The ethical concept of Informed Consent provides individuals with the right and the opportunity to approve of events that will occur regarding his or her own person. In medicine, informed consent is obtained for treatment and for research participation. However, under some circumstances, prospective informed consent cannot be obtained because of the devastating clinical condition of the patient. In emergency circumstances, treatment is never withheld if obtaining informed consent from a critically ill person is not possible or if a delay (...) while seeking surrogates would further endanger life. In emergency research circumstances, waiving informed consent for study participation is fraught with additional ethical considerations. This article will review a presentation given at the June 2, 2006 conference entitled “The Ethics of Research in Emergency Medicine”. (shrink)

In technologically grounded organizations, culture is bound tightly to the material characteristics of the technology that the organization manufactures, distributes, or services. Technological grounding helps explain why high-technology organizations often experience cultural integration problems following a merger. Examining the recent merger of US West and Qwest, this article analyzes how powerful actors strategically used the process of technological grounding to enroll a core technology to situate postmerger integration in technological terms, creating a discourse of inevitability that then justified publicly Qwest's (...) cultural domination of US West. (shrink)

In response to Walter Benjamin's caveat that every image of the past not recognized by the present as one of its own concerns threatens to disappear irretrievably, this essay examines images of spitting in the work of Michel de Montaigne and Georges Bataille. By resisting insertion within codified cycles of exchange-especially those of institutionalized violence-their images exemplify a defiance to servitude that can be generalized to a theory of sovereignty. An archaeological inventory indicates possibilities provided by the montage of images (...) for the construction of a heterological counterhistory, where spit and spitting challenge the dominance of spirit in Western culture. (shrink)

Background: Dementia care at home often involves decisions in which the caregiver must weigh safety concerns with respect for autonomy. These dilemmas can lead to situations where caregivers provide care against the will of persons living with dementia, referred to as involuntary treatment. To prevent this, insight is needed into how family caregivers of persons living with dementia deal with care situations that can lead to involuntary treatment. Objective: To identify and describe family caregivers’ experiences regarding care decisions for situations (...) that can lead to involuntary treatment use in persons living with dementia at home. Research design: A qualitative descriptive interview design. Data were analysed using the Qualitative Analysis Guide of Leuven. Participants and research context: A total of 10 family caregivers providing care for 13 persons living with dementia participated in in-depth semi-structured interviews. Participants were recruited by registered nurses via purposive sampling. Ethical consideration: The study protocol was approved by the Ethics Committee of the University Hospitals Leuven and the Medical Ethical Test Committee Zuyderland. Findings: Family caregivers experience the decision-making process concerning care dilemmas that can lead to involuntary treatment as complicated, stressful and exhausting. Although they consider safety and autonomy as important values, they struggle with finding the right balance between them. Due to the progressive and unpredictable nature of dementia, they are constantly seeking solutions while they adapt to new situations. Family caregivers feel responsible and experience social pressure for the safety of persons living with dementia. They may be blamed if something adverse happens to the persons living with dementia, which increases an already stressful situation. Their experience is influenced by characteristics of the care triad (persons living with dementia, professional and family caregivers) such as practical and emotional support, knowledge, and previous experiences. Discussion and conclusion: To prevent involuntary treatment, professionals need to proactively inform family caregivers, and they need to support each other in dealing with complex care situations. (shrink)

In the United States, the IRS now requires charities to publicly disclose any significant asset diversion, which is the theft or unauthorized use of assets, that the charity identifies during the year. We use this new disclosure to investigate whether strong governance reduces the likelihood of a charitable asset diversion. Specifically, for a sample of 1528 charities from 2008 to 2012, we simultaneously examine eleven measures of governance that capture four broad governance constructs: board monitoring, independence of key individuals, tone (...) at the top, and capital provider oversight. We find consistent evidence that good governance across all four constructs is negatively associated with the probability of an asset diversion. Of the eleven governance measures, our results indicate that monitoring by debt holders and government grantors, audits, and keeping managerial duties in-house are most strongly associated with lower incidence of fraud. Our results also indicate that the likelihood of a fraud is negatively associated with a board review of the Form 990, the existence of a conflict of interest policy, and the presence of restricted donations. In addition, we document that the likelihood of an asset diversion is negatively associated with program efficiency and positively associated with growth and organizational complexity. (shrink)

This volume is a wonderful introduction to Foucault and a testimony to the deep humanity of the man himself.

Purpose This study aims to explore how the public perceives the effectiveness of surveillance technology, and how people’s views on privacy and their views on effectiveness are related. Likewise, it looks at the relation between perceptions of effectiveness and opinions on the acceptable cost of surveillance technology. Design/methodology/approach For this study, surveys of Dutch students and their parents were conducted over three consecutive years. Findings A key finding of this paper is that the public does not engage in a trade-off (...) neither with regard to privacy-effectiveness nor with effectiveness-cost, but rather expects all three elements to be achieved simultaneously. This paper also found that the correlation between perceived effectiveness and perceived privacy was stronger for parents than for students. Research limitations/implications Participants for this study were exclusively in The Netherlands. Survey questions on the effectiveness of surveillance technology focused on one type of technology, and on private mobile device use in two scenarios. Social implications The public’s perceptions of the effectiveness of surveillance technology potentially influence its acceptance of the technology, which, in turn, can affect the legitimacy and use of the technology. Originality/value Within the much-discussed privacy-security debate lies a less-heard debate – that of the effectiveness of the surveillance technology in question. The public is one actor in this debate. This study examines the public’s perceptions of this less-heard debate. (shrink)

This article presents an overview for clinician investigators on the concepts of decision-making capacity and vulnerability as related to human subjects research. Tools for capacity assessment and unacknowledged sources of vulnerability are discussed, and the practical gaps in current informed consent requirements related to impaired capacity and potential vulnerability are described. Options are suggested for research discussions when full regulatory consent is not possible and an exception from informed consent does not apply.

The emergence of environmental governance practices raises a fundamental question as to whether they are substantive or symbolic. Toward that end, we analyze the relationship between a firm’s environmental governance and its environmental management as reflected in its ultimate outcome, environmental performance. We posit that substantive practices would bring changes in organizations, most notably in terms of improved environmental performance, whereas symbolic practices would portray organizations as environmentally committed without making meaningful changes to their operations. Focusing on a sample of (...) environmentally sensitive firms, results are consistent with environmental governance mechanisms being predominantly part of a symbolic approach to manage stakeholder perceptions on environmental management, having little substantial impact on organizations. Statistical analyses show mostly that there is no relation between environmental governance mechanisms and environmental performance, measured in terms of regulatory compliance, pollution prevention, and environmental capital expenditures. However, there is some indication that environmental incentives are associated with pollution prevention. Interviews with corporate directors shed further light on these results by underlining that environmental governance mechanisms are employed at the board level to protect the organization from reputational and/or regulatory harm, but are not necessarily intended to proactively improve environmental performance. (shrink)

The intuition that consciousness is hard to explain may fade away as empirically adequate theories of consciousness develop. We review socio-historical factors that account for why, as a field, the neuroscience of consciousness has not been particularly successful at developing empirically adequate theories. Based on this we argue that the meta-problem may be a self-fulfilling prophecy, created in part because we inadvertently focused too much on the so-called 'hard problem', limiting scientific progress.

Today, the French word “syndicat” designates both an association of workers and a group of producers or business concerns. In the nineteenth century, it was identified with “associations of resistance” which the law called “workers’ coalitions” and which were associations of workers, de facto or de jure, formed to improve the lot of the working class by one means or another. In this study we shall consider such organizations exclusively.

Modelling and simulations have gained a leading position in contemporary attempts to describe, explain, and quantitatively predict the human brain's operations. Computer models are highly sophisticated tools developed to achieve an integrated knowledge of the brain with the aim of overcoming the actual fragmentation resulting from different neuroscientific approaches. In this paper we investigate plausibility of simulation technologies for emulation of consciousness and the potential clinical impact of large-scale brain simulation on the assessment and care of disorders of consciousness, e.g. (...) Coma, Vegetative State/Unresponsive Wakefulness Syndrome, Minimally Conscious State.Notwithstanding their technical limitations, we suggest that simulation technologies may offer new solutions to old practical problems, particularly in clinical contexts. We take DOCs as an illustrative case, arguing that the simulation of neural correlates of consciousness is potentially useful for improving treatments of patients with DOCs. (shrink)

In this consensus report by a diverse group of academics who conduct and/or are concerned about social and behavioral genomics (SBG) research, the authors recount the often‐ugly history of scientific attempts to understand the genetic contributions to human behaviors and social outcomes. They then describe what the current science—including genomewide association studies and polygenic indexes—can and cannot tell us, as well as its risks and potential benefits. They conclude with a discussion of responsible behavior in the context of SBG research. (...) SBG research that compares individuals within a group according to a “sensitive” phenotype requires extra attention to responsible conduct and to responsible communication about the research and its findings. SBG research (1) on sensitive phenotypes that (2) compares two or more groups defined by (a) race, (b) ethnicity, or (c) genetic ancestry (where genetic ancestry could easily be misunderstood as race or ethnicity) requires a compelling justification to be conducted, funded, or published. All authors agree that this justification at least requires a convincing argument that a study's design could yield scientifically valid results; some authors would additionally require the study to have a socially favorable risk‐benefit profile. (shrink)

The use of aborted fetal tissues in research and therapy has raised exciting possibilities and a host of social, legal and ethical issues. Perhaps the most difficult issue is whether the use of materials from elective abortion can be viewed and weighed separately from the abortion itself, or if in using these tissues there is inherent complicity with the abortion act. Those who oppose FTT claim that there is complicity with the abortion act and liken the use of fetal tissue (...) from abortions to the use of data from the Nazi experiments. Within this lobby are those who claim that the option to donate fetal tissues will make abortion a more attractive alternative for pregnant women, and that there are doctors who will offer fetal tissue donation as a positive incentive to abortion-with the net effect that more abortions will take place. (shrink)

We assessed the attitudes, perceptions, and stereotypes toward Latino immigrants among 247 mental health professionals across 32 U.S. states. We also randomly presented two versions of an attitude measure that varied in their references to immigrants. Participants reported that they did not agree with the anti-immigration law Arizona SB 1070 and other similar bills. Also, greater multicultural awareness was related to positive attitudes and fewer stereotypes toward immigrants. Furthermore, participants who were asked to think about “undocumented immigrants” viewed Latino immigrants (...) more positively than those who were asked think about “illegal aliens.” Findings show the continued need for multicultural awareness and competence training for mental health professionals, which align with the American Psychological Association’s Ethical Principles of Psychologists and Code of Conduct. Limitations and future directions for research are discussed. (shrink)

The future of work is forcing the world to adjust to a new paradigm of working. New skills will be required to create and adopt new technology and working methods. Additionally, cognitive skills, particularly creative problem-solving, will be highly sought after. The future of work paradigm has threatened many occupations but bolstered others such as engineering. Engineers must keep up to date with the technological and cognitive demands brought on by the future of work. Using an exploratory mixed-methods approach, our (...) study sought to make sense of how engineers understand and use creative problem solving. We found significant associations between engineers’ implicit knowledge of creativity, exemplified creative problem solving, and the perceived value of creativity. We considered that the work environment is a potential facilitator of creative problem-solving. We used an innovative exceptional cases analysis and found that the highest functioning engineers in terms of knowledge, skills, and perceived value of creativity, also reported working in places that facilitate psychosocially safe environments to support creativity. We propose a new theoretical framework for a creative environment by integrating the Four Ps and psychosocial safety climate theory that management could apply to facilitate creative problem solving. Through the acquisition of knowledge to engage in creative problem solving as individuals or a team, a perception of value must be present to enforce the benefit of creativity to the engineering role. The future of work paradigm requires that organisations provide an environment, a psychosocially safe climate, for engineers to grow and hone their sought-after skills that artificial technologies cannot currently replace. (shrink)

This title opens the debate about what an ethics for the 21st century would look like and the role of corporations and how to work to ensure they produce results which benefit society as a whole.

Wilson et al. focus on one class of AGL tasks: the cognitively demanding task of detecting non‐adjacent dependencies (NADs) among items. They provide a typology of the different types of NADs in natural languages and in AGL tasks. A range of cues affect NAD learning, ranging from the variability and number of intervening elements to the presence of shared prosodic cues between the dependent items. These cues, important for humans to discover non‐adjacent dependencies, are also found to facilitate NAD learning (...) in several nonhuman animal species. (shrink)

The simplest and no doubt the most persistent of the ideas held on the relationship between society and power, from Menenius Agrippa to Auguste Comte, is that of an analogy between the social body and the human body. Both these men deduced that power is nothing other than the supreme regulating function of all functional activities, as harmoniously integrated in society as they are in human physiology. Ethnographic study often strengthened this organicist conception through description of the various social functions (...) as necessary or vital for the cohesion and the existence of primitive society. But historic societies provide a spectacle quite different from that of an integrated organism. In them social functions are not abstractions but are seen rather in the form of human groups whose relationships can scarcely be said to show an organic solidarity. Within these groups and working to set them against each other, powers have their own interests which they must protect against the inroads of ambitions. The permanence of certain functions (military, religious, and economic, for example) does not imply permanence in the structures which implement them or in the real or fictional power which accompanies them. Their meaning is ambivalent. Obviously, they contribute to the architecture of a society; they may have a latent content which is a disintegrating factor from the moment when their hierarchy no longer suits the changing stratifications of the social body. (shrink)

A single powerful idea, that of progress, dominated the nineteenth century and became its main symbol—or so it seemed to Renan when he measured “the enormous strides that the science of man has made during the last one hundred years.” Since the waning of the Middle Ages, intellectual progress had gone hand in hand with the rejection of the appeal to authority. Francis Bacon had assigned to this kind of progress a practical goal, and Descartes had provided it with an (...) effective method. It seemed, therefore, that it was capable of going on, for some time at least, by additions to, and a systematic completion of, already existing knowledge. It is in such terms that Pascal described it in the preface to his Traité sur le vide, assimilating the development of mankind to that of “a single individual who lives forever and learns continually.” This picture, which became common to all later doctrines of progress, did not specify whether the human species would continue to progress indefinitely, as Condorcet said it would, or whether it would reach a state of old age and decrepitude and eventually become extinct, as Fourier imagined it. When reason, in the eighteenth century, ceased to be the gift of providence to the established political authorities, it became the property of all men, and the standard by which their conduct was to be judged. The progress of the intellect was thus socialized. In Turgot's words, “the entire mass of men is on the move to greater perfection, though a period of calm may alternate with one of agitation, and good with evil, and no matter how slow the movement may be.” This move took place against the background of an immovable nature, and as a result of the spread of enlightenment throughout society; and according to Turgot and his contemporaries, it could not be stopped by ancient institutions that stood in its way. The framework of nature was soon to be shaken when, at the turn of the century, the theories of Kant and Laplace divested the Newtonian order of its appearance of eternity, and when advances in geology and, finally, the transmutationist theories which culminated in Lamarck's Philosophie zoologique (1809), seemed to show that both inorganic. matter and living species were in the process of transformation. In biology, the criterion of progress was an increase in the specialization of the organism. It is this criterion which Saint-Simon wanted to apply to human societies, reminding us with satisfaction of what he owed to the anatomist Vicq d'Azyr. In the beginning of the nineteenth century, embryological discoveries seemed to show that the biological evolution of man was continuous with that of the lower animals. This gave rise to the idea of a continuous progress, and to the conviction that no valid reason could be found why progress should be confined to the present. The perfection of the individual (sketched tentatively by Condorcet) and the perfection of society found in Saint-Simon, and later on in Spencer, their systematic interpreters; and so did the idea that individual and society were to achieve, either spontaneously or by design, a dynamic equilibrium. Pascal's purely speculative picture was thus transformed into an organic theory of social evolution. (shrink)

As a way of contributing to bioethics' understanding of itself, and, more particularly, to invigorate conversation about how we can best educate future colleagues, we present here a sketch of the quarter-century-old graduate concentration in medical ethics housed in the Department of Philosophy at the University of Tennessee, Knoxville. Our hope is to incite other programs to share their histories, strategies, problems, and aspirations, so as to help the field as a whole get a clearer sense of how we are (...) putting together our future, and of how we might best go about this important job. (shrink)

There is much discussion in the media and some of the scientific literature of how many of the conclusions from scientific research should be doubted. These critiques often focus on studies – typically in non‐experimental spheres of biomedical and social sciences – that search large datasets for novel correlations, with a risk that inappropriate statistical evaluations might yield dubious conclusions. By contrast, results from experimental biological research can often be interpreted largely without statistical analysis. Typically: novel observation(s) are reported, and (...) an explanatory hypothesis is offered; multiple labs undertake experiments to test the hypothesis; interpretation of the results may refute the hypothesis, support it or provoke its modification; the test/revise sequence is reiterated many times; and the field moves forward. I illustrate this experimental/non‐experimental dichotomy by examining the contrasting recent histories of: (a) our remarkable and growing understanding of how several inositol‐containing phospholipids contribute to the lives of eukaryote cells; and (b) the difficulty of achieving any agreed mechanistic understanding of why consuming dietary supplements of inositol is clinically beneficial in some metabolic diseases. (shrink)

Wilson et al. focus on one class of AGL tasks: the cognitively demanding task of detecting non‐adjacent dependencies (NADs) among items. They provide a typology of the different types of NADs in natural languages and in AGL tasks. A range of cues affect NAD learning, ranging from the variability and number of intervening elements to the presence of shared prosodic cues between the dependent items. These cues, important for humans to discover non‐adjacent dependencies, are also found to facilitate NAD learning (...) in several nonhuman animal species. (shrink)

Quelle différence y a-t-il entre des règles de droit et des ordres appuyés de menaces? Qu'est-ce qu'une obligation juridique et en quoi se trouve-t-elle apparentée à une obligation morale? Quelle est la nature des règles et dans quelle mesure le droit consiste-t-il en des règles? Qu'est-ce que la justice et en quoi diffère-t-elle du reste de la morale?Au cours d'une discussion approfondie et séparée de ces problèmes récurrents, l'auteur relève une série d'éléments d'une importance essentielle pour la compréhension du droit, (...) et réalise un nouveau départ dans la théorie du droit. L'ouvrage comporte une nouvelle analyse des notions de validité juridique, de souveraineté, et de fondement d'un système juridique, un nouvel examen du droit naturel et du positivisme juridique, une discussion originale des limites du formalisme dans l'élaboration de la décision judiciaire, et un examen de la nature du droit international.Le texte est complété par des notes bibliographiques détaillées et la discussion de thèses émises par des auteurs contemporains et plus anciens. Cette deuxième édition s'accompagne en outre d'une postface posthume, publiée sous la responsabilité de P.A. Bulloch et J. Raz. (shrink)

In the area of investment, responsibility may be expressed via four types of ethical concern: value-based ethics resulting in the exclusion of so-called "vicious" companies from the investment portfolio; fructification-oriented ethics with a view to long-term investment; consequence-based ethics aimed at initiating a behavioural change in the investment target; and ethics envisaged as a discriminating criterion in the search of the best financial performance. No single formula of responsible investment is available, and the "responsible" approach necessarily implies the active involvement (...) of a free acting subject striving to tackle fundamental ethical issues. The practice of responsible investment cannot be reduced to simply applying a particular legal rule or mathematical formula. (shrink)

Background: In prior reports, we described the design and initial performance of a fully implantable, bi-directional neural interface system for use in deep brain and other neurostimulation applications. Here we provide an update on the chronic, long-term neural sensing performance of the system using traditional 4-contact leads and extend those results to include directional 8-contact leads.Methods: Seven ovine subjects were implanted with deep brain stimulation leads at different nodes within the Circuit of Papez: four with unilateral leads in the anterior (...) nucleus of the thalamus and hippocampus; two with bilateral fornix leads, and one with bilateral hippocampal leads. The leads were connected to either an Activa PC+S® or Percept PC°ledR deep brain stimulation and recording device. Spontaneous local field potentials, evoked potentials, LFP response to stimulation, and electrode impedances were monitored chronically for periods of up to five years in these subjects.Results: The morphology, amplitude, and latencies of chronic hippocampal EPs evoked by thalamic stimulation remained stable over the duration of the study. Similarly, LFPs showed consistent spectral peaks with expected variation in absolute magnitude dependent upon behavioral state and other factors, but no systematic degradation of signal quality over time. Electrode impedances remained within expected ranges with little variation following an initial stabilization period. Coupled neural activity between the two nodes within the Papez circuit could be observed in synchronized recordings up to 5 years post-implant. The magnitude of passive LFP power recorded from directional electrode segments was indicative of the contacts that produced the greatest stimulation-induced changes in LFP power within the Papez network.Conclusion: The implanted device performed as designed, providing the ability to chronically stimulate and record neural activity within this network for up to 5 years of follow-up. (shrink)

While proponents of sustainability reporting believe in its potential to help corporations be accountable and transparent about their social and environmental impacts, there has been growing criticism asserting that such reporting schemes are utilized primarily as impression management tools. Drawing on Goffman’s self-presentation theory and its frontstage/backstage analogy, we contrast the frontstage sustainability discourse of a sample of large U.S. oil and gas firms to their backstage corporate political activities in the context of the passage of the American-Made Energy and (...) Good Jobs Act, also known as the Arctic National Wildlife Refuge Bill. The ANWR Bill was designed to allow oil exploration within the most sensitive environmental areas in the Refuge and this bill was vigorously debated in the United States Congress in 2005 and 2006. Our results suggest that the firms’ sustainability discourse on environmental stewardship and responsibility contrasts sharply with their less visible but proactive political strategies targeted to facilitate the passage of the ANWR Bill. This study thus contributes to the social and environmental accounting and accountability literature by highlighting the relevance of Goffman’s frontstage/backstage analogy in uncovering and documenting further the deceptive nature of the discourse contained in stand-alone sustainability reports. In addition, it seeks to contribute to the overall understanding of the multifaceted nature of sustainability reporting by placing it in relation to corporate political activities. (shrink)