In recent years, there has been a particular emphasis placed on conducting randomized controlled trials (RCTs) that compare the relative efficacy of psychosocial and pharmacological interventions. This article addresses relevant ethical considerations in the conduct of these treatment trials, with a focus on RCTs with children. Ethical concerns, including therapeutic misconception, treatment preference, therapeutic equipoise, structure of treatments, and balancing risks versus benefits, are introduced through a clinical scenario and discussed as they relate to psychotherapy versus medication RCTs. In each (...) case, suggestions are made for researchers seeking to minimize the impact of these ethical concerns on research participants. (shrink)

Elephants show a rich social organization and display a number of unusual traits. In this paper, we analyse reports collected over a thirty-five year period, describing behaviour that has the potential to reveal signs of empathic understanding. These include coalition formation, the offering of protection and comfort to others, retrieving and 'babysitting' calves, aiding individuals that would otherwise have difficulty in moving, and removing foreign objects attached to others. These records demonstrate that an elephant is capable of diagnosing animacy and (...) goal directedness, and is able to understand the physical competence, emotional state and intentions of others, when they differ from its own. We argue that an empathic understanding of others is the simplest explanation of these abilities, and discuss reasons why elephants appear to show empathy more than other non-primate species. (shrink)

BackgroundInstitutional review boards (IRBs) are formally designated to review, approve, and monitor biomedical research. They are responsible for ensuring that researchers comply with the ethical guidelines concerning human research participants. Given that IRBs might face different obstacles that cause delays in their processes or conflicts with investigators, this study aims to report the functions, roles, resources, and review process of IRBs in Saudi Arabia.MethodThis was a cross-sectional self-reported survey conducted from March 2021 to March 2022. The survey was sent to (...) 53 IRB chairpersons and the administration directors (or secretary) across the country through email after receiving verbal consent. The validated survey consisted of eight aspects: (a) organizational aspects, (b) membership and educational training, (c) submission arrangements and materials, (d) minutes, (e) review procedures, (f) communicating a decision, (g) continuing review, and (h) research ethics committee (REC) resources. A total of 200 points indicated optimal IRB functions.ResultsTwenty-six IRBs across Saudi Arabia responded to the survey. Overall, the IRBs in this study scored a total of 150/200 of the points on the self-assessment tool. Relatively newer IRBs (established less than ten years ago) conducted meetings at least once in a month, had annual funding, had more balanced gender representation, tended to score higher than older IRBs. The organizational aspect score was the lowest among all items in the survey (14.3 score difference, p-value < 0.01). The average turnaround time for expedited research from proposal submission to final decision was 7 days, while it was 20.5 days for the full committee review.ConclusionSaudi IRBs performed generally well. However, there is room for focused improvement with respect to extra resources and organizational issues that require closer evaluation and guidance from the regulatory bodies. (shrink)

The law often calls on the concept of public interest for assistance. Privacy law makes use of this concept in several ways, including to justify consent waivers for secondary research on health information. Because the law sees information privacy as a means for individuals to control their personal information, consent can only be set aside in special circumstances. Ballantyne and Schaefer argue that only public interest, and only a broad conception of public interest, can do the special ‘normative justificatory work’ (...) to override consent requirements. Other, similar-sounding concepts, such as public benefit, public good and social value, also provide useful services. But none more so than public interest. In fact, they argue, public interest is the superior concept precisely because it can capture those concepts as well as a range of other interests. Our response focuses on this claim. We argue their strategy is not as promising as it might first seem. Ballantyne and Schaefer construe the important role that public interest plays in this context as their endpoint. They claim that unless the concept is open and content-rich, it will lose some of its importance. But by refusing to place limits around it, their inquiry leads us back to a catch-all concept that lacks clear focus or meaning. In reply, we argue that, for practically minded theorists, a narrow conception of public interest is more useful. Further, the narrowing of public interest in this context can be achieved by first analysing it in its legal, rather than ethical, sense. (shrink)

In settler-colonial Canada, the state does not receive Indigenous testimony as credible evidence. While the state often accepts Indigenous testimony in formal hearings, the state fundamentally rejects Indigenous evidence as a description of the world as it is, as an onto-epistemology. In other words, the Indigenous worldview formation, while it functions as a knowledge system that knows and predicts life, is not admitted to regulatory discussions about effects of resource extraction projects on life. Particularly in such resource-extraction review hearings, partly (...) for obvious reasons of ecological ethics, there is no space for Indigenous relational-ontology. I theorize that beyond racism, white supremacy, and greed, settler-colonial onto-epistemological structures are structured to systematically eliminate the potential for relational-ontologies. This exclusion is complementary to resource-extractivist and legal positivist procedures and is biased against Indigenous knowledge and knowledge-sharing procedures; it is a crisis of state integrity and is philosophically unsound. In my analysis of Canadian National Energy Board documents, I ferret out some of these structures that de facto discredit Indigenous onto-epistemologies; I propose this fundamental problem of the Canadian settler-colonial state must be recognized and changed if the calls of Canada’s Truth and Reconciliation commission are to be met. (shrink)

Environmental chemicals accumulate in all human bodies and have the potential to affect the health of men and women, adults, and children. This article advances “precautionary consumption”—the effort to mediate personal exposure to environmental chemicals through vigilant consumption—as a new empirical site for understanding the intersections between maternal embodiment and contemporary motherhood as a consumer project. Using in-depth interviews, I explore how a group of 25 mothers employ precautionary consumption to mediate their children’s exposure to chemicals found in food, consumer (...) products, and the home. Most of the mothers in the study situate their children’s chemical “burdens” within their own bodies and undertake the labor of precautionary consumption as part of a larger and commodity-based motherhood project. In actively expanding the sphere of responsible motherhood to include managing children’s body burdens, these mothers navigate multiple and overlapping contexts that hold women accountable for children’s futures and value the agency of the proactive consumer. Yet, as the sphere of responsible mothering expands, women without financial resources, time, and family stability are pushed to the margins of normative motherhood. (shrink)

The philosopher Graham Harman argues that contemporary debates about the nature of reality as such, and about the nature of objects in particular, can be meaningfully applied to social theory and practice. With Immaterialism, he has recently provided a case-based demonstration of how this could happen. But social theorists have compelling reasons to oppose object-oriented social theory’s 15 principles. Fidelity to Harman’s aesthetic foundationalism, and his particular use of serial endosymbiosis theory as a mechanism of social change, constrain the very (...) practices which it is supposed to enable. However, social theory stands to benefit from object-oriented philosophy through what we call posthuman relationism – characterised as a commitment to the reality of the nonhuman, but not divorced from the human. The emphasis in object-oriented social theory on how objects withdraw from cognitive or affective capture and representation needs to be tempered by an equal focus on how objects appeal. (shrink)

The philosopher Graham Harman argues that contemporary debates about the nature of reality as such, and about the nature of objects in particular, can be meaningfully applied to social theory and practice. With Immaterialism, he has recently provided a case-based demonstration of how this could happen. But social theorists have compelling reasons to oppose object-oriented social theory’s 15 principles. Fidelity to Harman’s aesthetic foundationalism, and his particular use of serial endosymbiosis theory as a mechanism of social change, constrain the very (...) practices which it is supposed to enable. However, social theory stands to benefit from object-oriented philosophy through what we call posthuman relationism – characterised as a commitment to the reality of the nonhuman, but not divorced from the human. The emphasis in object-oriented social theory on how objects withdraw from cognitive or affective capture and representation needs to be tempered by an equal focus on how objects appeal. (shrink)

De Interpretatione is among Aristotle's most influential and widely read writings; C. W. A. Whitaker presents the first systematic study of this work, and offers a radical new view of its aims, its structure, and its place in Aristotle's system. He shows that De Interpretatione is not a disjointed essay on ill-connected subjects, as traditionally thought, but a highly organized and systematic treatise on logic, argument, and dialectic.

Feminist bioethics is a relatively new field, the major works in which only started to appear in the late 1980s. At first feminist bioethicists focused mainly on issues of particular concern to women such as reproduction. Recently, papers have begun to appear that show that a feminist analysis can be brought to bear on any subject traditional bioethics discusses. So far, however, feminist bioethics has not been brought to bear on psychiatry. There have been feminist critiques of psychiatry and feminist (...) discussions of certain diagnostic categories that disproportionately affect women, but these are concerned with womens issues within psychiatry and how psychiatry has been used to oppress women. Certainly these are important, but what has been missing is a discussion of psychiatry in the sense that feminist bioethics suggests a general critique of psychiatry and the rethinking of the practice of psychiatry, regardless of whether the specific instances involved are womens issues. In this paper I look at what such a feminist bioethical intervention into psychiatry would look like. (shrink)

"Active intervention" with suicidal callers to telephone crisis lines involves breaking confidentiality by dispatching emergency services, typically the police, to a suicidal person without that person's consent and sometimes without his or her knowledge.1 Those who oppose active intervention often refer to it as "nonvoluntary intervention." Active intervention is rapidly becoming the standard of practice for crisis centers and is required for certification by the American Association of Suicidology (AAS), the primary organization that certifies telephone crisis centers. A policy of (...) active intervention is also required for any crisis center affiliated with the Hope Line and the National Suicide Prevention Lifeline .. (shrink)

“Active intervention” with suicidal callers to telephone crisis lines involves breaking confidentiality by dispatching emergency services, typically the police, to a suicidal person without that person’s consent and sometimes without his or her knowledge. In this paper I am concerned with the issue of whether active intervention is ethically justified from a feminist bioethical perspective, and if so, under what conditions.

Obesity is a public health problem influenced by behavioral patterns that span an ecological spectrum of individual-level factors, social network factors and environmental factors. Both individual and environmental approaches necessarily include significant influences from social networks, but how and under what conditions social networks influence behavior change is often not clearly mapped out either in the obesity literature or in many intervention designs. In this paper, we provide an analysis of recent empirical work in obesity research that explicates social network (...) influences on eating behaviors. We argue that a relational rather than individualistic view of personhood should help us better understand the content and context of social network relations that inform health behavior choices. We introduce the concept of ‘identity-constitutive affiliations’ as the glue that binds these social relationships together. Finally, we outline the implications for public health ethics in the development of effective interventions to address overweight and obesity, leveraging the content and context of social network ties to reinforce healthy (or alter unhealthy) eating. More complex treatment of positive and negative behaviors stemming from social network connections should lead to more comprehensive theoretical models of health behavior change and more effective public health interventions. (shrink)

One of the most provocative projects in recent analytic philosophy has been the development of the doctrine of externalism, or, as it is often called, anti-individualism. While there is no agreement as to whether externalism is true or not, a number of recent investigations have begun to explore the question of what follows if it is true. One of the most interesting of these investigations thus far has been the question of whether externalism has consequences for the doctrine that we (...) have authoritative, a priori self-knowledge of our mental states. The selected works presented in this volume, some previously published, some new, are representative of this debate and open up new questions and issues for philosophical investigation, including the connection between externalism, self-knowledge, epistemic warrant, and memory. (shrink)

Experimental philosophers advocate expansion of philosophical methods to include empirical investigation into the concepts used by ordinary people in reasoning and action. We propose also including methods of qualitative social science, which we argue serve both moral and epistemic goals. Philosophical analytical tools applied to interdisciplinary research designs can provide ways to extract rich contextual information from subjects. We argue that this approach has important implications for bioethics; it provides both epistemic and moral reasons to use the experiences and perspectives (...) of diverse populations to better identify underlying concepts as well as to develop effective interventions within particular communities. (shrink)

The increase in ethnically and linguistically diverse older adults in Canada necessitates attention to their experiences and needs for healthy ageing. Arab immigrant women often report challenges in maintaining health, but little is known about their ageing experiences. This interpretive descriptive study uses a transnational life course framework to understand Arab Muslim immigrant women's experiences of engaging in health‐promoting practices as they age in Canada. Women's stories highlight social dimensions of health such social connectedness, social roles and social support that (...) are constructed and maintained within different migration contexts across the life course. Barriers and facilitators to healthy ageing in this population centred around five themes: (i) the necessity of staying strong, (ii) caring for self while caring for others, (iii) double jeopardy of chronic illnesses and loneliness, (iv) inadequate support within large social networks and (v) navigating access to health‐supporting resources. The findings point to transnational connections and post‐migration social support as major influencers in creating facilitators and barriers to healthy ageing for Arab Muslim immigrant women. (shrink)

Both Carnap and Quine made significant contributions to the philosophy of mathematics despite their diversedviews. Carnap endorsed the dichotomy between analytic and synthetic knowledge and classified certainmathematical questions as internal questions appealing to logic and convention. On the contrary, Quine wasopposed to the analytic-synthetic distinction and promoted a holistic view of scientific inquiry. The purpose of thispaper is to argue that in light of the recent advancement of experimental mathematics such as Monte Carlosimulations, limiting mathematical inquiry to the domain of (...) logic is unjustified. Robustness studies implemented inMonte Carlo Studies demonstrate that mathematics is on par with other experimental-based sciences. (shrink)

Understanding the relationship between obesity and fast food consumption encompasses a broad range of individual level and environmental factors. One theoretical approach, the health capability framework, focuses on the complex set of conditions allowing individuals to be healthy. This qualitative study aimed to identify factors that influence individual level health agency with respect to healthy eating choices in uniformly constrained environments. We used an inductive qualitative research design to develop an interview guide, conduct open-ended interviews with a purposive sample of (...) 14 student fast food workers, and analyze the data. Data analysis was conducted iteratively during the study with multiple coders to identify themes. Emergent themes included environmental influences on eating behaviors and internal psychological factors. A localized, embedded approach to analyzing the factors driving the obesity epidemic is needed. Addressing contextual interactions between internal psychological and external environmental factors responds to social justice and public health concerns, and may yield more relevant and effective interventions for vulnerable communities. (shrink)

This volume contains the selected discourses of four seventeenth-century philosophers, carefully chosen to illustrate the tenets characteristic of the influential movement known as Cambridge Platonism. Fundamental to their beliefs is the statement most clearly voiced by Benjamin Whichcote, their leader by common consent, that the spiritual is not opposed to the rational, nor Grace to nature. Religion is based on reason, even in the presence of 'mystery'. Free will and Grace are not mutually exclusive. The editor's comprehensive introduction delineates the (...) main principles of the Cambridge Platonists, in the light of their heritage. It compares their attitude to contemporary thought, stressing their mistrust both of institutionalised religion and of the rising tide of materialism. The sermons are reprinted from the original texts and fully annotated with comparisons and references to a wide range of works. The editor also includes a useful list for further reading, biographical notes and a comprehensive index. (shrink)

Postcolonial science studies entails ostensibly contradictory critical and empirical commitments. Science studies scholars influenced by Bruno Latour and Isabelle Stengers embrace forms of realist, radical empiricism, while postcolonial studies scholars influenced by Jacques Derrida trace the limits of the knowable. This essay takes their common use of the term cosmopolitics as an unexpected point of departure for reconciling Derrida’s program with Stengers’s and Latour’s. I read Derrida’s critique of hospitality and Stengers’s and Latour’s ontological politics as necessary complements for conceiving (...) a care-oriented subalternist cosmopolitics, a process of composing common worlds that remains attentive to the limits of representation. (shrink)

Biologists studying complex causal systems typically identify some factors as causes and treat other factors as background conditions. For example, when geneticists explain biological phenomena, they often foreground genes and relegate the cellular milieu to the background. But factors in the milieu are as causally necessary as genes for the production of phenotypic traits, even traits at the molecular level such as amino acid sequences. Gene-centered biology has been criticized on the grounds that because there is parity among causes, the (...) “privileging” of genes reflects a reductionist bias, not an ontological difference. The idea that there is an ontological parity among causes is related to a philosophical puzzle identified by John Stuart Mill: what, other than our interests or biases, could possibly justify identifying some causes as the actual or operative ones, and other causes as mere background? The aim of this paper is to solve this conceptual puzzle and to explain why there is not an ontological parity among genes and the other factors. It turns out that solving this puzzle helps answer a seemingly unrelated philosophical question: what kind of causal generality matters in biology? (shrink)

Bazzocchi disposes the text of the Tractatus in a user-friendly manner, exactly as Wittgenstein's decimals advise. This discloses the logical form of the book by distinct reading units, linked into a fashioned hierarchical tree. The text becomes much clearer and every reader can enjoy, finally, its formal and literary qualities.

The authors present a case study involving truth telling responsibilities in the setting of nonepileptic seizures. Specifically, over the course of several suspected nonepileptic seizures, a patient’s seizures stopped after he received a saline flush meant to precede the administration of anti-seizure medication. The patient and his surrogate believed he had received the medication each time, and the team wondered whether they should disclose the truth. Some worried that disclosure would reinforce the suspected psychogenic behavior, exacerbating the patient’s condition. In (...) this way, the case study presents a twist on the traditional truth telling archetype. While most truth telling cases center on navigating cultural differences or worries about emotional harm, this case presented concerns about medical harm in the form of exacerbating the patient’s condition. The authors describe the complex patient-family-team dynamic that preceded this ethical dilemma, describe the case, analyze the ethical issue, and describe the outcome. (shrink)