This paper reviews the technical and social problems concerned in donor insemination in the light of recent developments. The most important of these is the declining number of babies available for adoption by subfertile couples because modern methods and attitudes have reduced the number of unplanned births. At the same time the technique of donor insemination is being developed as public attitudes to it are changing.

The public communication of science and technology has become increasingly important over the last several decades. However, understanding the audience that receives this information remains the weak link in the science communication process. This essay provides a brief review of some of the issues involved, discusses results from an audience-based study, and suggests some strategies that both scientists and journalists can use to modify media coverage in ways that can help audiences better understand major public issues that involve science and (...) technology. (shrink)

The active debate about the return of incidental or secondary findings in research has primarily focused on return to research participants, or in some cases, family members. Particular attention has been paid to return of genomic findings. Yet, research may generate other types of findings that warrant consideration for return, including findings related to the pathology of donated biospecimens. In the case of deceased biospecimen donors who are also organ and/or tissue transplant donors, pathology incidental findings may be relevant not (...) to family members, but to potential organ or tissue transplant recipients. This paper will describe the ethical implications of pathology incidental findings in the Genotype-Tissue Expression project, the process for developing a consensus approach as to if/when such findings should be returned, possible implications for other research projects collecting postmortem tissues and how the scenario encountered in GTEx fits into the larger return of results/incidental findings debate. (shrink)

Book reviewed in this article: In That Case: Medical Ethics in Everyday Practice. By Alastair Campbell and Roger Higgs. Medical Genetics Casebook: A Clinical Introduction to Medical Ethics Systems Theory. By Colleen D. Clements. Cases in Bioethics from the Hastings Center Report. Edited by Carol Levine and Robert M. Veatch. Hastings‐on‐Hudson.

The Association of Research Ethics Committees is one of the leading providers of training and education for members of Research Ethics Committees. The introduction of the research governance strategy and the increasing complexity of ethical review place great demands on research ethics committee members that in turn creates challenges for training providers. This paper presents the outcome of an audit of REC members' views about training. Findings demonstrate that REC members are not a homogenous group. Several distinct sub-groups, each with (...) particular training needs emerged. All showed a preference for short, easily accessible events in which there were opportunities for discussion. (shrink)

There is limited consensus about what constitutes humanly sensitive care, or how it can be sustained in care settings. A new humanised care assessment tool may point to caring practices that are up to the task of meeting persons as humans within busy healthcare environments. This paper describes qualitative development of a tool that is conceptually sensitive to human dimensions of care informed by a life‐world philosophical orientation. Items were generated to reflect eight theoretical dimensions that constitute what makes care (...) feel humanly focused. An action research group process in 2014–2015 with researchers, service users, healthcare professionals in two diverse clinical settings (stroke rehabilitation and dermatology) was used. Feedback on conceptual content, transparency of meaning and readability was then gained from a panel in Sweden and third‐year student nurses in the UK. The tool can be applied to attune staff to human dimensions of care, offering items which point to concrete examples of humanising and dehumanising features of practice in ways that have not yet been fully captured in the caring literature. Based on theoretically led experiential items, with dedicated focus on what makes people feel more, or less than human, it may offer improvement on available assessments of care. (shrink)

Each contributor to this book has used personal experience as the basis from which to frame his individual sociological perspectives. Because they have personalized their work, their accounts are real, and recognizable as having come from 'real' persons, about 'real' experiences. There are no objectively-distanced disembodied third person entities in these accounts. These writers are actual people whose stories will make you laugh, cry, think, and want to know more.

Nel Noddings is arguably one of the premier philosophers of moral education in the English‐speaking world today. Although she is outside the mainstream theory, research, and practice traditions of cognitive‐developmentalism (the Kohlberg legacy) and of character education (which is in public ascendancy), her body of work is unrivalled for originality of insight, comprehensiveness and coherence. Whilst Carol Gilligan's In a different voice (1982) introduced the ethic of caring into academic and public discourse, it is Noddings ‘who has done most (...) to outline a specific feminist position on moral education’ (McClellan, 1999, p. 104), and whose influence extends to educational practice. This essay explicates Noddings's vision in sufficient depth to make the foregoing claims credible. Thematic focus is given to her attention to the ethical self or ethical ideal. The paper also examines Noddings's perspective on character education and the need to incorporate a morality of evil into any serious educational philosophy or practice. It is less a critical appraisal of that vision and perspective than an invitation to others to more fully engage with Noddings's writings.1. (shrink)

Emily Dickinson is the most paradoxical of poets: the very poet of paradox. By way of voluminous biographical material, not to mention the extraordinary intimacy of her poetry, it would seem that we know everything about her; yet the common experience of reading her work, particularly if the poems are read sequentially, is that we come away seeming to know nothing. We could recognize her inimitable voice anywhere—in the “prose” of her letters no less than in her poetry—yet it is (...) a voice of the most deliberate, the most teasing anonymity. “I’m Nobody!” is a proclamation to be interpreted in the most literal of ways. Like no other poet before her and like very few after her—Rilke comes most readily to mind, and, perhaps, Yeats and Lawrence—Dickinson exposes her heart’s most subtle secrets; she confesses the very sentiments that, in society, would have embarrassed her dog . Yet who is this “I” at the center of experience? In her astonishing body of 1,775 poems Dickinson records what is surely one of the most meticulous examinations of the phenomenon of human “consciousness” ever undertaken. The poet’s persona—the tantalizing “I”—seems, in nearly every poem, to be addressing us directly with perceptions that are ours as well as hers. The poems’ refusal to be rhetorical, their daunting intimacy, suggests the self-evident in the way that certain Zen koans and riddles do while being indecipherable. But what is challenged is, perhaps, “meaning” itself: Wonder—is not precisely KnowingAnd not precisely Knowing not—A beautiful but bleak conditionHe has not lived who has not felt—Suspense—is his maturer Sister—Whether Adult Delight is PainOr of itself a new misgiving—This is the Gnat that mangles men— [1331, ca. 1874]1 1. The Complete Poems of Emily Dickinson, ed. Thomas H. Johnson ; subsequent references in the text to the poems will cite the Johnson number and the date assigned by Johnson to each poem. Joyce Carol Oates is the Roger S. Berlind Distinguished Lecturer at Princeton University and the author most recently of the booklength essay On Boxing. “Soul at the White Heat” will be included in her book of essays, Writer: Occasions and Opportunities, to be published in the spring of 1988. (shrink)

This paper explores how Schutz’s ideas enrich and extend the ethic of care promulgated by feminist theorists such as Carol Gilligan, Nel Noddings, Sara Ruddick, and Eva Feder Kittay. Using Schutz’s ideas about the I-Thou relationship, systems of relevances, and growing old together, the author lays a foundation for continuing dialogue between feminist theorists of care and Schutzian phenomenologists.

Overdiagnosis refers to diagnosis that does not benefit patients because the diagnosed condition is not a harmful disease in those individuals. Overdiagnosis has been identified as a problem in cancer screening, diseases such as chronic kidney disease and diabetes, and a range of mental illnesses including depression and attention deficit hyperactivity disorder. In this paper, we describe overdiagnosis, investigate reasons why it occurs, and propose two different types. Misclassification overdiagnosis arises because the diagnostic threshold for the disease in question has (...) been set at a level where many people without harmful disease are nonetheless diagnosed. We illustrate misclassification overdiagnosis using the example of chronic kidney disease. Misclassification occurs in diseases diagnosed using biomarkers or based on patient reported phenomena. Maldetection overdiagnosis arises because, at the time the diagnosis is made and despite the presence of a 'gold standard' diagnostic test, it is not possible to discriminate between harmful and non-harmful cases of the index disease. We illustrate maldetection overdiagnosis using the example of thyroid cancer. While there is some overlap between misclassification and maldetection overdiagnosis, this conceptual analysis helps to clarify the phenomenon of overdiagnosis and is a necessary first step in developing strategies to address the problem. (shrink)

Bioethics, Volume 35, Issue 7, Page 623-633, September 2021.

Distributed Cognition is a hybrid approach to studying all aspects of cognition, from a cognitive, social and organisational perspective. The most well known level of analysis is to account for complex socially distributed cognitive activities, of which a diversity of technological artefacts and other tools and representations are an indispensable part.

Synthetic biology (synbio) involves designing and creating new living systems to serve human ends, using techniques including molecular biology, genomics, and engineering. Existing bioethical analyses of synbio focus largely on balancing benefits against harms, the dual-use dilemma, and metaphysical questions about creating and commercializing synthetic organisms. We argue that these approaches fail to consider key feminist concerns. We ground our normative claims in two case studies, focusing on the public good, who holds and wields power, and synbio research projects’ particularity (...) and context. Attention to feminist concerns is essential for synbio to realize its potential in ethically justifiable ways. (shrink)

Through 32 in-depth surveys with drag kings, I ask how do trans*/nonbinary individuals find a way to make a home in the Southeastern United States? I answer this by examining the use of drag kinging as a resource to explore gender identity and find resources for gender transition. This study adds to previous research on drag kinging by expanding beyond large cities and college towns to include a broader look at the Southeast, where queer lives have often been rendered invisible. (...) I highlight the importance of geographic location on attitudes about gender and resources available to trans*/nonbinary people. In contrast to other areas of the country, trans*/nonbinary drag kings in the Southeast use drag as a place to explore a “felt” identity that is stifled in the broader culture. (shrink)

This paper sketches an account of public health ethics drawing upon established scholarship in feminist ethics. Health inequities are one of the central problems in public health ethics; a feminist approach leads us to examine not only the connections between gender, disadvantage, and health, but also the distribution of power in the processes of public health, from policy making through to programme delivery. The complexity of public health demands investigation using multiple perspectives and an attention to detail that is capable (...) of identifying the health issues that are important to women, and investigating ways to address these issues. Finally, a feminist account of public health ethics embraces rather than avoids the inescapable political dimensions of public health. (shrink)

Surgery is an increasingly common and expensive mode of medical intervention. The ethical dimensions of the surgeon-patient relationship, including respect for personal autonomy and informed consent, are much discussed; but broader equity issues have not received the same attention. This paper extends the understanding of surgical ethics by considering the nature of evidence in surgery and its relationship to a just provision of healthcare for individuals and their populations.

Inclusion in research is a question of both scientific validity of research results and just distribution of the benefits of medical research within a community. Therefore, inappropriate exclusions from research can be regulated as a matter of science or a matter of ethics. In this paper we examine the definitions of appropriate/fair inclusion in the Australian and U.S. regulatory systems and discuss the processes for interpreting and implementing these normative standards. In the second part of the paper, we present original (...) results from the first study of sex-specific research in Australia. One hundred and thirteen published papers were examined: 35 percent were classified as inappropriate sex-specific research, where exclusion was not biologically necessary, and/or there was no justification for the exclusion of one sex. Our results indicate that a scientific approach to inclusion, rather than one grounded in ethical review, is likely to be more effective in achieving appropriate sex-specific research. In the absence of effective regulation, we will continue to see research that discriminates unfairly and perpetuates gender stereotyping. (shrink)

Trust is taken to be one of the foundational values in the doctor-patient relationship, facilitating access to the benefits of health care and providing a guarantee against possible harms. Despite this foundational role, some doctors betray the trust of their patients. Trusting involves granting discretionary powers and makes the truster vulnerable to the trustee. Patients trust medical practitioners to act with goodwill and to act competently. Some patients carry pre-existing vulnerabilities, for reasons such as gender, poverty, age, ethnicity, or disability, (...) and these vulnerabilities can be exacerbated when such patients extend their trust to a doctor. Gender stereotypes reduce women's ability to challenge and thereby assess their doctor's competency. In addition, women are more likely to be distrusted by their doctors and have their experiences of medical symptoms discounted. In this paper, we analyze two extreme examples of breaches of medical trust that exploited the vulnerability of women in the health care system: the "unfortunate experiment" at the National Women's Hospital in New Zealand and the Harold Shipman murders of elderly patients in the United Kingdom, examining the potential role of gender in the outcomes with regard to trust. Major breaches of medical trust such as these typically lead to government inquiries, revisions of ethical guidelines, and substantive policy change in an effort to re-establish public and patient trust. We argue that the medical profession has an ethical obligation to put mechanisms in place to protect vulnerable patients from abuses of trust, to monitor colleagues' competence, and to be prepared to blow the whistle to protect patients who are not in a position to recognize misplaced trust. Such mechanisms will act disprosportionately to reduce harm to women as patients. (shrink)

This article explores the affective dimension of resilient epistemological systems. Specifically, I argue that responsible epistemic practice requires affective engagement with nondominant experiences. To begin, I outline Kristie Dotson's account of epistemological resilience whereby an epistemological system remains stable despite counterevidence or attempts to alter it. Then, I develop an account of affective numbness. As I argue, affective numbness can promote epistemological resilience in at least two ways. First, it can reinforce harmful stereotypes even after these stereotypes have been rationally (...) demystified. To illustrate, I examine the stereotype of Black criminality as it relates to false confessions. Second, it can encourage “epistemic appropriation”, which I demonstrate by examining the appropriation of “intersectionality” and #MeToo by white culture. Finally, I conclude that resisting harmful resilience requires affective resistance, or efforts that target numbness via different kinds of affective engagement. I consider Kantian “disinterestedness” as a candidate. (shrink)

An international legal agreement governing the global antimicrobial commons would represent the strongest commitment mechanism for achieving collective action on antimicrobial resistance (AMR). Since AMR has important similarities to climate change—both are common pool resource challenges that require massive, long-term political commitments—the first article in this special issue draws lessons from various climate agreements that could be applicable for developing a grand bargain on AMR. We consider the similarities and differences between the Paris Climate Agreement and current governance structures for (...) AMR, and identify the merits and challenges associated with different international forums for developing a long-term international agreement on AMR. To be effective, fair, and feasible, an enduring legal agreement on AMR will require a combination of universal, differentiated, and individualized requirements, nationally determined contributions that are regularly reviewed and ratcheted up in level of ambition, a regular independent scientific stocktake to support evidence informed policymaking, and a concrete global goal to rally support. (shrink)

Today there is a tendency to do ethics on the basis of what I should like to call the “self-other model.” On this view, an action has no moral worth unless it benefits others–and not even then, unless it is motivated by altruism rather than selfishness. This radical rift between self-interest and virtue traces back at least to Philo of Alexandria, according to whom, “lovers of self, when they have stripped and prepared for conflict with those who value virtue, keep (...) up the boxing and wrestling until they have either forced their opponents to give in, or have completely destroyed them.” More recently, the distinction between those who value themselves and those who “value virtue” has been drawn sharply by Bernard Williams: “[I]n moral theory … it is not the Kantian leap from the particular and the affective to the rational and universal that makes all the difference; it is rather the Humean step–that is to say, the first Humean step–from the self to someone else.”. (shrink)

It is a commonplace to observe that we have been living through an extraordinary pan-European and trans-Atlantic populist moment. But do the heterogeneous phenomena lumped under the rubric “populist” in fact belong together? Or is “populism” just a journalistic cliché and political epithet? In the first part of the article, I defend the use of “populism” as an analytic category and the characterization of the last few years as a “populist moment,” and I propose an account of populism as a (...) discursive and stylistic repertoire. In the second part, I specify the structural trends and the conjunctural convergence of a series of crises that jointly explain the clustering in space and time that constitutes the populist moment. The question in my title is thus twofold: it is a question about populism as a term or concept and a question about populism as a phenomenon in the world. The article addresses both the conceptual and the explanatory question, limiting the scope of the explanatory argument to the pan-European and trans-Atlantic populist conjuncture of the last few years. (shrink)

Here is the first book to present Karl Marx as one of the great systematic philosophers, a man who went beyond the traditional bounds of the discipline to work out a philosophical system in terms of a concrete social theory and politico-economic critique. Basing her work on the Grundrisse (probably Marx's most systematic work and only translated into English for the first time in 1973), Gould argues that Marx was engaged in a single enterprise throughout his works, specifically the construction (...) of a systematic and philosophical theory of society. Gould examines five basic themes of Marx's social ontology: society, labor, causality, freedom, and justice, in five separate chapters, preceded by an introductory chapter explicating thesis and methods. The book shows how Marx's ontology, or theory of social reality, may be reconstructed from concrete details of his account of the historical stages of social development and from his analyses and critiques of capitalist economy. It clarifies further the value theory underlying Marx's critique of modern society and explores the question of how philosophy can play a major role in understanding and resolving social issues. This book will be of interest to all students of society, since it raises issues of the relationship of technologies to society and of the forms and prospects for socialism as a possible future society. It has deliberately been written in a style that makes the difficult, technical issues accessible to undergraduates just beginning to read Marx, as well as, of course, graduate students of social theory and specialized scholars. The lay reader will also be drawn to the particular content of this book and will enjoy the lucid, straightforward presentation. Marx's Social Ontology proposes a solution to a long-standing problem in interpretations of Marx: the apparent dilemma of his insistence on the ideal of full self-realization of the individual and his equal insistence on the ideal of full self-realization of the community. This is a book of major significance dealing with topics of enduring and current interest. (shrink)

Indirect routes by which gonadal hormones influence sexual differentiation are considered. In rats, differentiation may depend on the way in which the mother responds to the hormonal condition of her pups, and this has implications for the interpretation of the data for humans. Interaction between gonadal hormones and light experience in chicks is compared with the mammalian systems covered in Fitch & Denenberg's review.

That being than which a greater cannot be conceived.' This was the way in which the living God of biblical tradition was described by the great Medieval philosophers such as Augustine, Anselm and Aquinas.Contemporary philosophers find much to question, criticise and reject in the traditional analysis of that description. Some hold that the attributes traditionally ascribed to God - simplicity, necessity, immutability, eternity, omniscience, omnipotence, creativity and goodness - are inherently incoherent individually, or mutually inconsistent. Others argue that the divinity (...) described by philosophers cannot be the same as the providential God of revelation.In Perfect Being Theology Katherin A. Rogers defends the traditional approach, considering contemporary criticisms but concluding that the most adequate account of the nature of God should build upon the foundation laid by the Medieval philosophers.Written in a lively and accessible style and offering an important historical perspective, this book covers key areas of contention and many of the major ideas and thinkers from all sides of the debate are included. (shrink)