This article provides ethical guidance on using race in health research as a variable or in defining the study population. To this end, a plain, non-exhaustive checklist is provided for researchers and research ethics committees, preceded by a brief introduction on the need for justification when using race as a variable or in defining a study population, the problem of exoticism, that distinctions pertain between race, ethnicity and ancestry, the problematic naming of races, and that race does not serve well (...) as a presumed biological construct in genetic research. (shrink)

Distributional fairness of corporate distributions is an important social issue linked to accounting for equality. Value added and the information contained in the value added statement can conceptually be regarded as a reflection of how the company is managed for all stakeholders. We investigate value added information published in sustainability reports to determine if the information provided is useful for assessing distributional fairness between stakeholders. We find that the value added information disclosed lack conciseness, comparability and understandability. The divergence is (...) considerable and the explanations of the disclosed information so limited that the usefulness of the value added disclosures must be questioned. Our results suggest several obfuscating techniques in the disclosure of value added information, including disclosing information that is conceptually compromised, resulting in comparability issues and disclosing information that can’t be verified by reconciling back to the financial statements. Our findings have clear ethical and moral implications as they stress the societal issue of distributional fairness. It seems that companies are either reluctant to provide value added information that is useful, or deliberately use value added disclosures to obfuscate. Information reflecting distributional fairness is therefore compromised. (shrink)

The purpose of this article is to problematise a particular social transparency and disclosure regulation in the UK, that transcend national boundaries in order to control slavery in supply chains operating in the developing world. Drawing on notions from the regulatory and sociology literature, i.e. transparency and normativity, and by interviewing anti-slavery activists and experts, this study explores the limitations of the disclosure and transparency requirements of the UK Modern Slavery Act and, more specifically, how anti-slavery activists experience and interpret (...) the new regulations and the regulators’ implementation of the regulation. This research found limited confidence among anti-slavery activists regarding the Act’s call for transparency in relation to the elimination of slavery from global supply chains. The research also found that the limits of the transparency provisions within the Act appear to hinder the attainment of normativity. This study provides new and unique insights into the critical role that social activists play in exposing the lack of corporate transparency and failures of responsibility to protect workers within global supply chains. (shrink)

The book discusses different models of world order, traditional and modern. Any practical application of the concept at issue will be affected by the prevailing power structure, and to some degree, reflect it. The reality of American preeminence in the world today needs to be reconciled with the demand for international legitimacy.

THE FIRST PART OF MY RESPONSE to the commentaries on my earlier paper is about the place of language and logical systems in the understanding of the personal positions that recovering patients occupy in their life experiences. It includes the main reasons for using Frege's philosophy. Thereafter, I make the point that relational positions in recovery extend broader than positions of actor and patient.

This paper presents the philosophical theory underpinning an empirical study that found changes in the semantic usage of first person pronouns by recovering psychotherapy patients. The philosophical theory provided semantic variables that could serve as markers of recovery. It derived from the semantic theory by Gottlob Frege and the logic of relations, and accounts for the meaning expressed by the first person pronouns as distinct from their syntax and pragmatic symbolization. This distinction is worthwhile because empirical evidence was found for (...) change in the meaning expressed by these pronouns during recovery, but not for change in their syntax or pragmatic symbolization. Philosophical work on the concepts of illness and recovery was used to deduce that the semantic variables are markers of recovery in general rather than in psychotherapy only. As with the empirical study, the semantic variables were shown to change as follows when someone recovers: occupancy of alpha positions is taken up and occupancy of omega positions is relinquished. Potential applications of these findings were examined by which the tracking of the semantic variables may serve to improve the clinician's understanding of a patient, monitor a patient's progress, and enhance recovery. (shrink)

What renders some mentally disordered patients incapable of informed consent to medical interventions? It is argued that a patient is incapable of giving informed consent owing to mental disorder, if a mental disorder prevents a patient from understanding what s/he consents to; if a mental disorder prevents a patient from choosing decisively; if a mental disorder prevents a patient from communicating his/her consent; or if a mental disorder prevents a patient from accepting the need for a medical intervention. This paper (...) holds that a patient's capacity to give informed consent should be assessed clinically by using these conditions necessary for informed consent, and should be assessed specifically for each intervention and specifically at the time when the consent has to be given. The paper considers patients' incapacity to give informed consent to treatment, to give informed consent to be examined clinically, and to give informed consent to participate in research. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Tribute to an Altruistic EditorWerdie van Staden, MD, PhDThis editorial celebrates the altruistic work of Professor John Sadler during his tenure as editor of Philosophy, Psychiatry, and Psychology. Since its founding about 31 years ago, he has done this behind-the-scenes work, principally to the benefit of our scholarly community, creating a space and opportunity for excellence in advancing the common interests of philosophers, psychiatrists, psychologists and the people (...) they serve professionally. Much of this dedication and efforts never reach the limelight whilst the journal enjoys increasing visibility and impact, ranking currently seventh among 328 philosophy journals and featuring on the 94th percentile. We may attribute this achievement to the authors of PPP, but behind this success story, John has been the vital oxygen in the breathing and energy production of PPP.Our senior editors who have been working under John's leadership for some time, attest as follows in reversed alphabetical order: Michael Wong writes,I once wondered how a psychiatric ethicist like John operates as a journal chief editor? Does he always ask three questions for every submission? Could I publish it? Would I publish it? Should I publish it? I found out very soon after I joined PPP as a Senior Editor that John is actually an editor of empathy and compassion, if there is indeed such an entity in academic publishing, who also has an objective and critical mind. He impresses me that he feels the vulnerability of those who submit a manuscript for peer scrutiny and sees the imbalance of the power relationship between the author and the reviewers. This perceptiveness however never distracts him from spotting the inconvenient truth that a submission still has a lot more to work on before it is ready for publication. I am truly grateful to John for the privilege to have worked with him and to learn from the maestro how to appreciate the effort every author puts into his or her work and how to convey unambiguous yet constructive critique in a collegial manner that does nothing but to further research and scholarship. John, your generosity and leadership will always be missed.Tim Thornton writesMy most striking experience of John's editorship of PPP came at the start of my connection with the journal. In 2014, I inherited from Bill Fulford – the founding editor – the role of UK editor of what was, at the time, a dual UK-USA edited journal. 2014 was a bad year for me – my parents both died and I spent a term living in a dark cell in a castle in the University of Durham – and I leant very heavily on John's help, assisted by the very capable Linda Muncy. Editing an interdisciplinary journal seemed to me at the time an almost [End Page 93] impossible task. Balancing clinical, philosophical and relevant other reviews was difficult and time consuming. One paper – a very fine submission taking a theologically informed look at depression – had been in the review process seemingly forever though its author was very understanding of the delays. But John (and Linda) graciously and practically accommodated my apprenticeship. John wisely pressed for both the move to a modern electronic submission system and the recruitment of more senior editors. Both of these seem necessary for the smooth running of a modern journal and are a marked contrast with the time when even using a spreadsheet and a Psion Organiser seemed the height of technology.But the mark of a good editor is not just practical and technological but rather making difficult decisions balancing widening access to publication with high academic standards. This is a particular challenge for philosophy and mental healthcare but one that John has managed with aplomb.Derek Strijbos writesHe was a central figure in the international academic field of philosophy and psychiatry ever since I was introduced to the topic by my supervisors here in the Netherlands, about 20 years ago. I met John at several conferences during the past decade, one of which was in Amsterdam in 2015, about scientism in psychiatry. I clearly remember the interesting conversation we had during dinner, in which explained his view on values in psychiatry... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 12.1 (2005) 77-78 [Access article in PDF] Language, Mind, and World Werdie (C. W.) Van Staden Keywords psychotherapy, linguistics, semantics, references, speech The paper by Mcconnell and Gillett touches, in a Lacanian way, on the connections between language, world, and the conscious and unconscious mind. Their paper brings together the influential ideas of Freud, philosophical phenomenology, existentialism, and structuralism in describing Lacan's approach to (...) these connections. Going further than Lacan's concerns in psychotherapy, their paper calls on us to consider the importance of these connections more generally in philosophy, psychiatry, and psychology.These connections matter substantially in the practice of psychiatry and psychology, for there we need to understand as much as possible of the ways in which language is intimately involved with the minds and brains of people and their biological and interpersonal worlds. Even at first glance, we can easily concede that people use language to express their troubled minds and their past, present, and anticipated relations with their biological and interpersonal worlds; that language use depends inescapably on brain functions (of the Broca and the Wernicke areas, for example); and that practitioners use language receptively and exploratively to access and examine the minds as well as the biological and interpersonal worlds of the people.Cognizant of the connections between language, mind, and world, language has received considerable attention in the psychotherapy literature and practice (e.g., Russell 1987), including from Lacan and his followers. In addition to these practices and theoretical expositions, empirical linguistic studies in psychotherapy have also been published recently (e.g., Van Staden in press; Van Staden and Fulford 2004; Spence 1995; Spence, Mayes, and Dahl 1994).There has been, furthermore, a growing interest in defining linguistic variables for empirical research in general psychiatry and psychology (Van Staden 2002; Thomas and Fraser 1994). The necessary and intimate role of language has also been reviewed recently in coming to a diagnostic understanding of people's difficulties (Van Staden 2003) and in conducting ethically sound assessments of mentally disordered people's capacity to give informed consent (Van Staden and Krüger 2003). Furthermore, the underlying connections between language, mind, and world, for example, have brought about the expectation that genetic factors in the etiology of schizophrenia would be related to the far-reaching capacity of human beings to use language (Crow 1997).A philosophical interest in the connections between language, mind, and world can be traced back to Plato. More recently, it has been taking a central place in analytic philosophy. The vast and sophisticated philosophical literature on this topic suggests that these connections are very [End Page 77] intricate and that we probably have an inchoate understanding of them. These connections are about theories of reference; theories of descriptions; semantic theories of truth; Kant's distinction between form and content; meaning; contextual content; linguistic pragmatism and speech act theories—all elaborate topics, of course, intertwined with various ontological commitments (cf. Luntley 1999).Lacan's contribution, driven by practical need albeit in the constrained area of psychotherapy, has not yet been taken up in analytic philosophy circles. The paper by McConnell and Gillett sets the scene for further philosophical examination that could determine whether Lacan's work does advance contemporary analytic philosophy on this topic. The most potential for such advance concerns probably, as indicated by McConnell and Gillet, insights about the unconscious mind.Notwithstanding a worthy philosophical examination of whether Lacan's work advances contemporary analytic philosophy on the connections between language, mind, and world, it may prove to be a challenging undertaking—probably even more challenging than the admirable groundwork done in the paper by McConnell and Gillett. The reason is, in my opinion, that the depth of Lacan's work is difficult to penetrate, in part because of the abundance of his esoteric terms, some of which are prima facie incommensurable with ordinary analytic language. The philosophical cogency of his work, moreover, is difficult to verify, because he often simply made conjectures, true as they might be, without explicating (sufficiently) the justification thereof.Lacan's work is commendable, however, even if... (shrink)

This study examines the central contention of instrumental stakeholder theory— namely, that firms that breed trust-based, cooperative ties with their stakeholders will have a competitive advantage over firms that do not. Acase study of the introduction ofgenetically modified food products in the Netherlands provided the basis for the empirical analysis. The results support the instrumental stakeholder management thesis, showing that stakeholder integration, through the development ofmutually enforcing relationships with external parties, may result in both organizational learning and societal legitimacy.

According to widespread opinion, the meaning of body part terms is determined by salient discontinuities in the visual image; such that hands, feet, arms, and legs, are natural parts. If so, one would expect these parts to have distinct names which correspond in meaning across languages. To test this proposal, we compared three unrelated languages—Dutch, Japanese, and Indonesian—and found both naming systems and boundaries of even basic body part terms display variation across languages. Bottom‐up cues alone cannot explain natural language (...) semantic systems; there simply is not a one‐to‐one mapping of the body semantic system to the body structural description. Although body parts are flexibly construed across languages, body parts semantics are, nevertheless, constrained by non‐linguistic representations in the body structural description, suggesting these are necessary, although not sufficient, in accounting for aspects of the body lexicon. (shrink)

New agrifood technologies are often difficult to grasp for the public, which may lead to resistance or even rejection. Insight into which technology features determine public acceptability of the technology could offer guidelines for responsible technology development. This paper systematically assesses the relative importance of specific technology features for consumer response in the agrifood domain in two consecutive studies. Prominent technology features were selected from expert judgment and literature. The effects of these features on consumer evaluation were tested in a (...) consumer study. Fictitious technologies were used to avoid any uncontrollable contextual influences that existing new technologies may evoke. Results show that technologies that were seen as more natural and newer were perceived less risky, more beneficial, and were evaluated more positively. Technologies applied to food were judged to be more beneficial, but also more risky than those applied to non-food. Technologies used in the production process were perceived to be less risky and evaluated more positively than those used in the product. Technologies owned by the market leader were perceived to be more beneficial, and evaluated more positively than those that were freely available. In a next study, effects of the technology features on consumer response were tested for existing new agrifood technologies. This study replicated the results for perceived naturalness, perceived newness, and place in the production process where the technology is applied. However, in contrast to the first study, we did not find an effect of application area and technology ownership. (shrink)

Sections R1 to R3 attempt to take the sting out of hostile commentaries. Sections R4 to R5 engage Berlin and Kay and the World Color Survey to correct the record. Section R6 begins the formulation of a new theory of colour as an engineering project with a technological developmental trajectory. It is recommended that the colour space be abandoned.

The article by Potter and Rif S. El-Mallakh read empathically, invokes a sense of fulfilment in their experiences, serving as inspiration for others to learn and practice ethics better. It describes their growth that has culminated to this sense of fulfilment and inspirational dignity. Crucial for this desirable growth has been, I want to highlight, their good investment in virtuous relationships and diligent processes. I also highlight from their article a potential conceptual restriction to growing in our learning and practicing (...) of ethics. That is, the restriction that occurs when blinded by too narrow a view on what ethics is about or where its emphasis is supposed to be. (shrink)

Introduction: In The Netherlands, physicians have to be convinced that the patient suffers unbearably and hopelessly before granting a request for euthanasia. The extent to which general practitioners (GPs), consulted physicians and members of the euthanasia review committees judge this criterion similarly was evaluated. Methods: 300 GPs, 150 consultants and 27 members of review committees were sent a questionnaire with patient descriptions. Besides a “standard case” of a patient with physical suffering and limited life expectancy, the descriptions included cases in (...) which the request was mainly rooted in psychosocial or existential suffering, such as fear of future suffering or dependency. For each case, respondents were asked whether they recognised the case from their own practice and whether they considered the suffering to be unbearable. Results: The cases were recognisable for almost all respondents. For the “standard case” nearly all respondents were convinced that the patient suffered unbearably. For the other cases, GPs thought the suffering was unbearable less often (2–49%) than consultants (25–79%) and members of the euthanasia review committees (24–88%). In each group, the suffering of patients with early dementia and patients who were “tired of living” was least often considered to be unbearable. Conclusions: When non-physical aspects of suffering are central in a euthanasia request, there is variance between and within GPs, consultants and members of the euthanasia committees in their judgement of the patient’s suffering. Possible explanations could be differences in their roles in the decision-making process, differences in experience with evaluating a euthanasia request, or differences in views regarding the permissibility of euthanasia. (shrink)

We seek to add to the Corporate Social Responsibility (CSR) and Sustainable Development (SD) literature through the empirical study of Latin American firm membership in the United Nations Global Compact (GC) and Global Report Initiative (GRI). Within an institutional-based framework, we explore through three filters – commercial, state-signaling, and distinguished peers – the impact of normative and mimetic pressures associated with GC/gri membership. Our sample includes 207 public firms from six Latin American countries (Argentina, Brazil, Chile, Colombia, Mexico, and Peru). (...) Our results suggest Latin American firms from countries with a greater European influence (normative pressure) are twice as likely to be enrolled in the GC/gri. Additionally, we find that Latin American firms listed on the NYSE (mimetic pressure) are also twice as likely to sign up under the GC/gri. Hence, the normative and mimetic pillars of institutional theory are found to be significant factors for Latin American firms adopting sustainability initiatives. (shrink)

The Oxford Handbook of Psychiatric Ethics is the most comprehensive treatment of the field in history. The volume is organized into ten sections which survey the scope of the text: Introduction, People Come First, Specific Populations, Philosophy and Psychiatric Ethics, Religious Contexts of Psychiatric Ethics, Social Contexts of Psychiatric Ethics, Ethics in Psychiatric Citizenship and the Law, Ethics of Psychiatric Research, Ethics and Values in Psychiatric Assessment and Diagnosis, Ethics and Values in Psychiatric Treatment. Written and edited by an international (...) team of experts, this landmark book provides a powerful and compelling review of psychiatric ethics in the 21st Century. (shrink)

The King Report on Corporate Governance (1994) evoked unprecedented interest in corporate governance in South Africa. This does not mean that corporate governance was not an issue of concern before the release of this historical report. To the contrary, corporate governance in its broader sense has been at stake since the inception of the first publicly owned companies in South Africa. This article intends to give an overview of corporate governance in South Africa. It starts by making a distinction between (...) broad and narrow conceptions of corporate governance. Before applying this distinction to the practice of corporate governance in South Africa, a brief overview of the corporate landscape in South Africa is provided. Then the South African situation with regard to broad and narrow corporate governance respectively is analysed. The article ends with a discussion of the review of corporate governance that currently is in the making in South Africa. Throughout the article both the financial and ethical dimensions of corporate governance is attended to. (shrink)

Newborn screening involves a complex logistical process, which depends on the close cooperation of many professionals, such as midwives, laboratory technicians, general practitioners and pediatricians. These professionals may encounter moral problems in the process, which have not been systematically studied before. This study fills this gap. We conducted interviews with 36 professionals involved in NBS in the Netherlands and made an inventory of the moral problems they encounter, as well as of the ways in which they tend to respond to (...) them. The moral problems professionals encounter stem from interpersonal conflicts and intrapersonal conflicts. Given the complexity of the work of NBS professionals, the study suggests that the moral problems that occur on the work floor cannot easily be solved by means of offering better or more stringent policy guidelines. Rather, it should be appreciated that professionals contribute significantly to shaping the morality of NBS with the help of their daily choices, and they should be supported in carrying out this task—for example with the help of a moral training or regular multidisciplinary moral deliberation, facilitated by an ethicist. (shrink)

Legal and moral reasoning share much methodology, and they address similar problems. This volume charts two shared problems: the relation between theory, principles and particular judgments; and the role of facts and factual assertions in normative settings. The relation between 'theory' and 'practice' and between 'principle' and 'particular judgment' has become the subject of much debate in moral philosophy. In the ongoing debate, some moral philosophers refer to legal philosophy for a support of their views on the primacy of 'practice' (...) over 'theory'. According to them, legal philosophy should have a more balanced view in that relation. In the contributions to Part One this claim is critically analysed. The role of the facts is underestimated in discussions on legal reasoning and legal theory, as well as moral reasoning and ethical theory. Factual statements enter into moral and legal discussions not only because they link the conclusion with a rule. They also play a role as background assumptions in supporting a theory. Its focus on the role of facts in normative reasoning makes this book of special interest to scholars of legal and moral argumentation. (shrink)

In paediatric oncology, research and treatments are often closely combined, which may compromise voluntary informed consent of parents. We identified two key scenarios in which voluntary informed consent for paediatric oncology studies is potentially compromised due to the intertwinement of research and care. The first scenario is inclusion by the treating paediatric oncologist, the second scenario concerns treatments confined to the research context. In this article we examine whether voluntary informed consent of parents for research is compromised in these two (...) scenarios, and if so whether this is also morally problematic. For this, we employ the account of voluntary consent from Nelson and colleagues, who assert that voluntary consent requires substantial freedom from controlling influences. We argue that, in the absence of persuasion or manipulation, inclusion by the treating physician does not compromise voluntariness. However, it may function as a risk factor for controlling influence as it narrows the scope within which parents make decisions. Furthermore, physician appeal to reciprocity is not controlling as it constitutes persuasion. In addition, framing information is a form of informational manipulation and constitutes a controlling influence. In the second scenario, treatments confined to the research context qualify as controlling if the available options are restricted through manipulation of options. Although none of the influences is morally problematic in itself, a combination of influences may create morally problematic instances of involuntary informed consent. Therefore, safeguards should be implemented to establish an optimal environment for parents to provide voluntary informed consent in an integrated research-care context. (shrink)

Background: One of the ethical imperatives for a valid consent process in clinical medication trials is that the process be guided by and recorded in an informed consent document (ICD). Concerns have been expressed, however, about readability and participant understanding of ICDs, which are often 10–20 pages long. Objective measures of readability and understanding have been used to support these concerns in several articles, but surprisingly the voice of trial participants on ICDs has not been heard in previous studies. Hence, (...) this study compares participants' subjective views on readability and their understanding of ICDs with those ICDs' objective readability scores. It also evaluates whether family, friends, and additional aids would foster better understanding of the ICD. Methods: Sixty current trial participants rated the readability and their understanding of deidentified standard ICDs. These had been sourced from two multicenter international Phase III trials on medication for diabetes mellitus and cancer. Results: Less than 10% of participants considered the ICDs difficult to read or difficult to understand in spite of objective readability scores at levels of about 12th grade education, but about a quarter considered the ICDs to be too technical. Participants gave mixed responses about friends or family members helping or the need for videos, pictures, additional reading material, and frequently answered questions (FAQ) sheets as an aid to their understanding. Conclusions: These findings suggest individual clinical trial participants should be engaged on their views of an ICD, for doing so is part of informed consent as a process rather than consent being merely focused on written information. Such participant-specific engagement should guide whether family and friends, videos, pictures, additional reading material, and FAQ sheets would be of assistance in improving understanding. (shrink)