This chapter contains sections titled: Must We Shoot to Kill? Hunting in the Real World The Mastery of the Spectator and the Humility of the Hunter What Photography Cannot Capture Notes.

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ABSTRACT A key selling point of pharmacogenetics is the genetic stratification of either patients or diseases in order to target the prescribing of medicine. The hope is that genetically ‘tailored’ medicines will replace the current ‘one‐size‐fits‐all’ paradigm of drug development and usage. This paper is concerned with the relationship between difference and justice in the use of pharmacogenetics. This new technology, which facilitates the identification and use of difference, has, we shall argue, the potential to lead to injustice either by (...) the inappropriate use of difference or through the inappropriate failure to use difference. We build on empirical data from a detailed study of the range of options for the development of pharmacogenetics to present a consideration of the ethical issues that surround patient and disease stratification. In it we explore the ways in which the use of pharmacogenetics may lead to the creation of new, genetically stratified, forms of difference and new forms of injustice based on these divisions. We also examine the ways in which existing forms of difference and social stratification may interact with the use of pharmacogenetics. In conclusion, we suggest how an understanding of these ethical issues could usefully inform future policy discussions. (shrink)

Using video to facilitate data collection has become increasingly common in health research. Using video in research, however, does raise additional ethical concerns. In this paper we utilize family therapy data to provide empirical evidence of how recording equipment is treated. We show that families made a distinction between what was observed through the video by the reflecting team and what was being recorded onto videotape. We show that all parties actively negotiated what should and should not go ‘on the (...) record’, with particular attention to sensitive topics and the responsibility of the therapist. Our findings have important implications for both clinical professionals and researchers using video data. We maintain that informed consent should be an ongoing process and with this in mind we present some arguments pertaining to the current debates in this field of health-care practice. (shrink)

In this response article, we challenge a core assumption that lies at the centre of a round table discussion regarding the Pharmacogenetics to Avoid Loss of Hearing trial. The round table regards a genetic test for a variant (mt.1555A>G) that increases the risk of deafness if a carrier is given the antibiotic gentamicin. The idea is that rapid testing can identify neonates at risk, providing an opportunity to prevent giving an antibiotic that might cause deafness. We challenge the assumption that (...) a positive test unequivocally guides antibiotic choice because, aside from the risk of deafness, all antibiotics for neonatal sepsis are equivalent. We argue that this assumption is faulty and has particularly troubling moral consequences. We claim that giving an alternative to gentamicin is potentially providing inferior treatment and thereby may increase the risk of death. Parents and doctors are faced with a terrible choice as a result of positive point-of-care testing (POCT): give gold-standard treatment and risk deafness or give second line care and risk death. While we do not indicate an answer to this choice, what we do argue is that such a deep and difficult choice is one that may make parents wish genetic testing was never undertaken, and therefore, contra some authors in the round table, provides a reason to gain specific consent for POCT. (shrink)

This paper investigates what “free-range” eggs are available for sale in supermarkets in Australia, what “free-range” means on product labelling, and what alternative “free-range” offers to cage production. The paper concludes that most of the “free-range” eggs currently available in supermarkets do not address animal welfare, environmental sustainability, and public health concerns but, rather, seek to drive down consumer expectations of what these issues mean by balancing them against commercial interests. This suits both supermarkets and egg producers because it does (...) not challenge dominant industrial-scale egg production and the profits associated with it. A serious approach to free-range would confront these arrangements, and this means it may be impossible to truthfully label many of the “free-range” eggs currently available in the dominant supermarkets as free-range. (shrink)

The use of video for research purposes is something that has attracted ethical attention and debate. While the usefulness of video as a mechanism to collect data is widely agreed, the ethical sensitivity and impact of recording equipment is more contentious. In some clinical settings the presence of a camera has a dual role, as a portal to a reflecting team and as a recording device to obtain research data. Using data from one such setting, family therapy sessions, this article (...) shows how the role played by recording equipment is negotiated in the course of talk and other activities that constitute sessions. Analysis reveals that members of the therapy interaction orient in different ways and for different purposes to the value of recordings. The article concludes that there are layers of benefit to be derived from recording of clinical interactions, including for members themselves, and this has wider implications for the ways in which qualitative research designs in health sciences are evaluated. (shrink)

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Bradley’s philosophy of history, which was mostly embodied in his first published work, The Presuppositions of Critical History, has been the subject of a number of explanatory and critical pieces, several of them in the pages of this journal. In outlining the fundamentals of his approach to historical knowledge, therefore, I can be brief. He begins, ‘There is no history which in some respects is not more or less critical’, because selection of information is essential and the historian needs some (...) principle of selection. It is clear that Bradley includes selecting information not just from primary sources but from previous historians. And, ‘if we exclude or alter or rationalise to the very smallest extent then we have criticism at once.’ The criterion, or canon of selection has to be the historian himself. This has sometimes been dismissed as dangerously relativist, but such criticism misses the point that although the actual historian is the real criterion, ‘the historian as he ought to be’ is the ideal criterion; and ‘the historian who is true to the present is the historian as he ought to be.’ It is crucial to Bradley’s position and to the development of my argument in this paper to note that it is the historian who is true to the present, not to the past, who is the historian as he ought to be. For, as Bradley explained, ‘every man’s present standpoint ought to determine his belief in respect to all past events; but to no man do I dictate what his present standpoint ought to be. Consistency is the one word that I have emphasised.’ Bradley denied a correspondence theory of truth in favour of a coherence theory. Truth had to be constructed by the knower who was not a mere passive observer of reality.. (shrink)

Nathan Emmerich, in a recent issue of Research Ethics Review, has suggested that the ‘professional ethicist’ should be considered an ‘expert member’ in the research ethics committee. He raised a number of interesting questions and in seeking to answer them one may come to what may be regarded as an unexpected conclusion – that there is a prior need to clearly explain the concept of ‘ethical expertise’ and the ‘ethics professional’.

The Australian dingo, like the dog, descends from the wolf. However, although dogs have undergone a lengthy taming process that allows them to fit into human society, dingoes retain many wolf characteristics. Like the wolf and unlike the dog, dingoes do not bark. Dingoes howl; they come into season once a year, and they can dislocate their powerful jaws to seize prey. Since the arrival of settlers and their farming practices in Australia 200 years ago, dingoes have killed sheep, and (...) dogs have learned to protect and control those sheep. Medieval texts admire dogs for their intelligence while denigrating wolves as "cunning"—a word defined as deceitful, crafty, and treacherous. A study of Australian colonial texts reveals a popular representation of the dingo as cowardly, promiscuous, vicious—and cunning. This study compares the representation of dingoes with the representation of dogs . Finally, the paper examines those colonial writers who, either deliberately or unintentionally, allowed the dingo to escape the denigrating representation of cunning. (shrink)

The influence of direct-to-consumer advertising and physician promotions are examined in this study. We further examine some of the ethical issues which may arise when physicians accept promotional products from pharmaceutical companies. The data revealed that direct-to-consumer advertising is likely to increase the request rates of both the drug category and the drug brand choices, as well as the likelihood that those drugs will be prescribed by physicians. The data further revealed that the majority of responding physicians were either neutral (...) or did not feel that accepting some types of gifts from pharmaceutical companies affected their ethical behaviors. (shrink)

The National Health Service (NHS) was the first healthcare system globally to declare ambitions to become net carbon zero. To achieve this, a shift away from metered-dose inhalers which contain powerful greenhouse gases is necessary. Many patients can use dry powder inhalers which do not contain greenhouse gases and are equally effective at managing respiratory disease. This paper discusses the ethical issues that arise as the NHS attempts to mitigate climate change. Two ethical issues that pose a barrier to moving (...) away from metered-dose inhalers are considered: patients who decline an inhaler with a smaller carbon footprint and increased cost. I argue that while a patient is not morally justified in refusing a more environmentally sustainable inhaler due to the expected harms, a doctor may still prescribe a metered-dose inhaler if they believe that switching without consent might undermine trust or substantially worsen the patient’s health. Turning to cost, I argue that the imperative to combat climate change means the NHS should accept small increased financial costs for lower carbon inhalers, even though this provides no additional direct benefit for the patient. I then go on to consider the implications of the preceding analysis for policy and practice. I argue for a policy that minimises the impact of inhalers on the climate by advocating for a principle of environmental prescribing and explore decision-making in practice. While the arguments here pertain primarily to inhalers, the discussion has broader implications for debates around healthcare’s responsibility to be environmentally sustainable. (shrink)

This is a book about two stories of education. In one story there is a vocabulary of means, efficiency, bureaucracy, inspection and science; in the other, one of autonomy, democracy, emancipation and action research. One is the story of positivist managerialist approaches to education, the other is the story of reflective teaching. This book displaces both of these stories. By applying the techniques of deconstruction, Stuart Parker overturns the assumptions common to both of these positions and, in doing so, (...) jettisons some widely cherished beliefs about education, autonomy and rationality. Moving beyond current debates, this book articulates a new manifesto for education in postmodernity and highlights the implications for educational practices and institutions. (shrink)

Julian Savulescu argues for two principles of reproductive ethics: reproductive autonomy and procreative beneficence, where the principle of procreative beneficence is conceptualised in terms of a duty to have the child, of the possible children that could be had, who will have the best opportunity of the best life. Were it to be accepted, this principle would have significant implications for the ethics of reproductive choice and, in particular, for the use of prenatal testing and other reproductive technologies for the (...) avoidance of disability, and for enhancement. In this paper, it is argued that this principle should be rejected, and it is concluded that while potential parents do have important obligations in relation to the foreseeable lives of their future children, these obligations are not best captured in terms of a duty to have the child with the best opportunity of the best life. (shrink)

This volume aims to contextualize the development and reception of Husserl’s transcendental-phenomenological idealism by placing him in dialogue with his most important interlocutors – his mentors, peers, and students. Husserl’s “turn” to idealism and the ensuing reaction to Ideas I resulted in a schism between the early members of the phenomenological movement. The division between the realist and the transcendental phenomenologists is often portrayed as a sharp one, with the realists naively and dogmatically rejecting all of Husserl’s written work after (...) the Logical Investigations. However, this understanding of the trajectory of the phenomenological movement ignores the extensive and intricate contours of the idealism-realism debate. In addition to helping us better interpret Husserl’s attempts to defend his idealism, reconsidering the idealism-realism debate elucidates the relationship and differences between Husserl's phenomenology and the broader landscape of early 20th century German philosophy, particularly the Munich phenomenologists and the Neo-Kantians. The contributions to this volume reconsider many of the early interpretations and critiques of Husserl, inviting readers to assess the merits of the arguments put forward by his critics while also shedding new light on their so-called “misunderstandings” of his idealism. This text should be of interest to researchers working in the history of phenomenology and Husserlian studies. (shrink)

Extracorporeal membrane oxygenation (ECMO) is a form of life support for cardiac and/or pulmonary failure with unique ethical challenges compared to other forms of life support. Ethical challenges with ECMO exist when conventional standards of care apply, and are exacerbated during periods of absolute ECMO scarcity when “crisis standards of care” are instituted. When conventional standards of care apply, we propose that it is ethically permissible to withhold placing patients on ECMO for reasons of technical futility or when patients have (...) terminal, short-term prognoses that are untreatable by ECMO. Under crisis standards of care, it is ethically permissible to broaden exclusionary criteria to also withhold ECMO from patients who have a low likelihood of recovery, to maximize the overall number of lives saved. Unilateral withdrawal of ECMO against a patient’s preferences is unethical under conventional standards of care, but is ethical under crisis standards of care to increase access to ECMO to others in society. ECMO should only be rationed when true scarcity exists, and allocation protocols should be transparent to the public. When rationing must occur under crisis standards of care, it is imperative that oversight bodies assess for inequities in the allocation of ECMO and make frequent changes to improve any inequities. (shrink)

Transcranial direct current stimulation (tDCS) is a brain stimulation technique known for its relative safety and minimal invasiveness. tDCS has demonstrated efficacy as a potential treatment for certain neurological disorders, such as Parkinson’s disease, and has been shown to enhance a range of cognitive abilities under certain contexts. As a result, this technique has captured the interest of both the research community and the public at large. However, efforts to gather information about the effects of tDCS on the brain are (...) still in their infancy, leading to concerns about informed consent as it pertains to the possible risks associated with tDCS treatment. The ability to purchase tDCS equipment in the form of commercial, direct-to-consumer devices, generates even more cause for ethical concern, given the unknowns surrounding this technology and its potential broader societal impact. Previous research has touched on the many ethical issues raised by the emergence of this technology, including under what circumstances its use is justifiable and appropriate. In this paper, we survey recent normative and empirical works pertaining to the ethics of tDCS with the goal of summarizing the current state of ethical debate surrounding its use in the contexts of both therapy and cognitive enhancement, with a particular emphasis on the latter. Our analysis of the collected research finds that issues pertaining to user safety are paramount within existing scholarship; that tDCS use in children is an emerging area of concern entailing special considerations; and that regulatory bodies and legal agencies have struggled to implement appropriate, impactful regulation pertaining to tDCS and related technologies in order to balance public welfare against individual autonomy. This analysis will facilitate future efforts to develop bioethical approaches to tDCS by highlighting the ethical dimensions of tDCS prioritized in existing literature and identifying areas where further ethical consideration is needed. (shrink)

This article identifies conditions under which robust predictive modeling results have special epistemic significance---related to truth, confidence, and security---and considers whether those conditions hold in the context of present-day climate modeling. The findings are disappointing. When today’s climate models agree that an interesting hypothesis about future climate change is true, it cannot be inferred---via the arguments considered here anyway---that the hypothesis is likely to be true or that scientists’ confidence in the hypothesis should be significantly increased or that a claim (...) to have evidence for the hypothesis is now more secure. (shrink)

Increasingly there are calls for climate services to be “co-produced” with users, taking into account not only the basic information needs of users but also their value systems and decision contexts. What does this mean in practice? One way that user values can be incorporated into climate services is in the management of inductive risk. This involves understanding which errors in climate service products would have particularly negative consequences from the users’ perspective (e.g., underestimating rather than overestimating the change in (...) an impact variable) and then prioritizing the avoidance of those errors. This essay shows how inductive risk could be managed in climate services in ways that serve user values and argues that there are both ethical and practical reasons in favor of doing so. (shrink)