Three experiments investigated the hypothesis that internally generated images and thoughts were driven by meaning complexes, a construct which reflects a synthesis of semantic meaning and personal salience . Experiments 1 and 2 contrasted the mutual inhibition between encoding words and non-words on: the frequency that thoughts and images unrelated to the task were experienced and on the intensity of images generated from long-term memory and maintained under dual task conditions, which whilst familiar were not of particular personal salience . (...) Experiment 3 examined the physiological arousal associated with the experience of TUT in a semantic encoding task. Evidence suggested that, in general, internally generated images and thoughts, irrespective of the personal salience, were suppressed by the co-ordination of information in working memory. In addition, only the experience of spontaneous images and thoughts of personal salience interfered reliably with the encoding/retrieval of semantic information from memory. Finally, in Experiment 3, physiological arousal, as indexed by mean heart rate, was associated with a high frequency of TUT. The results of all three experiments support the notion that the maintenance of spontaneously occurring images and thoughts is simultaneously influenced by both the semantic content and the personal salience of the information held in working memory. (shrink)

Three experiments investigated the relationship between subjective experience and attentional lapses during sustained attention. These experiments employed two measures of subjective experience to examine how differences in awareness correspond to variations in both task performance and psycho-physiological measures . This series of experiments examine these phenomena during the Sustained Attention to Response Task . The results suggest we can dissociate between two components of subjective experience during sustained attention: task unrelated thought which corresponds to an absent minded disengagement from the (...) task and a pre-occupation with one's task performance that seems to be best conceptualised as a strategic attempt to deploy attentional resources in response to a perception of environmental demands which exceed ones ability to perform the task. The implications of these findings for our understanding of how awareness is maintained on task relevant material during periods of sustained attention are discussed. (shrink)

In this target article by Morain and Largent (2023), the authors focus on an investigator’s duty to patient-subjects specifically regarding incidental or collateral findings within the context of e...

Moral distress has been characterised in the nursing literature as a major problem affecting nurses in all healthcare systems. It has been portrayed as threatening the integrity of nurses and ultimately the quality of patient care. However, nursing discourse on moral distress is not without controversy. The notion itself is conceptually flawed and suffers from both theoretical and practical difficulties. Nursing research investigating moral distress is also problematic on account of being methodologically weak and disparate. Moreover, the ultimate purpose and (...) significance of the research is unclear. In light of these considerations, it is contended that the notion of moral distress ought to be abandoned and that concerted attention be given to advancing inquiries that are more conducive to improving the quality and safety of moral decision-making, moral conduct and moral outcomes in nursing and healthcare domains. (shrink)

Elizabeth Lanphier and Uchenna E. Anani provide a powerful argument for the value of a trauma-informed approach to the ethics consultation, which acknowledges the perspectives of all stakeho...

As members of the fetal surgery advisory board at a large tertiary care center, we read with great interest Hendriks’ et al. target article proposing a new ethical framework for fetal therap...

The topic of fake news has received increased attention from philosophers since the term became a favorite of politicians (Habgood-Coote 2016; Dentith 2016). Notably missing from the conversation, however, is a discussion of fake news and conspiracy theory media as a market. This paper will take as its starting point the account of noxious markets put forward by Debra Satz (2010), and will argue that there is a pro tanto moral reason to restrict the market for fake news. Specifically, we (...) begin with Satz’s argument that restricting a market may be required when i) that market inhibits citizens from being able to stand in an equal relationship with one another, and ii) this problem cannot be solved without such direct restrictions. Our own argument then proceeds in three parts: first, we argue that the market for fake news fits Satz’s description of a noxious market; second, we argue against explanations of the proliferation of fake news that are couched in terms of “epistemic vice”, and likewise argue against prescribing critical thinking education as a solution to the problem; finally, we conclude that, in the absence of other solutions to mitigate the noxious effects of the fake news market, we have a pro tanto moral reason to impose restrictions on this market. At the end of the paper, we consider one proposal to regulate the fake news market, which involves making social media outlets potentially liable in civil court for damages caused by the fake news hosted on their websites. (shrink)

A currently popular proposal for fairly distributing emission quotas is the equal shares view, which holds that that emission quotas should be distributed to all human beings globally on an equal per capita basis. In this paper I aim to show that a number of arguments in favour of equal shares are based on a misleading analysis of climate change as a global commons problem. I argue that a correct understanding of the way in which climate change results from the (...) overuse of a global commons shows those who defend equal shares using commons arguments to be harbouring more controversial commitments than might at first appear. I then discuss two options for equal shares theorists who wish to maintain the view in the face of my critique, and attempt to show that one approach holds more promise than the other. (shrink)

BackgroundCommunity engagement within biomedical research is broadly defined as a collaborative relationship between a research team and a group of individuals targeted for research. A Community Advisory Board is one mechanism of engaging the community. Within genomics research CABs may be particularly relevant due to the potential implications of research findings drawn from individual participants on the larger communities they represent. Within such research, CABs seek to meet instrumental goals such as protecting research participants and their community from research-related risks, (...) as well as intrinsic goals such as promoting the respect of participants and their community. However, successful community engagement depends on the degree to which CABs legitimately represent and engage with communities targeted for research. Currently, there is little literature describing the use of CABs in genomics research taking place in developing countries, and even less in the field of genomics research relating to mental illness. The aim of this article is to describe and consider the contributions made by a researcher-driven, population-specific CAB in a genomics of schizophrenia research project taking place in South Africa, from the perspective of the research team.DiscussionFour broad discussion topics emerged during the CAB meetings namely: 1) informed consent procedures, 2) recruitment strategies, 3) patient illness beliefs and stigma experiences, and 4) specific ethical concerns relating to the project. The authors consider these discussions in terms of their contributions to instrumental and intrinsic goals of community engagement.SummaryThe CAB gave valuable input on the consent processes and materials, recruitment strategies and suggested ways of minimizing the potential for stigma and discrimination. All of these contributions were of an instrumental nature, and helped improve the way in which the research took place. In addition, and perhaps more importantly, the CAB made a unique and important contribution relating to intrinsic functions such as promoting the respect and dignity of research participants and their community. This was particularly evident in ensuring sensitivity and respect of the community’s traditional beliefs about schizophrenia and its treatment, and in this way promoting a respectful relationship between the research team and the participants. (shrink)

In 2006, the Centers for Disease Control and Prevention launched an initiative to address the health of women of childbearing age in the United States—a preconception care campaign to improve fetal and maternal health in the country by targeting interventions on parents, and largely women, before conception occurs. In The Zero Trimester: Pre-Pregnancy Care and the Politics of Reproductive Risk, sociologist Miranda Waggoner uses this campaign as an entry point to address the emergence and widespread acceptance of preconception care and (...) its political consequences in the United States. Throughout the book, Waggoner interrogates how preconception care extends assumptions that the onus for children’s health falls... (shrink)

This paper provides an analysis of U.S. farmland owners, operators, and workers by race, ethnicity, and gender. We first review the intersection between racialized and gendered capitalism and farmland ownership and farming in the United States. Then we analyze data from the 2014 Tenure and Ownership Agricultural Land survey, the 2012 Census of Agriculture, and the 2013–2014 National Agricultural Worker Survey to demonstrate that significant nation-wide disparities in farming by race, ethnicity and gender persist in the U.S. In 2012–2014, White (...) people owned 98% and operated 94% of all farmland. They generated 98% of all farm-related income from land ownership and 97% of income from farm owner-operatorship. Meanwhile, People of Color farmers were more likely to be tenants rather than owners, owned less land, and generated less farm-related wealth per person than their White counterparts. Hispanic farmers were also disproportionately farm laborers. In addition to racial and ethnic disparities, there were disparities by gender. About 63% of non-operating landowners, 86% of farm operators, and 87% of tenant farmers were male, and female farmers tended to generate less income per farmer than men. This data provides evidence of ongoing racial, ethnic and gender disparities in agriculture in the United States. We conclude with a call to address the structural drivers of the disparities and with recommendations for better data collection. (shrink)

Dynamic Consent is both a model and a specific web-based tool that enables clear, granular communication and recording of participant consent choices over time. The DC model enables individuals to know and to decide how personal research information is being used and provides a way in which to exercise legal rights provided in privacy and data protection law. The DC tool is flexible and responsive, enabling legal and ethical requirements in research data sharing to be met and for online health (...) information to be maintained. DC has been used in rare diseases and genomics, to enable people to control and express their preferences regarding their own data. However, DC has never been explored in relationship to historical collections of bioscientific and genetic heritage or to contexts involving Aboriginal and Torres Strait Islander people.In response to the growing interest by First Peoples throughout Australia in genetic and genomic research, and the increasing number of invitations from researchers to participate in community health and wellbeing projects, this article examines the legal and ethical attributes and challenges of DC in these contexts. It also explores opportunities for including First Peoples' cultural perspectives, governance, and leadership as a method for defining DC on cultural terms that engage best practice research and data analysis as well as respect for meaningful and longitudinal individual and family participation. (shrink)

Here are two widely held positions on the ethics of dating: First, people are generally morally justified in excluding people they don’t find attractive from their dating pool. Second, people are not justified in maintaining a dating pool that is racially exclusive, even on grounds like attraction. In this paper, we demonstrate how these positions are consistent. To do so we differentiate our attitudes in dating and our dating behavior. Then we show how existing criticisms of racialized attitudes in dating (...) are incomplete as practical criticisms of our behavior. Finally, we give our account of the moral reasons whites have to change their dating preferences when they exclude people of color. In doing so, we supplement existing discussions of race-based discrimination in dating. (shrink)

In this paper, we examine how the availability of massive quantities of data i.e., the “Big Data” phenomenon, contributes to the creation, spread, and harms of online misinformation. Specifically, we argue that a factor in the problem of online misinformation is the evolved human instinct to recognize patterns. While the pattern-recognition instinct is a crucial evolutionary adaptation, we argue that in the age of Big Data, these capacities have, unfortunately, rendered us vulnerable. Given the ways in which online media outlets (...) profit from the spread of misinformation by preying on this pattern-finding instinct, we conceptualize the problem that we identify as a morally objectionable form of “epistemic exploitation.” As we argue, the consumer of digital misinformation is often exploited by having her pattern-recognition instinct used against her. This exploitation is morally objectionable because it deprives her of an epistemic good to which she has a right. This epistemic good is the integrity of the pattern-recognition instinct itself which, we argue, is a capacity that allows us to participate in uniquely human goods. While our primary goal is to bring attention to this form of epistemic exploitation, we conclude by briefly evaluating some general solutions to the growing problem of online misinformation. (shrink)

For much of their history, the relationship between anthropology and psychology has been well captured by Robert Frost's poem, “Mending Wall,” which ends with the ironic line, “good fences make good neighbors.” The congenial fence was that anthropology studied what people think and psychology studied how people think. Recent research, however, shows that content and process cannot be neatly segregated, because cultural differences in what people think affect how people think. To achieve a deeper understanding of the relation between process (...) and content, research must integrate the methodological insights from both anthropology and psychology. We review previous research and describe new studies in the domain of folk biology which examine the cognitive consequences of different conceptualizations of nature and the place of humans within it. The focus is on cultural differences in framework theories among Native Americans and European American children and adults living in close proximity in rural Wisconsin. Our results show that epistemological orientations affect memory organization, ecological reasoning, and the perceived role of humans in nature. This research also demonstrates that cultural differences in framework theories have implications for understanding intergroup conflict over natural resources and are relevant to efforts to improve science learning, especially among Native American children. (shrink)

This paper contends that eating shapes the self; that is, our practices and understandings of eating can cultivate, reinforce, or diminish important aspects of the self, including agency, values, capacities, affects, and self-understandings. I argue that these self-shaping effects should be included in our ethical analyses and evaluations of eating. I make a case for this claim through an analysis and critique of the hypothesis that young women’s vegetarianism is a risk, sign, or “cover” for eating disorders or disordered eating. (...) After outlining the relevant empirical literature, I suggest that the evidence for this hypothesis is inconclusive. Given this uncertainty, we should consider the risks of making a mistake when accepting or rejecting this understanding of young women’s eating. I argue that these risks importantly include negative effects on the self, such as damage to moral and epistemic agency. Along with other potential consequences of mistakenly accepting the hypothesis, these effects give us reason to reject it pending more conclusive research. Overall, this paper offers a philosophical intervention into the debate over the relationship between vegetarianism and eating disorders while illustrating the ethical importance and relevance of eating as a self-shaping activity. (shrink)

This article argues that Maurice Merleau-Ponty advances a queer notion of love. In particular, I argue that his notion of love as an institution, as a hollow fueled by the imaginary dimension of existence, shows that love unhinges petrified ideals of gender. I suggest that the crucial insight to be found in Merleau-Ponty's account of love is that love is a lived openness that invites us to seek out new ways of being.

Object-oriented ontology (OOO) is a philosophy that asks us to step outside the human-centric view of the world to recognize that objects have realities of their own. Although we cannot directly access a thing-in-itself, we can still come to know something about it through an indirect access that Graham Harman suggests is provided by aesthetics, specifically the metaphor. In the metaphor, we step into the place of the object-in-itself (that withdraws) and experience a taste of its reality. This main purpose (...) of this article is to show that the visual arts—specifically Haim Steinbach’s art works—offer a different way to know objects. Steinbach “arranges” found objects on shelves; this emphasis on “arrangement” raises questions about the nature of the space between objects. I argue that it is this space between objects (rather than the indirect contact with objects) that grants us some access to the thing-in-itself. By relating the spaces between objects to silence, I show that it is in these spaces that objects speak. In other words, the theatricality of the metaphor Harman privileges for understanding the object only exists in a silence that emerges from the spaces between objects. (shrink)

Those in the Gricean tradition take it that successful human communication features an audience who not only arrives at the intended content of the signal, but also recognizes the speaker’s intention that they do so. Some in this tradition have also argued that there are yet further conditions on communicative success, which rule out the possibility of communicating by luck. Supposing that both intention-recognition and some sort of anti-luck condition are correctly included in an analysis of human communication, this article (...) asks what the value of events satisfying these conditions is. I present a puzzle concerning the value of intention-recognition which is analogous to the Meno Problem in epistemology, but ultimately argue that this puzzle is solveable: the signaling-relevant value of intention recognition can be vindicated. However, I argue that the version of this puzzle that concerns the further proposed luck-proofing conditions on communication can not be answered. I argue therefore that communication, as analyzed by many, is no more valuable qua signal than a proper subset of its conditions. Human communication is thennot a uniquely valuable signaling event. (shrink)

Rousseau’s embrace of ceremony and festivals in his Considerations on the Government of Poland demonstrates one way for republican political thought to develop a substantive treatment of civic virtue. Differentiating the narcissism of spectacle and theater that Rousseau critiques in the Letter to d’Alembert from the Considerations’ call for a generous affect, I demonstrate that the latter is compatible with a republican ethos premised on civic virtue and patriotic attachment to the nation-state. Rousseau argues for the instantiation of political practices (...) that constantly cultivate political virtue and their associated affective orientations. His treatment of civic ceremonies in the Considerations should be read as an attempt to inculcate patriotic affect in republican citizens via constitutional measures. (shrink)

Discussion of supported decision making has been dominated by legal scholars, philosophers, and advocates for persons with disabilities. Peterson et al.’s primary contribution is introducing...

Down syndrome (DS) impacts several brain regions including the hippocampus and surrounding structures that have responsibility for important aspects of navigation and wayfinding. Hence it is reasonable to expect that DS may result in a reduced ability to engage in these skills. Two experiments are reported that evaluated route-learning of youth with DS, youth with intellectual disability (ID) and not DS, and typically developing (TD) children matched on mental age (MA). In both experiments, participants learned routes with eight choice point (...) presented via computer. Several objects were placed along the route that could be used as landmarks. Participants navigated the route once with turn indicators pointing the way and then retraced the route without them. In Experiment 1 we found that the TD children and ID participants performed very similarly. They learned the route in the same number of attempts, committed the same number of errors while learning the route, and recalled approximately the same number of landmarks. The participants with DS performed significantly worse on both measures of navigation (attempts and errors) and also recalled significantly fewer landmarks. In Experiment 2, we attempted to reduce TD and ID vs DS differences by focusing participants’ attention on the landmarks. Half of the participants in each group were instructed to identify the landmarks as they passed them the first time. The participants with DS again committed more errors than the participants in the ID and TD groups in the navigation task. In addition, they recalled fewer landmarks. While landmark identification improved landmark memory for both groups, it did not have a significant impact on navigation. Participants with DS still performed more poorly than did the TD and ID participants. Of additional interest, we observed that the performance of persons with DS correlated with different ability measures than did the performance of the other groups. The results the two experiments point to a problem in navigation for persons with DS that exceeds expectations based solely on intellectual level. (shrink)

Persons with dementia often prefer to participate in decisions about their health care, but may be prevented from doing so because healthcare decision-making law facilitates use of advance directives or surrogate decision makers for persons with decisional impairments such as dementia. Federal and state disability law provide alternative decision-making models that do not prevent persons with mild to moderate dementia from making their own healthcare decisions at the time the decision needs to be made. In order to better promote autonomy (...) and wellbeing, persons with dementia should be accommodated and supported so they can make their own healthcare decisions. (shrink)

Pickering, Newton-Howes, and Young assert that the traditional view of decisional capacity, premised on assessing patients’ abilities to communicate, understand, appreciate,...

This research examined the role of thought suppression in the formation of mental blocks. In Experiment 1, participants were asked to generate a series of creative associates for two target words after initially suppressing a word that was semantically related to one of the two target words. Participants produced fewer responses, and experienced a greater sensation of being mentally blocked, when attempting to produce associates for the target word that was semantically related to the suppressed word. In Experiment 2, participants (...) either thought about or suppressed a series of words prior to completing a word fragment completion task. Each word either corresponded exactly to one of the word fragment solutions or resembled one of the solutions but was slightly different in its orthographic properties . Participants performed most poorly on the items for which they had initially suppressed negative primes. (shrink)

Modernist Fiction and Vagueness marries the artistic and philosophical versions of vagueness, linking the development of literary modernism to changes in philosophy. This book argues that the problem of vagueness - language's unavoidable imprecision - led to transformations in both fiction and philosophy in the early twentieth century. Both twentieth-century philosophers and their literary counterparts were fascinated by the vagueness of words and the dream of creating a perfectly precise language. Building on recent interest in the connections between analytic philosophy, (...) pragmatism, and modern literature, Modernist Fiction and Vagueness demonstrates that vagueness should be read not as an artistic problem but as a defining quality of modernist fiction. (shrink)

In this discussion piece, eight scholars in geography, urban planning, and agri-food studies from the United States (US) and France engage in a bi-national comparison to deepen our collective understanding of food and land justice. We specifically contextualize land justice as a critical component of food justice in both the US and France in three key areas: access to land for cultivation, urban agriculture, and non-agricultural forms of food provisioning. The US and France are interesting cases to compare, considering the (...) differences and similarities in their colonial and agricultural histories, persistent and systemic race and class-based inequities in land access, and the roles of public bodies and social movements. In this paper, we synthesize literature, share reflections, and offer directions for future scholarship, including a broader comparative research agenda. An important difference we found is in the degree of scholarly attention to race and how it mediates access to land. We also observe that few scholars articulate a clear definition of justice in their work, nor do they share a common justice framework. We hope that this paper contributes to a more robust food and land justice framework for the use of scholars, practitioners and activists. (shrink)

I argue that propaganda does not characteristically interfere with individual rationality, but instead with group agency. Whereas it is often claimed that propaganda involves some sort of incitement to irrationality, I show that this is neither necessary nor sufficient for a case’s being one or propaganda. For instance, some propaganda constitutes evidence of the speaker’s power, or else of the risk and futility of opposing them, and there is nothing irrational about taking such evidence seriously. I outline an alternative account (...) of propaganda inspired by Hannah Arendt, on which propaganda characteristically creates or destroys group agency. One aspiring to control the public should have an interest in both creating and suppressing group agency, I argue, both because groups have capacities that individuals don’t, and because participation in group action can have a transformative effect upon the individual. Finally, I suggest that my characterization of propaganda suggests a vision of resistance to propaganda quite unlike the one that emerges from irrational-belief accounts, on which propaganda cannot be resisted by oneself. (shrink)

In an effort to address healthcare disparities in lesbian, gay, bisexual, transgender, and queer populations, many hospitals and clinics institute diversity training meant to increase providers’ awareness of and sensitivity to this patient population. Despite these efforts, many healthcare spaces remain inhospitable to LGBTQ patients and their loved ones. Even in the absence of overt forms of discrimination, LGBTQ patients report feeling anxious, unwelcome, ashamed, and distrustful in healthcare encounters. We argue that these negative experiences are produced by a variety (...) of subtle, ostensibly insignificant features of healthcare spaces and interpersonal interactions called microaggressions. Healthcare spaces and providers often convey heteronormative microaggressions, which communicate to LGBTQ—and, we suggest, intersex and asexual —people that their identities, experiences, and relationships are abnormal, pathological, unexpected, unwelcome, or shameful. We identify heteronormative microaggressions common to healthcare settings and specify how they negatively impact LGBTQIA patients. We argue that standard diversity training cannot sufficiently address heteronormative microaggressions. Despite these challenges, healthcare institutions and providers must take responsibility for heteronormative microaggressions and take steps to reduce their frequency and mitigate their effects on LGBTQIA care. We conclude by offering strategies for problem-solving at the level of medical education, institutional culture and policy, and individual awareness. (shrink)

Shavelson and colleagues (2023) describe how medical aid-in-dying laws in the United States prohibit assistance in administering aid-in-dying medication. This prohibition distinguishes aid in dying...

Contemporary educational theorists focus on the significance of Dewey’s conception of experience, learning-by-doing and collateral learning. In this essay, I reexamine the chapters of Dewey’s Democracy and Education, that pertain to thinking and highlight their relationship to Dewey’s How We Think: A Restatement of the Relation of Reflective Thinking in the Educative Process—another book written explicitly for teachers. In How We Think Dewey explains that nothing is more important in education than the formation of concepts. Concepts introduce permanency into an (...) otherwise impermanent world. He defines concepts as established meanings, or intellectual deposits used to found a better understanding of new experiences; they are what makes any experience educationally worthwhile. Dewey accuses traditional and progressive education of failing to appropriately form concepts in students. His position is that concepts are formed and transformed by experience, reflection and activity. He argues that the individual makes a personalized use of concepts for which he or she requires: continuity of experience, exposure to new or surprising possibilities, and sustained communication with others—all of which are discussed at length in Democracy & Education. I conclude with the practical recommendation that K-12 schools introduce philosophy into the curriculum. Philosophy not only invites students to engage their concepts in a reflective manner, but it also provides a valuable resource for that engagement. Most if not all of philosophy’s canonical texts are dedicated to analyzing such concepts as beauty, friendship, love and justice. The introduction of philosophy in K-12 education would, I suggest, offer a correction to both traditional and progressive education. (shrink)

According to a recent survey by the HR Research Institute, as the presence of artificial intelligence (AI) becomes increasingly common in the workplace, HR professionals are worried that the use of recruitment algorithms will lead to a “dehumanization” of the hiring process. Our main goals in this paper are threefold: i) to bring attention to this neglected issue, ii) to clarify what exactly this concern about dehumanization might amount to, and iii) to sketch an argument for why dehumanizing the hiring (...) process is ethically suspect. After distinguishing the use of the term “dehumanization” in this context (i.e., removing the human presence) from its more common meaning in the interdisciplinary field of dehumanization studies (i.e., conceiving of other humans as subhuman), we argue that the use of hiring algorithms may negatively impact the employee-employer relationship. We argue that there are good independent reasons to accept a substantive employee-employer relationship, as well as an applicant-employer relationship, both of which are consistent with a stakeholder theory of corporate obligations. We further argue that dehumanizing the hiring process may negatively impact these relationships because of the difference between the values of human recruiters and the values embedded in recruitment algorithms. Drawing on Nguyen’s (2021) critique of how Twitter “gamifies communication”, we argue that replacing human recruiters with algorithms imports artificial values into the hiring process. We close by briefly considering some ways to potentially mitigate the problems posed by recruitment algorithms, along with the possibility that some difficult trade-offs will need to be made. (shrink)

Enrollers play a critical yet often overlooked role in clinical research, particularly in informed consent processes. Study retention may depend in part on how complex information is conveyed to potential participants. This qualitative study aimed to assess communicative barriers during consent and enrolment in two South African TB/HIV clinical studies. In particular, we compared our own perceptions of potential challenges to consent with that of thirteen enrollers, gained via reflective journaling and focus group discussions. Some overlap of identified challenges was (...) evident, including terminology, jargon and consent document format. However there were mismatches to identified challenges. Enrollers provided further insights into potential challenges to consent, in particular, blood withdrawal, discussion of sexual issues and misunderstanding of study participation. Enrollers also reported feeling ill‐equipped to provide counselling when participants became distressed. We offer several recommendations for strengthening the inclusion of enrollers in the development of clinical research protocols and consent documents. (shrink)

In this paper I propose that, since the mid-eighteenth century medical science has simultaneously generated and disavowed ‘undead’ bodies, suspended between life and death. Through close analysis of three examples of ‘undeath’ taken from different moments in medical history, I consider what these bodies can tell us about medicine, its history, cultural meaning, scientific status and its role in shaping ideas of embodiment, identity and death. My first example is Edgar Allan Poe’s story ‘The facts in the case of M. (...) Valdemar’ which imagines the possibility of a man mesmerised at the point of death. I read this story as a response to the rise of professional, scientific medicine in the 1840s. I then look at the recurring issue of brain death in order to consider tensions within twentieth-century medical hegemony. Finally I read the Alder Hey scandal as a reactivation of undead anxiety in response to the emergent culture of medical consumerism at the end of the twentieth century. (shrink)

Equity in health and health care is animportant issue. It has been proposed that thepursuit of equity in health care is beinghampered by the dominance of individualism inhealth care practices. This paper explores theway in which communitarian ideals and practicesmight lend themselves to the pursuit of equity.Communitarians acknowledge, respect and fosterthe bonds that unite and identify communities.The paper argues that, to achieve equity inhealth care, these bonds need to be recognisedand harnessed rather than ignored. The notionof individual autonomy in the (...) context of thecommunity is examined. Alternative concepts ofautonomy – social autonomy and communityautonomy – are seen to be more respectful andnurturing of both the individual and thecommunity. Moreover, these concepts appeardesirable for the pursuit of health care equitygoals. The paper concludes with some thoughtsabout how equity in Australia's health caresystem can reasonably progress within acommunitarian vision. Disadvantaged communitiesare discussed throughout, in particular,Australian Aboriginal communities. (shrink)

This paper considers whether states have a duty to accept those who cross borders to escape environmental disasters associated with climate change. It then examines how such a responsibility might be distributed, focusing on the predicament of the citizens of small island states expected to be inundated by rising sea levels. In assessing states' responsibility to admit these individuals, I draw on Walzer's theory of mutual aid, demonstrating that even under this narrow conception of states' obligations, a duty to accept (...) displaced islanders can be established. However, the proximity principle is ill-suited to determining which states should shoulder responsibility in this situation. Drawing on Miller's account of remedial responsibility and his ‘connection theory,’ I suggest that the obligation to accept ‘environmental refugees’ should be shouldered principally by affluent states that share significant degrees of causal and moral responsibility for climate change, and also have particularly strong capacities to assist the displaced. (shrink)

SUMMARYContemporary scholars seeking to advance the study of political phenomena identify their inquiry as a ‘science' that attains success through rigorous method. Thus the ‘methodological anarchism' of Paul Feyerabend's philosophy of science might seem an inauspicious place to find a fruitful disciplinary vision. Nonetheless, it echoes a longstanding conception of the ‘science' of politics articulated by Niccolò Machiavelli. Looking to Feyerabend, we propose to surmount the impasse between Machiavelli's account of politics and the demands of modern science and recover his (...) contribution to the scientific study of politics. In doing so, Machiavelli illustrates the potential of a Feyerabendian political science. (shrink)

Richard Stanley Peters appreciates the centrality of concepts for everyday life, however, he fails to recognize their pedagogical dimension. He distinguishes concepts employed at the first-order (our ordinary language-use) from second-order conceptual clarification (conducted exclusively by academically trained philosophers). This distinction serves to elevate the discipline of philosophy at the expense of our ordinary language-use. I revisit this distinction and argue that our first-order use of concepts encompasses second-order concern. Individuals learn and teach concepts as they use them. Conceptual understanding (...) is an obligation that all individuals, and not just academically trained philosophers, must fulfil. I conclude that the role of philosophy in education is to provide a conversational context for the pedagogical dimension of concepts. I draw upon the philosophies of Cora Diamond, Stephen Mulhall, Iris Murdoch and Rush Rhees. (shrink)

BackgroundThe proper and ethical inclusion of PWLHIV and their young children in research is paramount to ensure valid evidence is generated to optimize treatment and care. Little empirical data exists to inform ethical considerations deemed most critical to these populations. Our study aimed to systematically review the empiric literature regarding ethical considerations for research participation of PWLHIV and their young children.MethodsWe conducted this systematic review in partnership with a medical librarian. A search strategy was designed and performed within the following (...) electronic databases: Ovid MEDLINE, Embase and CINAHL. We screened titles and abstracts using the following inclusion criteria: (1) a study population of PWLHIV or children under 5 years of age; and (2) collection of qualitative or quantitative data regarding ethics of research participation. Excluded were reviews, commentaries, policy statements, clinical care-related ethics concerns, abstracts, case studies, or studies unrelated to HIV research. Studies were appraised for quality, data were extracted, and studies were qualitatively analyzed using a principle-based ethical framework within the Belmont Report.ResultsOf the 7470 titles identified, 538 full-text articles were reviewed for eligibility and only three articles met full criteria for inclusion within this review. While we allowed for inclusion of studies involving young children born to mothers with HIV, only articles focused on PWLHIV were identified. Within the results of these studies, four themes emerged: (1) adequacy of informed consent; (2) consideration of paternal involvement; (3) balancing risks; and (4) access to research and treatment. A strength of this review is that it included perspectives of international research investigators, community leaders, and male partners. However, only two studies collected empiric data from PWLHIV regarding their experiences participating in researchConclusionResearchers and funding agencies should be aware of these considerations and appreciate the value of and critical need for formative research to ensure clinical trials involving PWLHIV promote ethical, well-informed research participation and, ultimately, improve care outcomes. More research is needed to create a comprehensive ethical framework for researchers when conducting studies with PWLHIV. (shrink)