BackgroundStudies on different methods to supplement the traditional informed consent process have generated conflicting results. This study was designed to evaluate whether participants who received group counseling prior to administration of informed consent understood the key components of the study and the consent better than those who received individual counseling, based on the hypothesis that group counseling would foster discussion among potential participants and enhance their understanding of the informed consent.MethodsParents of children participating in a trial of nutritional supplementation were (...) randomized to receive either group counseling or individual counseling prior to administration of the informed consent. To assess the participant's comprehension, a structured questionnaire was administered approximately 48-72 hours afterwards by interviewers who were blinded to the allocation group of the respondents.ResultsA total of 128 parents were recruited and follow up was established with 118 (90.2%) for the study. All respondents were aware of their child's participation in a research study and the details of sample collection. However, their understanding of study purpose, randomization and withdrawal was poor. There was no difference in comprehension of key elements of the informed consent between the intervention and control arm.ConclusionsThe results suggest that the group counseling might not influence the overall comprehension of the informed consent process. Further research is required to devise better ways of improving participants' understanding of randomization in clinical trials.Trial RegistrationClinical Trial Registry - India (CTRI): CTRI/2009/091/000612. (shrink)

Healthcare policy and academic literature have promoted improving the transitional care of young people leaving child and adolescent mental health services. Despite the availability of guidance on good practice, there seems to be no readily accessible, coherent ethical analysis of transition. The ethical principles of non-maleficence, beneficence, justice and respect for autonomy can be used to justify the need for further enquiry into the ethical pros and cons of this drive to improve transitional care. The objective of this systematic review (...) was therefore to systematically search for existing ethical literature on child- to adult-orientated health service transitions and to critically appraise and collate the literature, whether empirical or normative. A wide range of bioethics, biomedical and legal databases, grey literature and bioethics journals were searched. Ancestral and forward searches of identified papers were undertaken. Key words related to transition, adolescence and young adulthood, ethics, law and health. The timeframe was January 2000 to at least March 2016. Titles, abstracts and, where necessary, full articles were screened and duplicates removed. All included articles were critically appraised and a narrative synthesis produced. Eighty two thousand four hundred eighty one titles were screened, from which 96 abstracts were checked. Forty seven full documents were scrutinised, leading to inclusion of two papers. Ancestral and forward searches yielded four further articles. In total, one commentary, three qualitative empirical studies and two clinical ethics papers were found. All focused on young people with complex care needs and disabilities. The three empirical papers had methodological flaws. The two ethical papers were written from a clinical ethics context rather than using a bioethical format. No literature identified specifically addressed the ethical challenges of balancing the delivery of transitional care to those who need it and the risk of pathologizing transient and self-limited distress and dysfunction, which may be normal during adolescence. There is very little research on ethical aspects of transitional care. Most existing studies come from services for young people with complex care needs and disabilities. There is much scope for improvement in the amount and quality of empirical research and ethical analysis in this area. (shrink)

As infancy is characterized by rapid physical growth and critical periods of development, disruptions due to illness or disease reveal vulnerability associated with this period. Spinal cord injury has devastating consequences at any age, but its onset neonatally, at birth, or within the first year of life multiplies its impact. The immediate physical and physiological consequences are obvious and immense, but the effects on the typical trajectory of development are profound. Activity-based restorative therapies capitalize on activity-dependent plasticity of the neuromuscular (...) system below the lesion and when provided to children with SCI aim to improve the child’s neuromuscular capacity, health and quality of life. This is a report of an infant with a cervical SCI at birth resulting in paralysis of leg and trunk muscles and paresis of arm and hands who was enrolled in an ABRT program at 3 years of age. After 59 sessions of ABRT, the child demonstrated significant improvements in trunk control and arm function, as well as social and emotional development. Despite the chronicity of injury and low expectations for improvement with therapeutic interventions, ABRT had a positive impact on the child’s physical capacity and provided benefits across multiple developmental domains. (shrink)

Examining the fundamental thinking underpinning the foundation for economic studies of happiness, this book explores the theories of key economists and philosophers from the Greek philosophers to more modern schools of thought. Lall Ramrattan and Michael Szenberg explore the general measures of happiness, utility as a method, metrical measures of happiness, happiness in literature, and the scope of happiness in this concise book. Fundamentals of Happiness builds on major moral and philosophical theories from the ancient, medieval, and modern schools (...) that form the foundation of utility analysis. The authors classify the economics of happiness based on psychological, individual, social, and institutional views of happiness, revealing how historical schools of thought implicitly or explicitly deal with this. The book also focuses on the relationship between happiness and society and welfare, analysing the measurement of subjective well-being. This will be an invigorating read for economics students, in particular those studying the history of economic thought, looking to understand the basic principles underlying the economics of happiness. (shrink)

“Ethical dilemmas…are rarely simple and stark but are, instead, multifaceted, complex, and gut wrenching for parents and care givers alike.” This is never more the case than when one must treat vulnerable babies who are not, nor ever can be competent to offer us some guidance about that treatment. The ethical problems are heightened when the parents, or the single mother, are incompetent to make decisions themselves, for example, because of drug addiction. In such cases, when the baby is premature (...) and suffering the effects of the drugs the mother has taken, and the mother herself is either no longer available for consultation or so damaged by her own addiction that she is not a reliable decisionmaker, the usual trend In the United States is to initiate treatment and continue until it is virtually certain that the infant will die. (shrink)

We appreciated the important commentary provided by Michelle Oberman on our paper, (CQ Vol. 6, No. 1). For the most part we agree with Oberman's analysis of the issues, but there are seven points of variance, either of conception, emphasis, or accuracy. We wish to clarify these and welcome the chance her commentary provided to offer aspects of the social situation surrounding the case we presented.

Serial analysis of gene expression (SAGE) is a powerful technique that can be used for global analysis of gene expression. Its chief advantage over other methods is that it does not require prior knowledge of the genes of interest and provides qualitative and quantitative data of potentially every transcribed sequence in a particular cell or tissue type. This is a technique of expression profiling, which permits simultaneous, comparative and quantitative analysis of gene‐specific, 9‐ to 13‐basepair sequences. These short sequences, called (...) SAGE tags, are linked together for efficient sequencing. The sequencing data are then analyzed to identify each gene expressed in the cell and the levels at which each gene is expressed. The main benefit of SAGE includes the digital output and the identification of novel genes. In this review, we present an outline of the method, various bioinformatics methods for data analysis and general applications of this important technology. BioEssays 26:916–922, 2004. © 2004 Wiley Periodicals, Inc. (shrink)

This article explores the influence of modernity in India, within the larger framework of state-led modernity and its impact on identity and locality. The discourse on modernity has retained the common thread of transience and reflexivity as two constitutive features, both of which are taken up to explain the uncertain and provisional influence of modernity on the Indian society and identity, and the radical engagement of social movements with modernity. The article studies the complex functioning of modernity in India by (...) presenting a theoretical outline on the contested nature of the concept, with an emphasis on the discussion around reflexivity, which forms one of the core attributes for the creation of multiple and alternative modernities, by reviewing state-led modernity in India and its impact on identity formation as a consequence of the numerous and variable cultural and value systems that confront individuals and by looking at the local appropriation of contested spaces to enter into a radical, value-based engagement with global modernity. (shrink)

Nationwide, almost 11% of women abuse drugs during their pregnancy. In some communities, these numbers are as high as 25–30%. Drug abuse is not limited to the poor or to African Americans, but is seen among affluent and white Americans as well. It is widespread, irrespective of race or social class. Annually, nearly 375,000 infants are exposed to drugs in America. Because of the terrible suffering caused by these births, and the conflicts caregivers experience in the treatment of these infants, (...) Trollope's quote is very apropos. Although caregivers have good motives in trying to rescue these babies and helping place them in a nurturing environment, despair about this objective is always close to the surface. (shrink)

We appreciated the important commentary provided by Michelle Oberman on our paper, “Discontinuing Life Support in an Infant of a Drug-Addicted Mother: Whose Decision Is It?” . For the most part we agree with Oberman's analysis of the issues, but there are seven points of variance, either of conception, emphasis, or accuracy. We wish to clarify these and welcome the chance her commentary provided to offer aspects of the social situation surrounding the case we presented.

Although early-stage finance is critical to the growth of most ventures, it is even more important for social ventures as they face the challenges of balancing their social and commercial objectives. Drawing on institutional logics and signaling theory, this study uses a panel data set of 3,401 nascent social ventures to investigate the important role philanthropic grant funding plays in the organizational and financial development of social ventures. We find mixed results, with positive effects on employment and subsequent access to (...) debt finance, but no effects on revenues and access to equity. Our findings connect these theories by suggesting philanthropic grants provide social ventures with flexibility to invest in human capital without pushing them to pursue short-term financial objectives, and that receiving a philanthropic grant provides a signal that is interpreted differently by debt and equity financiers. These findings are especially relevant as funders increasingly use grants to support social entrepreneurship. (shrink)

The use of Ritalin and other stimulant drug treatments for attention-deficit hyperactivity disorder (ADHD) raises distinctive moral dilemmas for parents; these moral dilemmas have not been adequately addressed in the bioethics literature. This paper draws upon data from a qualitative empirical study to investigate parents' use of the moral ideal of authenticity as part of their narrative justifications for dosing decisions and actions. I show that therapeutic decisions and actions are embedded in valued cultural ideals about masculinity, self-actualization and success, (...) as well as in moral conceptions of authenticity and personal freedom. I argue that this investigation of parents' moral justifications and dosing dilemmas raises questions about the validity of authenticity as a transcendent moral principle. Moreover, this study demonstrates that in order to be relevant, bioethical analysis of neurocognitive enhancement must engage with ground-up studies of moral principles and decision-making in context. (shrink)

This paper compares the findings of content analyses of the corporate codes of ethics of Canada’s largest corporations in 1992 and 2003. For both years, a modified version of a technique used in several other studies was used to determine and categorize the contents of the codes. It was found, inter alia, that, in 2003, as in 1992, more of the codes were concerned with conduct against the firm than with conduct on behalf of the firm. Among the changes from (...) 1992 to 2003 were a significant increase in the frequency of mention of environmental affairs, legal responsibility as the basis of codes and enforcement/compliance procedures. (shrink)

In this article, we examine the American Institute of Certified Public Accountants’ (AICPA) efforts to conceal the offshoring of tax return preparation services by U.S. Certified Public Accountants (CPAs) through recommending an inadequate disclosure format for this type of work. We draw on Giddens’ theory of trust and expert systems, the professionalism literature, and Flyvbjerg’s concept of power to analyze the underlying agenda behind the revised ethics rulings (AICPA Ethics Ruling No. 112 under Rule 102, No. 12 under Rule 201, (...) and No. 1 under Rule 301). Specifically, we examine (1) the AICPA leadership’s stated professional justifications for outsourcing and its recommended client disclosures, (2) risks associated with outsourcing tax return preparation work overseas and the trust issues that result, and (3) the resistance to the AICPA leadership’s recommended outsourcing disclosure rules within the rank and file of the CPA profession. We argue that our analysis reveals the AICPA’s on-going promotion of their private interests, thus continuing to raise systemic concerns regarding the public’s trust in the U.S. public accounting profession. (shrink)

Our concern in this paper lies with a common argument from racial discrimination to realism about races: some people are discriminated against for being members of a particular race (i.e., racial discrimination exists), so some people must be members of that race (i.e., races exist). Error theorists have long responded that we can explain racial discrimination in terms of racial attitudes alone, so we need not explain it in terms of race itself. But to date there has been little detailed (...) discussion of whether it is better to explain racial discrimination in terms of race or in terms of racial attitudes alone. Our goal is to offer a novel and detailed argument in defense of explaining racial discrimination in terms of racial attitudes alone, by attending to the neglected phenomenon of misperception discrimination, which involves differential treatment due to misperceived race. We argue that the discriminatory action in misperception cases must be explained in the same way as cases where (according to the realist) the victim’s race is accurately perceived. Thus, the victim’s actual race cannot provide the best explanation. The main upshot of our argument is that explanatory arguments from racial discrimination to realism about race fail. (shrink)

The recent rise in ethical consumerism has seen increasing numbers of corporate brands project a socially responsible and ethical image. But does having a corporate brand that is perceived to be ethical have any influence on outcome variables of interest for its product brands? This study analyzes the relationship between perceived ethicality at a corporate level, and brand trust, brand affect and brand loyalty at a product level. A theoretical framework with hypothesized relationships is developed and tested in order to (...) answer the research question. Data have been collected for 45 product categories in the fast moving consumer goods sector using a panel of 4,027 Spanish consumers. The proposed relationships are tested using structural equations modeling. The results suggest there is a positive relationship between perceived ethicality of a brand and both brand trust and brand affect. Brand affect also positively influences brand trust. Further, brand trust and brand affect both show a positive relation with brand loyalty. The managerial and academic implications of the results are discussed. (shrink)

In this article, I examine children's reported experiences with stimulant drug treatments for attention deficit hyperactivity disorder in light of bioethical arguments about the potential threats of psychotropic drugs to authenticity and moral agency. Drawing on a study that involved over 150 families in the USA and the UK, I show that children are able to report threats to authenticity, but that the majority of children are not concerned with such threats. On balance, children report that stimulants improve their capacity (...) for moral agency, and they associate this capacity with an ability to meet normative expectations. I argue that although under certain conditions stimulant drug treatment may increase the risk of a threat to authenticity, there are ways to minimise this risk and to maximise the benefits of stimulant drug treatment. Medical professionals in particular should help children to flourish with stimulant drug treatments, in good and in bad conditions. (shrink)

Intentions are an important concept in Artificial Intelligence and Cognitive Science. We present a formal theory of intentions and beliefs based on Discourse Representation Theory that captures many of their important logical properties. Unlike possible worlds approaches, this theory does not assume that agents are perfect reasoners, and gives a realistic view of their internal architecture; unlike most representational approaches, it has an objective semantics, and does not rely on an ad hoc labeling of the internal states of agents. We (...) describe a minimal logic for intentions and beliefs that is sound and complete relative to our semantics. We discuss several additional axioms, and the constraints on the models that validate them. (shrink)

This paper investigates how specific notions of gender and ethnicity are integrated into diversity discourses presented on 241 top European company websites. Large European companies increasingly disclose equality and diversity policies in statements on websites. Such statements may be used to promote an ethical image of the company in terms of how well it manages diversity and guards against discrimination. In this paper, we argue that diversity statement discourses are important as they play a key part in socially constructing how (...) diversity should be regarded in the company by minority and majority groups, as well as indicating corporate values to external stakeholders (investors, government, community, press etc.). Sometimes, the notions of gender or ethnic diversity are positioned as a liability in need of protection, whilst in others, as a source of competitive advantage. We find evidence of use of discursive tools such as problematisation, rationalisation, fixation, reframing and naturalisation of the notions of gender and ethnic diversity, reinforced by use of symbols, such as statistics, photographs, membership badges and awards. Few statements directly associate gender and ethnic diversity with enhanced corporate performance. We found that diversity statements sometimes appear to reinforce existing business stereotypes of women and people from ethnic minorities, and in a few discourses, create new ones, particularly evident in photographs illustrating the diversity web pages. (shrink)

Lord Rabinder Singh has been one of the leading lights in the recent development of the common law, most notably in the field of human rights and the law of privacy. Here, for the first time, he reflects on the defining themes of his career as advocate and judge. Combining his trademark originality of thought and impeccable scholarship, he selects previously published and unpublished writings to track the evolution of his approach to the common law. A substantial introduction gives (...) context to the book, while opening introductions to each piece reflect on their relevance to contemporary legal thought. The essays explore themes as diverse as judicial review, equality, and privacy and personal autonomy. Insightful, erudite, and thought-provoking, this collection is a must read for all those interested in the law and its role in society. (shrink)

Langerhans cells (LCs), residing in the epidermis, are able to induce potent immunogenic responses and also to mediate immune tolerance. We propose that tolerogenic and immunogenic responses of LCs are directed by signaling from the epidermis and involve counter‐acting gene circuits that are coupled to a core maturation gene module. We base our analysis on recent genetic and genomic findings facilitating the understanding of the molecular mechanisms controlling these divergent immune functions. Comparing gene regulatory network (GRN) analyses of various types (...) of dendritic cells (DCs) including LCs we integrate signaling‐dependent (TGFβ, EpCAM, β‐Catenin) and transcription factor (IRF4, IRF1, NFκB) regulated gene circuits that appear to orchestrate the distinctive LC functional states. Our model proposes, that while epidermal signaling in the steady‐state promotes LC tolerogenic function, the disruption of cell‐cell contacts coupled with inflammatory signaling induces LC immunogenic programing. The conceptual framework emphasizes the sensing of discrete epidermal and inflammatory cues by resident LCs in dictating their genomic programing and cell state dynamics. (shrink)

The Great Illusion takes a scientific look at the brain itself, presenting research that supports the naturalistic stance that the mind is identical to the brain. Singh argues that if we take seriously the idea that the mind is the brain then it follows logically that free will must be an illusion, that there can be no consciousness independent of the brain, and that there can be no substantial self that exists independently from the brain. He further argues that (...) there can be no such thing as absolute moral responsibility. (shrink)

This study uses a specific method to analyze the contents of the codes of ethics of the largest corporations in Australia, Canada and Sweden and compares the findings of similar content analyses in 2002 and 2006. It tracks changes in code contents across the three nations over the 2002–2006 period. There were statistically significant changes in the codes of the three countries from 2002 to 2006: the Australian and Canadian codes becoming more prescriptive, intensifying the differences between these and the (...) Swedish codes. The contents of these codes and the nature of the changes they have undergone over time are culturally driven: Australia's and Canada's reflecting their similar cultural profiles and Sweden's reflecting its differences from these countries on organizationally relevant cultural dimensions. The study reveals that corporate codes of ethics are living documents as reflected by the significant longitudinal changes in the frequencies of mention of several of the 60 items underpinning the content analysis of the codes of ethics. Consequently, and in light of their growing prevalence and importance as instruments of corporate governance, they should not be treated as static but as dynamic documents that are subject to various environmental factors. The clear implication of the findings of this study is that for corporate codes of ethics ‘one size does not fit all’ and that these instruments must be carefully monitored and revised to reflect changing conditions. (shrink)