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)

This chapter has two aims.* First, it exegetes Aquinas’ notion of peace (pax) in his Commentary on the Gospel of St. John (14:7), which is centred around the definition, kinds and possibility of a perfected peace, as well as how love (amor) is the cause of peace. Second, rather than defending Aquinas’ position at length, I take the more humble task to defend one attractive, plausible feature of Aquinas’ position, showing how it reveals Medieval wisdom for the establishment of modern (...) peace. The position is two-fold: First, Aquinas’ position – at least how Josef Pieper (1904–97) reads him – that love is essentially the affirmation of the goodness of the existence of the other person. I read this as an empirically-supported, plausible source of peace. This thesis also reiterates Aquinas’ rejection of monadic theories of peace which hold that peace need only be outward (exterius) e.g., establishing socio-political peace by fighting for human rights, and not inward (interius) e.g., peace with oneself by cultivating the inner life (14, 7, 1962). Second, Aquinas’ position that love, and not other candidates e.g., tolerance, as the cause of peace, is an alternative, plausible position that merits critical attention. (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)

Numerous authors indicate that the influence of academic education extends beyond the growth of specialized knowledge gained by the graduates. Scholars are trying to identify and examine the potential impact of higher learning on students’ attitudes and choices. One of the dimensions considered by the researchers is the effect of university training on students’ moral choices. Our paper attempts to identify differences between the students’ declared moral choices and their majors (fields of studies). Working with a sample of university students (...) of Economics and Sociology (N = 181), and using three variants of the Trolley Problem, the subjects’ responses are used to identify the similarities and differences between their choices. The participants were asked to respond to three hypothetical situations regarding a runaway trolley. Their decision in the first scenario could save a person’s life or let her be run over by the trolley. In the second scenario, their decision could either let one person die and save five lives or save one life and let five people be killed. These two scenarios required pulling a lever to switch the trolley from one track to another. The third scenario requires pushing an obese person in front of the runaway trolley to stop it from killing five persons. As expected, we found a significant difference between the two groups (the economists and the sociologists) in the case of our third scenario, however, we found no evidence supporting the indoctrination hypothesis. We conclude that the existing differences between the choices made by the future economists and sociologists may support the preselection hypothesis. (shrink)

This article examines the risk and return profiles of stock indices composed of companies meeting environmental, social and governance screening criteria [such as the Dow Jones Sustainability Indices ] and conventional composite indices of eight Asian countries from 2002 to 2014. The results indicate that there are no significant differences in the returns or risk-adjusted returns between the ESG indices and the composite indices within countries. The results do reveal that the market volatility of the ESG indices is higher than (...) the market volatility of the conventional indices. Market betas of DJSI and ESG equity indices are significantly lower than betas of the composite equity indices. The overall results indicate that the performance of ESG equity indices of many Asian countries is similar to the performance of conventional indices, suggesting that investors can pursue socially responsible investing objectives without a material difference in portfolio performance from conventional investing. (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.

What is Augustine’s commentary on Alypius’ curiosity (curiositas) at the gladiatorial show in Confessiones 6, 8, 13 fundamentally about? Augustinian scholars have interpreted the story widely. Following recent scholarly developments, this work argues for a distinctively Thomistic reading of Alypius’ curiositas. In 1987, Joseph Torchia interpreted this passage as putting only a secondary focus on the story’s emphasis on, in his words, «conflict with God, its inner self, and others». However, this triadic conflict is found in Aquinas: in his Commentary (...) on the Gospel of John (14, 7), Aquinas argues that a conflict with God, self and others is what it means to lack peace (pax). Confessions 6, 8, 13 is read here through a Thomistic lens: the presentation of Alypius’ curiositas is fundamentally a statement about Alypius’ lack of peace. (shrink)

The journey of phenomenology apparently is not so extensive, because it was the first half of the twentieth century when Edmund Husserl appeared as the founder of phenomenology. But, it has its very roots in the works of ancient Greek philosophers like Socrates, Plato, and Aristotle. This journey did not stopped here, as various phenomenologists have also been contributing in this field and establishing the linkage between phenomenology and symbolic interactionism as well as its very relation to research. Researchers in (...) the presented work have critically analyzed the contributions of prominent phenomenologists, i.e. from Hegel to Dreyfus and have applied relational analysis. The present study propounds that with the passage of time, the concept of phenomenology has been constructively evolving; in a sense that it has become more calculative. (shrink)

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)

Josef Pieper (1904–1997) wrote his autobiography in three distinct volumes. Composing one volume of his complete works in his Gesammelte Werke (Felix Meiner Verlag, 1995) edited by Berthold Wald, he writes on his early (1904–1945), middle (1945–1964), and late years (1964–1985). Between Ignatius Press and St. Augustine’s Press, Pieper’s autobiographical writings have been translated into English over the last three decades. The first volume, Noch wusste es niemand: Autobiographische Aufzeichnungen 1904–1945 (Kosel-Verlag, 1979), was translated into English as No One Could (...) Have Known: An Autobiography: The Early Years 1904–1945 (Ignatius, 1987). Three decades later the second volume, Noch nicht aller Tage Abend: Autobiographische Aufzeichnungen 1945–1964 (Kosel-Verlag, 1979), was published in English as Not Yet the Twilight: An Autobiography 1945–1964 (St. Augustine’s Press, 2017). Finally, the third volume, Eine Geschichte wie ein Strahl: Autobiographische Aufzeichnungen seit 1964 (Kosel-Verlag, 1988), has been published under the title A Journey to Point Omega: Autobiography from 1964 (St. Augustine’s Press, 2020). (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)

This research investigates the factors that affect male gamers' behavioral intention to play PlayerUnknown's Battlegrounds, which is one of the most widely played online games of today's era. We examine the factors through the lens of the hedonic consumption model and use the gratification theory to predict behavioral intention to play PUBG. Data from 248 male PUBG gamers were analyzed using PLS-SEM analyses. The study involved an initial stage where an estimation model was analyzed to assess the constructs' reliability and (...) validity. Following this, the second stage involved assessing the theoretical model to test the relationship between the principle constructs. The study found that playful-consumption experience factors, such as escapism, emotional involvement, sensory experience, enjoyment, and arousal, significantly influenced the behavioral intentions to play PUBG. The research findings further indicate that role-projection and fantasy failed to impact consumers' intention to play PUBG. This study provides both theoretical and practical implications. It fills the literature gap by focusing on predicting the behavioral intention to play PUBG through the playful-consumption experiences of a popular online multiplayer game. Practically, this study could potentially open avenues for gaming companies to address how different playful-consumption experiences impact game users' behavioral intentions. (shrink)

PurposeThis study aimed to apply “multi-criteria decision approach and attitude-change theory” to examine post-COVID-19 impact on entrepreneurial mindset by investigating the link between entrepreneurs social capital and entrepreneurial success. Specifically, this study analyzed entrepreneurs' dispositional factor as an underlying mechanism to bridge trust and entrepreneurial success. Furthermore, it also analyzed entrepreneurs' situational factor as boundary condition.Design/methodology/approachWe applied time-lagged data collection from 505 industrial entrepreneurs. Survey method was used for data collection. A 7-point Likert scale was used for the respondent response. (...) Hayes developed PROCESS models 4 and 7 were used to test the hypothesis.FindingsThe direct impact of trust on three elements of the ecosystem was found significantly positive on both startup behavior and entrepreneurial success. The direct impact of startup behavior on entrepreneurial success is also significantly positive. The impact of startup behavior on indirect mediation between trust and entrepreneurial success is visibly positive. The moderated and moderated mediation impact of entrepreneurial strategy found positively significant at low and medium values. However, this study found an insignificant moderated impact at high values of entrepreneurial strategy between trust on media and startup behavior. Furthermore, this study also found insignificant moderated mediation impact at high values of entrepreneurial strategy by interacting with two elements of ecosystem through startup behavior on entrepreneurial success.Originality/valueThe authors suggested that startup behavior is an underlying mechanism through which industrial entrepreneurs trust achieved desired entrepreneurial success. The authors also suggested that the influencing role of “low level of entrepreneurial strategy” in comparison with “high level entrepreneurial strategy” is more helpful to achieve entrepreneurial success.ImplicationsThis study contributed to the literature on entrepreneurial strategy for its conditional indirect moderated impact on startup behavior and moderated mediation impact on firm entrepreneurial success. It also contributed to owners of the manufacturing industry for their startup behavior as an underlying mechanism through which trust influences entrepreneurial success. (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)

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)

It is a relatively uncontroversial proposition that without “ethics,” an “ethics of homelessness” is impossible. What is less uncontroversial, though, is that philosophy—or at least philosophical analysis—is a necessary condition of ethical discourse. The distrust—or skepticism regarding the utility of— philosophical analysis is predicated on rendering philosophy as useless. This, though, should create a sense of cognitive dissonance, since we universally acknowledge that ethics informs how we interact with ourselves and others, while we also accept, and rightly so, the uselessness (...) of philosophy. While pop- ular parlance has it that uselessness is logically and semantically equivalent to not needed or conceptually irrelevant, this, I will argue, is mistaken. This mis- take, as I see it, is a result of the failure to recognize that liberal arts are intrinsi- cally useless—and ought to be treated as such. To mend this mistake, I will outline the liberal arts in contrast to the servile arts and explain how Aristotle, and his later defender Josef Pieper, correctly understood the distinction. I will then move onto suggest that while philosophy—as a liberal art—is useless, and rightfully so, it is a conceptually relevant, necessary condition for dealing with conceptual problems which arise in ethics—and therefore in the ethics of homelessness. To explicate and defend this thesis, I argue that Plato’s three- fold division of goods, originating in Book ii of his Republic, helps to amalgamate our reservations in accepting philosophy as useless—strictly speaking—and simultaneously useful. From this, I move on to provide various ways in which philosophy is relevant to questions of home and homelessness generally, and display how philosophers themselves have, historically, taken seriously the question of home and homelessness as serious philosophical concepts. Finally, I outline how philosophers can work on the ethics of home- lessness by taking seriously the necessary presuppositions which make work- ing on the alleviation of homelessness not merely possible, but morally obligatory. Having sketched a broad picture of how philosophy interacts with the practical problems of homelessness, I conclude that progress in the field of the ethics of homelessness—as a conceptual endeavor—will ultimately arise from overcoming our prima facie interpretation of the liberal/servile arts distinction and thereby preserve its original meaning. (shrink)

Philosophers have various responsibilities. Articulating these responsibilities, however, is contingent on what one means by “philosophy” and what philosophers have “expertise” in. Responsible philosophers must therefore interact with the following kinds of questions: What do philosophers have expertise in? What responsibilities do philosophers have as intellectual experts, and to whom are they responsible? What are philosophers supposed to know and be able to publicly convey? What is the role of a philosopher in contributing to local, institutional, and global responsibilities? This (...) paper concerns itself with defending and articulating one such responsibility philosophers have: the invitation to others to engage in philosophizing. Using Josef Pieper’s (1904-97) life and writings as paradigmatically embodying this invitational-approach to philosophy, this paper articulates – by means of stories from his life – how this approach to philosophizing is pedagogically effective for instructors and students of philosophy i.e., in making philosophy worthwhile, accessible and relevant. (shrink)

Josef Pieper’s Weistum, Dichtung, Sakrament: Aufsätze und Notizen (Kösel-Verlag, 1954) has been translated into English by Dan Farrelly under the title Traditional Truth, Poetry, Sacrament. The text is composed of Pieper’s essays, notes, talks, lectures, radio addresses, and advisory opinions written during the 1930s, 1940s, and 1950s (pre- and post-World War II). This book review surveys the novel contributions this translation affords his English readers, omitting reference to writings whose themes overlap significantly with his works already available in English.

Many people, communities and countries are in favour of abortion as a healthcare right, arguing that women have a right to receive an abortion upon request. Some contexts place ethical constraints on this right, typically based on the age of the preborn child, the mother’s safety, or the circumstances of the mother (and her conceiving of her child) more generally. At the same time, intersex pediatric surgery (IPS) is being increasingly ethically challenged with many countries banning healthcare facilities from performing (...) IPS. At first, there appears to be no relation between these two ethical issues. However, modern biotechnology such as the assistive reproductive technology (ART), preimplantation genetic diagnosis (PGD), makes it possible to screen for intersex conditions in utero, opening the possibility of intersex-selective abortion (ISA), a sub-set or instance of sex-selective abortion (SSA). What emerges is the realization that if IPS is wrong because, as its critics have argued, it wrongfully discriminates against and harms intersex lives, then ISA is much more wrong because instead of misvaluing intersex lives, it devalues intersex lives altogether. In other words, IPS might, as some have argued, discriminate by implying that an intersex child is better off being male or female but not intersex, but ISA discriminates by implying that an intersex child is better off not existing at all. Some have recognized this connection and have vainly tried to maintain both their pro-abortion commitments and their anti-IPS commitments. This has proved at best duplicitous, and at worst conceptually impossible. While it is known that a strong stance against IPS results in an inability to morally condemn ISA, with one notable exception in moral theology, this connection has not been generally appreciated. (shrink)

Leadership which lacks ethical conduct can be dangerous, destructive, and even toxic. Ethical leadership, though well discussed in the literature, has been tested empirically as a construct in very few studies. An empirical investigation of ethical leadership in Singapore's construction industry is reported. It is found that ethical leadership is positively and significantly associated with transformational leadership, transformational culture of organization, contingent reward dimension of transactional leadership, leader effectiveness, employee willingness to put in extra effort, and employee satisfaction with the (...) leader. However, it is also found that ethical leadership bears no correlations with transactional leadership. Also, it is negatively correlated with laissez-faire leadership and transactional culture of the organization. The findings also reveal that ethical leadership plays a mediating role in the relationship between employee outcomes and organizational culture. Practical implications of these findings are discussed. Directions for future research are also suggested. (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)

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...

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)

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)