Importance Informed consent is essential to ethical, rigorous research and is important to recruitment and retention in cancer trials.Objective To examine cancer clinical trial (CCT) participants’ perceptions of informed consent processes and variations in perceptions by cancer type.Design and Setting and Participants Cross-sectional survey from mixed-methods study at National Cancer Institute–designated Northeast comprehensive cancer center. Open-ended and forced-choice items addressed: (1) enrollment and informed consent experiences and (2) decision-making processes, including risk-benefit assessment. Eligibility: CCT participant with gastro-intestinal or genitourinary, hematologic-lymphatic (...) malignancies, lung cancer, and breast or gynecological cancer (N = 334).Main Outcome Measures Percentages satisfied with consent process and information provided; and assessing participation’s perceptions of risks/benefits. Multivariable logistic or ordinal regression examined differences by cancer type.Results Most patient-participants felt well informed by the consent process (more than 90% overall and by cancer type) and. most (87.4%) reported that the consent form provided all the information they wanted, although nearly half (44.8%) reported that they read the form somewhat carefully or less. More than half (57.9%) said that talking to research staff (i.e., the consent process) had a greater impact on participation decisions than reading the consent form (2.1%). A third (31.1%) were very sure of joining in research studies before the informed consent process (almost half of lung cancer patients did—47.1%). Most patients personally assessed the risks and benefits before consenting. However, trust in physicians played an important role in the decision to enroll in CCT.Conclusions and Relevance Cancer patients rely less on written features of the informed consent process than on information obtained from the research staff and their own physicians. Research should focus on information and communication strategies that support informed consent from referring physicians, researchers, and others to improve patient risk-benefit assessment and decision-making. (shrink)

As the usual regulatory framework did not fit well during the last Ebola outbreak, innovative thinking still needed. In the absence of an outbreak, randomised controlled trials of clinical efficacy in humans cannot be done, while during an outbreak such trials will continue to face significant practical, philosophical, and ethical challenges. This article argues that researchers should also test the safety and effectiveness of novel vaccines in wild apes by employing a pluralistic approach to evidence. There are three reasons to (...) test vaccines in wild populations of apes: i) protect apes; ii) reduce Ebola transmission from wild animals to humans; and iii) accelerate vaccine development and licensing for humans. Data obtained from studies of vaccines among wild apes and chimpanzees may even be considered sufficient for licensing new vaccines for humans. This strategy will serve to benefit both wild apes and humans. (shrink)

Empirical work has lately confirmed what many philosophers have taken to be true: people are ‘biased toward the future’. All else being equal, we usually prefer to have positive experiences in the future, and negative experiences in the past. According to one hypothesis, the temporal metaphysics hypothesis, future-bias is explained either by our beliefs about temporal metaphysics—the temporal belief hypothesis—or alternatively by our temporal phenomenology—the temporal phenomenology hypothesis. We empirically investigate a particular version of the temporal belief hypothesis according to (...) which future-bias is explained by the belief that time robustly passes. Our results do not match the apparent predictions of this hypothesis, and so provide evidence against it. But we also find that people give more future-biased responses when asked to simulate a belief in robust passage. We take this to suggest that the phenomenology that attends simulation of that belief may be partially responsible for future-bias, and we examine the implications of these results for debates about the rationality of future-bias. (shrink)

Empirical evidence suggests that a majority of people believe that time robustly passes, and that many also report that it seems to them, in experience, as though time robustly passes. Non-dynamists deny that time robustly passes, and many contemporary non-dynamists—deflationists—even deny that it seems to us as though time robustly passes. Non-dynamists, then, face the dual challenge of explaining why people have such beliefs and make such reports about their experiences. Several philosophers have suggested the stable-self explanation, according to which (...) what partly explains one or both of the explananda is that people believe themselves to have a stable persisting self which is imagined either as moving through time, or as being stationary, with time moving around it. This paper empirically investigates this explanation. We found, however, no evidential support for the stable-self explanation, leaving the non-dynamist but also, we will argue, the dynamist, with an extant explanatory challenge. (shrink)

The European Legacy, Volume 17, Issue 3, Page 405, June 2012.

Ethics in participatory research -- Partnership, collaboration and power -- Blurring the boundaries between researcher and researched, academic and activist -- Community rights, conflict and democratic representation -- Co-ownership, dissemination and impact -- Anonymity, privacy, and confidentiality -- Institutional ethical review processes -- Social action for social change.

The rapid and dynamic nature of digital transformation challenges companies that wish to develop and deploy novel digital technologies. Like other actors faced with this transformation, companies need to find robust ways to ethically guide their innovations and business decisions. Digital ethics has recently featured in a plethora of both practical corporate guidelines and compilations of high-level principles, but there remains a gap concerning the development of sound ethical guidance in specific business contexts. As a multinational science and technology company (...) faced with a broad range of digital ventures and associated ethical challenges, Merck KGaA has laid the foundations for bridging this gap by developing a Code of Digital Ethics (CoDE) tailored for this context. Following a comprehensive analysis of existing digital ethics guidelines, we used a reconstructive social research approach to identify 20 relevant principles and derive a code designed as a multi-purpose tool. Versatility was prioritised by defining non-prescriptive guidelines that are open to different perspectives and thus well-suited for operationalisation for varied business purposes. We also chose a clear nested structure that highlights the relationships between five core and fifteen subsidiary principles as well as the different levels of reference—data and algorithmic systems—to which they apply. The CoDE will serve Merck KGaA and its new Digital Ethics Advisory Panel to guide ethical reflection, evaluation and decision-making across the full spectrum of digital developments encountered and undertaken by the company whilst also offering an opportunity to increase transparency for external partners, and thus trust. (shrink)

Current orthodoxy in research ethics assumes that subjects of clinical trials reserve rights to withdraw at any time and without giving any reason. This view sees the right to withdraw as a simple extension of the right to refuse to participate all together. In this paper, however, I suggest that subjects should assume some responsibilities for the internal validity of the trial at consent and that these responsibilities should be captured by contract. This would allow the researcher to impose a (...) penalty on the subject if he were to withdraw without good reason and on a whim. This proposal still leaves open the possibility of withdrawing without penalty when it is in the subject's best interests to do so. Giving researchers recourse to legal remedy may now be necessary to protect the science, as existing methods used to increase retention are inadequate for one reason or another. (shrink)

ABSTRACT Many people argue that disagreements and inconsistencies between Research Ethics Committees are morally problematic and there has been much effort to ‘harmonise’ their judgements. Some inconsistencies are bad because they are due to irrationality, or carelessness, or the operation of conflicting interests, and so should be reduced or removed. Other inconsistencies, we argue, are not bad and should be left or even encouraged. In this paper we examine three arguments to reject the view that we should strive for complete (...) consistency between committees. The first argument is that differences in judgement are not necessarily incompatible with ideas of justice for patients who are potential participants of research reviewed by different committees. We call this ‘the justice argument.’ The second argument is that such committees do not have access to a single moral truth, to which their judgement is supposed to correspond. We call this the ‘moral pluralism argument.’ The third argument is that the process of ethics committee review is also morally relevant and not solely the outcome. We call this the ‘due process argument.’ While we fall short of establishing exactly how much variation and on what substantive issues would be ethically permissible, we show that it is largely inevitable and that a certain amount of variation could be seen as a desirable part of the institution of medical research. (shrink)

This study investigates the hypothesis that the advantage corporate social performance (CSP) yields in attracting human resources depends on the degree of job choice possessed by the job seeking population. Results indicate that organizational CSP is positively related to employer attractiveness for job seekers with high levels of job choice but not related for populations with low levels suggesting advantages to firms with high levels of CSP in the ability to attract the most qualified employees.

Most ethics committees which review research protocols insist that potential research participants reserve unconditional or absolute ‘right’ of withdrawal at any time and without giving any reason. In this paper, I examine what consent means for research participation and a sense of commitment in relation to this right to withdraw. I suggest that, once consent has been given (and here I am excluding incompetent minors and adults), participants should not necessarily have unconditional or absolute rights to withdraw.This does not imply (...) that that there should be a complete absence of rights, or, indeed, an abandonment of the right to withdraw. The point of this paper is to show that the supposed unconditional or absolute nature of these rights may be self‐defeating and so fail to respect the autonomy of participants. In addition, and on a more positive note, I suggest that, attaching certain conditions on the right to withdraw, may better respect the autonomy of these participants by underlining the idea that autonomy is more than mere whim or indifference to the fate of others. On the contrary, research staff are currently unable to ‘push’ participants, who may merely have logistical difficulties unrelated to the research itself, but who really want to stay the course, for fear of coercing them. Furthermore, researchers now try to ‘screen out’ people they think may be unreliable to protect the science of the study and so groups at risk of dropping out may be unfairly denied access to research treatments. I conclude that on‐going negotiation between the relevant parties could be on balance the only truly acceptable way forward but concede certain important limitations to take into account. (shrink)

Canada is six years into a new era of legalized medical assistance in dying (MAiD). The law continues to evolve, following a pattern in which Canadian courts rule that legal restrictions on eligibility for MAiD are unconstitutional and Parliament responds by gradually expanding eligibility for MAiD. The central tension underlying this dialogue between courts and government has focused on two conceptions of how to best promote and protect the interests of people who are vulnerable by virtue of intolerable and irremediable (...) suffering due to an illness, disease, or disability. Do we, as a society, have a duty to protect vulnerable people from seeking certain medical procedures that are contrary to their interests, as those are perceived by others? Or do we have a duty to uphold their rights to autonomy, including the right to make choices within a range that may be constrained by many factors, some of which may be socially unjust? This is a recurrent problem in bioethics and medical law, which we explore through the lens of how Canadian courts and Parliament have grappled with defining eligibility for MAiD. (shrink)

Future-bias is the preference, all else being equal, for positive states of affairs to be located in the future not the past, and for negative states of affairs to be located in the past not the future. Three explanations for future-bias have been posited: the temporal metaphysics explanation, the practical irrelevance explanation, and the three mechanisms explanation. Understanding what explains future-bias is important not only for better understanding the phenomenon itself, but also because many philosophers think that which explanation is (...) the correct one has implications for our evaluation of the normative status of future-bias. In this paper we focus on the connection between future-bias and the temporal value asymmetry. The latter refers to the fact that people tend to assign more value to a state of affairs when it is located in the future, as opposed to being equidistant in the past. All three candidate explanations offered for future-bias proceed by explaining the temporal value asymmetry, and then supposing that future-bias is simply a manifestation of that asymmetry. Recently, however, it has been argued that the conditions under which people display the temporal value asymmetry and future-bias are different, and that this is reason to doubt that the latter is a manifestation of the former. In this paper we empirically test one response to this argument against the manifestation thesis—the simulation response—according to which once we control for the degree to which people can simulate the object of their preference, we find that people display future-bias and the temporal value asymmetry in the same conditions. We find no evidence in favour of the simulation response. Moreover, our results support some previous research that suggests that the temporal value asymmetry is less robust than previously thought, and this in itself casts doubt on the idea that future bias is just a manifestation of this asymmetry. (shrink)

ABSTRACT In this paper, I support the claim that placing certain restrictions on public access to possible new treatments is morally problematic under some exceptional circumstances. Very ill patients may find that all available standard treatments are unacceptable, either because they are ineffective or have serious adverse effects, and these patients may understandably be desperate to try something new even if this means stepping into the unknown. Faced with certain death, it is rational to want to try something new and (...) to chance a dire outcome. Restricting possible new treatments to research trials may put these treatments scientifically, geographically or economically out of reach of these patients. For those who can get access, research restrictions could weaken, though not necessarily eliminate, the value of consent participants of such trials are able to give. Some participants may therefore be exploited for scientific purposes in the name of public interest. There are nonetheless compelling reasons for keeping some restrictive regulation in this area. (shrink)

Several philosophers have suggested that certain aspects of people’s experience of agency partly explains why people tend to report that it seems to them, in perceptual experience, as though time robustly passes. In turn, it has been suggested that people come to believe that time robustly passes on the basis of its seeming to them in experience that it does. We argue that what require explaining is not just that people report that it seems to them as though time robustly (...) passes, and that they believe that it does, but rather, the substantial variation (a) in people’s reports regarding whether it seems as though time robustly passes, and (b) their beliefs about whether time robustly passes. We empirically investigate the agentive explanation of (a), according to which variation in people’s agentive experiences explains variation in people’s reports regarding whether it seems to them as though time robustly passes. We also empirically investigate the experiential seeming explanation of belief, according to which variation in people’s beliefs about whether time robustly passes is explained by variation in their reports regarding whether it seems in experience as though time robustly passes. We found empirical support for the agentive explanation, but not for the experiential seeming explanation of passage beliefs. We consider the implications of our results for three views about temporal experience and temporal beliefs: dynamism, passage illusionism and deflationism. (shrink)

This is the first in a series of five papers on the role, remit and function of research ethics committees which are intended to provide for REC members a broad understanding of the most important issues in research ethics and governance. The first considers the rationale for having ethics review by committee at all; seeking to explain why ethics committees, as we currently have them, are so important to the wider system of governing research.

Alfandre et al. helpfully outlines the case for attending to contingency planning as well as to crisis measures during a pandemic. The authors provides a helpful framework for reflecting on...

I explicate the distinction between ethics and morality in terms of four central contrasts, and argue (1) that moral theories that embrace the implicit divide are both theoretically and practically problematic in their failure to meet certain widely accepted standards of theoretical coherence and in their resulting propensity to generate indeterminable conflicts among norms, and (2) that social roles represent one aspect of the moral life that cannot be understood in terms of this distinction. My suggestion will be that we (...) ought to explore an interpretation of the moral realm according to which all moral attributes are relative to social roles, since a role-centered morality promises a way of overcoming this problematic divide. (shrink)

We investigated, experimentally, the contention that the folk view, or naïve theory, of time, amongst the population we investigated is dynamical. We found that amongst that population, ~ 70% have an extant theory of time that is more similar to a dynamical than a non-dynamical theory, and ~ 70% of those who deploy a naïve theory of time deploy a naïve theory that is more similar to a dynamical than a non-dynamical theory. Interestingly, while we found stable results across our (...) two experiments regarding the percentage of participants that have a dynamical or non-dynamical extant theory of time, we did not find such stability regarding which particular dynamical or non-dynamical theory of time they take to be most similar to our world. This suggests that there might be two extant theories in the population—a broadly dynamical one and a broadly non-dynamical one—but that those theories are sufficiently incomplete that participants do not stably choose the same dynamical theory as being most similar to our world. This suggests that while appeals to the ordinary view of time may do some work in the context of adjudicating disputes between dynamists and non-dynamists, they likely cannot do any such work adjudicating disputes between particular brands of dynamism. (shrink)

Unfortunately, cases like Mr. Turner’s are common, and likely to become more so in the near future, as the number of people aged 65 and older is expected to increase to about 74 million by 2030, an...

It has widely been assumed, by philosophers, that our first-person preferences regarding pleasurable and painful experiences exhibit a bias toward the future (positive and negative hedonic future-bias), and that our preferences regarding non-hedonic events (both positive and negative) exhibit no such bias (non-hedonic time-neutrality). Further, it has been assumed that our third-person preferences are always time-neutral. Some have attempted to use these (presumed) differential patterns of future-bias—different across kinds of events and perspectives—to argue for the irrationality of hedonic future-bias. This (...) paper experimentally tests these descriptive hypotheses. While as predicted we found first-person hedonic future-bias, we did not find that participants were time-neutral in all other conditions. Hence, the presumed asymmetry of hedonic/non-hedonic and first/third-person preferences cannot be used to argue for the irrationality of future-bias, since no such asymmetries exist. Instead, we develop a more fine-grained approach, according to which three factors—positive/negative valence, first/third-person, and hedonic/non-hedonic—each independently influence, but do not determine, whether an event is treated in a future-biased or time-neutral way. We discuss the upshots of these results for the debate over the rationality of future-bias. (shrink)

This paper empirically investigates one aspect of the folk concept of time by testing how the presence or absence of directedness impacts judgements about whether there is time in a world. Experiment 1 found that dynamists, showed significantly higher levels of agreement that there is time in dynamically directed worlds than in non-dynamical non-directed worlds. Comparing our results to those we describe in Latham et al., we report that while ~ 70% of dynamists say there is time in B-theory worlds, (...) only ~ 45% say there is time in C-theory worlds. Thus, while the presence of directedness makes dynamists more inclined to say there is time in a world, a substantial subpopulation of dynamists judge that there is time in non-directed worlds. By contrast, a majority of non-dynamists judged that there was time in both growing block worlds and C-theory worlds, with no significant differences between the means. Experiment 2 found that when participants are only presented with non-dynamical worlds—namely, a directed world and a non-directed world—they report significantly higher levels of agreement that there is time in B-theory worlds. However, the majority of participants still judge that there is time in C-theory worlds. We conclude that while the presence of directedness bolsters judgements that there is time, most people do not judge it to be necessary for time. (shrink)

This is the third in a series of five papers on the role, remit and function of research ethics committees which are intended to provide for REC members a broad understanding of the most important issues in research ethics and governance. This paper examines the role of ethics committees in balancing the social value of the research it reviews against the risks it imposes on those who take part. The ethics committee's role in assessing the social value of research goes (...) well beyond checking its scientific validity and this assessment may affect the risks ethics committees are prepared to ask of subjects not only for their own potential personal interests but importantly and inevitably in the name of science. However, their function is importantly restricted by the wider regulatory and governance environment in which they work. (shrink)

An introduction to the paragone -- The archetype of beauty : Narcissus and the birth of the beau idéal -- Pygmalion and Galatea : the battle between iconophobes and iconodules -- Salomé versus Medusa.

In this paper I explore how citizenship education might position students as always/everywhere political to diminish the pervasive belief that one either is or is not a “political person.” By focusing on how liberal and radical democracy are both necessary frameworks for engaging with issues of power, I address how we might reframe citizenship education to highlight the ubiquity of politics, offering a deepened sense of democracy. This reframing of citizenship education entails highlighting how liberalism and radical democracy are mutually (...) reinforcing when it comes to illustrating political life as entangled in power relations. My argument centers on Sigal Ben-Porath’s :381–395, 2012) concept of shared fate as a frame for citizenship education. In this model, students are habituated into thinking of democracy as an “enduring pluralism” in which their fates are connected to that of their fellow citizens. In this paper I recast shared fate education in the singular to an education of shared fates in the plural. By doing so I theorize how citizenship education might construct citizenship as relational, emotional, embedded in power, and uncomfortable. (shrink)

The American Journal of Bioethics, Volume 12, Issue 6, Page 35-37, June 2012.

Volume 20, Issue 9, September 2020, Page 39-41.

Philosophers working on time-biases assume that people are hedonically biased toward the future. A hedonically future-biased agent prefers pleasurable experiences to be future instead of past, and painful experiences to be past instead of future. Philosophers further predict that this bias is strong enough to apply to unequal payoffs: people often prefer less pleasurable future experiences to more pleasurable past ones, and more painful past experiences to less painful future ones. In addition, philosophers have predicted that future-bias is restricted to (...) first-person preferences, and that people’s third-person preferences are time-neutral. Philosophers disagree vigorously about the normative status of these preferences—i.e., they disagree about whether first-person future-bias is rationally permissible. Time-neutralists, for example, have appealed to the predicted asymmetry between first- and third-person preferences to argue for the rational impermissibility of future-bias. We empirically tested these predictions, and found that while people do prefer more past pain to less future pain, they do not prefer less future pleasure to more past pleasure. This was so in both first and third-person conditions. This suggests that future-bias is typically non-absolute, and is more easily outweighed in the case of positive events. We connect this result to the normative debate over future-bias. (shrink)

Deflationists hold that it does not seem to us, in experience, as though time robustly passes. There is some recent empirical evidence that appears to support this contention. Equally, empirical evidence suggests that we naïvely represent time as dynamical. Thus deflationists are faced with an explanatory burden. If, as they maintain, the world seems to us in experience as though it is non-dynamical, then why do we represent time as dynamical? This paper takes up the challenge of investigating, on the (...) part of the deflationist, one candidate explanation. We hypothesise that people’s belief that the future is what we call deliberatively open partly explains why they represent time as dynamical. In a series of two experiments we test this hypothesis. We find no evidence that beliefs about deliberative openness explain why people represent time as dynamical. Hence there remains an explanatory burden for the deflationist to discharge. (shrink)

Jansen and Wall suggest a new way of defending hard paternalism in clinical research. They argue that non-therapeutic research exposing people to more than minimal risk should be banned on egalitarian grounds: in preventing poor decision-makers from making bad decisions, we will promote equality of welfare. We argue that their proposal is flawed for four reasons.First, the idea of poor decision-makers is much more problematic than Jansen and Wall allow. Second, pace Jansen and Wall, it may be practicable for regulators (...) to uncover the values that a potential research participant holds when agreeing to enter a research project, so their claim that we must ban such research projects for all if we are to ban them for poor decision-makers looks to be unmotivated. Third, there seem to be cases where the liberty to enter the sort of research project Jansen and Wall discuss is morally weighty, and arguably should outweigh concerns of egalitarian distribution. Fourth, banning certain types of research, which seem on the face of it to offer an unfavourable risk-benefit ratio, would have unwelcome consequences for all clinical research, which Jansen and Wall do not recognize. (shrink)

Recent research (Latham, Miller and Norton, forthcoming) reveals that a majority of people represent actual time as dynamical. But do they, as suggested by McTaggart and Gödel, represent time as essentially dynamical? This paper distinguishes three interrelated questions. We ask (a) whether the folk representation of time is sensitive or insensitive: i.e., does what satisfies the folk representation of time in counterfactual worlds depend on what satisfies it actually—sensitive—or does is not depend on what satisfies it actually—insensitive, and (b) (...) do those who represent actual time as dynamical, represent time in all possible worlds as dynamical—what we call insensitive dynamism—or do they represent time in all possible worlds as dynamical only conditional on the actual world in fact being dynamical—what we call sensitive dynamism and (c) do dynamists and non-dynamists deploy two different representations of time, or deploy the same representation, but disagree about what actually satisfies that representation? We found no evidence that the folk representation of time is sensitive, or that the folk representation of time is essentially dynamical in either sense, though we did find evidence of a shared representation, on which dynamical features are sufficient, but not necessary, for time. (shrink)