BackgroundThe Western-European concept of libertarian rights-based autonomy, which advocates respect for individual rights, may conflict with African cultural values and norms. African communitarian ethics focuses on the interests of the collective whole or community, rather than rugged individualism. Hence collective decision-making processes take precedence over individual autonomy or consent. This apparent conflict may impact informed consent practice during biomedical research in African communities and may hinder ethical principlism in African bioethics. This study explored African biomedical researchers' perspectives regarding informed consent (...) and potential limitations to the principle of respect for autonomy in African communities.MethodsWe conducted a qualitative study based on in-depth interviews with 12 biomedical researchers, five females and seven males aged 34 to 74 years, currently working at an African university. Interviews lasted 35–40 min each and involved semi-structured open-ended interviews, which allowed participants to offer information about their perceptions and feelings regarding respect for autonomy and informed consent as practised in Africa. Empirical data from the interviews were recorded, transcribed, and analysed using thematic content analysis, together with an interrogation of relevant scientific literature about African communitarian ethics, making evaluations and drawing inferences consistent with the empirical bioethics approach.ResultsBased on these interviews and analysis of relevant literature, we found that informed consent is difficult to apply in an African context because it derives from a Western conception of libertarian rights-based autonomy. Most respondents pointed out that it was challenging to implement informed consent in the African setting. Furthermore, communalism, customary beliefs, spirituality, and relational autonomy are predominant in most African communities, as exemplified by the African moral philosophies of Ubuntu/botho and Ukama, which emphasize communitarianism over individual rights. We also found that language, education, poverty, and cultural beliefs are barriers to obtaining proper informed consent in African communities.ConclusionsWe conclude that there are limitations to applying the principle of respect for autonomy and informed consent in African communities, especially in the context of human biomedical research. We recommend using a more relational approach, such as Ross’s prima facie duties, to implement informed consent in African communities. (shrink)

BackgroundThe issue of stigma is very important in the battle against HIV/aids in Africa since it may affect patient attendance at healthcare centres for obtaining antiretroviral medications and regular medical check-ups. Stigmatization creates an unnecessary culture of secrecy and silence based on ignorance and fear of victimization. This study was designed to determine if there is external stigmatization of people living with HIV and AIDS by health care workers at a tertiary hospital in KwaZulu-Natal province, South Africa. The study investigated (...) the impact of knowledge of HIV/aids by HCWs on treatment of patients, as well as the comfort level and attitude of HCWs when rendering care to PLWHA.MethodsA descriptive cross sectional study was designed to collect data using an anonymous self-administered structured questionnaire from 334 HCWs. The study was conducted in clinical departments of a large multidisciplinary 922-bed tertiary care teaching hospital in Durban, KZN.ResultsOverall HCWs had an above average knowledge about HIV/aids although some gaps in knowledge were identified. Tests of statistical significance showed that there was association between level of education and knowledge of HIV/aids ; occupation and knowledge of HIV/aids ; and gender and knowledge of HIV/aids. Test for comfort level was only significant for gender, with males showing more comfort and empathy when dealing with PLWHA. The study also revealed that patients were sometimes tested for HIV without informed consent before surgery, due to fear of being infected, and there was some gossiping about patients' HIV status by HCWs, thereby compromising patient confidentiality. The majority of HCWs showed a willingness to report incidents of stigmatization and discrimination to higher authorities, for better monitoring and control.ConclusionsAlthough knowledge, attitude and comfort level of HCWs taking care of PLWHA was above average, enforcement of existing antidiscrimination laws and continuing education in medical ethics and healthcare law, would greatly improve the performance of HCWs taking care of PLWHAs. More psychological support and counselling should be provided to HCWs, to further reduce the impact of stigmatization and discrimination against PLWHA. (shrink)

Mr Sylvester assesses Lowe's career and political importance, and argues for a reconsideration of his somewhat reactionary reputation.

'This book is an excellent, theoretically sound and politically relevant reader', Professor Wolfschaefer, Universitat des Bundeswehr, Hamburg 'Up to date complete overview of European monetary and fiscal policy issues. Highly readable, good mix of theory and data' 'I think the book contains a wealth of useful, precise information, presented in a straightforward, readable way in a quintessentially comparative perspective', Dr M Mclean, Royal Holloway University 'Excellent treatment - quite comprehensive, full references, accessible for non-economists', Charlotte Bretherton, Liverpool John Moores Univesity (...) 'A useful addition to student literature', MJ Macmillan, Exeter University 'This is a top class book and does not limit itself to assessing the adequacy of the European political economy to the precepts of advanced monetary economics...This book is an excellent tool for teaching EMU economics, and raising the level of EMU economics in the reaserch-field of international political economy. Students and scholars will appreciate the explicit assessment the authors make of complex economic issues, and their unbiased stance in the study of EMU economic and political interplay.' Miriam L.Campamella, Jean Monnet Professor, Faculty of Political Science, University of Turin. ECSA Review, Winter 2001This textbook offers a fresh and comprehensive examination of European monetary and fiscal policy in the third stage of Economic and Monetary Union. Professors Eijffinger and de Haan give a brief history of European economic integration before the transition to EMU, and continue with a comprehensive analysis of institutions, legislation, and policies. Their analysis includes the functions and goals of the European Central Bank, the Treaty on European Union, the Stability and Growth Pact, and the harmonization of taxes. Other topics discussed include the targets and instruments of European monetary policy, the integration of European financial markets, and the competition between financial institutions in Europe. (shrink)

Dans son article, Gaëlle Ferré propose une analyse de la production gestuelle de personnes souffrant d'aphasie, fluente ou non-fluente, qu’elle compare avec les gestes effectués par des locuteurs ne souffrant d'aucun trouble du langage. Elle vise à mieux comprendre ce qu'il advient des gestes lors des nombreuses dysfluences de la parole en tant qu’elles sont provoquées par le trouble du langage. Elle tente d'éclairer les liens qui existent entre parole et gestualité dans l'interaction multimo...

Non-Duality Questions, Non-Duality Answers is an organic, interactive exploration of non-duality--the understanding that in life there is no separation, only seamless Oneness. Designed to answer questions as they arise, this book invites readers to participate in the argument for non-separation, inquire about the nature of the self and the experience of liberation, and understand how non-dual awareness can impact our lives. With a unique blend of patience, compassion, respect, provocation, and humor, author Richard Sylvester helps frustrated spiritual seekers gain clarity (...) on what non-duality is--and what it isn't. (shrink)

At the time of his death in 1986, Robert Peter Sylvester was in the process of preparing this book for publication.

The 3rd Pan-African Ethics Human Rights and Medical Law (3rd EHRML) conference was held in Johannesburg on July 7, 2013, as part of the Africa Health Congress. The conference brought together bioethicists, researchers and scholars from South Africa, Zimbabwe, Kenya and Nigeria working in the field of bioethics as well as students and healthcare workers interested in learning about ethical issues confronting the African continent. The conference which ran with a theme of "Bioethical and legal perspectives in biomedical research and (...) medical practice in Africa with a focus on: Informed consent, HIV-AIDS & Tuberculosis, leadership & organizational ethics, patients and healthcare workers rights," was designed to expand the dialogue on African bioethics beyond the traditional focus on research ethics and the ethical dilemmas surrounding the conduct of biomedical research in developing countries. This introductory article highlights some of areas of focus at the conference including issues of leadership, organizational ethics and patients and healthcare workers rights in Africa. We analyze the importance of free speech, public debate of issues, argumentation and the need to introduce the teaching and learning of ethics to students in Africa in accordance with UNESCO guidelines. This article also focuses on other challenges confronting Africa today from an ethical standpoint, including the issues of poor leadership and organizational ethics which are main contributors to the problems prevalent in African countries, such as poverty, poor education and healthcare delivery systems, terrorism, social inequities, infrastructural deficits and other forms of 'structural violence' confronting vulnerable African communities. We believe that each of the eight articles included in this supplement, which have been rigorously peer-reviewed are a good example of current research on bioethics in Africa, and explore some new directions towards broadening the African bioethics agenda as we move forward to a new dawn for Africa in the 21st century. (shrink)

The term "callous" has not, to this point, been studied empirically or considered philosophically in the context of healthcare professionalism. It should be, however, because its uses seem peculiar. Sometimes "callous" is used to suggest that becoming callous confers a benefit of some protection against emotional distress, which might be considered expedient in the healthcare work environment. But, "callous" also refers to a person's unappealing demeanor of hardened insensitivity. The tension between these different moral connotations of "callous" prompts several empirical, (...) psychological, and moral questions; I introduce and entertain a few here. I also suggest a distinction between callousness and inurement and argue for why this distinction is important to appreciate and uphold in health professions education. (shrink)

This book evaluates the major debates around which the discipline of international relations has developed in the light of contemporary feminist theories. The three debates (realist versus idealist, scientific versus traditional, modernist versus postmodernist) have been subject to feminist theorising since the earliest days of known feminist activities, with the current emphasis on feminist, empiricist standpoint and postmodernist ways of knowing. Christine Sylvester shows how feminist theorising could have affected our understanding of international relations had it been included in the (...) three debates. She elaborates a feminist method of empathetically cooperative conversation which challenges the identity politics of IR, and illustrates that method with reference to the Greenham Common Women's Peace Camp and the efforts of Zimbabwean women to negotiate international funding for their local producer cooperatives. (shrink)

This book is a defense of political liberalism as a feminist liberalism. A novel and restrictive account of public reason is defended. Then it is argued that political liberalism's core commitments restrict reasonable conceptions of justice to those that secure genuine, substantive equality for women and other marginalized groups.

Christie is a member of the Department of Religious Studies at Baldwin-Wallace College, Cleveland, Ohio (U.S.A.).

Roots are good to think with indeed most of us use them as a metaphor every day. A root can signify the hiddenness of our beginnings, or, in its bifurcating structure, the various possibilities in the life of an individual or a collective. This book looks at rootedness as a metaphor for the genealogical origins of people and their attachment to place and how this metaphor transformed so rapidly in twentieth-century Europe. Christy Wampole s case study is France, with (...) its contradictory legacies of Enlightenment universalism, anti-Semitism, and colonialism. At one time, French nationalist rhetoric portrayed the Jews as unrooted and thus unrighteous people. After the two world wars, the root metaphor figured in the new French philosophy (notably Deleuze and Guattari). And recently, Caribbean thinkers in Haiti, Guadeloupe, and Martinique have debated whether their roots were in Africa, France, the Caribbean, or in some pan-national network that could not be identified on a map. Walpole argues that while the metaphor was perhaps once useful in the establishment of communities and identities, that usefulness has expired. The longer we remain attached to the figure of rootedness, the more discord it sows. Giving up on the metaphor of rootedness, Wampole urges, allows us to see at last that we are in fact unbound by the land we inhabit.". (shrink)

Is a feminist political liberalism possible? Political liberalism’s regard for a wide range of comprehensive doctrines as reasonable makes some feminists skeptical of its ability to address sex inequality. Indeed, some feminists claim that political liberalism maintains its position as a political liberalism at the expense of securing substantive equality for women. We claim that political liberalism’s core commitments actually restrict all reasonable political conceptions of justice to those that secure genuine substantive equality for all, including women and other marginalized (...) groups. In particular, we argue that political liberalism’s criterion of reciprocity limits reasonable political conceptions of justice to those that eliminate social conditions of domination and subordination relevant to reasonable democratic deliberation among equal citizens and that the criterion of reciprocity requires the social conditions necessary for recognition respect among persons as equal citizens. As a result, we maintain that the criterion of reciprocity limits reasonable political conceptions of justice to those that provide genuine equality for women along various dimensions of social life central to equal citizenship. (shrink)

Background: Informed consent (IC) is an ethical and legal obligation protected by constitutional rights to bodily integrity, well-being, and privacy in South Africa. The National Health Act 2003 codified IC regulations, requiring that all healthcare professionals inform patients about diagnosis, risks, benefits, options, and refusal rights while factoring in patients’ language and literacy levels. Objectives: This study’s primary aim was to determine the extent of South African professional/staff nurses’ compliance with current IC regulations and ascertain socio-cultural impediments impacting proper IC (...) practice. Methods: A cross-sectional survey using semi-structured questionnaires was used to evaluate knowledge and practice of IC among nurses in KwaZulu-Natal province. Data were analyzed using SPSS, v.21. Descriptive statistics, chi-squared tests, and content analysis were used to compare nursing domains. Results: Three hundred fifty-five (355) nurses, 92% females, with 1 to 41 years of professional experience, completed this study. Information disclosed by nurses to patients included diagnosis (77%), treatment benefits (71%), risks (69%), recommendations (65%), risks of refusal (80%), and right of refusal (67%). Nurses (80%) felt information disclosure was adequate, while 85% reported that patients understood disclosed information. Conclusions: Nurses practicing in local public hospitals had moderate knowledge of IC regulations. Practical implementation appeared deficient. Barriers to IC included language, workload, time constraints, lack of interpreters, and skewed gender norms in the nursing profession. Nurses require continuing professional education in healthcare law and ethics, a “corps of trained interpreters”, and gender transformation in the nursing profession to improve IC practice and overall quality of healthcare service delivery in South Africa. (shrink)

Publication date: 14 June 2017 Source: Author: Sylvester Tabe Arrey This work examines events from Cameroon's life since becoming a nation to foster understanding of the worrisome political situation the country has been traversing since 2016. Bitter and unhappy with their treatment since joining the French-speaking part, many citizens of the minority English-speaking part feel fed up and desire a breakup. I show that apart from constituting an aspect of its pride, Cameroon's history is also a source of tricky challenges (...) the country has been wrestling with since inception. I contend that issues of this kind will always be around if those in the country's cockpit fly it to a destination other than what satisfies and respects the two people – especially the one that moved the English-speaking part to opt for a joint destiny. Instead of toying with truth to score personal political points, authorities should yield to truth, operating in good faith to correct errors and heal hurt hearts so that both people will willingly, not by force, accept to work together. Contrary actions will risk the future. Happiness moves people to look at their history with pride finding things to build while pain stirs frustration and fury, moving them to search for flaws to fix or fight. I hold that both parts face almost the same challenges from unmet needs to emaciating struggles of survival. However, the English-speaking part has unique plaques that ache terribly and have nothing to do with the country’s general cry of lagging development. They touch on its identity and survival, unleashing pain many out of its shoes might fail to feel and so unable to understand the degree of excruciation. I caution that though it has been a show of two regions, the likelihood of someday evolving into a ten-region revolution is certain if wise and inclusive actions are not applied. Apart from groaning in their own pain, many among the other eight are sympathetic to the predicament of the lamenting two, expressing fury, first, against the denial by highly placed authorities of the existence of any problem, and second, in their ruthless and brutal treatment of those who complain or challenge their stance. Anger increased as people's patience waned. Their calm will not last if things stay unchanged. When arguments evolve and accommodate their worries they will get on board pushing the heat to levels officials will have problems containing without facing the temptation of fighting the people they are in office to protect. I end with recommendations the state and activists might find useful. They highlight measures that can help in a heterogeneous society like Cameroon to preserve peace and save it from becoming a scene of mayhem and butchery. (shrink)

Cet ouvrage est composé de vingt et un articles de Jacqueline Guillemin-Flescher (désormais JGF) soigneusement sélectionnés, réunis, édités et présentés par Maryvonne Boisseau, Hélène Chuquet, Jean Chuquet et Françoise Doro-Mégy avec la collaboration de Lucie Gournay, Agnès Leroux et Raluca Nita. Ces responsables éditoriaux sont soit des contrastivistes formés par JGF, soit appartiennent au groupe de chercheurs qui s’inscrivent dans la perspective de la linguistique contrastive inspirée par l...

Epistemic interactivism, an aspect of the epistemology of representation, is a cognitive intercourse between the subject and person-object of knowledge that underlies the conception of a person in Esan thought. Traditional theories of representation (especially as presented by Descartes and Locke) separated the subject from the object of knowledge, and classified persons and non-persons as object of knowledge. This separation and classification ignored the cognitive and moral values of persons, disengaged the subject from the world and burden the self with (...) solitude and isolation, and created propositional knowledge that dehumanised the relationship between the subject and person-object of knowledge. Within the theoretical framework of Hegel's epistemic interactivism (meliorated by Bowne's personalism) and Esan epistemology (in African philosophy), this book exposes the epistemic interactivism of Esan thought which unified the subject and person-object of knowledge on cognitive and moral grounds; thus providing adequate basis for personhood and resolving the dehumanised relationship between the subject and person-object of knowledge in the traditional theories of representation. Within the context of epistemic injustices, this book analyses the interactivist epistemology of indigenous Esan thought as an alternative epistemological conception of the person-object of knowledge which resolves the deficiency of the traditional theories of representation. (shrink)

Beginning with a discussion of why value neutrality on the part of the genetics counselor does not necessarily preserve autonomy of the counselee, the idea that social values unavoidably underlie the articulation of risks and benefits of genetic testing is made explicit. Despite the best efforts of a counselor to convey value neutral facts, risk assessment by the counselee and family is done according to normative analysis, experience with illness, and definitions of health. Each of these factors must be known (...) by the genetic counselor in order to relate those facts which she acknowledges as relevant to the decisions that will be made by those people seeking the genetic information. (shrink)

In writing Equal Citizenship and Public Reason, we aimed to show that political liberalism is a feminist liberalism. To that end, we develop and defend a particular understanding of the commitments of political liberalism. Then, we argue that certain laws and policies are needed to protect and secure the interests of persons as free and equal citizens. We focus on the laws and policies that we think are necessary for gender justice. In particular, we apply our view to the contexts (...) of prostitution law, family and marriage law, state support for caregivers, and religious exemptions from generally applicable laws. In this article, we consider some of the challenges made by the thoughtful critics who are part of this symposium. In particular, we address: why the collective enterprise view of liberal democracy requires shared reasons for the justification of certain laws and policies; how we understand substantive equality and why our understanding of substantive equality does not commit us to a comprehensive doctrine; how we avoid defending a particular political conception of justice in showing that political liberalism is a feminist liberalism; and how it is that, given justice pluralism, public reasons can provide stability for the right reasons. (shrink)

In their article “The Rise of Citizen Science in Health and Biomedical Research,” Wiggins and Wilbanks (2019) present a new typology for understanding the complex landscape of health and biomedical...

Gouvernance et libéralités de Saladin: D’après les données inédites de six documents arabes. Edited by Jean-Michel Mouyon; Dominique Sourdel; and Janine Sourdel-Thomine. Documents relatifs à l’histoire des croisades, vol. 22. Paris: AcadémIe des Inscriptions et Belles-Lettred, 2015. Pp. 148. €30.

With advancing rank in medical training comes increased academic and clinical responsibility, including education and supervision of trainees and junior staff. When I became a senior postdoctoral fellow sub‐specializing in neonatology, I assumed the role of co‐attending in the neonatal intensive care unit. At that point in my training, I felt well prepared for the challenging task. I would be in charge, make decisions independently with the team, and supervise, as well as teach, the junior fellows, residents, and practitioners. In (...) short, I would assume full responsibility for the care of the patients, their families, and the medical team. My mentor, an experienced attending, would discuss every patient with me each day, but would otherwise stand in the shadows, available for help and guidance when needed. On the very first day, one of the smaller premature babies on our service started having difficulty breathing, and it was soon clear that she would need to have her endotracheal tube reinserted. (shrink)

While ethicists have directed much attention to controversial biomedical issues--including euthanasia, abortion, and genetic engineering--they have largely ignored the less obvious, but more pervasive, everyday ethical problems faced by family physicians. Ethical Issues in Family Medicine addresses these problems, offering an ethics that reflects the distinctive features of family practice, and helping family physicians to appreciate the extent to which ethical issues influence their practice.

Convergence liberalism has emerged as a prominent interpretation of public reason liberalism. Yet, while its main rival in the public reason literature—the Rawlsian consensus account of public reason—has faced serious scrutiny regarding its ability to secure equal citizenship forallmembers of society, especially for members of historically subordinated groups, convergence liberalism has not. With this article, we hope to start a discussion about convergence liberalism and its (in)ability to address group-based social inequalities. In particular, we aim to show that given the (...) core features of the viewandreal-world pluralism, the policies needed to secure gender equality and protect equal citizenship for women will not be justified. We make our case by considering various inequalities that are due to the gendered division of labor and potential convergence liberal responses. (shrink)