Caring for seriously ill and dying patients plays a key role in the patient-physician story. The emotional experience, while at times gratifying, can also be quite burdensome. In “The Inner Lives o...

Brain death, or the determination of death by neurological criteria, has been described as a legal fiction. Legal fictions are devices by which the law treats two analogous things (in this case, biological death and brain death) in the same way so that the law developed for one can also cover the other. Some scholars argue that brain death should be understood as a fiction for two reasons: the way brain death is determined does not actually satisfy legal criteria requiring (...) the permanent cessation of all brain function, and brain death is not consistent with the biological conception of death as involving the irreversible cessation of the functioning of an organism as a whole. Critics counter that the idea that brain death is a legal fiction is deceptive and undemocratic. I will argue that diagnosing brain death as a hidden legal fiction is a helpful way to understand its historical development and current status. For the legal‐fictions approach to be ethically justifiable, however, the fact that brain death is a legal fiction not aligned with the standard biological conception of death must be acknowledged and made transparent. (shrink)

Assigning a date to Kumārila is notoriously difficult. Kumārila’s dates are usually assigned through a relative chronology of Brahmanical and Buddhist philosophers with whom Kumārila engages or is engaged. This is a precarious method because the dates of these interlocutors are equally unstable. But what if in considering systematic dialogues (_śāstra_) to be the primary medium for interreligious philosophical debate we have missed a source that does engage with Kumārila, and that can be reliably dated? In this article, I turn (...) to a religious group whom, it has been previously thought, did not respond to Kumārila until the eighth century—Jainas—as well as to a genre that is not typically viewed as a site of systematic philosophical dialogue—narrative. I argue that the _Padmacarita_, a Jaina Rāmāyaṇa composed by a Digambara writer called Raviṣeṇa, contains a narrative refutation of Kumārila’s commentary to _Mīmāṃsāsūtra_ 1.1.2. By bringing to light this refutation, and explaining how Raviṣeṇa’s _Padmacarita_ can be reliably dated, I assign Kumārila’s _terminus ante quem_ to the date of the _Padmacarita_’s composition, 676 CE. Finally, I suggest that Raviṣeṇa’s _Padmacarita_ is the earliest extant Jaina text to discuss Kumārila’s claims, and that Jainas used narrative to reflect on Mīmāṃsā before they turned to _śāstra_ as another medium for this dialogue. (shrink)

The recent Ebola outbreak in West Africa began in the spring of 2014 and has since caused the deaths of over 6,000 people. Since there are no approved treatments or prevention modalities specifically targeted at Ebola Virus Disease , debate has focused on whether unproven interventions should be offered to Ebola patients outside of clinical trials. Those engaged in the debate have responded rapidly to a complex and evolving crisis, however, and this debate has not provided much opportunity for in-depth (...) analysis. Additionally, the existing literature on access to unproven therapies has focused on contexts like HIV/AIDS and oncology, which are very different than the Ebola epidemic. In this paper, we examine the ethical issues surrounding access to unproven therapies in the context of the recent Ebola outbreak to yield new insights about this controversial and unsettled issue. We argue first that, in this context, the interests of patients in obtaining access to unproven therapies are not fully aligned.. (shrink)

One of the most remarkable manifestations of social cohesion in large-scale entities is the belief in a shared, distinct and ancestral past. Human communities around the world take pride in their ancestral roots, commemorate their long history of shared experiences, and celebrate the distinctiveness of their historical trajectory. Why do humans put so much effort into celebrating a long-gone past? Integrating insights from evolutionary psychology, social psychology, evolutionary anthropology, political science, cultural history and political economy, we show that the cultural (...) success of historical myths is driven by a specific adaptive challenge for humans: the need to recruit coalitional support to engage in large scale collective action and prevail in conflicts. By showcasing a long history of cooperation and shared experiences, these myths serve as super-stimuli, activating specific features of social cognition and drawing attention to cues of fitness interdependence. In this account, historical myths can spread within a population without requiring group-level selection, as long as individuals have a vested interest in their propagation and strong psychological motivations to create them. Finally, this framework explains, not only the design-features of historical myths, but also important patterns in their cross-cultural prevalence, inter-individual distribution, and particular content. (shrink)

Clinical research with children generates special ethical concern, raising the need for additional protections beyond those for research with competent adults. Most guidelines permit research with children when it offers a prospect of direct benefit, or poses minimal risk. Unlike many other guidelines, the U.S. federal regulations also allow institutional review boards to approve pediatric research that does not offer a prospect of direct benefit when the risks are no greater than a minor increase over minimal risk. To approve research (...) in this category, IRBs must find that two additional conditions obtain:1). The intervention or procedure presents experiences to subjects that are reasonably commensurate with those inherent in their actual or expected medical, dental, psychological, social, or educational situations; and 2). The intervention or procedure is likely to yield generalizable knowledge about the subjects disorder or condition which is of vital importance for the understanding or amelioration of the subjects disorder or condition. (shrink)

Jesudason and Weitz's article examines two public policy debates in California, where both sides of the debate used similar language that had the potential to be detrimental to women. Specifically, they show how anti-abortion crusaders in California used similar language to describe why women's rights should be curtailed as pro-choice advocates use when fighting for more choice and privacy for women's reproductive decisions. This commentary builds upon their article by demonstrating the harm that such co-opting causes to women's rights using (...) the example of sex selective abortion. By examining the legislative history of state and national bills to ban sex-selective abortion, this commentary demonstrates how the anti-abortion lobby has adopted the language of pro-choice advocates quite effectively. Although the framing of this issue as being “woman-protective” is strategic and insincere, such political framing is powerful, as Jesudason and Weitz have noted. Anti-abortion activists have convinced lawmakers in many states that sex-selective abortion is a dire issue in their state and that they must restrict it in order to protect women. In fact, there is no evidence that sex selective abortion is a problem in the United States, yet these frames have been very effective in weakening women's privacy rights. Whenever woman-protective framings are invoked for self-serving purposes, women's rights advocates must work hard to uncover the truth behind these discourses to prevent successful legislative efforts that curtail women's reproductive freedom. (shrink)

The American Journal of Bioethics, Volume 11, Issue 6, Page 22-23, June 2011.

It is shown that there are incomparable Σ2 e-degrees a, b such that every e-degree strictly less than a is also less than b.

Preface -- Introduction -- 1. Muslim reformists and the transition to English rule -- 2. The making of the "Indian Arab" and the tale of Sayyid Fadl -- 3. Rahmatullah Kairanwi and the Muslim cosmopolis -- 4. Haji Imdadullah Makki in Mecca -- 5. Nawab Siddiq Hasan Khan and the Muslim cosmopolis -- 6. Maulana Jafer Thanesri and the Muslim ecumene -- Conclusion -- Notes -- Acknowledgments -- Index.

Ali Shariati is typically understood as a theorist of “political Islam.” Yet his theological innovations within what is called “mystical thought” are also worthy of attention. Shariati does not consider mystical thought as an escapist, transcendent paradigm, but as a means to interpret and navigate the socio-political world. Of particular relevance to Shariati is an idea ubiquitous across Islamic mysticism: the transformation of the self. Within Islamic mysticism, there are various iterations of the idea that to become closer to God, (...) one must enact a radical transfiguration of the self, one that occurs simultaneously at the divine and existential registers. For Shariati, this transformation of the self is tied not only to one’s relationship with God, but also to the desire to alter the social realm. This is an ethos that, for Shariati, should infiltrate all aspects of life, material and immaterial, cerebral and social. If one wishes to overturn the status quo, one must cultivate not only a revolutionary subjectivity but a mystically-oriented subjectivity as well, or one that is characterized by constant change and growth. (shrink)

The U.S. Federal regulations allow institutional review boards (IRBs) to approve non-beneficial pediatric research when the risks are a minor increase over minimal, provided that the research is likely to develop generalizable knowledge about the subjects' disorder or condition. This “subjects' condition” requirement is quite controversial; commentators have argued for a variety of interpretations. Despite this considerable disagreement in the literature, there have not been any attempts to apply principles of legal interpretation to determine how the subjects' condition requirement should (...) be understood. (shrink)

The U.S. federal regulations require investigators conducting nonbeneficial research to obtain the assent of children who are capable of providing it. Unfortunately, there has been no analysis of which children are capable of assent or even what abilities ground the capacity to give assent. Why should investigators be required to obtain the positive agreement of some children, but not others, before enrolling them in research that does not offer a compensating potential for direct benefit? We argue that the scope of (...) children's research decision making should be based on the principles of respect for autonomy and nonmaleficence. These principles imply that the threshold for assent should be fixed at 14 years of age, and a dissent requirement should be adopted for all children in the context of nonbeneficial research. (shrink)

The target article proposes a model involving the important but not well-investigated topics of curiosity and creativity. The model, however, falls short of providing convincing explanations of the basic mechanisms underlying these phenomena. We outline the importance of mechanistic thinking in dealing with the concepts outlined in this article specifically and within psychology and cognitive neuroscience in general.

While it is known that reward induces attentional prioritization, it is not clear what effect reward-learning has when associated with stimuli that are not fully perceived. The masked priming paradigm has been extensively used to investigate the indirect impact of brief stimuli on response behavior. Interestingly, the effect of masked primes is observed even when participants choose their responses freely. While classical theories assume this process to be automatic, recent studies have provided evidence for attentional modulations of masked priming effects. (...) Most such studies have manipulated bottom-up or top-down modes of attentional selection, but the role of “newer” forms of attentional control such as reward-learning and selection history remains unclear. In two experiments, with number and arrow primes, we examined whether reward-mediated attentional selection modulates masked priming when responses are chosen freely. In both experiments, we observed that primes associated with high-reward lead to enhanced free-choice priming compared to primes associated with no-reward. The effect was seen on both proportion of choices and response times, and was more evident in the faster responses. In the slower responses, the effect was diminished. Our study adds to the growing literature showing the susceptibility of masked priming to factors related to attention and executive control. (shrink)

Sociological studies of culture have made significant progress on conceptual clarification of the concept, while remaining comparatively quiescent on questions of measurement. This study empirically examines internal conflicts (or “infighting”), a ubiquitous phenomenon in political organizing, to propose a “resinous culture framework” that holds promise for redirection. The data comprise 674 newspaper articles and more than 100 archival documents that compare internal dissent across two previously unstudied lesbian and gay Marches on Washington. Analyses reveal that activists use infighting as a (...) vehicle to engage in otherwise abstract definitional debates that provide concrete answers to questions such as who are we and what do we want. The mechanism that enables infighting to concretize these cultural concerns is its coupling with fairly mundane and routine organizational tasks. This mechanism affords one way to release the culture concept, understood here as collective self-definitions, from being “an amorphous, indescribable mist which swirls around society members,” as it was once provocatively described. (shrink)

In the 1940s, Georges Canguilhem has established the concept of biological normativity on the level of the organism in his key work on “ The Normal and the Pathological ”. We would like to present a contemporary analysis of Canguilhem’s work, set it in context with more recent results from the field of complexity and immunology, and evaluate the problematic whether normativity is a genuine capacity of the organism. Based on Canguilhem’s conditions of the definition of biological normativity, we show (...) that the immune system as one of the complex systems of the living equally shares the capacity to be normative. We will then conclude that normativity can also be conceptually independently displayed on the level of complex systems of the living. (shrink)

In _Civility, Nonviolent Resistance, and the New Struggle for Social Justice_, contributors expose the roots of injustice and violence, and propose civil, nonviolent ways of challenging them.

Papers presented at the Seminar on Ethics and Aesthetics in Indian Literary Practices, held at Udaipur in Rajasthan, India in 2009; organized by Department of English, Mohanlal Sukhadia University, Udaipur, India.

This essay argues that feminist legal theory offers an important, and underutilized, perspective to examine health law and policy. We use several theoretical frameworks developed by feminist legal theorists including relational autonomy, intersectionality, vulnerability theory, and the feminist critique of the public-private divide to demonstrate the utility of these theories to health law analysis. These frameworks provide insights relevant not only to issues that obviously relate to gender, but also to matters of choice, quality, and access that are less obviously (...) gender-related. We map three key areas of existing scholarship and future inquiry at the intersection of health law and feminist legal theory: patient choice and relational autonomy, patriarchy, power and patient safety, and access to health care and healthy living conditions at the public-private divide. Uniting these areas of inquiry is a nagging question central to the relationship between critical legal scholarship and pragmatic action to combat injustice: Can we use legal rights to achieve our aims even as we recognize them as tainted tools that have propped up oppressive social structures? A feminist agenda for health law and policy must grapple with this dilemma. (shrink)

The UNESCO research projects focusing on The Silk Routes and The Slave Routes were launched at just the right time to remind us that globalization is not a novel dimension of the history of humanity. Not only am I among those who analyze capitalism as a worldwide system from its very inception, but I have also found it pertinent to recall that prior to the sixteenth century, societies were not at all isolated from one another but rather competing within regional (...) systems (and perhaps within one global system). To underestimate this fact is to condemn ourselves to a misunderstanding of the very dynamics of change within societies. At the same time, I maintain that in the history of the world, capitalism represents a qualitative rupture that had its beginnings around 1500. Accordingly I emphasize the distinction that must be made between the integrated structure of the worldwide capitalist system and the protocapitalist elements that are to be found in earlier societies; I also underline the specificity of the contrast between centers and peripheries, which is unique to global capitalism and which differs from previous forms of polarization. (shrink)

The intellectual legacy of Confucianism has loomed large in efforts to understand China's past, present, and future. While Confucian ethics has been thoroughly explored, the question remains: what exactly is Confucian political thought? Classical Confucian Political Thought returns to the classical texts of the Confucian tradition to answer this vital question. Showing how Confucian ethics and politics diverge, Loubna El Amine argues that Confucian political thought is not a direct application of Confucian moral philosophy. Instead, contrary to the conventional view (...) that Confucian rule aims to instill virtue in all members of society, El Amine demonstrates that its main aim is to promote political order. El Amine analyzes key aspects of the Confucian political vision, including the relationship between the ruler and the people, the typology of rulers, and the role of ministers and government officials. She also looks at Confucianism’s account of the mechanisms through which society is to be regulated, from welfare policies to rituals. She explains that the Confucian conception of the political leaves space open for the rule of those who are not virtuous if these rulers establish and maintain political order. She also contends that Confucians defend the duty to take part in government based on the benefits that such participation can bring to society. Classical Confucian Political Thought brings a new understanding to Confucian political theory by illustrating that it is not chiefly idealistic and centered on virtue, but rather realistic and driven by political concerns. (shrink)

Evidence suggests a limited contribution to the total research output in leading obstetrics and gynaecology journals by researchers from the developing world. Editorial bias, quality of scientific research produced and language barriers have been attributed as possible causes for this phenomenon. The aim of this study was to understand the prevalence of editorial board members based out of low and lower-middle income countries in leading journals in the field of obstetrics and gynaecology. The top 21 journals in the field of (...) obstetrics and gynaecology were selected based on their impact factor, SCImago ranking and literature search. The composition of the editorial boards of these journals was studied based on World Bank Income Criteria to understand the representation status of researchers from low and lower-middle income countries. A total of 1315 board members make up the editorial composition of leading obstetrics and gynaecology journals. The majority of these editors belong to high-income countries (n = 1148; 87.3%). Low (n = 6; 0.45%) and lower-middle income (n = 55; 4.18%) countries make up for a very minuscule proportion of editorial board members. Only a meagre 9 out of 21 journals have editorial board members from these countries (42.85%). Low and low-middle countries have poor representation in the editorial boards of leading obstetrics and gynaecology journals. Poor representation in research from these countries has grave consequences for a large proportion of the global population and multidisciplinary collaborative efforts must be taken to rapidly change this statistic with immediate effect. (shrink)

In rapidly evolving medical fields where the standard of care or prevention changes frequently, guidelines are increasingly likely to conflict with what participants receive in research. Although guidelines typically set the standard of care, there are some cases in which research can justifiably deviate from guidelines. When guidelines conflict with research, an ethical issue only arises if guidelines are rigorous and should be followed. Next, it is important that the cumulative evidence and the conclusions reached by the guidelines do not (...) eliminate the need for further research. Even when guidelines are rigorous and the study still asks an important question, we argue that there may be good reasons for deviations in three cases: (1) when research poses no greater net risk than the standard of care; (2) when there is a continued need for additional evidence, for example, when subpopulations are not covered by the guidelines; and (3) less frequently, when clinical practice guidelines can be justified by the evidence, but practitioners disagree about the guidelines, and the guidelines are not consistently followed as a result. We suggest that procedural protections may be especially useful in deciding when studies in the third category can proceed. (shrink)

Los más diversos teóricos de la modernidad suelen presentar este período como un proceso continuo de desarrollo tecnológico y económico, progreso en las artes y las ciencias, expansión de la democracia y racionalización de las instituciones y las costumbres. Sin embargo, persisten las contradicciones del capitalismo, el colapso de la civilización es inminente y el Pueblo no vive ni ha vivido en la modernidad tal y como sus teóricos la describen. Esto es tanto más cierto en nuestro país, habitado por (...) una suerte de magdaleniense o pre-Tartessos lleno de cacharritos con iconos, llamadas, avisos, avatares, tamagotchies, móviles y juegos online integrados sin la menor discrepancia sobre una capa de rituales del año de la polka, fetiches, incienso, lágrimas, sangre, joyas, ofrendas, sacrificios, reliquias de miembros de santos y matriarcas fenicio-neolíticas devenidas madres de Cristo al tiempo que supporters del equipo de fútbol local. El ultrarracionalismo se presenta como un nuevo método y movimiento filosófico cuya voluntad es afrontar los desafíos del futuro sin dejar de hacer justicia a esta auténtica marejada de lo grotesco. (shrink)

This essay exposes how recent attempts at lethal injection reform have involved unethical and illegal research on prisoners. States are varying the doses and types of drugs used, developing methods designed for non-medical professionals to administer medical procedures, and gathering data or making provisions for the gathering of data to learn from executions gone wrong. When individual prisoners are executed under these conditions, states are conducting research on them. Conducting research or experimentation on prisoners in the process of reform is (...) problematic because it violates ethical frameworks and state laws. The Supreme Court has recently taken up the challenge of elucidating the standard for determining the constitutionality of lethal injection. If the Court suggests an approach to lethal injection reform that is akin to some of the more thoughtful and cautious approaches other courts have proposed, the Court's decision may also contravene state laws or ethical precepts regarding research with prisoners. Thus, this paper provides important limitations on the kinds of reform that may be permissible and outlines the open questions that must be addressed before it can be determined whether the risks and uncertainties involved in lethal injection can be remedied. (shrink)

The “dead-donor rule” states that, in any case of vital organ donation, the potential donor should be determined to be dead before transplantation occurs. In many countries around the world, neurological criteria can be used to legally determine death (also referred to as brain death). Nevertheless, there is considerable controversy in the bioethics literature over whether brain death is the equivalent of biological death. This international legal review demonstrates that there is considerable variability in how different jurisdictions have evolved to (...) justify the legal status of brain death and its relationship to the dead-donor rule.In this article, we chose to review approaches that are representative of many different jurisdictions—the United States takes an approach similar to that of many European countries; the United Kingdom’s approach is followed by Canada, India, and influences many other Commonwealth countries; Islamic jurisprudence is applicable to several different national laws; the Israeli approach is similar to many Western countries, but incorporates noteworthy modifications; and Japan’s relatively idiosyncratic approach has received some attention in the literature. Illuminating these different justifications may help develop respectful policies regarding organ donation within countries with diverse populations and allow for more informed debate about brain death and the deaddonor rule. (shrink)

In the limited literature on gender and climate change, two themes predominate – women as vulnerable or virtuous in relation to the environment. Two viewpoints become obvious: women in the South will be affected more by climate change than men in those countries and that men in the North pollute more than women. The debates are structured in specific ways in the North and the South and the discussion in the article focuses largely on examples from Sweden and India. The (...) article traces the lineage of the arguments to the women, environment and development discussions, examining how they recur in new forms in climate debates. Questioning assumptions about women's vulnerability and virtuousness, it highlights how a focus on women's vulnerability or virtuousness can deflect attention from inequalities in decision-making. By reiterating statements about poor women in the South and the pro-environmental women of the North, these assumptions reinforce North–South biases. Generalizations about women's vulnerability and virtuousness can lead to an increase in women's responsibility without corresponding rewards. There is need to contextualise debates on climate change to enable action and to respond effectively to its adverse effects in particular places. -/- . (shrink)

Peace, the article shows, is achieved by culturally evolved institutions that incentivize positive-sum relationships. We propose that this insight has important consequences for the design of human social cognition. Cues that signal the existence of such institutions should play a prominent role in detecting group membership. We show how this accounts for previous findings and suggest avenues for future research.

Many guidelines for international research require that studies be responsive to host community health needs or health priorities. Although responsiveness possesses great intuitive and rhetorical appeal, existing conceptions are confusing and difficult to apply. Not only are there few examples of what research the responsiveness requirement permits and what it rejects, but its application can lead to contradictory results. Because of the practical difficulties in applying responsiveness and the danger that misapplying responsiveness could harm the interests of developing countries, we (...) argue that responsiveness should be refocused in three ways: in terms of (1) who enforces it, (2) under what standard, and (3) in what cases. We conclude that responsiveness should be applied by host country officials at the policy level with the exercise of judgment when externally funded research threatens to displace scarce local resources. (shrink)

What does it mean to study places in ‘crisis’ and how does that affect the research done on the ‘rural’? To be considered to be in crisis is not really new as any literature review of rural studies indicates. And yet, we live now in a new context, with new challenges for ‘rural’ research, in particular that of sustainability. Sustainability is the new policy focus and is increasingly reflected in research on rural Europe. Although scholars are beginning to theorize on (...) what is sustainable in and for rural areas, our intention is to take this further. We theorize on what the focus on crisis and, increasingly on sustainability, means for the research we do and the knowledge we produce on rural Europe. Our aim is to bring attention to the politics of past and present knowledge production on the rural to be able to imagine just and sustainable futures. In an analysis of literature primarily from Sweden and the UK, we argue that two construals, that of a rural crisis and that of rural–urban polarization, have set the tone for rural studies and may have overshadowed a more plural approach. We outline what might be needed from rural research to meet future challenges and what the notion of sustainability, with its emphasis on the entanglements of the social, economic and environmental, might mean for the future of rural research. (shrink)

Feminist decolonial scholars have called for disengaging from the current system built on a hierarchical logic of race and gender central to modern, colonial thinking. They have looked to worlds outside the modern system to lead us out of current unjust practices harming both humans and the environment. Although policymaking may be seen as the stronghold of the current political agenda and of the structures that have led to the climate crisis, we argue that climate policies too, are also crucial (...) for rethinking and transforming societies. Our examination of climate adaptation policies in Sweden and the literature from Europe shows how policy documents ignore and unknow the oppressive intersections of gender and power despite the knowledge that exists on these issues in the public domain. Drawing on the tools of agnotology, we examine how this is achieved by strategies of ‘denial, dismissal, diversion and displacement.’ Building on feminist post and decolonial scholarship, we make explicit the gendered and racial hierarchies and dichotomies underpinning these policy documents. At the same time, we bring attention to the nuances in the policy documents we study and look for the openings that might be used to bring about transformation by making these hierarchies explicit and calling them into question. We argue that a transformation is possible through a feminist post and decolonial intervention, even in policymaking otherwise ignorant of culture, values and the colonial histories that have produced contemporary society. (shrink)

Research on opioid use in pregnancy is critically important to understand how the opioid epidemic has affected a generation of children, but also raises significant ethical and legal challenges. Embedded ethicists can help to fill the gaps in ethics oversight for such research, but further guidance is needed to help strike the balance between integration and independence.

The Common Rule creates a division of moral labor in research. It implies that investigators and sponsors can outsource their ethical obligations to IRBs and participants, thereby fostering a culture of compliance, rather than one of responsibility. The proposed revisions to the Common Rule are likely to exacerbate this problem. To harness the expressive power of the law, I propose the Common Rule be revised to include the ethical responsibilities of investigators and sponsors.