Background As a number of commentators have noted, SARS exposed the vulnerabilities of our health care systems and governance structures. Health care professionals (HCPs) and hospital systems that bore the brunt of the SARS outbreak continue to struggle with the aftermath of the crisis. Indeed, HCPs – both in clinical care and in public health – were severely tested by SARS. Unprecedented demands were placed on their skills and expertise, and their personal commitment to their profession was severely tried. Many (...) were exposed to serious risk of morbidity and mortality, as evidenced by the World Health Organization figures showing that approximately 30% of reported cases were among HCPs, some of whom died from the infection. Despite this challenge, professional codes of ethics are silent on the issue of duty to care during communicable disease outbreaks, thus providing no guidance on what is expected of HCPs or how they ought to approach their duty to care in the face of risk. Discussion In the aftermath of SARS and with the spectre of a pandemic avian influenza, it is imperative that we (re)consider the obligations of HCPs for patients with severe infectious diseases, particularly diseases that pose risks to those providing care. It is of pressing importance that organizations representing HCPs give clear indication of what standard of care is expected of their members in the event of a pandemic. In this paper, we address the issue of special obligations of HCPs during an infectious disease outbreak. We argue that there is a pressing need to clarify the rights and responsibilities of HCPs in the current context of pandemic flu preparedness, and that these rights and responsibilities ought to be codified in professional codes of ethics. Finally, we present a brief historical accounting of the treatment of the duty to care in professional health care codes of ethics. Summary An honest and critical examination of the role of HCPs during communicable disease outbreaks is needed in order to provide guidelines regarding professional rights and responsibilities, as well as ethical duties and obligations. With this paper, we hope to open the social dialogue and advance the public debate on this increasingly urgent issue. (shrink)
BackgroundAs a number of commentators have noted, SARS exposed the vulnerabilities of our health care systems and governance structures. Health care professionals and hospital systems that bore the brunt of the SARS outbreak continue to struggle with the aftermath of the crisis. Indeed, HCPs – both in clinical care and in public health – were severely tested by SARS. Unprecedented demands were placed on their skills and expertise, and their personal commitment to their profession was severely tried. Many were exposed (...) to serious risk of morbidity and mortality, as evidenced by the World Health Organization figures showing that approximately 30% of reported cases were among HCPs, some of whom died from the infection. Despite this challenge, professional codes of ethics are silent on the issue of duty to care during communicable disease outbreaks, thus providing no guidance on what is expected of HCPs or how they ought to approach their duty to care in the face of risk.DiscussionIn the aftermath of SARS and with the spectre of a pandemic avian influenza, it is imperative that we consider the obligations of HCPs for patients with severe infectious diseases, particularly diseases that pose risks to those providing care. It is of pressing importance that organizations representing HCPs give clear indication of what standard of care is expected of their members in the event of a pandemic. In this paper, we address the issue of special obligations of HCPs during an infectious disease outbreak. We argue that there is a pressing need to clarify the rights and responsibilities of HCPs in the current context of pandemic flu preparedness, and that these rights and responsibilities ought to be codified in professional codes of ethics. Finally, we present a brief historical accounting of the treatment of the duty to care in professional health care codes of ethics.SummaryAn honest and critical examination of the role of HCPs during communicable disease outbreaks is needed in order to provide guidelines regarding professional rights and responsibilities, as well as ethical duties and obligations. With this paper, we hope to open the social dialogue and advance the public debate on this increasingly urgent issue. (shrink)
In this fresh and powerfully argued book, Mark Bernstein identifies the qualities that make an entity deserving of moral consideration. It is frequently assumed that only (normal) human beings count. Bernstein argues instead for "experientialism"--the view that having conscious experiences is necessary and sufficient for moral standing. He demonstrates that this position requires us to include many non-human animals in our moral realm, but not to the extent that many deep ecologists champion.
Recent developments in the field of neurosurgery, specifically those dealing with the modification of mood and affect as part of psychiatric disease, have led some researchers to discuss the ethical implications of surgery to alter personality and personal identity. As knowledge and technology advance, discussions of surgery to alter undesirable traits, or possibly the enhancement of normal traits, will play an increasingly larger role in the ethical literature. So far, identity and enhancement have yet to be explored in a neurosurgical (...) context, despite the fact that 1) neurological disease and treatment both potentially alter identity, and 2) that neurosurgeons will likely be the purveyors of future enhancement implantable technology. Here, we use interviews with neurosurgical patients to shed light on the ethical issues and challenges that surround identity and enhancement in neurosurgery. The results provide insight into how patients approach their identity prior to potentially identity-altering procedures and what future ethical challenges lay ahead for clinicians and researchers in the field of neurotherapeutics. (shrink)
Perhaps the greatest impediment to a viable libertarianism is the provision of a satisfactory explanation of how actions that are undetermined by an agent''s character can still be under the control of, or up to, the agent. The luck problem has been most assiduously examined by Robert Kane who supplies a detailed account of how this problem can be resolved. Although Kane''s theory is innovative, insightful, and more resourceful than most of his critics believe, it ultimately cannot account for the (...) type of control that moral responsibility and (ultimate) agency legitimately require. (shrink)
The principle of gratuitous suffering -- The value of humans and the value of animals -- The holocaust of factory farming -- Hunting -- Animal experimentation -- The law and animals -- Women and animals.
It has become virtually a matter of dogma—among both philosophers and laypersons—that human lives are more valuable than animal lives. One argument for this claim dominates the philosophical literature and, despite its employment by a host of philosophers, should be found wanting. I try to show that this line of reasoning, as well as one that is less popular but still with significant appeal, are faulty. The errors in each argument seem fatal: the pervasive argument begs the question, and the (...) more selective is, at bottom, unintelligible. We should judge that the lives of humans and animals are equally valuable, an assessment that should be accompanied by major changes in some of our fundamental practices. (shrink)
Contained in the face is a vast body of social information, both fixed and flexible. Across multiple lines of converging evidence it has become increasingly clear that face processing is subject to one of the most potent and best understood of social cognitive phenomena: social categorization. This article reviews this research at the juncture of social psychology and face perception showing the interplay between social categorization and face processing. It lays out evidence indicating that social categories are extracted easily from (...) faces, suggesting that the effects of social categories can occur quickly and unintentionally. Recent evidence that social categories can affect perception of both invariant and variant facial characteristics is discussed. Finally, the article summarizes recent evidence indicating that the motivational consequences of social categories can affect which faces are remembered and how faces are processed. (shrink)
We argue that critiques of political process theory are beginning to coalesce into new approach to social movements--a "multi-institutional politics" approach. While the political process model assumes that domination is organized by and around one source of power, the alternative perspective views domination as organized around multiple sources of power, each of which is simultaneously material and symbolic. We examine the conceptions of social movements, politics, actors, goals, and strategies supported by each model, demonstrating that the view of society and (...) power underlying the political process model is too narrow to encompass the diversity of contemporary change efforts. Through empirical examples, we demonstrate that the alternative approach provides powerful analytical tools for the analysis of a wide variety of contemporary change efforts. (shrink)
A problem closely related to the perennial free will question is whether autonomy of persons can be reconciled with socialization. If this latter compatibilism can be established, It would have great bearing on the more general issue of freedom being reconcilable with determinism. In several recent articles robert young has tried to demonstrate the consistency of autonomy with socialization, But the author argues that he has failed to notice the depth and global nature of the socialization critic's position, And as (...) such fails in his attempt. As a result, There are no beneficial consequences reaped for the free will problem. (shrink)
Helping scientists and engineers challenge received assumptions about how science, engineering, and society relate is a critical cornerstone for macroethics education. Scientific and engineering research are frequently framed as first steps of a value-free linear model that inexorably leads to societal benefit. Social studies of science and assessments of scientific and engineering research speak to the need for a more critical approach to the noble intentions underlying these assumptions. “Science Outside the Lab” is a program designed to help early-career scientists (...) and engineers understand the complexities of science and engineering policy. Assessment of the program entailed a pre-, post-, and 1 year follow up survey to gauge student perspectives on relationships between science and society, as well as a pre–post concept map exercise to elicit student conceptualizations of science policy. Students leave Science Outside the Lab with greater humility about the role of scientific expertise in science and engineering policy; greater skepticism toward linear notions of scientific advances benefiting society; a deeper, more nuanced understanding of the actors involved in shaping science policy; and a continued appreciation of the contributions of science and engineering to society. The study presents an efficacious program that helps scientists and engineers make inroads into macroethical debates, reframe the ways in which they think about values of science and engineering in society, and more thoughtfully engage with critical mediators of science and society relationships: policy makers and policy processes. (shrink)
For Bakhtin the “gradual narrowing down” of the carnival’s regenerative power is directly linked to its separation from “folk culture” and its ensuing domestication as “part of the family’s private life.” Nonetheless, Bakhtin’s faith in the inherent indestructibility of “the carnival spirit” compels him to find it preserved, even if in an interiorized and psychological form, in the post-Renaissance literary tradition, and he specifically names Diderot, along with Molière, Voltaire, and Swift, as authors who kept alive the subversive possibilities of (...) a Saturnalian laughter . But, of course, as Bakhtin himself recognizes, much more has changed in both the nature and the effects of that laughter than merely its locus of action. The crucial difference, according to Bakhtin, is a new sense of terror felt at the heart of the post-Renaissance carnival grotesque:The transformation of the principle of laughter which permeates the grotesque, that is the loss of its regenerating power, leads to a series of other essential differences between Romantic grotesque and medieval and Renaissance grotesque…The world of Romantic grotesque is to a certain extent a terrifying word, alien to man…Something frightening is revealed in that which was habitual and secure. [Pp. 38-39]Directly linked to this burden of terror, of laughter as a response to dread, not exuberance, is a change in the literary function of madness:Other specific traits are linked with the disappearance of laughter’s regenerating power…. The theme of madness is inherent to all grotesque forms, because madness makes men look at the world with different eyes, not dimmed by “normal,” that is by commonplace ideas and judgments. In folk grotesque, madness is a gay parody of official reason, of the narrow seriousness of official “truth.” It is a “festive” madness. In Romantic grotesque, on the other hand, madness acquires a somber, tragic aspect of individual isolation. [P. 39]Bakhtin’s typology of laughter, for all its richly textured local insights, is haunted, from its inception, by a wistfully nostalgic longing for a realm of pure and ahistorical spontaneity, a rite of universal participation whose essentially affirmative character is guaranteed by its very universality. The most characteristic feature of such a carnival is, in fact, its abolition of all distinctions between participant and viewer:Carnival does not know footlights, in the sense that it does not acknowledge any distinction between actors and spectators. Footlights would destroy a carnival, as the absence of footlights would destroy a theatrical performance. Carnival is not a spectacle seen by the people; they live in it, and everyone participates because its very idea embraces all the people. While carnival lasts, there is no other life outside it…. It has a universal spirit: it is a special condition of the entire world, of the world’s revival and renewal, in which all take part. [P. 7]Yet as soon as the question of representation arises, whether in Rabelais or in his successors, the “footlights” which separate actor and spectator, reader and character, come into being, introducing the very divisions the work’s themes deny. Belatedness, the knowledge of coming after the festival has already been fragmented, is thus not limited to a post-Rabelaisian, bourgeois culture; it is itself a condition of every Saturnalian text, and what has changed is not the inclusiveness of the carnival per se but the literary consequences of acknowledging that belatedness. Michael André Bernstein, associate professor of English and comparative literature at the University of California, Berkeley, is the author of The Tale of the Tribe: Ezra Pound and the Modern Verse Epic and Prima della Rivoluzione, a volume of verse. He is currently at work on a book about the Abject Hero and literary genealogy. (shrink)
Although great progress in neuroanatomy and physiology has occurred lately, we still cannot go directly to those levels to discover the neural mechanisms of higher cognition and consciousness. But we can use neurocomputational methods based on these details to push this project forward. Here we describe vector subtraction as an operation that computes sequential paths through high-dimensional vector spaces. Vector-space interpretations of network activity patterns are a fruitful resource in recent computational neuroscience. Vector subtraction also appears to be implemented neurally (...) in primate frontal eye field activity, which computes dimensions of saccadic eye movements. We use this apparent neural implementation as a model and construct from it a general neurocomputational account of an important type of sequential cognitive and conscious process. We defend the biological plausibility of all components of the general model and show that it yields testable anatomical and physiological predictions. We close by suggesting some interesting consequences for consciousness if our model characterizes correctly the neural mechanisms producing a common type of episode in our conscious streams. (shrink)
Advances in neuromodulation and an improved understanding of the anatomy and circuitry of psychopathology have led to a resurgence of interest in surgery for psychiatric disease. Clinical trials exploring deep brain stimulation (DBS), a focally targeted, adjustable and reversible form of neurosurgery, are being developed to address the use of this technology in highly selected patient populations. Psychiatric patients deemed eligible for surgical intervention, such as DBS, typically meet stringent inclusion criteria, including demonstrated severity, chronicity and a failure of conventional (...) therapy. Although a humanitarian device exemption by the US Food and Drug Administration exists for its use in obsessive-compulsive disorder, DBS remains a largely experimental treatment in the psychiatric context, with its use currently limited to clinical trials and investigative studies. The combination of a patient population at the limits of conventional therapy and a novel technology in a new indication poses interesting challenges to the informed consent process as it relates to clinical trial enrollment. These challenges can be divided into those that relate to the patient, their disease and the technology, with each illustrating how traditional conceptualisations of research consent may be inadequate in the surgical psychiatry context. With specific reference to risk analysis, patient autonomy, voluntariness and the duty of the clinician-researcher, this paper will discuss the unique challenges that clinical trials of surgery for refractory psychiatric disease present to the consent process. Recommendations are also made for an ethical approach to clinical trial consent acquisition in this unique patient population. (shrink)