (IQ), hair and eye colour. Unlike well-known safety risks with human genome editing, (...) there are negligible risks with PGT-P, because there are no man-made genetic modifications that can be transmitted to future generations. Nevertheless, the current efficacy of using PGT-P to select IVF embryos for either increased or decreased probability of developing specific polygenic traits is still far from certain. Hence, the regulatory safeguards proposed here will be based on the assumption that the efficacy of this new technology platform has already been validated. These include: (1) restricting the application of PGT-P only for prevention of clinically relevant polygenic disease traits, (2) securely blocking patients’ access to the raw genomic DNA sequencing data of their IVF embryos, (3) validating diagnosis of polygenic disease traits in the prospective parents/grandparents of IVF embryos, and restricting PGT-P only for preventing specifically diagnosed polygenic disease traits and (4) mandating rigorous and comprehensive genetic counselling for IVF patients considering PGT-P. There is an urgent and dire need to prevent abuse of the PGT-P technique, as well as protect the interests and welfare of patients if its clinical application is to be permitted in the country. (shrink)

BackgroundResearch and academic institutions use various delivery channels to deliver Research Integrity education in their communities. Yet there is no consensus on the best delivery method and the effectiveness of these channels in inculcating a positive RI culture varies across institutions. Hence, this study aimed to understand the preferences of the research community in Nanyang Technological University, Singapore.MethodsAn online survey was conducted on NTU research community to understand their experience with, and preference for each RI education mode offered in NTU. (...) The RI education modes surveyed in the general ranking question are Data Management Plan workshops, Epigeum e-Learning, Compass e-newsletter, and NTU policy on Research Integrity and Responsible Conduct of Research. There were 242 responses, comprising 50% research students, 32.2% research staff and 17.8% faculty members. Non-parametric statistical techniques were used to analyse preferences across different RI education modes and within sub-groups.ResultsMore than 92% of respondents subscribed to the importance of RI education, but with different preferences for education modes. With respect to RI education in NTU, Compass e-newsletters were ranked the lowest. Most felt that they were too wordy and unengaging, making it difficult to absorb information. Similarly, Epigeum e-Learning and ‘policy’ were found to be too lengthy in presentation. The compulsory NTU RI education modes enjoyed higher participation rates of 70–80% compared with 32–37% for the self-regulated modes. This suggests that regulatory mechanisms are still necessary to promote participation in RI education, and thus, core RI education content should be made compulsory in research/academic institutions. Although Epigeum is a compulsory course, some may not have participated in the programme due to technical issues or they might have forgotten to participate in the programme within the permissible timeframe. For all four RI education modes in NTU, the lack of awareness was among the top cited reasons for not participating.ConclusionsMost NTU researchers perceived RI education positively although they may have reservations for some approaches. Conversely, e-Learning is favored over all the other modes except for the mode of Policy. Findings from this study are useful for improving the design of RI education strategies to be more appealing to the research community by enhancing user experience in terms of user-friendliness, relevance to specialisation, providing concise information and better presentation of materials For institutions with similar modes of RI education as NTU, these results may be relevant in improving participation rates and presentation of RI education modes, such as the use of infographics and more concise information. (shrink)

IntroductionClinical ethics committees (CECs) support and enhance communication and complex decision making, educate healthcare professionals and the public on ethical matters and maintain standards of care. However, a consistent approach to training members of CECs is lacking. A systematic scoping review was conducted to evaluate prevailing CEC training curricula to guide the design of an evidence-based approach.MethodsArksey and O’Malley’s methodological framework for conducting scoping reviews was used to evaluate prevailing accounts of CEC training published in six databases. Braun and Clarke’s (...) thematic analysis approach was adopted to thematically analyse data across different healthcare and educational settings.Results7370 abstracts were identified, 92 full-text articles were reviewed and 55 articles were thematically analysed to reveal four themes: the design, pedagogy, content and assessment of CEC curricula.ConclusionFew curricula employ consistent approaches to training. Many programmes fail to provide CEC trainees with sufficient knowledge, skills and experience to meet required competencies. Most programmes do not inculcate prevailing sociocultural, research, clinical and educational considerations into training processes nor provide longitudinal support for CEC trainees. Most CEC training programmes are not supported by host institutions threatening the sustainability of the programme and compromising effective assessment and longitudinal support of CEC trainees. While further reviews are required, this review underlines the need for host organisations to support and oversee a socioculturally appropriate ethically sensitive, clinically relevant longitudinal training, assessment and support process for CEC trainees if CECs are to meet their roles effectively. (shrink)

Monetary intelligence theory asserts that individuals apply their money attitude to frame critical concerns in the context and strategically select certain options to achieve financial goals and ultimate happiness. This study explores the dark side of monetary Intelligence and behavioral economics—dishonesty. Dishonesty, a risky prospect, involves cost–benefit analysis of self-interest. We frame good or bad barrels in the environmental context as a proxy of high or low probability of getting caught for dishonesty, respectively. We theorize: The magnitude and intensity of (...) the relationship between love of money and dishonest prospect may reveal how individuals frame dishonesty in the context of two levels of subjective norm—perceived corporate ethical values at the micro-level and Corruption Perceptions Index at the macro-level, collected from multiple sources. Based on 6382 managers in 31 geopolitical entities across six continents, our cross-level three-way interaction effect illustrates: As expected, managers in good barrels, mixed barrels, and bad barrels display low, medium, and high magnitude of dishonesty, respectively. With high CEV, the intensity is the same across cultures. With low CEV, the intensity of dishonesty is the highest in high CPI entities —the Enron Effect, but the lowest in low CPI entities. CPI has a strong impact on the magnitude of dishonesty, whereas CEV has a strong impact on the intensity of dishonesty. We demonstrate dishonesty in light of monetary values and two frames of social norm, revealing critical implications to the field of behavioral economics and business ethics. (shrink)

Monetary Intelligence theory asserts that individuals apply their money attitude to frame critical concerns in the context and strategically select certain options to achieve financial goals and ultimate happiness. This study explores the bright side of Monetary Intelligence and behavioral economics, frames money attitude in the context of pay and life satisfaction, and controls money at the macro-level and micro-level. We theorize: Managers with low love of money motive but high stewardship behavior will have high subjective well-being: pay satisfaction and (...) quality of life. Data collected from 6586 managers in 32 cultures across six continents support our theory. Interestingly, GDP per capita is related to life satisfaction, but not to pay satisfaction. Individual income is related to both life and pay satisfaction. Neither GDP nor income is related to Happiness. Our theoretical model across three GDP groups offers new discoveries: In high GDP entities, “high income” not only reduces aspirations—“Rich, Motivator, and Power,” but also promotes stewardship behavior—“Budget, Give/Donate, and Contribute” and appreciation of “Achievement.” After controlling income, we demonstrate the bright side of Monetary Intelligence: Low love of money motive but high stewardship behavior define Monetary Intelligence. “Good apples enjoy good quality of life in good barrels.” This notion adds another explanation to managers’ low magnitude of dishonesty in entities with high Corruption Perceptions Index. In low GDP entities, high income is related to poor Budgeting skills and escalated Happiness. These managers experience equal satisfaction with pay and life. We add a new vocabulary to the conversation of monetary intelligence, income, GDP, happiness, subjective well-being, good and bad apples and barrels, corruption, and behavioral ethics. (shrink)

Background The use of lengthy, detailed, and complex informed consent forms is of paramount concern in biomedical research as it may not truly promote the rights and interests of research participants. The extent of information in ICFs has been the subject of debates for decades; however, no clear guidance is given. Thus, the objective of this study was to determine the perspectives of research participants about the type and extent of information they need when they are invited to participate in (...) biomedical research. Methods This multi-center, cross-sectional, descriptive survey was conducted at 54 study sites in seven Asia-Pacific countries. A modified Likert-scale questionnaire was used to determine the importance of each element in the ICF among research participants of a biomedical study, with an anchored rating scale from 1 to 5. Results Of the 2484 questionnaires distributed, 2113 were returned. The majority of respondents considered most elements required in the ICF to be ‘moderately important’ to ‘very important’ for their decision making. Major foreseeable risk, direct benefit, and common adverse effects of the intervention were considered to be of most concerned elements in the ICF. Conclusions Research participants would like to be informed of the ICF elements required by ethical guidelines and regulations; however, the importance of each element varied, e.g., risk and benefit associated with research participants were considered to be more important than the general nature or technical details of research. Using a participant-oriented approach by providing more details of the participant-interested elements while avoiding unnecessarily lengthy details of other less important elements would enhance the quality of the ICF. (shrink)

This paper considers the ethical implications of applying three major ethical theories to the memory structure of an artificial companion that might have different embodiments such as a physical robot or a graphical character on a hand-held device. We start by proposing an ethical memory model and then make use of an action-centric framework to evaluate its ethical implications. The case that we discuss is that of digital artefacts that autonomously record and store user data, where this data are used (...) as a resource for future interaction with users. (shrink)

BackgroundAmidst expanding roles in education and policy making, questions have been raised about the ability of Clinical Ethics Committees (CEC) s to carry out effective ethics consultations (CECons). However recent reviews of CECs suggest that there is no uniformity to CECons and no effective means of assessing the quality of CECons. To address this gap a systematic scoping review of prevailing tools used to assess CECons was performed to foreground and guide the design of a tool to evaluate the quality (...) of CECons.MethodsGuided by Levac et al’s (2010) methodological framework for conducting scoping reviews, the research team performed independent literature reviews of accounts of assessments of CECons published in six databases. The included articles were independently analyzed using content and thematic analysis to enhance the validity of the findings.ResultsNine thousand sixty-six abstracts were identified, 617 full-text articles were reviewed, 104 articles were analyzed and four themes were identified – the purpose of the CECons evaluation, the various domains assessed, the methods of assessment used and the long-term impact of these evaluations.ConclusionThis review found prevailing assessments of CECons to be piecemeal due to variable goals, contextual factors and practical limitations. The diversity in domains assessed and tools used foregrounds the lack of minimum standards upheld to ensure baseline efficacy.To advance a contextually appropriate, culturally sensitive, program specific assessment tool to assess CECons, clear structural and competency guidelines must be established in the curation of CECons programs, to evaluate their true efficacy and maintain clinical, legal and ethical standards. (shrink)

Corruption involves greed, money, and risky decision-making. We explore the love of money, pay satisfaction, probability of risk, and dishonesty across cultures. Avaricious monetary aspiration breeds unethicality. Prospect theory frames decisions in the gains-losses domain and high-low probability. Pay dissatisfaction (in the losses domain) incites dishonesty in the name of justice at the individual level. The Corruption Perceptions Index, CPI, signals a high-low probability of getting caught for dishonesty at the country level. We theorize that decision-makers adopt avaricious love-of-money aspiration (...) as a lens and frame dishonesty in the gains-losses domain (pay satisfaction-dissatisfaction, Level 1) and high-low probability (CPI, Level 2) to maximize expected utility and ultimate serenity. We challenge the myth: Pay satisfaction mitigates dishonesty across nations consistently. Based on 6500 managers in 32 countries, our cross-level three-dimensional visualization offers the following discoveries. Under high aspiration conditions, pay dissatisfaction excites the highest- (third-highest) avaricious justice-seeking dishonesty in high (medium) CPI nations, supporting the certainty effect. However, pay satisfaction provokes the second-highest avaricious opportunity-seizing dishonesty in low CPI entities, sustaining the possibility effect—maximizing expected utility. Under low aspiration conditions, high pay satisfaction consistently leads to low dishonesty, demonstrating risk aversion—achieving ultimate serenity. We expand prospect theory from a micro and individual-level theory to a cross-level theory of monetary wisdom across 32 nations. We enhance the S-shaped Curve to three 3-D corruption surfaces across three levels of the global economic pyramid, providing novel insights into behavioral economics, business ethics, the environment, and responsibility. (shrink)

Good agricultural practices certification schemes have been promoted to enhance agricultural sustainability. This study seeks to explain the adoption of GAP certification schemes through an analysis of the role of personal values in guiding such choice. It is a departure from approaches taken in previous studies in the area. Through the laddering interview technique of means-end chain analysis, a hierarchical value map was systematically schematized to illustrate the relationship between adoption of GAP, outcomes, and personal values driving the choice. The (...) personal values identified in this study cluster under the headings of “better life”, “religious responsibility”, “healthy life”, and “responsible farmer”. Amongst these, the main evidence pointed to the desire to have “better life” through the enhanced financial position that is perceived to arise as a consequence of GAP adoption as being of primary importance. These findings suggest that, while profit is not the sole end driver of adoptive behavior, GAP certification schemes have to be seen as lucrative and to enhance the goals of achieving core personal values. Other empirical information in this study also has significant policy implications. It is a key finding of this paper that effective promotions of GAP should be tailored and targeted at specific segments of the farmer population. (shrink)

BackgroundThe therapeutic effect of deep brain stimulation (DBS) of the subthalamic nucleus (STN) for Parkinson's disease (PD) is related to the modulation of pathological neural activities, particularly the synchronization in the β band (13–35 Hz). However, whether the local β activity in the STN region can directly predict the stimulation outcome remains unclear.ObjectiveWe tested the hypothesis that low-β (13–20 Hz) and/or high-β (20–35 Hz) band activities recorded from the STN region can predict DBS efficacy.MethodsLocal field potentials (LFPs) were recorded in (...) 26 patients undergoing deep brain stimulation surgery in the subthalamic nucleus area. Recordings were made after the implantation of the DBS electrode prior to its connection to a stimulator. The maximum normalized powers in the theta (4–7 Hz), alpha (7–13 Hz), low-β (13–20 Hz), high-β (20–35 Hz), and low-γ (40–55 Hz) subbands in the postoperatively recorded LFP were correlated with the stimulation-induced improvement in contralateral tremor or bradykinesia–rigidity. The distance between the contact selected for stimulation and the contact with the maximum subband power was correlated with the stimulation efficacy. Following the identification of the potential predictors by the significant correlations, a multiple regression analysis was performed to evaluate their effect on the outcome.ResultsThe maximum high-β power was positively correlated with bradykinesia–rigidity improvement (rs = 0.549, p < 0.0001). The distance to the contact with maximum high-β power was negatively correlated with bradykinesia–rigidity improvement (rs = −0.452, p < 0.001). No significant correlation was observed with low-β power. The maximum high-β power and the distance to the contact with maximum high-β power were both significant predictors for bradykinesia–rigidity improvement in the multiple regression analysis, explaining 37.4% of the variance altogether. Tremor improvement was not significantly correlated with any frequency.ConclusionHigh-β oscillations, but not low-β oscillations, recorded from the STN region with the DBS lead can inform stimulation-induced improvement in contralateral bradykinesia–rigidity in patients with PD. High-β oscillations can help refine electrode targeting and inform contact selection for DBS therapy. (shrink)

The coming of bioethics to Singapore / W. Calvin Ho and Sylvia S.N. Lim -- The impact of the bioethics advisory committee on the research community in Singapore / Charmaine K.M. Chan and Edison T. Liu -- Engaging the public : the role of the media / Chang Ai-Lien and Judith Tan -- Confucian trust and the biomedical regulatory framework in Singapore / Anh Tuan Nuyen -- The clinician-researcher : a servant of two masters? / Alastair V. Campbell, Jacqueline (...) class='Hi'>Chin, and Teck Chuan Voo -- The US model for oversight of human stem cell research / Lindsay Parham and Bernard Lo -- Genetics and stem cell research : models of international policy-making / Bartha Maria Knoppers, Emily Kirby and Rosario Isasi -- Public engagement and bioethics commissions / Thomas H. Murray and Ross S. White -- Norm-making on human-animal chimeras and hybrids in Singapore, the United Kingdom and the international domain / W. Calvin Ho and Martin Bobrow -- How will future bioethical issues engage Singapore? / John Elliott. (shrink)

1. Introducción a la ciencia del derecho natural.

The development of the CRISPR gene editing technique has been hyped as a technique that could fundamentally change scientific research and its clinical application. Unrecognized is the fact that it joins other technologies that have tried and failed under the same discourse of scientific hype. These technologies, like gene therapy and stem cell research, have moved quickly passed basic research into clinical application with dire consequences. Before hastily moving to clinical applications, it is necessary to consider basic research and determine (...) how CRISPR/Cas systems should be applied. In the case of single gene diseases, that application is expected to have positive impacts, but as we shift to more complex diseases, the impact could be unintentionally negative. In the context of common disabilities, the level of genetic complexity may render this technology useless but potentially toxic, aggravating a social discourse that devalues those with disabilities. This paper intends to define the issues related to disability that are associated with using the CRIPSR/Cas system in basic research. It also aims to provide a decision tree to help determine whether the technology should be utilized or if alternative approaches beyond scientific research could lead to a better use of limited funding resources. (shrink)

Richard Nisbett's The Geography of Thought is one of several recent works that have highlighted purported differences in thinking patterns between East Asians and Westerners on the basis of empirical research. This has implications for teaching and for other issues such as cultural integration. Based on a framework consisting of three distinct notions of rationality, this paper argues that some of the differences alleged by Nisbett are either not real or exaggerated, and that his geography of thought fails to provide (...) an adequate account of thinking styles across cultures. The paper concludes with a discussion of the implications for teaching and learning critical thinking that can be drawn from the framework developed. (shrink)

I review José Medina's The Epistemology of Protest: Silencing, Epistemic Activism, and the Communicative Life of Resistance, and raise some questions about the felicity, legitimacy and civility of protest.

Analysis of the use of the key term 'the people' shows that it has varied both semantically and syntactically along the time-line of the evolution of the CPC.

Ryan Darby, Judith Edersheim, and Bruce Price (DEP) argue that patients with Behavioral-Variant Frontotemporal Dementia have intact moral knowledge. In effect, they assume a motivational externalist understanding of moral knowledge. We question this by probing the cases they present as evidence for their position.

The structure of pluralist arguments -- The inadequacy of multiculturalism -- The incompatibility of subsidiarity -- Associative democracy and the corporatist temptation -- Two conceptions of sovereignty -- A positivist pluralism? -- Law as intelligibility -- Pluralist authority -- This unity of life and action -- The personality of associations -- Property, personality, and public justification -- The spectre of intractability.

In “Punishing Intentions and Neurointerventions”, Birks and Buyx (2018) provide a novel argument on why the use of mandatory neurointerventions on convicted criminals is morally objectionable “in a...

This paper proposes that Levinas's philosophy of alterity and infinitude based upon the ethical relation between Self and Other - is both profound and limited in its ability to account for social practice. Instead of simply accepting the common criticism of Levinas, however, that he places an intolerable ethical burden of infinitude upon human relations, this paper aims to move beyond this impasse by placing Levinas's metaphysics within a frame that privileges the dynamic between the Self and the Other as (...) a socially oriented, participative practice of teaching and learning. It is suggested that Etienne Wenger's work on the emergence of identity as a constant negotiation between the Others and the Self provides a conceptual framework for how business ethics may be owned, negotiated and learned within organizational communities without sacrificing the horizon of infinitude bestowed upon us by Levinas's ethical philosophy. Finally, the practical implications of such a comparative approach for the teaching of alterity in business ethics are discussed. (shrink)

This paper proposes that Levinas's philosophy of alterity and infinitude – based upon the ethical relation between Self and Other – is both profound and limited in its ability to account for social practice. Instead of simply accepting the common criticism of Levinas, however, that he places an intolerable ethical burden of infinitude upon human relations, this paper aims to move beyond this impasse by placing Levinas's metaphysics within a frame that privileges the dynamic between the Self and the Other (...) as a socially oriented, participative practice of teaching and learning. It is suggested that Etienne Wenger's work on the emergence of identity as a constant negotiation between the Others and the Self provides a conceptual framework for how business ethics may be owned, negotiated and learned within organizational communities without sacrificing the horizon of infinitude bestowed upon us by Levinas's ethical philosophy. Finally, the practical implications of such a comparative approach for the teaching of alterity in business ethics are discussed. (shrink)

Standard accounts of shame characterize shame as an emotion of global negative self-assessment, in which an individual necessarily accepts or assents to a global negative self-evaluation. According to non-standard accounts of shame, experiences of shame need not involve a global negative self-assessment. I argue here in favor of non-standard accounts of shame over standard accounts. First, I begin with a detailed discussion of standard accounts of shame, focusing primarily on Gabriele Taylor’s (1985) standard account. Second, I illustrate how Adrian Piper’s (...) ([1992] 1996) experience of groundless shame can be portrayed as 1) both a rational and an irrational experience of shame, in accordance with Taylor’s account as a paradigm model of standard accounts of shame, and 2) as a rational experience of shame when taken in its own right as a legitimate, rational account of shame. Third, without denying that some experiences of shame either are or can be irrational experiences of shame, I elucidate how standard accounts of shame can act as mechanisms of epistemic injustice, and in doing so can transmute the righteous indignation of the marginalized by recasting them as shameful experiences (i.e., by recasting them as experiences of the righteous shame of the marginalized). (shrink)

In this chapter, I argue that we can understand how original intentionality (i.e., a genuine mental life) fits into a natural and scientific understanding of the world through an understanding of the import of the intentionality of emotions to our knowledge of the world in which we live. To do so, I first argue that emotions demonstrate our original intentionality (i.e., a genuine mental life). I then explain how the intentionality of emotions is necessary for us to have knowledge of (...) the world in virtue of our emotional responses. I conclude with a brief discussion of how the neuroscience of emotion can help to provide an explanation of how we can know in virtue of our emotional experiences—how epistemology can be naturalized via emotions. (shrink)

This study empirically examined the effects of ethical leadership and ethical climate on employee ethical behavior in the international port context using survey data collected from 128 respondents who worked in Taiwan International Ports Corporation in Taiwan. Research hypotheses were formulated from the previous literature and tested using structural equation modeling. Results indicated that ethical leadership had a significant impact on ethical climate and the ethical behavior of TIPC employees. Ethical climate was found to be positively associated with employee ethical (...) behavior. The theoretical and practical implications of the research findings are discussed. (shrink)