In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 14.4 (2004) 411-425 [Access article in PDF] Vulnerability, Vulnerable Populations, and Policy Mary C. Ruof "Special justification is required for inviting vulnerable individuals to serve as research subjects and, if they are selected, the means of protecting their rights and welfare must be strictly applied."Guideline 13: Research Involving Vulnerable Persons International Ethical Guidelines for Biomedical Research Involving Human Subjects Council for International Organizations (...) of Medical Sciences (CIOMS) and World Health Organization (WHO) Geneva, Switzerland, 2002 Within medical research and healthcare certain groups are afforded special protections and services because of their designation as vulnerable. The vulnerable require special justification to participate in human subject research in order to eliminate potential human rights abuses. The Nuremberg Code of 1947 was written in response to the extreme human subject abuses that occurred under the Nazi regime, and, although the intent of the 1947 Code was to protect human rights, rigid voluntary consent requirements deprived some individuals of the right to participate in clinical trials. Recent human research guidelines, such as the CIOMS/WHO guidelines referenced above and the guidelines referenced in Section V of this Scope Note, attempt to balance both protection from abuse in research and access to new, experimental treatments for the vulnerable.Although various protective guidelines stipulate special protections for vulnerable populations, the concept of vulnerability and consequently the criteria designating vulnerable populations remain vague. Precisely who are the vulnerable? The word "vulnerability" stems from the Latin vulnerare, "to wound." (Oxford Encyclopedic English Dictionary 1995). In clinical research, the term [End Page 411] vulnerable generally is applied to individuals who are unable to give informed consent or who are susceptible to coercion. The Common Rule (45 CFR 46, Subpart A) includes as vulnerable research subjects: children, prisoners, pregnant women, and persons who are handicapped, mentally disabled, economically disadvantaged, or educationally disadvantaged. Although the Common Rule specifies certain vulnerable categories, the guidelines were not intended to be exclusive, leaving open the interpretation of vulnerability.In medical research and health policy, vulnerability is an abstract concept that has concrete effects both for those labeled vulnerable and for those not. Clinical researchers, healthcare workers, ethical reviewers, and policymakers must be able to identify vulnerable subjects to establish how healthcare resources will be allocated and who will qualify for special protections and socialized benefits. Attempts to quantify vulnerability in clear, measurable ways have met little if any consensus. As Alexander Morawa (II, 2003, p. 150) states, "There is no single approach to definition of vulnerability. In fact, there is no purposeful categorisation at all."Difficulties in defining vulnerability have prompted discourse surrounding its utility as a qualifying factor in the allocation of health resources and its appropriateness as a guiding principle in bioethics. Some of the authors cited in this Scope Note argue against the labeling and categorization of vulnerable individuals and populations. "Labeling individuals as 'vulnerable' risks viewing vulnerable individuals as 'others' worthy of pity, a view rarely appreciated" (III, Danis and Patrick 2002, p. 320). The categories of vulnerable groups listed under the Common Rule have been the source of controversy, "for example, many find the suggestion that pregnant women are vulnerable to be quite sexist" (IV, DeBruin 2001, p. 7). Instead of creating categories of vulnerable populations, would it not be better to derive an account of just treatment from a just social policy at large that encompasses human vulnerabilities (II, Brock 2002, p. 283).For some of the authors listed here, the concept of vulnerability is essential to bioethics. Robert Goodin (I, 1985, p. 107) writes that the vulnerability of other human beings is the source of our special responsibilities to them. In contrast to the four American principles of biomedical ethics—autonomy, nonmaleficence, beneficence, and justice—the four principles of European bioethics and biolaw include vulnerability along with autonomy, dignity, and integrity. According to, Jacob Dahl Rendtorff and Peter Kemp (I, 2000, p. 274) "the principle of vulnerability is ontologically prior to the other [European] principles, it expresses better than all of the other ethical principles... the finitude of the human condition."Some of the... (shrink)

H. B. Smith, Professor of Philosophy at the influential 'Pennsylvania School' was (roughly) a contemporary of C. I. Lewis who was similarly interested in a proper account of 'implication'. His research also led him into the study of modal logic but in a different direction than Lewis was led. His account of modal logic does not lend itself as readily as Lewis' to the received 'possible worlds' semantics, so that the Smith approach was a casualty rather than a beneficiary of (...) the renewed interest in modality. In this essay we present some of the main points of the Smith approach, in a new guise. (shrink)

Feminist bioethics poses a challenge to bioethics by exposing the masculine marking of its supposedly generic human subject, as well as the fact that the tradition does not view womens rights as human rights. This essay traces the way in which this invisible gendering of the universal renders the other gender invisible and silent. It shows how this attenuation of the human in man is a source of sickness, both cultural and individual. Finally, it suggests several ways in which images (...) drawn from womens experience and womens bodies might contribute to a constructive rethinking of basic ethical concepts. (shrink)

ABSTRACT This essay focuses on two underlying presumptions that impinge on the effort of UNESCO to engender universal agreement on a set of bioethical norms: the conception of universality that pervades much of the document, and its disregard of structural inequalities that significantly impact health. Drawing on other UN system documents and recent feminist bioethics scholarship, we argue that the formulation of universal principles should not rely solely on shared ethical values, as the draft document affirms, but also on differences (...) in ethical values that obtain across cultures. UNESCO's earlier work on gender mainstreaming illustrates the necessity of thinking from multiple perspectives in generating universal norms. The declaration asserts the ‘fundamental equality of all human beings in dignity and rights’1 and insists that ‘the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition’2 yet it does not explicitly recognize disparities of power and wealth that deny equal dignity and rights to many. Without attention to structural (as opposed to merely accidental) inequities, UNESCO's invocation of rights is so abstract as to be incompatible with its avowed intention. (shrink)

Psychoanalytic theory is considered as the appropriate context in which to make sense of the masculine/feminine difference, insofar as it offers a methodology for "reading the text of the body." The extent to which the idea of "penis envy" distorts the psychoanalytic reading of feminine embodiment is demonstrated. In undoing this distortion, a positive account of feminine life is developed in the idea of "becoming the mother of oneself.".

Just Life reorients ethics and politics around the generativity of mothers and daughters rather than the right to property and the sexual proprieties of the Oedipal drama. Invoking two concrete universals – everyone is born of a woman and everyone needs to eat – Rawlinson rethinks labor and food as relationships that make ethical claims and sustain agency. Just Life counters the capitalization of bodies under biopower with the solidarity of sovereign bodies.

The establishment of a Research Ethics Committee (REC) is a significant step to ensure the standard procedures in ethics review process that protect human participants. However, in instances when RECs are not yet established, surrogate activities are practiced by some institutions. The objective of this study was to identify prevailing research ethical practices of research directors and faculty researchers in the absence of a research ethics committee in their respective academic institutions. Specifically, it aimed to explore the participants’ 1) experiences (...) in research subject protection and 2) challenges when there is no existing REC in the institution. Participants were selected from universities in Manila City whose institutions did not have RECs at the time of the conduct of this study. Key informant interviews and focus group discussions were used as approaches for data collection. The authors used NVivo to organize data from the transcribed audio-recorded interviews and were analyzed utilizing a basic interpretive qualitative approach. Based on the results, surrogate practices of participants involved (1) providing “informed consent forms” to target participants and the (2) roles of different personalities in the evaluation/conduct of the research paper. Implications of this study and recommendations were likewise discussed in this paper. (shrink)

Few works have had the impact on contemporary philosophy exerted by Hegel's Phenomenology of Spirit. Twentieth-century philosophers in France were bound together by a reading of Hyppolite's translation and commentary. Sartre, Merleau-Ponty, Lacan, and Bataille were all shaped by Kojève's lectures on the book. Late twentieth-century philosophers such as Derrida, Lyotard, Deleuze, and Irigaray all operate against a Hegelian horizon. Similarly, in Germany Heidegger, Adorno, and Habermas developed their philosophies in large part through an engagement with Hegel. In the United (...) States the book has had a profound influence on feminism and gender studies. Thinkers as diverse as Butler, Benhabib, Mills, and Honig have developed political theories as well as theories of sexual difference by rereading Hegel's reading of Antigone. As Derrida suggests, this text must be read. It lays out the infrastructures and architectures of life in the modern nation state. It unfolds a grand narrative of the ways of thinking and acting that comprise human experience in "our time." The purpose of the text is to effect a transformation in readers, so that they cease to think of themselves as particular humans and come to know that their existence inheres in membership in a complex community-social, cultural, economic, religious, aesthetic, and political infrastructures that form the culture of possibilities in which self-consciousness emerges and is sustained. Rawlinson's reading reveals how Hegel's politics of the "we" is undermined both by his effacement of sexual difference and by his misappropriation of art as a "betrayal of substance." Both of these gestures discount specificity in favor of a generic subject and a mutual recognition in which the other is the same. She uses Hegel's own critique of abstraction against him to rethink the "we" as a community of difference, figured materially in the differentiated styles or signatures of art, and in so doing argues that that the task of phenomenology is never completed and that the abstract concepts of logic will always be dependent on phenomenology's productive or generative movement. In her reading Hegel is neither a metaphysician nor a subjective idealist. He is a phenomenologist, analyzing experience to articulate the ways in which humans generate narratives and material infrastructures to sustain the complexities of life. (shrink)

As professionals, nurses are engaged in a moral endeavour, and thus confront many challenges in making the right decision and taking the right action. When nurses cannot do what they think is right, they experience moral distress that leaves a moral residue. This article proposes a theory of moral distress and a research agenda to develop a better understanding of moral distress, how to prevent it, and, when it cannot be prevented, how to manage it.

This article discusses two complementary themes that play an important role in contemporary South African political philosophy: (1) the racist tradition in Western philosophy; and (2) the role of ubuntu in regaining an authentic African identity, which was systematically suppressed during the colonial past and apartheid. These are also leading themes in Mogobe Ramose’s African Philosophy Through Ubuntu. The first part concentrates on John Locke. It discusses the thesis that the reprehensible racism of many founders of liberal political philosophy has (...) lethally infected liberal theory. This view neglects the distinction between genesis and justification. Political liberalism has since cleansed itself of the prejudices of its spiritual ancestors. Liberal human rights exclude racism as a matter of principle. The second part discusses the claim that the ubuntu philosophy provides a better basis for a constitution in a modern society than political liberalism. A major problem is that ubuntu is an essentially contested concept. Some philosophers consider ubuntu to be a moribund notion (Matolino); others see it as a vital concept par excellence. In the latter case, it is elaborated from sundry incompatible political views, ranging from African nationalism (Ramose) via humanist communitarianism (Metz) to liberalism (Mboti). Conclusion: as an essentially contested ideological concept, ubuntu should not be a decisive constitutional standard for the application of state force. In contrast, the constitutional model of political liberalism provides a reasonable alternative, as it is designed precisely to solve the problem of social plurality and ideological contest. (shrink)

Predictable somatosensory feedback leads to a reduction in tactile sensitivity. This phenomenon, called tactile suppression, relies on a mechanism that uses an efference copy of motor commands to help select relevant aspects of incoming sensory signals. We investigated whether tactile suppression is modulated by the task-relevancy of the predicted consequences of movement and the intensity of related somatosensory feedback signals. Participants reached to a target region in the air in front of a screen; visual or tactile feedback indicated the reach (...) was successful. Furthermore, tactile feedback intensity varied across two groups of participants. We measured tactile suppression by comparing detection thresholds for a probing vibration applied to the finger either early or late during reach and at rest. As expected, we found an overall decrease in late-reach suppression, as no touch was involved at the end of the reach. We observed an increase in the degree of tactile suppression when strong tactile feedback was given at the end of the reach, compared to when weak tactile feedback or visual feedback was given. Our results suggest that the extent of tactile suppression can be adapted to different demands of somatosensory processing. Downregulation of this mechanism is invoked only when the consequences of missing a weak movement sequence are severe for the task. The decisive factor for the presence of tactile suppression seems not to be the predicted action effect as such, but the need to detect and process anticipated feedback signals occurring during movement. (shrink)

While the history of philosophy has traditionally given scant attention to food and the ethics of eating, in the last few decades the subject of food ethics has emerged as a major topic, encompassing a wide array of issues, including labor justice, public health, social inequity, animal rights and environmental ethics. This handbook provides a much needed philosophical analysis of the ethical implications of the need to eat and the role that food plays in social, cultural and political life. Unlike (...) other books on the topic, this text integrates traditional approaches to the subject with cutting edge research in order to set a new agenda for philosophical discussions of food ethics. The Routledge Handbook of Food Ethics is an outstanding reference source to the key topics, problems and debates in this exciting subject and is the first collection of its kind. Comprising over 35 chapters by a team of international contributors, the Handbook is divided into 7 parts: the phenomenology of food gender and food food and cultural diversity liberty, choice and food policy food and the environment farming and eating other animals food justice Essential reading for students and researchers in food ethics, it is also an invaluable resource for those in related disciplines such as environmental ethics and bioethics. (shrink)

This study examined the relationship between moral distress intensity, moral distress frequency and the ethical work environment, and explored the relationship of demographic characteristics to moral distress intensity and frequency. A group of 106 nurses from two large medical centers reported moderate levels of moral distress intensity, low levels of moral distress frequency, and a moderately positive ethical work environment. Moral distress intensity and ethical work environment were correlated with moral distress frequency. Age was negatively correlated with moral distress intensity, (...) whereas being African American was related to higher levels of moral distress intensity. The ethical work environment predicted moral distress intensity. These results reveal a difference between moral distress intensity and frequency and the importance of the environment to moral distress intensity. (shrink)

After we die, our persona may live on in the minds of the people we know well. Two essential elements of this process are mourning and acts of commemoration. These behaviors extend well beyond grief and must be cultivated deliberately by the survivors of the deceased individual. Those who are left behind have many ways of maintaining connections with their deceased, such as burials in places where the living are likely to return and visit. In this way, culturally defined places (...) often serve as metaphors of social association and shared experience. Humans are the only kind of animal that buries their dead, and this gesture is preserved in Paleolithic sites as early as 120,000 years ago. Though not the only method of honoring the dead in human cultures, the emergence of burial traditions in the Middle Paleolithic implies that both Neandertals and early anatomically modern humans had already begun to conceive of the individual as unique and irreplaceable. Claims of primitive mortuary behavior in earlier periods than the Middle Paleolithic fall short in that they lack any signs of positive social-spatial associations between the deceased and survivors. The archaeological evidence for burial behavior in the Middle Paleolithic provides the first clear translation of mourning into a stereotypical action. These burials therefore may represent the first ritualized bridge between the living and the deceased in human evolutionary history. (shrink)

Studies of consumer complaint behavior have shown that many elderly consumers are very reluctant to pursue their rights through the complaint process when they encounter problems with products or services. This passive complaint behavior may be very costly to the elderly, who often live on fixed incomes. This paper presents a theory developed in experimental psychology that may help explain why clderly consumers are more likely than other consumers to incur losses rather than engage in complaint activity. The theory, known (...) as learned helplessness (LH), refers to a process whereby noncontingent reinforcement produces the expectation that events are uncontrollable.The theory of learned helplessness is presented and related to specific behaviors of dissatisfied elderly consumers that have been reported in the literature. Strategy implications of the theory are discussed for counselors, consumer affairs practitioners, and others interested in helping elderly consumers exercise their rights. (shrink)

Motorheadbangers, the official fan club for rock giants, Motorhead, has never stopped. Like the band on tour, in the studio and playing live to audiences across the world, Motorheadbangers, through its stalwart fan base, has matched the band's enthusiasm to keep going against all the odds. Since the first fanzine the fan club membership has written of their experiences at seeing and meeting one of the greatest rock n roll bands in the world. In this way, Motorhead's history has been (...) catalogued. However, the majority of those fanzines have long been out of print. (shrink)

The power, wealth and impact of multinational corporations now exceed that of many national govern ments, and this fact has created an expectation that corporations have a responsibility to manage their impacts on the wider social context. Although these observations are increasingly cited as 'truisms' in the business press and in policy debates, few business schools have given attention to the management of social impacts into their core curriculum. In this article the author raises the question that, if business leaders, (...) pol icy makers, NGOs and even the media agree there is a need, why is there so little expressed demand from business who recruit at business schools? The work done at the Aspen Institute has been presented in this regard. The Aspen Institute's Initiative for Social Innovation through Business has taken a system atic look at both the 'demand' for and the 'supply' of business education that addresses the interdependence between business needs and wider societal concerns. By means of global dialogues among CEOs and lead ers of the public, NGOs and academic sectors, as well as through surveys, focus groups and traditional research, Aspen ISIB has gathered data that illuminates this question of supply and demand, and also sug gests powerful levers for influencing what business scholars research and what business educators teach about the management of social impacts. (shrink)