Studies on informed consent to medical research conducted in low or middle-income settings have increased, including empirical investigations of consent to genetic research. We investigated voluntary participation and comprehension of informed consent among women involved in a genetic epidemiological study on breast cancer in an urban setting of Nigeria comparing women in the case and control groups.

In 1785, George Washington described a “knowing farmer” as “one who can convert every thing he touches into manure, as the first transmutation towards Gold.” With these words, Washington linked the “knowing farmer” to the alchemist who endeavored to transform base metals into gold with the aid of a philosopher's stone. In each instance, the challenge was to convert raw materials into something new and precious.Today, the “knowing bioethicist” is in a similar position. American bioethics harbors a variety of ethical (...) methods that emphasize different ethical factors, including principles, circumstances, character, interpersonal needs, and personal meaning. Each method reflects an important aspect of ethical experience, adds to the others, and enriches the ethical imagination. (shrink)

A medical information commons is a networked data environment utilized for research and clinical applications. At three deliberations across the U.S., we engaged 75 adults in two-day facilitated discussions on the ethical and social issues inherent to sharing data with an MIC. Deliberants made recommendations regarding opt-in consent, transparent data policies, public representation on MIC governing boards, and strict data security and privacy protection. Community engagement is critical to earning the public's trust.

Abstract:This essay suggests that the word decolonial offers analytic power for feminist historians of women. As a category, it creates interpretive space for female experience beyond the elite/subaltern binary, where arguably most women live and work in the modern period. As a reading practice, the decolonial fosters intellectual awareness of social and intellectual practices that neither address the state, as in “anti-imperialism,” nor proffer counter nationalism or counter racialization as responses to coloniality. Offering examples from the archive, the media, and (...) teaching, this essay describes the decolonial as a productive site of women's agency in domains all too easily overlooked when historians focus on the conventional categories of state and nation. (shrink)

We describe and analyze 13 cases handled by our ethics consultation service (ECS) in which families requested continuation of physiological support for loved ones after death by neurological criteria (DNC) had been declared. These ethics consultations took place between 2005 and 2013. Patients’ ages ranged from 14 to 85. Continued mechanical ventilation was the focal intervention sought by all families. The ECS’s advice and recommendations generally promoted “reasonable accommodation” of the requests, balancing compassion for grieving families with other ethical and (...) moral concerns such as stewardship of resources, professional integrity, and moral distress. In cases we characterized as finitegoal accommodation, a “reasonable accommodation” strategy proved effective in balancing stakeholders’ interests and goals, enabling steady progress toward resolution. When a family objected outright to a declaration of DNC and asked for an indefinite accommodation, the “reasonable accommodation” approach offered clinicians little practical direction, and resolution required definitive action by either the family or the clinical team. Based on our analysis and reflections on these 13 cases, we propose ethically justified and practical guidelines to assist healthcare professionals, administrators, and ECSs faced with similar cases. (shrink)

In 1785, George Washington described a “knowing farmer” as “one who can convert every thing he touches into manure, as the first transmutation towards Gold.” With these words, Washington linked the “knowing farmer” to the alchemist who endeavored to transform base metals into gold with the aid of a philosopher's stone. In each instance, the challenge was to convert raw materials into something new and precious.Today, the “knowing bioethicist” is in a similar position. American bioethics harbors a variety of ethical (...) methods that emphasize different ethical factors, including principles, circumstances, character, interpersonal needs, and personal meaning. Each method reflects an important aspect of ethical experience, adds to the others, and enriches the ethical imagination. (shrink)

Much of the fascination that Petronius' Satyricon holds for its readers originates in the work's gleeful violation of traditional categories of classical genres. Critical terminology makes explicit the issue of unconventionality, as it is reduced to the neutral word ‘work’ in describing the Satyricon, which, as far as we can tell, belongs to no single category , but appropriates elements from many sources in both poetry and prose. Perhaps if we had more evidence with which to compare the work, such (...) as a greater selection of Menippean satire or proto-novels from antiquity, we might be able to identify it more accurately. But the suspicion remains that the intense variety of its evocations, allusions, and parodic passages differentiates it clearly from its component genres without allowing it to settle firmly in any one established genre. A certain amount of ‘Kreuzung der Gattungen’ is, of course, typical of both Alexandrian and consequently Roman texts. But the Satyricon seems to revel in its generic instability; it plays with the notion of ‘literariness’ by revealing impulses from non-literary forms such as mime and subliterary prose fiction, raising this material to an unfamiliar level of literary sophistication even as it debases other traditional genres through parodic techniques. One of the results of this open experimentation with style and decorum is an extremely dense fabric of literary allusion which some would label ‘literary opportunism’. The reader quickly learns to expect intertextual pyrotechnics, swift changes from the sublime to the ridiculous, and humorous incongruities in plot and form, as the stylistic disorder of the text reflects the topsyturvy Petronian world. The modern reader's response to this profusion of referents is to explore the recognizable categories and sources embedded in the work, to tease out the familiar elements in the hope of gaining a better understanding of the whole. Since a great deal of the allusion in the Satyricon functions parodically, there is yet another step necessary in the interpretation, namely taking into account the effect of the decontextualization of language and events from the source material and their recombination and transformation into the new text. (shrink)

While sympathetic to Tilley’s call for a practical philosophy of religion, I raise three questions: Does Tilley think that one can do philosophy of religion from a position other than that of a committed believer? Does Tilley’s description of the ordinary believer disburden most people from doubt and answerability? Does Tilley’s description of the role of the theologian place too much trust in the theologian? I suggest that some insights from contemporary phenomenology and hermeneutics would lead to a clearer understanding (...) of the role that philosophy of religion can play in the development of a practical philosophy of religion. (shrink)

While sympathetic to Tilley’s call for a practical philosophy of religion, I raise three questions: Does Tilley think that one can do philosophy of religion from a position other than that of a committed believer? Does Tilley’s description of the ordinary believer disburden most people from doubt and answerability? Does Tilley’s description of the role of the theologian place too much trust in the theologian? I suggest that some insights from contemporary phenomenology and hermeneutics would lead to a clearer understanding (...) of the role that philosophy of religion can play in the development of a practical philosophy of religion. (shrink)

Cartesian Views is a fitting tribute to a man of many parts, to use Alison Wylie’s apt description . Richard A. Watson has provoked, evoked, and invoked new directions in Cartesian scholarship—both methodologically and substantively. Watson’s Downfall of Cartesianism and its sequel, The Breakdown of Metaphysics , have become required reading for students of early modern philosophy and are largely responsible for the revival of many “minor” Cartesians, while serving as sourcebook for methodological attention to history and rational reconstruction. Cartesian (...) Views is an important collection that hearkens a forty-year retrospective of Cartesian studies while simultaneously turning our sights to what lies in the future.Although an eclectic collection, each paper in the volume reflects some counterpoint to, advancement of, or commentary upon some aspect, claim, argument, or theme found in Watson’s philosophical works. The opening paper by Nadler questions Watson’s view that dualism and the problem of mind-body interaction was the central issue that stimulated. (shrink)

In Phylogenetic Systematics (1966), Willi Hennig conflates the Linnaean hierarchy with what Hennig refers to as the divisional hierarchy. In doing so, he lays the foundations of that school of biological taxonomy known as cladism on a philosophically ambiguous basis. This paper compares and contrasts the two hierarchies and demonstrates that Hennig conflates them. It shows that Hennig's followers also conflate them. Finally, it illuminates five persistent problems in cladism by suggesting that they arise from Hennig's original confusion.

This paper defends the view that Frege’s reduction of arithmetic to logic would, if successful, have shown that arithmetical knowledge is analytic in essentially Kant’s sense. It is argued, as against Paul Benacerraf, that Frege’s apparent acceptance of multiple reductions is compatible with this epistemological thesis. The importance of this defense is that (a) it clarifies the role of proof, definition, and analysis in Frege’s logicist works; and (b) it demonstrates that the Fregean style of reduction is a valuable tool (...) for those who would investigate the nature of arithmetical knowledge. (shrink)

The notion of “cultural competency” in healthcare has gained currency in recent years. Health professionals are expected to be sensitive to the cultural backgrounds and language of their patients. Courses on cultural competency are now routinely offered to physicians, nurses, and others working in health fields. Although the rhetoric of cultural competency has been applied to clinical contexts, little attention has been given to its applicability in health research generally or, more specifically, in international health research. In this paper, I (...) briefly explore the relevance and limitations of cultural competency for informed consent to international health research, particularly in the context of low-resource settings. (shrink)

This paper considers the ethical implications of applying three major ethical theories to the memory structure of an artificial companion that might have different embodiments such as a physical robot or a graphical character on a hand-held device. We start by proposing an ethical memory model and then make use of an action-centric framework to evaluate its ethical implications. The case that we discuss is that of digital artefacts that autonomously record and store user data, where this data are used (...) as a resource for future interaction with users. (shrink)

A comprehensive look at fictive letters in Greek literature from Homer to Philostratus, first published in 2001. It includes both embedded epistolary narratives in a variety of genres, and works consisting solely of letters, such as the pseudonymous letter collections and the invented letters of the Second Sophistic. The book challenges the notion that Ovid 'invented' the fictional letter form in his Heroides and considers a wealth of Greek antecedents for the later European epistolary novel tradition. Epistolary technique always problematizes (...) the boundaries between fictionality and reality. Based on a process of selection and self-censorship, the letter is a construction, not a reflection, of reality. The author bypasses the question of sincerity for a close look at epistolary self-representation, the function of the letter form and the nature of the relationship between writer and reader in a wide range of ancient Greek texts. (shrink)

Callimachus' Victoria Berenices has received a good deal of scholarly attention since its first publication in 1976, both from textual critics, attempting to clarify uncertain readings, and from specialists in Latin poetry, eager to trace allusions to Callimachus in Vergil, Statius, or Ovid. While the search for Callimachean influence on the later texts has proved quite fruitful, it opens up the possibility of reading certain issues inappropriately backwards into the Hellenistic material. The discovery of parallels may lead to an assumption (...) of complete agreement that misrepresents the earlier, more fragmentary text. I would like to consider one particular incident in the Victoria Berenices that has fallen prey to this fate, namely the reception of Heracles by the farmer Molorcus. (shrink)

Callimachus' Victoria Berenices has received a good deal of scholarly attention since its first publication in 1976, both from textual critics, attempting to clarify uncertain readings, and from specialists in Latin poetry, eager to trace allusions to Callimachus in Vergil, Statius, or Ovid. While the search for Callimachean influence on the later texts has proved quite fruitful, it opens up the possibility of reading certain issues inappropriately backwards into the Hellenistic material. The discovery of parallels may lead to an assumption (...) of complete agreement that misrepresents the earlier, more fragmentary text. I would like to consider one particular incident in the Victoria Berenices that has fallen prey to this fate, namely the reception of Heracles by the farmer Molorcus. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Truth Will Set You Free, or How a Troubled Philosophical Theory May Help to Understand How People Talk About Their AddictionPatricia A. Ross (bio)Keywordsveridicality of narrative, contingency of theories, belief-behavior, causal connectionConsider the following proposition: If one were to recognize the unsatisfactory implications of maintaining a certain theoretical position, one would thereby be motivated to accept a more adequate theory, which would alter one's beliefs and, in turn, (...) alter the behaviors that are based upon those beliefs. Faith in this proposition is what motivates many of us to teach. But, alas...Allison Mitchell's argument for rethinking addiction intervention—in particular, rethinking twelve-step programs—is premised on this proposition. According to her argument, addicts function with an impoverished sense of self that is reflective of a grossly simplified form of philosophical materialism. By recognizing the limitations of this philosophically unconvincing view, and by, in effect, accepting a better, more complete materialism, addicts can come to modify their self-conception. This modification is instrumental to recovery.A careful consideration of the chain of events being proposed, and the problems with it, is helpful for understanding the limitations of her argument. There are four points that I consider in turn: (1) considering narratives can tell us something about the self-conception of addicts, (2) philosophical materialism can help us to understand and explain something about an addict's self-conception and how it is inadequate, (3) this sense of self is distinct from nonusers and the way in which it is distinct helps to understand the problem of addiction, and (4) a change in self-conception with respect to materialism helps recovery and, thus, our best intervention is one based on having addicts accept a full materialist theory of the self and not a pretheoretic one. [End Page 227]With respect to the first point, it should be noted that Mitchell's overall argument does not depend on whether or not it is true that narratives of addiction tell us something veridical about the self-conception of addicts. Such narratives may simply provide us with a potential theory—a possible worlds scenario—of how addicts conceive of themselves. Mitchell points this out herself. The narratives and the interpretation that she provides of these narrative, "are meant only to highlight a certain pattern of self-expression and conception that may in fact be common in persons who use mind-altering substances; the readings do not establish any empirical matters of fact or philosophical truths, nor do they prove any conclusions about how such persons (must) express themselves or conceive their nature" (Mitchell 2006, 214).Thus, what the argument is actually concerned with are the theoretical claims about the self-conception of addicts that are garnered from these narratives. Nevertheless, because the narratives provide the starting point for Mitchell's argument, it is worth thinking carefully about the epistemic status of this body of literature. In particular, could a consideration of such literature lead us astray in our endeavors to understand how addicts might misconceive of themselves and, if so, in what way? What sort of epistemic status does this information hold?Mitchell is motivated by Wittgensteinian analyses of the relationship between thought and language. The particular idea that she employs from Wittgenstein is that every act of self-expression, whether it is verbal or written narrative, reveals something about the conceptual framework with which the author is working. Thus, one can learn about the author of a narrative—one can acquire a sense of how that individual conceives of him- or herself—by looking at the language that is employed to talk about and describe him- or herself.Mitchell enumerates some problems with this approach. She mentions that the author may fail to make his or her intended sense clear to readers; that the reader's narrative expectations determine the interpretation given to the narrative; that literary narrative may be less direct, less ordinary than everyday uses of language; and that interpreting such narrative via philosophical framework may ascribe to people positions that are more precise and sophisticated than they actually intend (p. 213).Aside from these quite serious problems, it is necessary to recognize... (shrink)

We examined differences in the knowledge and beliefs that exist among nurse researchers in the USA (n = 119) regarding informed consent and the use of data from patients’ medical records. Using a mail survey, two domains of ethical knowledge and beliefs were assessed: the legal right to privacy and the moral right to privacy. More than half of the participants were very confident in their knowledge of institutional review board procedures, research ethics, informed consent, the legal right to privacy, (...) and the moral right to privacy. In contrast, most rated themselves as uncertain about US federal research regulations and there was wide variation in knowledge about current federal guidelines. Those who were more confident in their knowledge of or had more practical experience with research ethics, were no more likely to answer correctly a question about current federal guidelines regulating the use of patient data from medical records than those who reported less confidence or experience. (shrink)

The theologies of the saints of Hans Urs Von Balthasar and Karl Rahner are grounded in the theologians' distinct articulations of the relationship between nature and grace, Rahner's shaped by his response to the Nouvelle Théologie and Von Balthasar's influenced by his engagement with Henri De Lubac and Karl Barth. It is a generalization, but one useful for drawing contrasts, that for Rahner the saints are mediators of the Mediator and that for Von Balthasar they are revealers of the Revealer. (...) While the theologies can be reconciled, a richer understanding of the function of saints can emerge by maintaining the contrasts. The symbolic capacity of saints in Rahner's thought and the saints' exemplary abandonment to personal mission in Von Balthasar's thought are each an emphasis valuable in communicating saints' instructional and efficacious presence for others in the ecclesial Body. (shrink)

This essay views Christian doctrines of the atonement in the light of evolution and sociobiology. It argues that most of the doctrines are false because they use a false premise, the historicity of Adam and the Fall. However, two doctrines are not false on those grounds: Abelard’s idea that Jesus’ life is an example and Athanasius’s concept that the atonement changes human nature. Employing evolution’s and sociobiology’s concepts of the egocentric and ethnocentric nature of humanity and the synergy between genes (...) and environments to produce a "nature," this essay shows that these two doctrines can be amalgamated to make sense of the atonement in the late twentieth century. (shrink)

WARD Joseph Joubert and the Critical Tradition Platonism and Romanticism LIBRAIRIE DROZ SA 11, rue Massot GENEVE 1980 ...

. Current debates concerning the concept of mental disorder involve many different philosophical issues. However, it is not always clear from these discussions how, or whether, these issues relate to one another, or in exactly what way they are important for the definition of disorder. This article aims to sort through some of the philosophical issues that arise in the current literature and provide a clarification of how these issues are related to one another and whether they are necessary for (...) defining disorder. I argue that the main concern in defining disorder, namely demarcation, is obscured by a number of these other philosophical issues and that a focus on demarcation gives us a means of placing these other issues in a clarifying context. (shrink)

While ethical conflicts in the provision of healthcare are common, the current third-party mediator model is limited by a lack of expert ethical mediators, who are often not on site when conflict escalates. In order to improve clinical outcomes in situations such as conflicts at the end of life, we suggest that clinicians—physicians, nurses and social workers—be trained to prevent and deescalate emerging conflicts. This can be achieved using a mediation model framed by a communication-training approach. A case example is (...) presented and the model is discussed. The implication of this preventative/early intervention model for improving clinical outcomes, in particular end-of life conflict, is considered. (shrink)

The severe shortage of organs for transplantation and the continual reluctance of the public to voluntarily donate has prompted consideration of alternative strategies for organ procurement. This paper explores the development of market approaches for procuring human organs for transplantation and considers the social and moral implications of organ donation as both a gift of life and a commodity exchange. The problematic and paradoxical articulation of individual autonomy in relation to property rights and marketing human body parts is addressed. We (...) argue that beliefs about proprietorship over human body parts and the capacity to provide consent for organ donation are culturally constructed. We contend that the political and economic framework of biomedicine, in western and non-western nations, influences access to transplantation technology and shapes the form and development of specific market approaches. Finally, we suggest that marketing approaches for organ procurement are and will be negotiated within cultural parameters constrained by several factors: beliefs about the physical body and personhood, religious traditions, economic conditions, and the availability of technological resources. (shrink)