In this article, the author aims to demonstrate how Agamben’s concept of Homo Sacer is ideally epitomized by a soldier in war. A soldier in war holds a peculiar position, as killing of soldiers is considered neither illegal by laws nor immoral by ethics, and so a soldier is not considered to be legally or morally “guilty” in the usual sense of the word if he or she kills another soldier in war. The author analyzes the notion of Homo (...) Sacer – a figure representing a human that can be killed without the killer being punished, but at the same time someone who cannot be sacrificed – and further demonstrates that a soldier in war can be said to hold precisely such a status. The reason why a soldier cannot be sacrificed resides in the fact that he has already been “sacrificed to war” by his own society, in exchange for the safety of all other members of society. Perceiving a soldier as Homo Sacer provides a novel explanation and an additional argument for the moral symmetry of combatants, one of the pillars of non-revisionist Just War Theory, as all soldiers can be understood as persons sacrificed by their own societies. (shrink)

This paper argues that professionals who make boundary-related decisions should be guided by relationship-based practice. In our roles as service users and professionals, drawing from our lived experiences of professional relationships, we argue we need to move away from distance-based practice. This includes understanding the boundary stories and narratives that exist for all of us – including the people we support, other professionals, as well as the organisations and systems within which we work. When we are dealing with professional boundary (...) issues, we should centre relationship-building skills that are central to many other aspects of our work. Skills that foster relationships at all levels – between professionals, service users, and services – need to be revalued. Our final recommendation is to create, develop, and foster safer spaces within and outside of organisations, as well as inter-professionally, for the discussion and exploration of boundary-related issues and practice. We are interested in hearing from those with experiences of being marginalised by boundaries so that they can inform a reshaping of our collective ideas around boundary related practices. To foster relationship-based practices in organisations, we have outlined several recommendations here; however, we recognize that these do not go far enough, and that collective action is needed to inform systemic change. (shrink)

The Association of Research Ethics Committees is one of the leading providers of training and education for members of Research Ethics Committees. The introduction of the research governance strategy and the increasing complexity of ethical review place great demands on research ethics committee members that in turn creates challenges for training providers. This paper presents the outcome of an audit of REC members' views about training. Findings demonstrate that REC members are not a (...) homogenous group. Several distinct sub-groups, each with particular training needs emerged. All showed a preference for short, easily accessible events in which there were opportunities for discussion. (shrink)

This paper seeks to clarify the process of ethical review primarily through a consideration of the lay member's role; it considers some of the conventional accounts of the role and portrays weaknesses in them. Its positive account places the ethical review service in a wide political context allowing the definition of lay member as a politically-positioned individual in the REC with the function of formally representing the public standards of morality in the medical research context.

Most hospitals and nursing homes have individuals who engage in ethics consultation, and most do so with very little, if any, training. The goal of this article is not to advance the scholarly literature on training clinical ethics consultants, but instead to provide a road map for individuals doing ethics consultation who would like more training. In this way, I hope to advance the field in some small way, by educating, empowering, and encouraging small- to medium-sized hospitals (...) to train the members of their ethics committee who engage in ethics consultation. (shrink)

In the United States, people may donate organs and tissues to a family member, friend, or anyone whose specific need becomes known to them. For example, in late 2003 dozens of people came forward to donate a kidney to a professional basketball player known to them only through his sports performances. People may also donate a kidney to no one in particular through a process known as nondirected donation. In nondirected donation, people donate a kidney to the organ allocation system (...) rather than to anyone known to them personally. There are limits, though, to generosity. People are usually not allowed to donate to groups of people, no matter the contours of the group, whether white, black, Catholic or Presbyterian, third-time liver recipient, and so on. As the agency that oversees national transplantation policy, the United Network for Organs Sharing does not allow this sort of restricted donation, though it appears that some regional Organ Procurement Organizations occasionally bend the rules when donors insist that their organs go to children or to first-time recipients. Those ad hoc arrangements are, however, the exception to the rule. (shrink)

In clinical mental health research with children, both child and parent are essential members of the research team. The 3 R's of parent/child team membership are respect, rapport, and recognition. Respect and recognition include fair reimbursement for time, expense, and inconvenience, but the most important compensation for many families is the appreciation of the other team members for their sacrifice and cooperation. Reimbursement, although honoring the principles of justice and respect for persons, raises difficult issues about appropriate amount, (...) particularly in research involving children. The 3 R's are supported by the investigator 5 A's: attitude, adaptability, availability, attachment, and appreciation. Although the principles seem clear in the abstract, implementation encounters many practical problems. Perhaps the most difficult of these is determining the appropriate amount of compensation that avoids undue inducement but not at the expense of the 3 R's and 5 A's. (shrink)

Engagement in health research is increasingly practised worldwide. Yet many questions remain under debate in the ethics field about its contribution to health research and these debates have largely not been informed by those who have been engaged in health research. This paper addresses the following key questions: what should the ethical goals of engagement in health research be and how should it be performed? Qualitative data were generated by interviewing 22 people with lived experience, members of the (...) public, and engagement managers about power sharing in health research. Thematic analysis of study data identified the following five themes: the value of engagement in research, ideal engagement, tokenistic engagement, terms to describe those engaged, and engagement roles in research. The paper presents that data and then considers what insights it offers for what engagement should look like—its ethical goals and approach—according to those being engaged. (shrink)

This book explores a wide range of topics in digital ethics. It features 11 chapters that analyze the opportunities and the ethical challenges posed by digital innovation, delineate new approaches to solve them, and offer concrete guidance to harness the potential for good of digital technologies. The contributors are all members of the Digital Ethics Lab, a research environment that draws on a wide range of academic traditions. The chapters highlight the inherently multidisciplinary nature of the subject, (...) which cannot be separated from the epistemological foundations of the technologies themselves or the political implications of the requisite reforms. Coverage illustrates the importance of expert knowledge in the project of designing new reforms and political systems for the digital age. The contributions also show how this task requires a deep self-understanding of who we are as individuals and as a species. The questions raised here have ancient -- perhaps even timeless -- roots. The phenomena they address may be new. But, the contributors examine the fundamental concepts that undergird them: good and evil, justice and truth. Indeed, every epoch has its great challenges. The role of philosophy must be to redefine the meaning of these concepts in light of the particular challenges it faces. This is true also for the digital age. This book takes an important step towards redefining and re-implementing fundamental ethical concepts to this new era. (shrink)

Objectives To determine the frequencies and types of limitation of medical treatment performed by physician members of the German Society for Palliative Medicine and to analyse the findings with respect to clinical and ethical aspects of end-of-life practices. Design Cross-sectional postal survey. Setting Data collection via the secretary of the German Society for Palliative Medicine using the German language version of the EURELD survey instrument. Subjects All 1645 physician members of the German Society for Palliative Medicine. Main outcome (...) measures Types and frequencies of limitation of treatment and possible determinants. Results 901 physicians participated in the study (response rate 55.8%). Participants reported limitation of treatment in 69.1% of cases. These decisions most often affected artificial nutrition (19%), chemotherapy (14%), antibiotics (11%) and medication other than antibiotics (11%). In the majority of eligible cases, physicians estimated the life-shortening effect of limitation of treatment to be <7 days. However, estimations differ depending on the medical measures in question. Bivariate statistical analysis indicated that withholding of treatment was performed significantly more frequently for patients aged ≥65 years (p=0.019). In addition, there were significant associations between the incidence of limitation of treatment and the different diseases reported by respondents as the underlying cause of death. Conclusion The findings of this study provide information on the current state of an ethically and clinically challenging aspect of clinical practice and can serve as a starting point for further interdisciplinary research on normative and empirical aspects of treatment decision-making at the end of life. (shrink)

Recent law and ethics literature has been inundated with recommendations of the "best interests" criterion as the appropriate guide for neonatal and maternal-fetal decision-making. Increasingly, however, its adequacy is being questioned. In Chapter 1, I survey the arguments of "best interests" defenders and critics and suggest one problem is that the "best interests" criterion has yet to be subjected to a systematic conceptual and ethical analysis. In Chapter 2, therefore, I conduct such an analysis to evaluate more systematically its (...) appropriateness as a decision-making guide in neonatal and maternal-fetal medicine, concluding that the "best interests" criterion cannot assist us in seeing and addressing all that is at stake in neonatal and maternal-fetal decision-making because it excludes any consideration of the "interdependent" and other interests of family members. Therefore, I suggest that an ethical criterion or set of criteria which can explicitly consider and adequately balance the interests of infants or fetuses and family members would be a more helpful guide for neonatal and maternal-fetal decision-making. ;In Chapters 3-7, I attempt to move beyond the "best interests" criterion, drawing on fieldwork I conducted in the United States, Sweden, and India to point out some conceptual and normative gaps to be addressed in the development of a more adequate guide for neonatal and maternal-fetal decision-making. In Chapter 3, I describe this fieldwork and explain its purpose as illustrating the clinical ethical strategies employed in these countries to balance the interests of various parties in actual decision-making. In Chapters 4-6, I describe these strategies. Finally, in Chapter 7, I point out some conceptual and normative gaps in these decision-making strategies, noting that these gaps have also been unaddressed by the "best interests" critics reviewed in Chapters 1 and 2. I suggest that we must address these gaps to develop theoretical structures that will enable us to explicitly consider and adequately balance the "interdependent" and other interests of infants or fetuses, their family members, and even society in neonatal and maternal-fetal decision-making. (shrink)

Ethics commissions provide expert advice to governments on what policies to implement regarding pressing ethical issues, most often in bioethics. These commissions distinguish themselves by having members from the professions we are most likely to think of as moral experts, if we believe that these exist. The relationship between moral experts and the composition of ethics commissions is worthy of further exploration, especially because of the highly controversial nature of whether moral expertise exists and, if so, how, (...) and whether, we can identify moral experts. Moreover, it has been argued that the emergence of ethics commissions and how they have been composed have led to a “thinner” debate. In the first part of the article, the problem regarding checks for identifying moral experts is discussed. I argue that one way to handle this difficulty is through the application of Rawls’ concept of comprehensive doctrines. These doctrines have inherent standards that function similarly to independent checks, making it possible to identify moral experts from within such different doctrines. Using this approach makes it manageable to appoint moral experts to ethics commissions. In the second part, I consider the implications of seeing moral expertise through the prism of comprehensive doctrines for the composition of ethics commissions. One natural conclusion is that we should select moral experts representing different reasonable comprehensive doctrines to serve as members of ethics commissions. I consider six challenges to my proposal and demonstrate why these lack merit, and I point out some practical concerns that need further inquiry. (shrink)

ABSTRACTGiven the ethical controversies concerning HIV vaccine trials , we aimed to understand through an exploratory study how members of institutional review boards in the United States and research ethics committees in South Africa view issues concerning the process and content of reviews of these studies. We mailed packets of 20 questionnaires to 12 US IRB chairs and administrators and seven REC chairs to distribute to their members. We received 113 questionnaires . In both countries, members (...) tended to be white males with advanced academic degrees. Compared to the US, SA members called for ‘major changes’ in HVT protocols more frequently , and were less likely to think that HVT participants understood risks and benefits or informed consent forms . In both countries, members were divided on several critical issues , but agreed that they needed more training. Of the SA respondents, 40% reported that they were ‘self‐taught’ in ethics. This study, the first we know of to offer quantitative data comparing US vs. non‐US IRBs/RECs, thus suggests key similarities and differences , along with needs for education. These initial exploratory data in this area have important implications for IRBs, RECs, policy‐makers and scholars concerning future practice, training, policy, and investigations in research ethics, and prevention and treatment of HIV and other diseases in the developing world and elsewhere. (shrink)

BACKGROUND: It can be argued that the ethical conduct of research involves achieving a balance between the rights and needs of three parties-potential research participants, society, and researchers. Local Research Ethics Committees (LRECs) have a number of roles and functions in the research enterprise, but there have been some indications that LREC members, researchers and the public can have different views about these responsibilities. Any such differences are potential sources of disagreement and misunderstanding. OBJECTIVES: To compare the views (...) of LREC members, researchers and the public towards the roles and functions of LRECs. DESIGN: A questionnaire that contained items concerned with a variety of such roles was distributed to general practice patients (as proxies for potential research participants), researchers and LREC members. FINDINGS: While general practice patients believed that the main function of LRECs is to ensure that research participants come to no harm, LREC members were more concerned with the protection of participants' rights. There was also some disagreement between members and researchers with regard to the consideration of proposals on the grounds of scientific merit. CONCLUSIONS: Local Research Ethics Committee members need to be aware of potential differences in views, that they ought to make their priorities clear, and that membership of LRECs ought to reflect the views of both researchers and potential research participants. (shrink)

This paper focuses on the REC and its political context to clarify the process of ethical review. The examples initially considered are taken from a Research Ethics Review editorial to develop the social explanation of the membership and function of a research ethics committee. It is suggested that the management and administration of medical matters are not always best understood solely in medical terms. The conclusion of the paper is that the larger political relationships determine the membership and (...) function of the research ethics committee. The REC is defined as the political mechanism for formally socializing medical research and its lay members as similarly socializing the REC. (shrink)

The publication ‘Governance arrangements for NHS Research Ethics Committees’ is clear in its recommendations about the composition of National Health Service research ethics committees in the United Kingdom. It highlights the need for a sufficiently broad range of experience and expertise, balanced age and gender distribution and every effort to be made to recruit members from black and ethnic minority backgrounds, as well as people with disabilities. It was considered that this composition would make it possible for (...) the scientific, clinical and methodological aspects of a research proposal to be reconciled with the welfare of research participants, and with broader ethical implications. Black and other ethnic minorities constitute 7.9 per cent of the UK population. Ideally, in any research ethics committee with a maximum of 18 members, at least one would be a member of the black or other ethnic minority groups. However, this does not appear to be the case; some committees having more than one, while most do not have any. This paper looks at the present position and suggests ways of improving recruitment and retention of members of these groups. (shrink)

The thesis of the paper is that there are no important differences between problems in business ethics and problems in engineering ethics. The problems are both of the same logical type. What keeps this contention from being obvious is that many view engineers as professionals and business persons as nonprofessionals. If you accept the traditional definition of professional neither engineering nor business qualify. If you adopt the attitudinal definition of a profession which I propose, both practitioners could be (...) professionals. This thesis is then tested by applying it to six specific issues in business and/or engineering ethics. (shrink)

Since the 1988 Cartwright Inquiry, lay members of ethics committees have been tasked with ensuring that ordinary New Zealanders are not forgotten in ethical deliberations. Unlike Institutional Review Boards in North America, where lay members constitute a fraction of ethics committee membership, 50% of most New Zealand ethics committees are comprised of lay members. Lay roles are usually defined in very broad terms, which can vary considerably from committee to committee. This research queries who (...) lay representatives are, what they do, and what if anything they represent. Our findings are based on data collection with 12 participants: eight semi-structured interviews with lay members from diverse types of ethics committees who described their roles, and commentary from four ethics committee chairs, three of these lay members who commented on this article’s final draft. Findings indicate that the role of New Zealand lay persons – although distinctively valued – is otherwise similar to the documented role of lay persons within North American ethics committees. Lay members see their role as primarily protecting the research participant and at times offering a corrective to non-lay members’ views and the interests of their institutions. However, in spite of their numbers, most lay members do not see themselves as representing any particular constituent groups or institutionally unaffiliated areas of concern. On tertiary education committees especially, there is a good deal of ambiguity in the lay role. (shrink)

Kant is gaining popularity in business ethics because the categorical imperative rules out actions such as deceptive advertising and exploitative working conditions, both of which treat people merely as means to an end. However, those who apply Kant in this way often hold businesses themselves morally accountable, and this conception of collective responsibility contradicts the kind of moral agency that underlies Kant's ethics. A business has neither inclinations nor the capacity to reason, so it lacks the conditions necessary (...) for constraint by the moral law. Instead, corporate policies ought to be understood as analogous to legal constraints. They may encourage or discourage certain actions, but they cannot determine a person's maxim - which for Kant is the focus of moral judgment. Because there is no collective intention apart from any intentions of the individual agents who act as members of the corporation, an organization itself has no moral obligations. This poses a dilemma: either apply the categorical imperative to the actions of particular businesspeople and surrender the notion of collective responsibility, or apply a different moral theory to the actions of businesses themselves. Given the diffusion of responsibility in a bureaucracy, the explanatory usefulness of collective responsibility may force business ethicists to abandon Kant's moral philosophy. (shrink)

A decade ago some members of the American Society for Bioethics and the Humanities (ASBH) concluded that the society's reluctance to develop a code of professional ethics, although a tolerable anom...

The Dutch law states that a physician may perform euthanasia according to a written advance euthanasia directive when a patient is incompetent as long as all legal criteria of due care are met. This may also hold for patients with advanced dementia. We investigated the differing opinions of physicians and members of the general public on the acceptability of euthanasia in patients with advanced dementia.

Controlled Human Infection Studies (CHIS) involving the deliberate exposure of healthy individuals to infectious agents, are emerging as a valuable tool for medical research. This systematic survey explores the perceptions of ethics committee members from various Indian medical research institutions after participating in a sensitization workshop on CHIS. This cross-sectional study was conducted on the workshop participants through an online survey. The workshop was held in a hybrid mode and around 60 participants from four tertiary care institutions and (...) research institutes had participated. A structured questionnaire was used to assess their evolving perspectives, challenges, and recommendations related to CHIS and the effectiveness of the workshop. Both Likert scale and open-ended items were included in the survey. Responses are presented as percentage and views supported through the quotes from responses. Around 43 participants responded to the survey (72%). Participants acknowledged the potential benefits of CHIS but were concerned about the psychological harm and other risks. Challenges were identified in conducting and reviewing CHIS, including regulatory approvals, risk assessment, and robust informed consent. The need for development of regulatory guidelines, specialized training, risk mitigation strategies, community engagement, and compensation mechanisms were highlighted. The sensitization workshop was considered valuable in enhancing participants' understanding of CHIS, although participants expressed a need for continued training and experience to effectively review such studies. With the Indian Council of Medical Research (ICMR) releasing a policy statement on ethical conduct of CHIS in India, this study provides a foundation for future capacity-building initiatives among ethics committee members. The findings emphasize the significance of ongoing dialogue to standardize the ethical review process for CHIS, thus facilitating their acceptance and realization in India's medical research landscape. (shrink)

The natural instinct for members of the Committee on Publication Ethics, which now number almost 12,200, as well as academia, is to assume that this organization works under strict and clearly defined ethical parameters, with a solid vision, and an independent mandate that is not influenced by power, think tanks, or partisan interests. Naturally, whistle-blowing and science shaming are not practices that one would usually associate with an ethics organization like COPE, because they involve ethically and morally (...) questionable practices. Despite this, ethical borders have become blurred between the objectives of Retraction Watch and PubPeer, two self-moderated science watchdogs that rely heavily on these questionable practices, in their efforts to grow and survive, and the values espoused by COPE. A Retraction Watch post, in which the former COPE Chair, Virginia Barbour, made a claim of apparent harassment, is the most striking example of the dangers when collaboration may take place between science-shaming websites, and an ethics organization, COPE. These bonds appear to have been in development for a number of years already, with the inclusion of Elizabeth Wager, the former COPE Chair, as a director of The Center for Science Integrity Inc., Retraction Watch’s parent organization. Retraction Watch was financed by, among other groups, the Laura and John Arnold Foundation, whose leader, John Arnold, an ex-Enron trader, declared a “war on bad science”, which may naturally include the destruction of aspects of science as well. Retraction Watch embraces several infamous pseudonymous personas under the broad umbrella of freedom of speech, liaising thereby with PubPeer. There is no doubt that errors in the literature need correcting, but this apparent connection with COPE raises questions about the basic ethical foundation of this relationship. Are scientists to embrace this bond between COPE and science watchdogs and pseudonymous whistle-blowers as the new normal in the correction of the scientific literature? This opinion piece puts forward arguments why the author believes that the ethical compass of COPE has become skewed. (shrink)

The upcoming Regulation No 536/2014 on clinical trials on medicinal products for human use, which will replace the current Clinical Trial Directive at the end of 2021, has triggered a significant reform of research ethics committee systems in Europe. Changes related to ethics review of clinical trials in the EU were considered to be essential to create a more favourable environment to conduct clinical trials in the EU. The concern is, however, that the role of the research (...) class='Hi'>ethics committees will weaken in at least some of the Member States because the new Regulation allows narrowing down the scope of ethics review as compared with the currently valid Clinical Trial Directive. Although the new Regulation may lead to faster approval procedures for clinical trials, which is especially relevant in the context of pandemics, high-quality ethics reviews integrating methodological aspects of a clinical trial should nevertheless be ensured. To maintain high research ethics standards as well as to foster measures to mitigate potential negative consequences of the reform, it is therefore of vital importance to start debating and sharing the reflections about the potential consequences of these transformations and trends as soon as possible. (shrink)

BackgroundBrazil is among the sixteen countries that conducts the most clinical trials in the world. It has a system to review research ethics with human beings made up by the National Commission on Research Ethics and 779 Research Ethics Committees, in 2017. The RECs are supposed to follow the same rules regarding their membership, although the RECs that review Social Science and Humanities researches must respect Resolution 510/16. There are Brazilian RECs that review SSH and clinical trials. (...) This study aimed to analyze the academic professional profile of the members of the CONEP and Brazilian RECs, their adequacy to the norms, and the challenges faced by the REC’s Chairs to compose their membership. MethodsAll 779 Brazilian RECs’ chairs are invited to fill in a questionnaire informing academic and professional background of the RECs members, and 92 answered. However, eight were excluded for having sent an incomplete questionnaire, leaving a total of 84 participants. The variables were described by absolute and relative frequency. The Chi-square test and ANOVA was used to analyze regional differences related difficulties to compose the committee. The significance level was 95%. ResultsThe results showed a predominance of members from the biomedical area, while 33% were members of the Social Sciences and Humanities and 5.5% were community representatives. As for the academic degree, there were PhD and masters. The divergences in relation to the guidelines result from the difficulties of having participants in some areas and the little interest in the work carried out by the committees.ConclusionThe RECs are partially adequate to the norms and their performance may be compromised by the low participation of community representatives. The organization of REC’s specifics to review biomedical research could improve the ethical review process, ensuring a membership more qualified for these protocols. (shrink)

International institutions such as the International Labour Organization (ILO) have been examined from various industrial relations viewpoints. This article seeks to discuss the ILO from the standpoint of moral philosophy. Traditionally, philosophy has not been concerned with industrial relations (IR) and IR writers have not engaged with ethics either. Nonetheless, all IR agents and institutions, international or otherwise, are moral agents. Being part of the United Nations (UN), the ILO follows the Universal Declaration of Human Rights (1948). In philosophical (...) terms, the ILO carries connotations of the German moral philosopher Kant's (1724-1084) concept of universalism. Ethical universalism is also the core of American psychologist and philosopher Laurence Kohlberg's developmental model that allows an assessment of moral values and ethical behaviours. To ascertain the ILO's morality, an empirical study (n=121) was conducted at a regional University. The study indicated that most respondents (68%) saw the ILO as a reflection of the morality of " defending everyone's right to justice and welfare, universally applied while applying well-thought principles and being ready to share and debate these openly and non-defensively with others". In line with the ILO's self-understanding, survey respondents also viewed it as a thoroughly moral agent committed to the advancement of humanity as a whole. Respondents also thought that the ILO goes beyond the confinements of the standard industrial relations framework, actively engaging with the universality of all people. The overall conclusion is that the way the ILO is perceived to act along the scale of Kohlberg's text matches the ILO's actual existence and work. For the first time, the ILO's moral status has been tested using Kohlberg's scale of morality. This provides a significant contribution to our understanding of the morality of a very important universal institution that has virtually all countries as members. (shrink)

1. Each NABC member institutions should ensure that subject matter on ethical issues associated with food and agricultural biotechnology is systematically integrated into the curriculum of their institution. The pattern of implementation will vary a teach institution, but we expect that some combination of the following three strategies will be employed at most institutions. a) Modules Included in Basic and Applied Science Courses b) Modules Included in General Courses on Applied Ethics c) Special courses on Ethics and Food (...) Biotechnology 2. Each NABC member institution should develop an institutional mechanism for supporting faculty interest and research on ethical issues. Again, implementation will vary. In some institutions, an informal network of interested colleagues will fulfill this function, but in many places an annual workshop or a formal faculty/center will be needed to carry this out. (shrink)

This is the third in a series of five papers on the role, remit and function of research ethics committees which are intended to provide for REC members a broad understanding of the most important issues in research ethics and governance. This paper examines the role of ethics committees in balancing the social value of the research it reviews against the risks it imposes on those who take part. The ethics committee's role in assessing the (...) social value of research goes well beyond checking its scientific validity and this assessment may affect the risks ethics committees are prepared to ask of subjects not only for their own potential personal interests but importantly and inevitably in the name of science. However, their function is importantly restricted by the wider regulatory and governance environment in which they work. (shrink)

This is the second in a series of five papers on the role, remit and function of research ethics committees which are intended to provide for REC members a broad understanding of the most important issues in research ethics and governance. This paper examines the role of ethics committees in assessing the science of the research it reviews. While ethics committees are not specifically constituted to review the science of a project, they must nevertheless assess (...) the social benefits of research and, in this context, have an important role in checking that the science has been properly peer-reviewed. (shrink)

Objective—To demonstrate Japanese doctors' and nurses' attitudes towards and practices of voluntary euthanasia (VE) and to compare their attitudes and practices in this regard. Design—Postal survey, conducted between October and December 1999, using a self-administered questionnaire. Participants—All doctor members and nurse members of the Japanese Association of Palliative Medicine. Main outcome measure—Doctors' and nurses' attitude towards and practices of VE. Results—We received 366 completed questionnaires from 642 doctors surveyed (response rate, 58%) and 145 from 217 nurses surveyed (68%). (...) A total of 54% (95% confidence interval (CI): 49-59) of the responding doctors and 53% (CI: 45-61) of the responding nurses had been asked by patients to hasten death, of whom 5% (CI: 2-8) of the former and none of the latter had taken active steps to bring about death. Although 88% (CI: 83-92) of the doctors and 85% (CI: 77-93) of the nurses answered that a patient's request to hasten death can sometimes be rational, only 33% (CI: 28-38) and 23% (CI: 16-30) respectively regarded VE as ethically right and 22% (CI: 18-36) and 15% (CI: 8-20) respectively would practise VE if it were legal. Logistic regression model analysis showed that the respondents' profession was not a statistically independent factor predicting his or her response to any question regarding attitudes towards VE. Conclusions—A minority of responding doctors and nurses thought VE was ethically or legally acceptable. There seems no significant difference in attitudes towards VE between the doctors and nurses. However, only doctors had practised VE. (shrink)

This is the fourth in a series of five papers on the role, remit and function of research ethics committees which are intended to provide for REC members a broad understanding of the most important issues in research ethics and governance. This paper explores the role of ethics committees in reviewing proposed conditions for recruiting human subjects and in checking the intended procedures for gaining consent. In so doing the paper will reiterate the conditions which are (...) traditionally thought to make consent valid, identify a number of limitations to meeting these conditions, and show when consent, however broadly construed or indeterminately focused, may be unnecessary. (shrink)

In the context of academic research, a diversity of ethical issues, conditioned by the different roles of members within these institutions, arise. Previous studies on this topic addressed mainly the perceptions of researchers. However, to our knowledge, no studies have explored the transversal ethical issues from a wider spectrum, including other members of academic institutions as the research ethics board (REB) members, and the research ethics experts. The present study used a descriptive phenomenological approach to (...) document the ethical issues experienced by a heterogeneous group of Canadian researchers, REB members, and research ethics experts. Data collection involved socio-demographic questionnaires and individual semi-structured interviews. Following the triangulation of different perspectives (researchers, REB members and ethics experts), emerging ethical issues were synthesized in ten units of meaning: (1) research integrity, (2) conflicts of interest, (3) respect for research participants, (4) lack of supervision and power imbalances, (5) individualism and performance, (6) inadequate ethical guidance, (7) social injustices, (8) distributive injustices, (9) epistemic injustices, and (10) ethical distress. This study highlighted several problematic elements that can support the identification of future solutions to resolve transversal ethical issues in research that affect the heterogeneous members of the academic community. (shrink)

What is the value of an early diagnosis of dementia in the absence of effective treatment? There has been a lively scholarly debate over this question, but until now patients have not played a large role in it. Our study supplements biomedical research into innovative diagnostics with an exlporation of its meanings and values according to patients. Based on seven focusgroups with patients and their care-givers, we conclude that stakeholders evaluate early diagnostics with respect to whether and how they expect (...) it to empower their capacity to care. They value it, for instance, with respect to whether it explains experienced complaints, allows to start a process of psychological acceptance and social adaptation to the expected degeneration, contributes to dealing with anxieties, informs adequately about when to start preparing for the end of life, informs the planning of a request for euthanasia, or allows society to deal with a growing amount of dementia patients. Our study suggests that information about disease is considered ‘harmful’ or ‘premature’ when recipients feel unable to act on that information in their care. The results of this research offers input to further ethical research. It invites to adopt a care perspective in evaluation and to seek ways to prevent the ‘harm’ that such diagnostic methods can bring about. (shrink)

Presently philosophers, social theorists, educationists and legal scholars are busy with issues of contemporary importance such as affirmative actions, animal’s rights, capital punishment, cloning, euthanasia, immigration, pornography, privacy in civil society, values in nature, human rights, cultural values and world hunger etc. Since ancient time ethics is one of the most important part of philosophical speculations and human development. The development of morality comes under three stages viz. intrinsic morality, customary morality and reflective morality. Intrinsic morality has traditionally been (...) thought to lie at the heart of ethics and this is the first stage of morality where the objective is to be moral is to lead one’s life according its basic needs. Customary morality is the second stage of morality, where customs of a particular group and tribe rule the life of the man living in this group and morals based on the customs and traditions of society. Members of the group are motivated to sacrifice their lives to save the culture and norms of the particular group or tribe. In the last reflective morality, man started thinking himself and started to do reflection on their life and contributed to the development of the nation or society where he/she lives. Here he/she is independent to think and follow the best for his life. Reflective morals are those that are based on what you believe to be right and not others. The ideas related to the development of art, values, human rights and quality education etc., all are because of man’s reflection. Reflective morality is the best stage of development of morality in human society. In this paper an attempt is made to draw an outline of development of morality in human life and its application of morality in public and personal life. (shrink)

Humor can be used as a tool for a wide range of tasks, including fighting for social justice. How to most effectively use it, however, is a matter of contention. Jokes that alienate members of an out-group can be called “Otherizing,” and can cause harm by virtue of the alienation. Woke comics, like Hari Kondabolu, intentionally avoid Otherizing in general, but may engage in a version of it that seeks to defang stereotypical treatments of out-groups by replacing the alienating (...) content with something benign. We term this use of Otherizing, “mOtherizing.” Pride comics, like Russell Peters, take a different approach and try to usurp the power of Otherizing by over-engaging in it. The intention is to use the jokes to cobble together a coalition of out-groups that turns itself into an in-group. We term this use of Otherizing, “brOtherizing.”. (shrink)

Background: Due to recent legislations on euthanasia and its current practice in the Netherlands and Belgium, issues of end-of-life medicine have become very vital in many European countries. In 2002, the Ethics Working Group of the German Association for Palliative Medicine (DGP) has conducted a survey among its physician members in order to evaluate their attitudes towards different end-of-life medical practices, such as euthanasia (EUT), physician-assisted suicide (PAS), and terminal sedation (TS). Methods: An anonymous questionnaire was sent to (...) the 411 DGP physicians, consisting of 14 multiple choice questions on positions that might be adopted in different hypothetical scenarios on situations of “intolerable suffering” in end-of-life care. For the sake of clarification, several definitions and legal judgements of different terms used in the German debate on premature termination of life were included. For statistical analysis t-tests and Pearson-correlations were used. Results: The response rate was 61% (n=251). The proportions of the respondents who were opposed to legalizing different forms of premature termination of life were: 90% opposed to EUT, 75% to PAS, 94% to PAS for psychiatric patients. Terminal sedation was accepted by 94% of the members. The main decisional bases drawn on for the answers were personal ethical values, professional experience with palliative care, knowledge of alternative approaches, knowledge of ethical guidelines and of the national legal frame. Conclusions: In sharp contrast to similar surveys conducted in other countries, only a minority of 9.6% of the DGP physicians supported the legalization of EUT. The misuse of medical knowledge for inhumane killing in the Nazi period did not play a relevant role for the respondents’ negative attitude towards EUT. Palliative care needs to be stronger established and promoted within the German health care system in order to improve the quality of end-of-life situations which subsequently is expected to lead to decreasing requests for EUT by terminally ill patients. (shrink)

ABSTRACT The Universal Draft Declaration on Bioethics and Human Rights seeks to provide moral direction to nations and their citizens on a series of bioethical concerns. In articulating principles, it ranks respect for human rights, human dignity and fundamental freedoms ahead of respect for cultural diversity and pluralism. This ranking is controversial because it entails the rejection of the popular theory, conventionalist ethical relativism. If consistently defended, this theory also undercuts other United Nations activities that assume member states and people (...) around the world can reach trans‐cultural judgments having moral authority about health, pollution, aggression, rights, slavery, and so on. To illustrate problems with conventionalist ethical relativism and the importance of rejecting it for reasons of health, human rights, human dignity and fundamental freedoms, the widespread practice of female genital circumcision or cutting is discussed. These surgeries are virtually a test case for conventionalist ethical relativism since they are widely supported within these cultures as religious and health practices and widely condemned outside them, including by the United Nations. (shrink)

This paper considers the roles and definitions of expert and lay members of ethics committees, focussing on those given by the National Research Ethics Service which is mandated to review all research conducted in National Health Service settings in the United Kingdom. It questions the absence of a specified position for the ‘professional ethicist’ and suggests that such individuals will often be lay members of ethics committees, their participation being a reflection of their academic interest (...) and expertise. The absence of a specified position for professional ethicists and the concomitant but implicit denial of ethical expertise appear to be an anomalous state of affairs if one considers that the training offered to members of ethics committees is often delivered by academic ethicists. It is suggested that this is based on a misunderstanding of the concept ‘ethical expertise’ and that properly understood the ethicist can assist the work of ethics committees by drawing on their expert knowledge. (shrink)

This study presents a qualitative description of situations at work that staff members perceive as giving rise to ethical issues. All staff members working with patients across seven wards were given the opportunity to freely describe ethical considerations in an ethical diary over the course of one week. One hundred and five staff members kept a diary. The diaries were analysed with qualitative content analysis where four dominant themes emerged: good care, order and clarity, loyalty, and inadequacy. (...) These results contain statements in which patients are respected and listened to, as well as statements that express a desire for relatively strict, routine-based care. Relatively few statements were of a reflective or discussing nature which highlights the need for clinical ethical support. There is a need of a visible and supportive leadership which encourages ethical reflection. Reflections on real cases could provide an opportunity to challenge existing practices and thereby promote ethical awareness. (shrink)

This paper examines the ethics of the Australian business community’s responses to the phenomenon of modern slavery. Engaging a critical discourse approach, we draw upon a data set of submissions by businesses and business representatives to the Australian government’s Joint Standing Committee on Foreign Affairs, Defence and Trade ‘Parliamentary Inquiry into Establishing a Modern Slavery Act in Australia’—which preceded the signing into law of Australia’s Modern Slavery Act 2018—to examine the business community’s discursive construction in their submissions of the (...) ethical–political concept of freedom. The paper shows how the concept of freedom was employed by Australian business in a manner that privileged their own subject status and advocated for legislation with minimal burden. Relating this contemporary case to a longer historical context, we show how Australian business responses towards modern slavery map onto liberal and neoliberal ethics in which the freedom of the propertied takes precedent over that of the property-less. Further, we show discursive similarities in the arguments presented by modern Australian businesses and certain historical efforts by members of the business community to privilege commercial freedoms in responses to 18th and 19th Century abolitionist movements. Overall, our research makes two important contributions: first, it highlights the value of a critical discourse lens in business ethics research to show how business and other stakeholders in the field construct and shape their own and other’s ethically-laden understanding of reality; and second, it presents a case for considerable scepticism about the motivation of business to employ the freedoms made available to it under neo/liberal discourse to confront a key human rights challenge. (shrink)

The return of individual research results and incidental findings from biobanking research is a much debated ethical issue globally but has extensive relevance in India where the burden of out of pocket health care expenses is high for the majority. The views of 21 ethics committee (EC) members and 22 researchers from Bengaluru, India, concerning the ethics of biobanking research were sought through in‐depth interviews using an unfolding case vignette with probes. A shared view among most was (...) that individual research results which are ‘actionable’ or have ‘clinical significance’ should be returned to the sample contributors through their treating physicians. This was seen as an ethical obligation and a moral duty on the side of the researcher to “give back” to the person who contributed to the research. The challenges foreseen were that of resources, both financial and personnel, for the time and counseling needed to accompany the disclosure of results. Perceptions of ‘ownership’ appear to influence the concept of benefit sharing. While benefit sharing in financial terms was considered ethically challenging, certain researchers and ethics committee members made a case for “two way altruism” where the researcher in return for the altruistic ‘valuable contribution’, shares with the contributor/ community, benefits of the research which could include research findings, improved patient care, and more affordable access to the new diagnostic tests or products arising from the research. This defines the emerging ethic of “giving back” which goes beyond individual rights and ensures reciprocity and distributive justice. (shrink)