This article examines the conceptual impact of equal pay legislation on Canadian trade unionism. Ambiguous, largely voluntary, legislation poses major challenges to unions negotiating wage parity for their members. Furthermore, the movement finds itself caught between conflicting responsibilities as champion of the underpaid and protector of traditional interests. The authors examine this challenge within the context of the historic development, and fundamental principles of trade unionism. They conclude that many of the conflicts discussed arise directly from established union practices and (...) must, therefore, be resolved by the movement and other affected parties together. (shrink)

Due to the COVID-19 pandemic, cities and states adopted social distancing, social isolation, or quarantine measurements to slow the transmission of the disease. Negative mental health outcomes including depression and anxiety have been associated with social distancing or social isolation. The purpose of the present study was to examine changes in psychological health and physical activity over an 8 week period under social distancing policies during the COVID-19 pandemic.Methods: Ninety individuals participated in this study. Qualifying participants answered questions using an (...) online survey regarding their loneliness, depressive symptoms, anxiety symptoms, mood state, and physical activity over four time points each lasting two weeks.Results: Symptoms of depression and state anxiety were increased in the population when compared to nationwide statistics from before the COVID-19 pandemic. Time point 2, ~1 month into social isolation, showed the most significant effects on mental health. During this time point, 100% of the participants showed symptoms of depression. There were no significant changes in physical activity over the 8 weeks. Loneliness, depressive symptoms, fatigue, and mood state were negatively associated with participation in physical activity. Vigor and state anxiety were associated with participation in physical activity.Conclusion: Social isolation and social distancing practices have had a negative effect on depression, anxiety, and mood over time. It appeared that depressive symptoms and total mood disturbance was elevated during time point two. Depressive symptoms were much higher than average compared to previous epidemiological data. Physical activity amount did not change over time but was associated with poor mental health. (shrink)

ABSTRACT According to one widely accepted view, our actions and emotions ought to be proportional to the degree of value present in their objects. Against this proportionality principle, Pettigrove sketches a view according to which the value of some virtuous actions and attitudes derives from the characteristic way of being of the agent herself, and not from any other goods that agent appreciates, pursues, or promotes. Granting Pettigrove’s rejection of the proportionality principle, I raise some questions for his replacement account. (...) I suggest that it is not just the characteristic way of being of an agent who loves and forgives virtuously that explains the goodness of their love and forgiveness, but also the role such virtues play in making possible valuable relationships that are partially constitutive of human flourishing. (shrink)

Open-mindedness is widely valued as an important intellectual virtue. Definitional debates about open-mindedness have focused on whether open-minded believers must possess a particular first-order attitude toward their beliefs or a second-order attitude toward themselves as believers, taking it for granted that open-mindedness is motivated by the pursuit of propositional knowledge. In this article, Rebecca Taylor develops an alternative to knowledge-centered accounts of open-mindedness. Drawing on recent work in epistemology that reclaims understanding as a primary epistemic good, Taylor argues for (...) an expanded account of open-mindedness as an intellectual virtue motivated by the pursuit of both knowledge and understanding. Incorporating understanding allows for a more robust account of open-mindedness that better accommodates common usage, avoids common criticisms, and better explains the widespread acceptance of open-mindedness as an important intellectual virtue. Taylor also identifies the connections between open-mindedness and several other intellectual virtues, including intellectual humility, intellectual courage, and intellectual diligence. (shrink)

Despite some improvements in access to evidence-based medications for opioid use disorder, treatment rates remain low at under a quarter of those with need. High costs for brand name products in these medication markets have limited the volume of drugs purchased, particularly through public health insurance and grant programs. Brand firm anti-competitive practices around the leading buprenorphine product Suboxone — including product hops, citizen petitions and Risk Evaluation and Mitigation Strategy abuses — helped to maintain high prices by extending (...) brand exclusivity periods and hindering generic drug entry. Remedies to address costly anti-competitive activities include adoption of the proposed CREATES Act and modernization of the Hatch-Waxman Act by the Congress, and implementation of substantive modifications to the Food and Drug Administration citizen petition filing procedures. Given the persistence of these abuses, prescriptive changes are favorable to the procedural and clarifying steps thus far favored by the federal government. Extrapolating from the 37% price declines attributable to generic entry for buprenorphine tablets in 2011, our calculations suggest that implementing these remedies to facilitate generic competition with Suboxone film would have resulted in savings of approximately $703 million overall and $203 million to Medicaid in 2017. (shrink)

It's not unusual to hear someone say, ‘I'd rather be dead than have Alzheimer's’. In ‘Alzheimer Disease and Preemptive Suicide’,1 Dena Davis explains why this is a reasonable position. People taking this position will welcome the discovery of biomarkers permitting very early AD diagnosis, Davis suggests, for this will enable more of them to end their lives while they remain motivated and able to do so. At the same time, Davis observes, people would have less reason to resort to the (...) drastic remedy of pre-emptive suicide if they had absolute authority over the medical treatment they received as patients with dementia; but the threat of pre-emptive suicide is not, in my view, a sufficient reason to grant competent individuals that authority.If preclinical diagnosis of AD becomes possible, some pre-emptive suicides will probably occur. There would be no ethical or practical way to ban such suicides, and it would be silly to try. Clinicians will undoubtedly try to discourage people seeking biomarker information in furtherance of a suicide plan, but savvy individuals will simply conceal their true motivation for having the tests. The real problem for people intent on self-destruction is that biomarkers are unlikely to deliver a clear suicide signal.First, as Davis notes, work on biomarkers remains in the research stage. No one yet knows whether biomarker tests will prove accurate enough to warrant clinical use. Second, even clinically accepted biomarker tests will generate imperfect information about future disease. Biomarkers may produce more accurate estimates of a person's risk of developing AD, but like all predictive tests, they will also yield false positive and negative results. The …. (shrink)

During its 2018–2019 term, the United States Supreme Court considered the constitutionality of executing a prisoner with dementia. In Madison v. Alabama, the Court ruled that, in certain circumstances, executing a prisoner with dementia violates the Eighth Amendment’s ban on cruel and unusual punishment. Vernon Madison was sentenced to death for killing a police officer in 1985. After many years on Alabama’s death row, he had a series of strokes and was diagnosed with vascular dementia. In 2016, Madison’s lawyers unsuccessfully (...) sought a stay of execution, arguing that, in light of his cognitive impairments, imposing the death penalty would violate the Constitution. After Alabama set a 2018 execution date, lawyers returned to the state court, arguing that the finding of competence should be reversed because Madison’s cognitive impairments had worsened. When the trial court refused to grant the stay of execution, Madison’s lawyers asked the Supreme Court to review the constitutionality of the state court decision. (shrink)

Background: Discussion of the influence of money on bioethics research seems particularly salient in the context of research on the ethical, legal, and social implications (ELSI) of human genomics, as this research may be financially supported by the ELSI Research Program. Empirical evidence regarding the funding of ELSI research and where such research is disseminated, in relation to the specific topics of the research and methods used, can help to further discussions regarding the appropriate influence of specific institutions and institutional (...) contexts on ELSI and other bioethics research agendas. Methods: We reviewed 642 ELSI publications (appearing between 2003 and 2008) for reported sources of funding, forum for dissemination, empirical and nonempirical methods, and topics of investigation. Results: Most ELSI research is independent of direct grant-based funding sources; 66% reported no such sources of funding. The National Human Genome Research Institute (NHGRI) is the most dominant source of funding; 16% of publications acknowledged at least one source of NHGRI grant funding. Funding is acknowledged more frequently in empirical than nonempirical publications and more frequently in publications in public health journals than in any other ELSI research dissemination forums. Dominant research topics vary by publication forum and by reported funding. Conclusions: ELSI research is surprisingly independent of direct grant-based funding, yet correlations are apparent between this type of funding and publication placement, topics addressed, and methods used, implying a not insignificant influence on ELSI research agenda setting. However, given the relatively low percentage of publications acknowledging external grant-based funding, as well as other significant correlations between publication placement and topics addressed, additional institutional contexts, perhaps related to professional advancement or valuation, may shape research agendas in ways that potentially exceed the direct influences of grant-based funding in this area. In some cases, grant-based funding may actually counter other potentially problematic institutional influences. (shrink)

The principle of procreative beneficence, first suggested by Julian Savulescu, argues that: If couples have decided to have a child, and selection is possible, then they have a significant moral reason to select the child, of the possible children they could have, whose life is expected, in light of the relevant available information, to go best or at least not worse than any of the others. While the validity of this moral principle has been widely contested, in this paper we (...) move away from these issues and grant, for the sake of argument, that PB is a valid moral principle, and that the justification for PB provided by Savulescu and co-authors is sound. We do this in order to explore the implications and consequences of accepting PB and show that even if we put aside questions about the validity and theoretical foundations of this principle, PB has many interesting, astonishing and highly problematic implications that have not been made explicit in the writing of Savulescu and others who support the notion of an obligation to bring to birth the best child possible :204, 2002). We suggest that these implications should be taken into account when considering both the soundness and strength of PB. (shrink)

The Supreme Court has ruled in the case of Y that there is no requirement to seek the approval of the Court of Protection in decisions to withdraw clinically assisted nutrition and hydration from patients in a prolonged disorder of consciousness.1 Mr Y was 52-year-old man who suffered a cardiac arrest after a myocardial infarction as a result of coronary artery disease. It was not possible to resuscitate him for well over 10 min, resulting in severe cerebral hypoxia which caused (...) extensive brain damage. Mr Y’s family and the NHS Trust treating him agreed that Mr Y would not want to be kept alive through the provision of CANH given his poor prognosis. They sought a declaration that it was not mandatory for applications of withdrawal of CANH to come before the court, which was granted by Mrs Justice O’Farrell in the first instance.2 Permission was granted for the appeal to ‘leapfrog’ the Court of Appeal and to proceed to the Supreme Court for consideration. In the interim, Mr Y died after contracting acute respiratory sepsis, but the Supreme Court determined that the appeal should go ahead in light of the general importance of the issues raised. In delivering the opinion of the Supreme Court on 30 July 2018, Lady Justice Black rejected the historical distinction that had been drawn between patients in PDOC and non-PDOC patients, in a way that had justified judicial involvement for patients in PDOC but not for others.3 She was clear that the correct approach to all cases involving CANH was to make a decision based on what was in the best interests of the patient. She further outlined that: > The documentation supplied to us shows that the difficulty that there is in assessing the patient and in …. (shrink)

Generation Y is a cohort of the population larger than the baby boom generation. Consisting of approximately 80 million people born between 1981 and 2000, Generation Y is the most recent cohort to enter the workforce. Workplaces are being redefined and organizations are being pressed to adapt as this new wave of workers is infused into business environments. One critical aspect of this phenomenon not receiving sufficient research attention is the impact of Gen Y ethical beliefs and ethical conduct in (...) workplace contexts. It is widely accepted that distinct generational experiences shape ethical ideologies and ethical ideologies in turn affect the way people function in the workplace. Thus, Gen Y’s unique cohort experiences are likely to shape their ethical ideologies and consequent workplace judgments and actions. In this article, we examine Gen Y’s ethical ideology and study its impact on workplace functioning regarding leadership style, teamwork, and judgments about ethical violations. Our analyses indicate that Gen Y’ers tend toward situationalism (high idealism and high relativism), and their socially connected orientation produces more lenient judgments of collaborative vs. unilateral ethical violations. However, Gen Y’ers do exhibit individual variation. Relativist Gen Y’ers are more tolerant of ethical violations, whereas, Gen Y Idealists are less tolerant of ethical violations. High Idealists also show stronger teamwork and leadership characteristics. In addition, Gen Y’ers possessing servant leader traits exhibit incrementally better teamwork, and greater perceived unacceptability of ethical violations. We conclude by discussing implications of these findings for managing ethical climates and conduct. (shrink)

Previous work in Game Studies has centered on several loci of investigation in seeking to understand virtual gameworlds. First, researchers have scrutinized the concept of the virtual world itself and how it relates to the idea of “the magic circle”. Second, the field has outlined various forms of experienced “presence”. Third, scholarship has noted that the boundaries between the world of everyday life and virtual worlds are porous, and that this fosters a multiplicity of identities as players identify both with (...) themselves-offline and themselves-in-game. Despite widespread agreement that these topics are targets for research, so far those working on these topics do not have mutually agreed-upon framework. Here we draw upon the work of Alfred Schutz to take up this call. We provide a phenomenological framework which can be used to describe the phenomena of interest to Game Studies, as well as open new avenues of inquiry, in a way acceptable and useful to all. This helps to distinguish the core of the field from the supplemental theoretical and critical commitments which characterize diverse approaches within the field. (shrink)

Games Studies reveals the performative nature of playing a character in a virtual-game-world (Nitsche 2008, p.205; Pearce 2006, p.1; Taylor 2002, p.48). Tbe Player/Character relationship is typically understood in terms of the player’s in-game “presence” (Boellstorff 2008, p.89; Schroeder 2002, p.6). This gives the appearance that living-into a game-world is an all-or- nothing affair: either the player is “present” in the game-world, or they are not. I argue that, in fact, a constitutive phenomenology reveals the Player/Character relationship to be a (...) multi-dimensional matter of empathy. I advance a broadly Schutzian framework, drawing on his 1932 discussions of “face-to-face encounters” and ”historical predecessors,” showing how at- tention to empathy reveals a variety of “presences” that different kinds of Player/Character relationships afford. The central determinants of empathetic affordances which I focus on here are (i) how much players know about a character (especially the character’s past) and (ii) how players learn this information.The purpose of this discussion will be to show that a phenomenological analysis reveals that the relationship between a player and their character is complex, highly variable, and inherently social. Furthermore, it will add to the growing body of scholarship that demonstrates that video games are rich social objects deserving of study. (shrink)

Gilbert et al. argue that the neuroethics literature discussing the putative effects of Deep Brain Stimulation on personality largely ignores the scientific evidence and presents distorted claims that personality change is induced by the DBS stimulation. This study contributes to the first-hand primary research on the topic exploring DBS clinicians’ views on post-DBS personality change among their patients and its underlying cause. Semi-structured interviews were conducted with sixteen clinicians from various disciplines working in Australian DBS practice for movement disorders and/or (...) psychiatric conditions. Thematic analysis of the interviews revealed five primary themes: 1) types, frequency and duration of personality change, 2) causes of personality change, 3) impact on patient and family, 4) communication, comprehension and awareness, and 5) management. Clinicians described a variety of personality changes in Parkinson’s disease following DBS including irritability, impulsivity and impaired decision-making. The frequency of personality change seen in patients varied amongst clinicians, but changes were overwhelmingly transient. Clinicians considered both DBS stimulation and additional factors as inducing personality change. For DBS patients with major depressive disorder, a restoration of pre-morbid personality was associated with alleviation of illness. Considerations for future research of personality change following DBS include selecting suitable tools for quantitative examination and developing a common language between the scientific and ethics communities. Clinical implications including recommendations for the informed consent process for patients and families and clinicians’ management of personality change are discussed. (shrink)

Gilbert et al. argue that the neuroethics literature discussing the putative effects of Deep Brain Stimulation on personality largely ignores the scientific evidence and presents distorted claims that personality change is induced by the DBS stimulation. This study contributes to the first-hand primary research on the topic exploring DBS clinicians’ views on post-DBS personality change among their patients and its underlying cause. Semi-structured interviews were conducted with sixteen clinicians from various disciplines working in Australian DBS practice for movement disorders and/or (...) psychiatric conditions. Thematic analysis of the interviews revealed five primary themes: 1) types, frequency and duration of personality change, 2) causes of personality change, 3) impact on patient and family, 4) communication, comprehension and awareness, and 5) management. Clinicians described a variety of personality changes in Parkinson’s disease following DBS including irritability, impulsivity and impaired decision-making. The frequency of personality change seen in patients varied amongst clinicians, but changes were overwhelmingly transient. Clinicians considered both DBS stimulation and additional factors as inducing personality change. For DBS patients with major depressive disorder, a restoration of pre-morbid personality was associated with alleviation of illness. Considerations for future research of personality change following DBS include selecting suitable tools for quantitative examination and developing a common language between the scientific and ethics communities. Clinical implications including recommendations for the informed consent process for patients and families and clinicians’ management of personality change are discussed. (shrink)

Heidegger’s engagement with the poet Friedrich Hölderlin often dwells on the issue of temporality. For Heidegger, Hölderlin is the most futural thinker (zukünftigster Denker) whose poetry is necessary for us now and must be wrested from being buried in the past. Heidegger frames his reading of Hölderlin in terms of past, present, and future and, more importantly, describes him as being able to poetize time. This paper examines what it means to poetize time and why Hölderlin’s poetry in particular allows (...) us to understand temporality as the interplay of presence and non-presence. (shrink)

Gilbert et al. argue that the neuroethics literature discussing the putative effects of Deep Brain Stimulation on personality largely ignores the scientific evidence and presents distorted claims that personality change is induced by the DBS stimulation. This study contributes to the first-hand primary research on the topic exploring DBS clinicians’ views on post-DBS personality change among their patients and its underlying cause. Semi-structured interviews were conducted with sixteen clinicians from various disciplines working in Australian DBS practice for movement disorders and/or (...) psychiatric conditions. Thematic analysis of the interviews revealed five primary themes: 1) types, frequency and duration of personality change, 2) causes of personality change, 3) impact on patient and family, 4) communication, comprehension and awareness, and 5) management. Clinicians described a variety of personality changes in Parkinson’s disease following DBS including irritability, impulsivity and impaired decision-making. The frequency of personality change seen in patients varied amongst clinicians, but changes were overwhelmingly transient. Clinicians considered both DBS stimulation and additional factors as inducing personality change. For DBS patients with major depressive disorder, a restoration of pre-morbid personality was associated with alleviation of illness. Considerations for future research of personality change following DBS include selecting suitable tools for quantitative examination and developing a common language between the scientific and ethics communities. Clinical implications including recommendations for the informed consent process for patients and families and clinicians’ management of personality change are discussed. (shrink)

Focusing on the paradoxes revealed in the multibillion dollar mistake of the Universal Camouflage Pattern and the expansive ambit of a leaked National Security Agency briefing on its approach to “identity intelligence,” this article analyzes security glitches arising from the state’s application of mechanized logics to security and visibility. Presuming that a digital-looking pattern would be more deceptive than designs inspired by natural forms, in 2004, the US Army adopted a pixelated “digital” camouflage pattern, a print that rendered soldiers more, (...) rather than less, visible in the field; it acknowledged this error in 2012. Two years later, “Identity Intelligence: Image Is Everything” visualized the episteme of National Security Agency surveillance with an illustration detailing hundreds of different types of data—biometric, biographic, and contextual—that the agency believes it could exploit to identify and monitor “targets of interest.” These glitches originate in technofetishistic convictions about the nature of digital images and information, limited ways of imagining bodies and lives, and reductive understandings of complex relationships between power and perception. Together, they expose the paradoxes that arise as the state tries to extend its power over the body and the contingency of that power on the smallest of things. (shrink)

Many research projects rely on human biological materials and some of these projects generate revenue. Recently, it has been argued that investigators have a moral claim to share in the revenue generated by these projects, whereas persons who provide the biological material have no such claim (Truog, Kesselheim, and Joffe 2012). In this paper, we critically analyze this view and offer a positive proposal for why tissue providers have a moral claim to benefit. Focusing on payment as a form of (...) benefit, we argue that research is a joint project and propose a contribution principle for paying participants in those joint projects. We distinguish between contributions that shape a project’s revenue generating properties, grounding a claim to payment, and contributions that fail to ground such a claim. We conclude, contrary to existing arguments and practices, that some tissue providers have a moral claim to payment beyond compensation for risk and burden. This conclusion suggests that investigators, institutions, and sponsors should reconsider the fairness of their current practices. (shrink)

A digital solution to the problems caused by US military personnel misusing their digital cameras, pixelization (the intentional post-production enlargement of pixels to obscure potentially disturbing content) has become a defining feature of newsmedia visualizations of American military atrocity during the War on Terror. Here, I consider the ethics and politics of pixelizing photographs depicting torture at Abu Ghraib, the exploits of the American ‘Kill Team’ in Afghanistan, and the carnality of US Marines urinating on the corpses of Taliban soldiers. (...) Ostensibly, as a technique applied to those parts of the photograph that reveal the corporeal truth of war most graphically, such redaction is meant to protect the victims. But it also renders their appearance variable, subject to editorial whim, and pixelization alters not only the appearance of the photograph, but how it signifies. I query whether pixelization offers any meaningful redress for the victims and the extent to which it blunts photography’s capacity to document harm. (shrink)

Inequities in global health are increasingly of interest to health care providers in developed countries. In response, many academic healthcare programs have begun to offer international service learning programs. Participants in these programs are motivated by ethical principles, but this type of work presents significant ethical challenges, and no formalized ethical guidelines for these activities exist. In this paper the ethical issues presented by international service learning programs are described and recommendations are made for how academic healthcare programs can carry (...) out international service learning programs in a way that minimizes ethical conflicts and maximizes benefits for all stakeholders. Issues related to project sustainability and community involvement are emphasized. (shrink)

Attention is vital to success in all aspects of life (Erickson, Thiessen, Godwin, Dickerson, & Fisher, 2015; Meck & Benson, 2002), hence it is important to identify biomarkers of later attentional problems early enough to intervene. Our objective was to determine if any of 11 genes (APOE, BDNF, HTR4, CHRNA4, COMT, DRD4, IGF2, MAOA, SLC5A7, SLC6A3, and SNAP25) predicted the trajectory of attentional development within the same group of children between infancy and childhood. We recruited followup participants from children who (...) participated as infants in visual attention studies and used a similar task at both time points. Using multilevel modeling, we associated changes in the participant’s position in the distribution of scores in infancy to his/her position in childhood with genetic markers on each of 11 genes. While all 11 genes predicted reaction time (RT) residual scores, only MAOA had a significant interaction including time point. We conclude that the MAOA SNP rs1137070 is useful in predicting which girls are likely to develop slower RTs on an attention task between infancy and childhood. This early identification is likely to be helpful in early intervention. (shrink)