If stem cell-based therapies are developed, we will likely confront a difficult problem of justice: for biological reasons alone, the new therapies might benefit only a limited range of patients. In fact, they might benefit primarily white Americans, thereby exacerbating long-standing differences in health and health care.
We report on the deliberations of an interdisciplinary group of experts in science, law, and philosophy who convened to discuss novel ethical and policy challenges in stem cell research. In this report we discuss the ethical and policy implications of safety concerns in the transition from basic laboratory research to clinical applications of cell-based therapies derived from stem cells. Although many features of this transition from lab to clinic are common to other therapies, three aspects of stem cell biology pose (...) unique challenges. First, tension regarding the use of human embryos may complicate the scientific development of safe and effective cell lines. Second, because human stem cells were not developed in the laboratory until 1998, few safety questions relating to human applications have been addressed in animal research. Third, preclinical and clinical testing of biologic agents, particularly those as inherently complex as mammalian cells, present formidable challenges, such as the need to develop suitable standardized assays and the difficulty of selecting appropriate patient populations for early phase trials. We recommend that scientists, policy makers, and the public discuss these issues responsibly, and further, that a national advisory committee to oversee human trials of cell therapies be established. **NB we did not reccommend a NAC, we think it might be appropriate**. (shrink)
The article discusses leadership enactment in medical emergencies. We draw on video recordings of simulated obstetric emergencies and investigate how senior clinicians ‘do being’ the leader discursively in the spatiomaterial context of the emergency room. We take an interactional analysis approach, combining conversation analysis and interactional sociolinguistics and look specifically into the ways in which professional roles do interactional control using directives and questions in the material space of the obstetric room. We discuss this interactional performance in relation to the (...) clinical performance of the teams. Our analysis shows that leadership in medical emergencies is multimodally achieved; professionals draw on discursive strategies, the affordances of material space, body and gaze orientation, which build on each other and converge in indexing leadership. Our findings highlight the situated nature of negotiating responsibility, illustrating that leadership in our context is claimed, projected and resisted discursively. We provide a typology of the functions of questions in the emergency encounter, and close the article by foregrounding the implications of our study and providing directions for further research. (shrink)
While new generations of implantable brain computer interface devices are being developed, evidence in the literature about their impact on the patient experience is lagging. In this article, we address this knowledge gap by analysing data from the first-in-human clinical trial to study patients with implanted BCI advisory devices. We explored perceptions of self-change across six patients who volunteered to be implanted with artificially intelligent BCI devices. We used qualitative methodological tools grounded in phenomenology to conduct in-depth, semi-structured interviews. Results (...) show that, on the one hand, BCIs can positively increase a sense of the self and control; on the other hand, they can induce radical distress, feelings of loss of control, and a rupture of patient identity. We conclude by offering suggestions for the proactive creation of preparedness protocols specific to intelligent—predictive and advisory—BCI technologies essential to prevent potential iatrogenic harms. (shrink)
Lucy O'Brien argues that a satisfactory account of first-person reference and self-knowledge needs to concentrate on our nature as agents. Clearly written, with rigorous discussion of rival views, this book will be of interest to anyone working in the philosophy of mind and action.
Most models of corporate social responsibility revolve around the controversy as to whether business is a single dimensional entity of profit maximization or a multi-dimensional entity serving greater societal interests. Furthermore, the models are mostly descriptive in nature and are based on the experiences of western countries. There has been little attempt to develop a model that accounts for corporate social responsibility in diverse environments with differing socio-cultural and market settings. In this paper an attempt has been made to fill (...) this gap by developing a two-dimensional model of corporate social responsibility and empirically testing its validity in the context of two dissimilar cultures – Australia and Bangladesh. The two dimensions are the span of corporate responsibility and the range of outcomes of social commitments of businesses. The test results confirm the validity of the two-dimensional model in the two environments. The Factor analysis revealed two leading dimensions. Cluster analysis pointed to two distinctive clusters of managers in both Australia and Bangladesh, one consisting of managers with a broad contemporary concept of social responsibility, and the other with a limited narrow view. The paper concludes that corporate social responsibility is two-dimensional and universal in nature and that differing cultural and market settings in which managers operate may have little impact on the ethical perceptions of corporate managers. (shrink)
Niche construction is the process whereby organisms, through their activities and choices, modify their own and each other’s niches. By transforming natural-selection pressures, niche construction generates feedback in evolution at various different levels. Niche-constructing species play important ecological roles by creating habitats and resources used by other species and thereby affecting the flow of energy and matter through ecosystems—a process often referred to as “ecosystem engineering.” An important emphasis of niche construction theory is that acquired characters play an evolutionary role (...) through transforming selective environments. This is particularly relevant to human evolution, where our species has engaged in extensive environmental modification through cultural practices. Humans can construct developmental environments that feed back to affect how individuals learn and develop and the diseases to which they are exposed. Here we provide an introduction to NCT and illustrate some of its more important implications for the human sciences. (shrink)
In this paper I want to propose that we see solipsism as arising from certain problems we have about identifying ourselves as subjects in an objective world. The discussion will centre on Wittgenstein’s treatment of solipsism in his Tractatus Logico- Philosophicus. In that work Wittgenstein can be seen to express an unusually profound understanding of the problems faced in trying to give an account of how we, who are subjects, identify ourselves as objects in the world. We have in his (...) compressed remarks, the kernels of a number of arguments which all come together to form what can be called the problem of self-identification. I want to argue that the solipsism of the Tractatus arises at least in part as a solution to, or – to put it less optimistically – as a symptom or articulation of this problem. In approaching Wittgenstein’s early discussion of solipsism in this way I will obviously be in disagreement with some other interpretations of the work. For example, there are those who think that there is no ‘solipsism of the Tractatus’.1 In fact, the Tractarian arguments presented below as motivating solipsism have been seen as fulfilling the quite opposite function of refuting it. I do not intend in this piece to engage with alternative interpretations. Let me say a little bit about why I have granted myself the licence not to do so. First, the focus of my concern with solipsism is on how it connects with what I have called the problem of self-identification. While it is a concern that emerged in an attempt to make sense of Wittgenstein’s remarks in. (shrink)
Doctors have an ethical and legal duty to respect patient confidentiality. We consider the basis for this duty, looking particularly at the meaning and value of autonomy in health care. Enabling patients to decide how information about them is disclosed is an important element in autonomy and helps patients engage as active partners in their care.Good quality data is, however, essential for research, education, public health monitoring, and for many other activities essential to provision of health care. We discuss whether (...) it is necessary to choose between individual rights and the wider public interest and conclude that this should only rarely be necessary. The paper makes some recommendations on practical steps which could help ensure that good quality information is available for work which benefits society and the public health, while still enabling patients’ autonomy to be respected. (shrink)
Hume is usually taken to have an evidentialist account of testimonial belief: one is justified in believing what someone says if one has empincal evidence that they have been reliable in the past. This account is impartialist: such evidence is required no matter who the person is, or what refotions she may have to you. I, however, argue that Hume has another account of testimony, one grounded in sympathy. This account is partialist, in that empincal evidence is not required in (...) order for one to be justified in believing some of the assertions of one's friends. (shrink)
Heidegger?s accounts of Dasein?s dual nature as both individual and social in Being and Time have been a longstanding source of confusion and controversy in the literature. Many critics have been keen to identify contradictions between Heidegger?s positive account of the social nature of everyday Dasein and the putatively solipsistic account of authentic Dasein which comes later. This paper focuses on Heidegger?s brief attempts to sketch the outlines for the notion of something like authentic intersubjectivity. In doing so we will (...) see where the temptation arises to read Heidegger as having failed to remain consistent but also how Heidegger himself is responsible for some of the confusion here. (shrink)
This paper explores the character of emotion and its value in understanding ethical dilemmas in work organisations. Specifically, we examine the emotional labour of human resource professionals. Through in-depth interviews and diary study, we uncover the emotional and ethical struggles of HRPs as they search for the ‘right thing to do’ in situated interaction. Through the lens of emotion, we chart the process of how the very framing of what is deemed ‘right’ can move from the social to the moral (...) order and vice versa. Based on our findings, we contribute to understanding the linkages between emotional and ethical dilemmas, and how expectations of multiple ‘others’ at the individual, interpersonal and organisational level shape and constrain ethical choices. (shrink)
The behavioral sciences have flourished by studying how traditional and/or rational behavior has been governed throughout most of human history by relatively well-informed individual and social learning. In the online age, however, social phenomena can occur with unprecedented scale and unpredictability, and individuals have access to social connections never before possible. Similarly, behavioral scientists now have access to “big data” sets – those from Twitter and Facebook, for example – that did not exist a few years ago. Studies of human (...) dynamics based on these data sets are novel and exciting but, if not placed in context, can foster the misconception that mass-scale online behavior is all we need to understand, for example, how humans make decisions. To overcome that misconception, we draw on the field of discrete-choice theory to create a multiscale comparative “map” that, like a principal-components representation, captures the essence of decision making along two axes: aneast–westdimension that represents the degree to which an agent makes a decision independently versus one that is socially influenced, and anorth–south dimensionthat represents the degree to which there is transparency in the payoffs and risks associated with the decisions agents make. We divide the map into quadrants, each of which features a signature behavioral pattern. When taken together, the map and its signatures provide an easily understood empirical framework for evaluating how modern collective behavior may be changing in the digital age, including whether behavior is becoming more individualistic, as people seek out exactly what they want, or more social, as people become more inextricably linked, even “herdlike,” in their decision making. We believe the map will lead to many new testable hypotheses concerning human behavior as well as to similar applications throughout the social sciences. (shrink)
How is it that we think and refer in the first-person way? For most philosophers in the analytic tradition, the problem is essentially this: how two apparently conflicting kinds of properties can be reconciled and united as properties of the same entity. What is special about the first person has to be reconciled with what is ordinary about it. The range of responses reduces to four basic options. The orthodox view is optimistic: there really is a way of reconciling these (...) apparently contradictory properties as contained within the same thing. The heretical views are pessimistic and content to be so: there is no such way, and that is because there is simply nothing to reconcile – because there is really nothing special about what is in question; or there is really nothing ordinary about it; or there is really nothing …. (shrink)
The twelve specially written essays in this volume investigate the neglected topic of mental action, and show its importance for the metaphysics, epistemology, and phenomenology of mind. The essays investigate what mental actions are, how we are aware of them, and what is the relationship between mental and physical action.
Stobaeus records a placitum where Empedocles says that the world is destroyed by the domination in turn of Love and of Strife. The placitum makes perfectly good sense in the context of Empedocles' belief that Love and Strife produce, in turn, a non-cosmic state of total unity (Love) and of total separation (Strife). But for over two hundred years scholars have been unable to hear that simple message. Sturz (1805) emended the text so as to make it fit the non-cyclical (...) interpretation of Empedocles that he had taken over from the pages of Tiedemann (1791). When Diels included Stobaeus' text in his edition of Aetius, in the "Doxographi graeci" (1879), he failed to remove the emendation, although his own reconstruction of the chapter heading in Aetius made the emendation impossible. Twenty years later, Diels saw the light, and printed Stobaeus' placitum, unemended, in his "Poetarum philosophorum fragmenta" (1901) and in successive editions of his "Fragmente der Vorsokratiker" (from 1903 onwards). But Kranz resurrected the emendation in the "Nachträge" to his sixth edition of the "Fragmente der Vorsokratiker" (1951). The emended placitum is used again by Uvo Hölscher (1965) to support a non-cyclical interpretation of Empedocles and is repeated in the latest collection of the fragments and testimonia (Brad Inwood, 1992). Hölscher fails to appreciate that the text that he uses to support his reconstruction is merely Sturz's translation into Greek of the non-cyclical interpretation of Empedocles proposed by Tiedemann at the end of the eighteenth century. (shrink)
Information is the fourth core element of public health legal preparedness and of legal preparedness for public health emergencies specifically. Clearly, the creation, transmittal, and application of information are vital to all public health endeavors. The critical significance of information grows exponentially as the complexity and scale of public threats increase.Only a small body of organized information on public health law existed before the 21st century: a series of landmark books published beginning in 1926 by Tobey, Grad, and Wing ; (...) model public health laws published as early as 1907; systematic reviews of original research studies published in the 1990s; and a small but growing number of articles published in public health journals and law reviews.With the new century came new public health law programs and activities at the Centers for Disease Control and Prevention, in public health professional associations, and in numerous non-profit and academic organizations. (shrink)
Archaeologists have proposed that behavioral knowledge of a tool can be conceptualized as a “recipe”—a unit of cultural transmission that combines the preparation of raw materials, construction, and use of the tool, and contingency plans for repair and maintenance. This parallels theories in cognitive psychology that behavioral knowledge is hierarchically structured—sequences of actions are divided into higher level, partially independent subunits. Here we use an agent-based simulation model to explore the costs and benefits of hierarchical learning relative to holistic learning, (...) where entire behavioral sequences are learned in an all-or-nothing fashion, and diffusionist learning, where actions are completely independent. Hierarchical learning is favored under the reasonable assumptions that learning is associated with some degree of both error and cost, and that behavior can be grouped into subunits that repeat in one or more tool recipes. These general predictions can be tested in the archaeological and ethnographic record. Recent advances in evolutionary developmental biology have revealed a number of parallels between the hierarchically structured, recipe-like organization of behavioral knowledge that we examine here and the manner in which biological organisms develop. (shrink)