© 2015 NATCO, The Organization for Transplant Professionals.Despite the known benefits of kidney transplant, less than 30% of the 615 000 patients living with end-stage renal disease in the United States have received a transplant. More than 100 000 people are presently on the transplant waiting list. Although the shortage of kidneys for transplant remains a critical factor in explaining lower transplant rates, another important and modifiable factor is patients' lack of comprehensive education about transplant. The purpose of this article (...) is to provide an overview of known best practices from the broader literature that can be used as an evidence base to design improved education for ESRD patients pursuing a kidney transplant. Best practices in chronic disease education generally reveal that education that is individually tailored, understandable for patients with low health literacy, and culturally competent is most beneficial. Effective education helps patients navigate the complex health care process successfully. Recommendations for how to incorporate these best practices into transplant education design are described. Providing more ESRD patients with transplant education that encompasses these best practices may improve their ability to make informed health care decisions and increase the numbers of patients interested in pursuing transplant. (shrink)

As the gap between the need for and supply of human organs continues to widen, the aim of securing additional sources of these “gifts of the body” has become a seemingly overriding moral imperative, one that could—and some argue, should—override the widespread ban on organ markets. As a medical practice, organ transplantation entails the inherent risk that one human being, a donor, will become little more than a means to the end of healing for another human being and that he (...) or she will come to have a purely instrumental value. With the establishment of organ markets, not only will the harms of instrumentalization be a reality—the ends of medicine will be further compromised and confused. (shrink)

The history of the dyestuffs industry during the period 1775–1860 is interesting for three reasons. In the first place it was in connection with the manufacture of synthetic dyestuffs, begun in 1856, that the industrial research laboratory and the organization scientist first unmistakably appeared in the last decades of the nineteenth century. Secondly, there are the enigmas of W. H. Perkin, the man who discovered and manufactured the first coal-tar colours, but who retired somewhat abruptly from the industry in 1874: (...) just after the synthesis of alizarine. Thirdly, the dyestuffs industry was in intimate association with the textile industries which had for a long time been subject to frequent radical scientific and technological innovation. Among the most important of these we may mention John Smeaton's classic paper of 1759 on the maximum work obtainable from a given fall of water: a problem important not only for the abstract science of mechanics, but also for the design of waterwheels—the main source of power for the early textile mills. (The waterwheel was not, during the eighteenth century, the epitome of the quaint and picturesque: it was in the van of scientific and technical progress.) Again, the textile industries were quick to employ the Watt rotative engine; previously a two cylinder Newcomen engine had been tried out. Bleaching powders, based on Scheele's discovery of chlorine and its properties, were rapidly adopted: in this context one cannot help contrasting the indifference of medical science to Davy's early suggestion of using nitrous oxide as an anaesthetic; or Faraday's comment in 1818 on the anaesthetic power of sulphuric ether. The textile industries saw, over this period, a rapid succession of new machines, the pace of invention being so hot that in 1832 Charles Babbage reported that machines became obsolete long before they wore out. A Salford cotton mill was the first industrial establishment to use gas lighting: James Thomson, calico printer, introduced gas lighting to the town of Clitheroe when he installed it in his works. And there were many other important technical and scientific innovations. It was to supply these industries, so well accustomed to change, that the synthetic coal-tar dyestuffs were introduced from 1856 onwards. It is interesting that, so far as we can see, the appearance of these synthetic dyestuffs was the last in the series of major innovations in the textiles and related industries: at least until recent times. (shrink)

The National Science Foundation's Second Merit Criterion, or Broader Impacts Criterion , was introduced in 1997 as the result of an earlier Congressional movement to enhance the accountability and responsibility as well as the effectiveness of federally funded projects. We demonstrate that a robust understanding and appreciation of NSF BIC argues for a broader conception of research ethics in the sciences than is currently offered in Responsible Conduct of Research training. This essay advocates augmenting RCR education with training regarding broader (...) impacts. We demonstrate that enhancing research ethics training in this way provides a more comprehensive understanding of the ethics relevant to scientific research and prepares scientists to think not only in terms of responsibly conducted science, but also of the role of science in responding to identified social needs and in adhering to principles of social justice. As universities respond to the mandate from America COMPETES to “provide training and oversight in the responsible and ethical conduct of research”, we urge institutions to embrace a more adequate conception of research ethics, what we call the Ethical Dimensions of Scientific Research, that addresses the full range of ethical issues relevant to scientific inquiry, including ethical issues related to the broader impacts of scientific research and practice. (shrink)

The eight pieces constituting this Meeting Report are summaries of presentations made during a panel session at the 2011 Association for Practical and Professional Ethics (APPE) annual meeting held between March 3rd and 6th in Cincinnati. Lisa Newton organized the session and served as chair. The panel of eight consisted both of pioneers in the field and more recent arrivals. It covered a range of topics from how the field has developed to where it should be going, from identification of (...) issues needing further study to problems of training the next generation of engineers and engineering-ethics scholars. (shrink)

Cognitive Science, Volume 46, Issue 1, January 2022.

In lieu of an abstract, here is a brief excerpt of the content:President’s Council on BioethicsEdmund D. Pellegrino (bio) and F. Daniel Davis (bio)Approximately two weeks before what was to have been its final meeting, the White House dissolved the President’s Council on Bioethics by terminating the appointments of its 18 members. The letters of dismissal, dated 10 June 2009, informed the members that their service on the Council would end with the close of business the next day.The Council’s (...) term was set to expire on 30 September 2009. After President Obama’s election in November and during the transition, we were advised to proceed on the assumption that the Council would be permitted to cease on that date. Reasons for the abrupt move to disband the Council are unknown. We have accepted the fact that we Council members served at the pleasure of the President and that he simply exercised his rightful prerogative. No explanation is therefore required.Some observers have speculated that the action was retaliatory. They related to the fact that several members of the Council disagreed with the President’s stem cell policy in a signed statement published in the Hastings Center’s Bioethics Forum. Others have speculated that the move was pre-emptive. At its final meeting, scheduled for 25–26 June, the Council was set to sign-off on two of its final publications. One was a comprehensive report on the ethics of organ transplantation, and the other a white paper entitled Health Care and the Common Good. The aim was immediately to release the latter as a contribution to the intensifying debate about health care reform. Health Care and the Common Good could well have aided rather than impeded the President’s drive to better control health care costs and achieve universal coverage. The Council report attempted to ground both goals in the ethical framework of, as the title indicates, the common good of all Americans.In his letter terminating the members’ appointments, Assistant to the President for Presidential Personnel Don Gips said that the President “recognizes the values of having a commission of experts in bioethical issues to provide objective and non-ideological bioethics advice to his administration.” Gips went on to say that the President is “currently rethinking the purposes and goals of such a bioethics commission, and is carefully considering a revitalized mission and mandate.” And, [End Page 309] responding to media enquiries, White House press officer Reid Cherlin explained that the President’s Council was terminated because it was a “philosophically leaning advisory group” and, according to a New York Times account by Nicholas Wade, “because it favored discussion over developing a shared consensus.” As for the ultimate outcome of the President’s “rethinking,” Cherlin indicated that President Obama will appoint a new commission with the mandate of offering “practical policy options” in bioethics.In the light of our experiences with the Council, we leave it with hopes that certain questions of national importance will be addressed. In light of the nature of federal advisory commissions, what is or are the proper roles of a national bioethics commission? If the aim is to provide advice and counsel to the President or, perhaps to the U. S. Congress, is that advice best rendered as a group consensus or as an in-depth exploration of the inevitably conflicting ethical perspectives on a given issue? How should such a commission be constituted—with what sorts of individuals? And what is the nature of the expertise that they individually and collectively bring to the commission’s functions? If the commission is to promote public debate and discussion, how exactly should it go about that task? And how is the efficacy of a commission to be assessed? Such questions inevitably lead us deep into contested territory, as the experience of this Council has shown: into the intersections of politics, religion, and science and into the relations between practice and theory—between policy and what some seem to deride as “philosophy.” Indeed, policy without an underlying philosophy is an edifice without a foundation; philosophy without policy is a foundation without an edifice.At the last meeting of the Council in March 2009, we launched a discussion of these questions with the... (shrink)

In the atavistic model of cancer progression, tumor cell dedifferentiation is interpreted as a reversion to phylogenetically earlier capabilities. The more recently evolved capabilities are compromised first during cancer progression. This suggests a therapeutic strategy for targeting cancer: design challenges to cancer that can only be met by the recently evolved capabilities no longer functional in cancer cells. We describe several examples of this target‐the‐weakness strategy. Our most detailed example involves the immune system. The absence of adaptive immunity in immunosuppressed (...) tumor environments is an irreversible weakness of cancer that can be exploited by creating a challenge that only the presence of adaptive immunity can meet. This leaves tumor cells more vulnerable than healthy tissue to pathogenic attack. Such a target‐the‐weakness therapeutic strategy has broad applications, and contrasts with current therapies that target the main strength of cancer: cell proliferation. (shrink)

Three experiments investigated the relationship between subjective experience and attentional lapses during sustained attention. These experiments employed two measures of subjective experience to examine how differences in awareness correspond to variations in both task performance and psycho-physiological measures . This series of experiments examine these phenomena during the Sustained Attention to Response Task . The results suggest we can dissociate between two components of subjective experience during sustained attention: task unrelated thought which corresponds to an absent minded disengagement from the (...) task and a pre-occupation with one's task performance that seems to be best conceptualised as a strategic attempt to deploy attentional resources in response to a perception of environmental demands which exceed ones ability to perform the task. The implications of these findings for our understanding of how awareness is maintained on task relevant material during periods of sustained attention are discussed. (shrink)

This paper is one of the four interrelated action agenda papers resulting from the National Summit on Public Health Legal Preparedness convened in June 2007 by the Centers for Disease Control and Prevention and multi-disciplinary partners. Each of the action agenda papers deals with one of the four core elements of public health legal preparedness: laws and legal authorities; competency in using those laws; coordination of law-based public health actions; and information. Options presented in this paper are for consideration by (...) policy makers and practitioners — in all jurisdictions and all relevant sectors and disciplines — with responsibilities for all-hazards emergency preparedness.Advancing and protecting the public's health depends upon the coordination of actions by many, diverse partners. For effective public health preparedness, there must be effective coordination of legal tools and law-based strategies across local, state, tribal, and federal jurisdictions, and also across sectors such as public health, health care, emergency management, education, law enforcement, community design, and academia. (shrink)

BackgroundDespite rapid growth of the scientific literature, no consensus guidelines have emerged to define the optimal criteria for editors to grade submitted manuscripts. The purpose of this project was to assess the peer reviewer metrics currently used in the surgical literature to evaluate original manuscript submissions.MethodsManuscript grading forms for 14 of the highest circulation general surgery-related journals were evaluated for content, including the type and number of quantitative and qualitative questions asked of peer reviewers. Reviewer grading forms for the seven (...) surgical journals with the higher impact factors were compared to the seven surgical journals with lower impact factors using Fisher’s exact tests.ResultsImpact factors of the studied journals ranged from 1.73 to 8.57, with a median impact factor of 4.26 in the higher group and 2.81 in the lower group. The content of the grading forms was found to vary considerably. Relatively few journals asked reviewers to grade specific components of a manuscript. Higher impact factor journal manuscript grading forms more frequently addressed statistical analysis, ethical considerations, and conflict of interest. In contrast, lower impact factor journals more commonly requested reviewers to make qualitative assessments of novelty/originality, scientific validity, and scientific importance.ConclusionSubstantial variation exists in the grading criteria used to evaluate original manuscripts submitted to the surgical literature for peer review, with differential emphasis placed on certain criteria correlated to journal impact factors. (shrink)

A long-standing objection to the artistic pretensions of photography is that, because of the ‘causal’ nature of the process whereby a photographic image is produced, the formative intelligence of the photographer does not play a significant role in the generation of the image. Only where we can see such intelligence manifested in an image, it is claimed, can we legitimately take the representational content of the image to be a proper subject of artistic interest. I examine the most sophisticated modern (...) version of this argument in Roger Scruton's paper, ‘Photography and Representation’. I first critically examine Dominic Lopes's reconstruction of Scruton's argument and his proposed response to it. I then present an alternative analysis that brings out a central charge—what I term the ‘inscrutability’ argument that is obscured in Lopes's analysis. I then suggest how we can answer the inscrutability argument. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Addressing Alterity:Rhetoric, Hermeneutics, and the Nonappropriative RelationDiane DavisTeaching is not reducible to maieutics; it comes from the exterior and brings me more than I contain.—Emmanuel Levinas, Totality and InfinityThere is always the matter of a surplus that comes from an elsewhere and that can no more be assimilated by me, than it can domesticate itself in me. A teaching that may part ways with Heidegger's motif of our being (...) able to learn only what we already understand—when does learning take place? what do we already understand?—the Conversation belongs, as ethical relation, to the effort of thinking the infinite, the transcendent, the Stranger. None of this amounts to thinking an object.—Avital Ronell, DictationsFrom Rhetorical Power to Reception Histories Steven Mailloux has brilliantly performed and explicated a "rhetorical hermeneutics" that demonstrates the "practical inseparability of interpretation and language use and thus of the discourses that theorize those practices, hermeneutics and rhetoric" (1998, 3). Many rhetoricians have challenged the specifics of Mailloux's various arguments and have more generally objected that "rhetorical hermeneutics" leans too far toward the hermeneutical, reducing rhetoric to an analytic or critical art and giving its productive (political) function the squeeze.1 Yet within these lively debates, very few have challenged his basic premise that rhetoric and hermeneutics are inextricably intertwined: the question has not been whether they are indissociable but which side of the production-reception coin rhetorical studies ought to emphasize.2 Michael Leff, for example, flipped Mailloux's adjective-noun relation to spotlight production, promoting a "hermeneutical rhetoric" that focuses more on political than literary texts; nonetheless, he agrees that "all interpretive work involves participation in a rhetorical exchange, and that every rhetorical exchange involves some interpretive work" (1997, 197-98). [End Page 191] Rosa Eberly goes further in Citizen Critics, offering a hermeneutical rhetoric that is less interested in "already-written discourses" than in spotlighting "rhetoric's power as an art productive of discourses and subjectivities for the present and the future" (2000, 34). Yet Eberly, too, affirms Mailloux's basic premise, which was nudged in the direction of conflation in the introduction to the 1997 collection Rhetoric and Hermeneutics in Our Time, in which the editors, Walter Jost and Michael Hyde note in passing that their title can "be understood as virtually tautological."And there is of course no doubt that rhetoric has a hermeneutic dimension; or, more carefully, that rhetoric constitutes the hermeneutic dimension. If "hermeneutics" indicates "the art of understanding," as Friedrich Schleirmacher wanted, then interpretation clearly depends upon production.3 "Rhetoric not only has its place within the sphere of objects surveyed by hermeneutics," as Werner Hamacher puts it, "but also constitutes an integral component of every hermeneutic operation. Every step in an interpretation corresponds to a rhetorical—or grammatical—figure" (1996, 70). Put more bluntly: intelligibility, including self-intelligibility, is a tropological product; cognition itself is a trope that can in no way be secured. Hermeneutics—as it's being used here—is completely dependent on, even absorbed by, rhetoric.4 I have no problem with this. Nor with Mailloux's suggestion that the reverse is also true:In some ways rhetoric and interpretation are practical forms of the same extended human activity: Rhetoric is based on interpretation; interpretation is communicated through rhetoric. Furthermore, as a reflection on practice, hermeneutics and rhetorical theory are mutually defining fields: hermeneutics is the rhetoric of establishing meaning, and rhetoric the hermeneutics of problematic linguistic situations.(Mailloux 1998, 4)I don't disagree: As the production and appropriation of meaning, rhetoric and hermeneutics are an indissociable team; together, they complete understanding's circle. I take this as a given.However, I want to suggest that there is also a non-hermeneutical dimension of rhetoric that has nothing to do with meaning-making, with offering up significations to comprehension. This dimension is reducible neither to figuration nor to what typically goes by the name persuasion; it is devoted to a certain reception, but not to the appropriation of meaning. Preceding and exceeding all hermeneutic interpretation, it deals not in signified meaning but in the address itself, in the exposure to the other; it deals not... (shrink)

Late in 1990, the Center for the Study of Ethics in the Professions at Illinois Institute of Technology (lIT) received a grant of more than $200,000 from the National Science Foundation to try a campus-wide approach to integrating professional ethics into its technical curriculum.! Enough has now been accomplished to draw some tentative conclusions. I am the grant's principal investigator. In this paper, I shall describe what we at lIT did, what we learned, and what others, especially philosophers, can learn (...) from us. We set out to develop an approach that others could profitably adopt. I believe that we succeeded. (shrink)

The distinction between singular and multiple artworks is usually drawn modally in terms of the notion of an ‘instance’ of a work. Singular works, it is claimed, can only have a single instance, whereas multiple works allow of more than one instance. But this is enlightening only if we have a clear idea of what is meant by an ‘instance’. I argue that there are two different notions of a work's ‘instances’ in play in the literature – what I term (...) its ‘provenential instances’ (‘P-instances’) and its ‘purely epistemic instances’ (E-instances). I further argue that these notions are conflated in the literature critical of Gregory Currie's ‘instance multiplicity hypothesis’ (IMH) – the claim that all artworks are multiple in nature. I defend a modified version of the IMH as a claim about a work's E-instances against a range of criticisms. (shrink)

The relationship between ethics and job satisfaction for MIS professionals is examined empirically. Five dimensions of job satisfaction are examined: (1) satisfaction with pay, (2) satisfaction with promotions, (3) satisfaction with co-workers, (4) satisfaction with supervisors and (5) satisfaction with the work itself. These dimensions of satisfaction are compared to top management's ethical stance, one's overall sense of social responsibility and an ethical optimism scale (i.e., the degree of optimism that one has concerning the positive relationship between ethics and success (...) in his/her company).Results indicate that MIS professionals are more satisfied with the various dimensions of their jobs when top management stresses ethical behavior and when they are optimistic about the relationship between ethics and success within their firms. The one exception to this is pay satisfaction which is unrelated to these constructs. One's sense of social responsibility is also relatively unrelated to job satisfaction. (shrink)

Research indicates that actors who intentionally bring about harmful consequences are blamed more for their actions than those who do so unintentionally. However, in many instances of harmful behavior, intentions are ambiguous. The Culpable Control Model of Blame (CCM) predicts that the degree to which an actor is blamed for causing a harmful outcome is strongly influenced by information about the actor’s character, motives, or desires and that initial blame assessments impact important blame-related criteria such as judgements regarding the actor’s (...) intent. Deviant causal sequences, those in which negative outcomes occur in ways that the actor did not foresee, are highly unlikely, or are coerced, include circumstances that could mitigate assignment of blame. Such sequences provide a test of predictions derived from the CCM. Findings of three studies supported a model in which participants ascribed greater blame to an actor with opprobrious character, motives, or desires, which, in turn, affected judgments of a main criterion related to intent, and, in the last step, accounted for ascriptions of intent. These findings support the CCM’s contention that blame-reactions to an actor and outcome influence judgments about criteria, such as intent, that are often considered to be determinants rather than consequences of blame. (shrink)

At strategic moments in his very didactic letter to the church in Rome, Paul moves to poetic language and displays a sense of wonder at the heart of his doctrine of salvation.

Background: The Declaration of Helsinki, the World Medical Association’s statement of ethical guidelines regarding medical research, is published in the three official languages of the WMA: English, French and Spanish.Methods: A detailed comparison of the three official language versions was carried out to determine ways in which they differed and ways in which the wording of the three versions might illuminate the interpretation of the document.Results: There were many minor linguistic differences between the three versions. However, in paragraphs 1, 6, (...) 29, 30 and in the note of clarification to paragraph 29, there were differences that could be considered potentially significant in their ethical relevance.Interpretation: Given the global status of the Declaration of Helsinki and the fact that it is translated from its official versions into many other languages for application to the ethical conduct of research, the differences identified are of concern. It would be best if such differences could be eliminated but, at the very least, a commentary to explain any differences that are unavoidable on the basis of language or culture should accompany the Declaration of Helsinki. This evidence further strengthens the case for international surveillance of medical research ethics as has been proposed by the WMA. (shrink)

BackgroundCentral to ethically justified clinical trial design is the need for an informed consent process responsive to how potential subjects actually comprehend study participation, especially study goals, risks, and potential benefits. This will be particularly challenging when studying deep brain stimulation and whether it impedes symptom progression in Parkinson’s disease, since potential subjects will be Parkinson’s patients for whom deep brain stimulation will likely have therapeutic value in the future as their disease progresses.MethodAs part of an expanded informed consent process (...) for a pilot Phase I study of deep brain stimulation in early stage Parkinson’s disease, an ethics questionnaire composed of 13 open-ended questions was distributed to potential subjects. The questionnaire was designed to guide potential subjects in thinking about their potential participation.ResultsWhile the purpose of the study (safety and tolerability) was extensively presented during the informed consent process, in returned responses 70 percent focused on effectiveness and 91 percent included personal benefit as potential benefit from enrolling. However, 91 percent also indicated helping other Parkinson’s patients as motivation when considering whether or not to enroll.ConclusionsThis combination of responses highlights two issues to which investigators need to pay close attention in future trial designs: (1) how, and in what ways, informed consent processes reinforce potential subjects’ preconceived understandings of benefit, and (2) that potential subjects see themselves as part of a community of Parkinson’s sufferers with responsibilities extending beyond self-interest. More importantly, it invites speculation that a different paradigm for informed consent may be needed. (shrink)

Sober (1992) has recently evaluated Brandon's (1982, 1990; see also 1985, 1988) use of Salmon's (1971) concept of screening-off in the philosophy of biology. He critiques three particular issues, each of which will be considered in this discussion.

We analyze the effects of uncertainty on WTA, WTP and the WTA–WTP gap. Extending the approach of Weber (Econom Lett 80:311–315, 2003) to the case of lotteries, we develop an exact expression for the WTA–WTP gap that allows identification of its magnitude under different utility specifications. Reinterpreting and extending results by Gabillon(Econom Lett 116:157–160, 2012), we also identify generally the relationship between an agent’s utility of income and the gap’s algebraic sign, as well as the effects of risk increases on (...) WTA and WTP. Finally, we derive the limit behavior of the gap as income or risk increase. (shrink)

Background: The division of non-paid labor in heterosexual parents in the West is usually still gender-based, with mothers taking on the majority of direct caregiving responsibilities. However, in same-sex couples, gender cannot be the deciding factor. Inspired by Feinberg’s ecological model of co-parenting, this study investigated whether infant temperament, parent factors (biological relatedness to child, psychological adjustment, parenting stress, and work status), and partner relationship quality explained how first-time gay, lesbian, and heterosexual parents divided labor (childcare and family decision-making) when (...) their infants were four months and 12 months old. We also tested whether family type acted as a moderator. Method: Participants were drawn from [MASKED FOR REVIEW]. Only those who provided information about their biological relatedness (yes or no) to their child (N = 263 parents) were included. When infants were four months (T1), parents completed a password-protected online questionnaire exploring their demographic characteristics including work status and standardized online-questionnaires on task division (childcare and family decision-making), infant temperament, parental anxiety, parental depression, parental stress, and partner relationship satisfaction. When infants were 12-months-old (T2), parents provided information about task division and their biological relatedness to their children. Results: Linear mixed models showed that no factor explained the division of family decision making at T1 and T2. For relative time spent on childcare tasks at T1, biological relatedness mattered for lesbian mothers only: biologically related mothers appeared to spend more time on childcare tasks than did non-related mothers. Results showed that, regardless of family type, parents who were not working or were working part-time at T1 performed more childcare tasks at T1. This was still true at T2. The other factors did not significantly contribute to relative time spent on childcare tasks at T2. Conclusion: We had the opportunity to analyze the division of non-paid tasks in families where parenting was necessarily planned and in which gender could not affect that division. Although Feinberg’s model of co-parenting suggests that various factors are related to task division, we found that paid work outside the home was most important during the first year of parenthood in determining caregiving roles. (shrink)