The Médecins Sans Frontières ethics review board has been solicited in an unprecedented way to provide advice and review research protocols in an ‘emergency’ mode during the recent Ebola epidemic. Twenty-seven Ebola-related study protocols were reviewed between March 2014 and August 2015, ranging from epidemiological research, to behavioural research, infectivity studies and clinical trials with investigational products at early development stages. This article examines the MSF ERB’s experience addressing issues related to both the process of review and substantive ethical issues (...) in this context. These topics include lack of policies regarding blood sample collection and use, and engaging communities regarding their storage and future use; exclusion of pregnant women from clinical and vaccine trials; and the difficulty of implementing timely and high-quality qualitative/anthropological research to consider potential upfront harms. Having noticed different standards across ethics committees, we propose that when multiple ethics reviews of clinical and vaccine trials are carried out during a public health emergency they should be accompanied by transparent communication between the ECs involved. The MSF ERB experience should trigger a broader discussion on the ‘optimal’ ethics review in an emergency outbreak and what enduring structural changes are needed to improve the ethics review process. (shrink)

Médecins Sans Frontières is one of the world’s leading humanitarian medical organizations. The increased emphasis in MSF on research led to the creation of an ethics review board in 2001. The ERB has encouraged innovation in the review of proposals and the interaction between the ERB and the organization. This has led to some of the advances in ethics governance described in this paper.

Paradoxes are more than just intellectual puzzles - they raise substantive philosophical issues and offer the promise of increased philosophical knowledge. In this introduction to paradox and paradoxes, Doris Olin shows how seductive paradoxes can be, why they confuse and confound, and why they continue to fascinate. Olin examines the nature of paradox, outlining a rigorous definition and providing a clear and incisive statement of what does and does not count as a resolution of a paradox. The view that (...) a statement can be both true and false, that contradictions can be true, is seen to provide a challenge to the account of paradox resolution, and is explored. With this framework in place, the book then turns to an in-depth treatment of the Prediction Paradox, versions of the Preface/Fallibility Paradox, the Lottery Paradox, Newcomb's Problem, the Prisoner's Dilemma and the Sorites Paradox. Each of these paradoxes is shown to have considerable philosophical punch. Olin unpacks the central arguments in a clear and systematic fashion, offers original analyses and solutions, and exposes further unsettling implications for some of our most deep-seated principles and convictions. (shrink)

This book is a provocative contribution to contemporary ethical theory challenging foundational conceptions of character that date back to Aristotle. John Doris draws on behavioral science, especially social psychology, to argue that we misattribute the causes of behavior to personality traits and other fixed aspects of character rather than to the situational context. More often than not it is the situation not the nature of the personality that really counts. The author elaborates the philosophical consequences of this research for (...) a whole array of ethical theories and shows that, once rid of the misleading conception of motivation, moral psychology can support more robust ethical theories and more humane ethical practices. (shrink)

Do we know what we're doing, and why? Psychological research seems to suggest not: reflection and self-awareness are surprisingly uncommon and inaccurate. John M. Doris presents a new account of agency and responsibility, which reconciles our understanding of ourselves as moral agents with empirical work on the unconscious mind.

In this essay, Doris Santoro examines the discourse of “fidelity of instruction” to show how it is doublespeak for teacher compliance that is incompatible with democracy and education. Analyzing the distorted use of the term “fidelity” by market-based reformers, Santoro illustrates how it can be used as a weapon against teacher intelligence and moral response. She argues that John Dewey's philosophy provides conceptual resources to reframe some teacher infidelity as intelligent response, the moral agency required for pedagogical responsibility.

__Demoralized: Why Teachers Leave the Profession They Love and How They Can Stay_ offers a timely analysis of professional dissatisfaction that challenges the common explanation of burnout. _Featuring the voices of educators, the book offers concrete lessons for practitioners, school leaders, and policy makers on how to think more strategically to retain experienced teachers and make a difference in the lives of students. Based on ten years of research and interviews with practitioners across the United States, the book theorizes the (...) existence of a “moral center” that can be pivotal in guiding teacher actions and expectations on the job. Education philosopher Doris Santoro argues that demoralization offers a more precise diagnosis that is born out of ongoing value conflicts with pedagogical policies, reform mandates, and school practices. _Demoralized_ reveals that this condition is reversible when educators are able to tap into authentic professional communities and shows that individuals can help themselves. Detailed stories from veteran educators are included to illustrate the variety of contexts in which demoralization can occur. Based on these insights, Santoro offers an array of recommendations and promising strategies for how school leaders, union leaders, teacher groups, and individual practitioners can enact and support “re-moralization” by working to change the conditions leading to demoralization. (shrink)

ABSTRACT Benefit sharing aims to achieve an equitable exchange between the granting of access to a genetic resource and the provision of compensation. The Convention on Biological Diversity (CBD), adopted at the 1992 Earth Summit in Rio de Janeiro, is the only international legal instrument setting out obligations for sharing the benefits derived from the use of biodiversity. The CBD excludes human genetic resources from its scope, however, this article considers whether it should be expanded to include those resources, so (...) as to enable research subjects to claim a share of the benefits to be negotiated on a case‐by‐case basis. Our conclusion on this question is: ‘No, the CBD should not be expanded to include human genetic resources.’ There are essential differences between human and non‐human genetic resources, and, in the context of research on humans, an essentially fair exchange model is already available between the health care industry and research subjects. Those who contribute to research should receive benefits in the form of accessible new health care products and services, suitable for local health needs and linked to economic prosperity (e.g. jobs). When this exchange model does not apply, as is often the case in developing countries, individually negotiated benefit sharing agreements between researchers and research subjects should not be used as ‘window dressing’. Instead, national governments should focus their finances on the best economic investment they could make; the investment in population health and health research as outlined by the World Health Organization’s Commission on Macroeconomics and Health; whilst international barriers to such spending need to be removed. (shrink)

This article considers how we should frame the ethical issues raised by current proposals for large-scale genebanks with on-going links to medical and lifestyle data, such as the Wellcome Trust and Medical Research Council's 'UK Biobank'. As recent scandals such as Alder Hey have emphasised, there are complex issues concerning the informed consent of donors that need to be carefully considered. However, we believe that a preoccupation with informed consent obscures important questions about the purposes to which such collections are (...) put, not least that they may be only haphazardly used for research —an end that would not fairly reflect the original altruistic motivation of donors, and the trust they must invest. We therefore argue that custodians of such databases take on a weighty pro-active duty, to encourage public debate about the ends of such collections and to sponsor research that reflects publicly agreed priorities and provides public benefits. (shrink)

If the work carried out to gain a detailed understanding of the process of photosynthesis, and probably other types of bioenergetic conversions as well, fulfills the criteria of a molecular biology, and if the groups funding this research and those who worked in the laboratory regarded it as such, why has it been necessary for me to argue here that bioenergetics should always have been counted as part of - indeed, may have been in the forefront in establishing — the (...) molecular biology tradition? Why have the investigators themselves not insisted on correcting the historical record that has emerged thus far? I would like to offer two reasons: one institutional, the other scientific. (shrink)

Since trauma is a thoroughly relational phenomenon, it is highly unpredictable, and cannot be made to fit within the scientific framework Freud so admired. In _Toward a Psychology of Uncertainty: Trauma-Centered Psychoanalysis,_ Doris Brothers urges a return to a trauma-centered psychoanalysis. Making use of relational systems theory, she shows that experiences of uncertainty are continually transformed by the regulatory processes of everyday life such as feeling, knowing, forming categories, making decisions, using language, creating narratives, sensing time, remembering, forgetting, and (...) fantasizing. Insofar as trauma destroys the certainties that organize psychological life, it plunges our relational systems into chaos and sets the stage for the emergence of rigid, life-constricting relational patterns. These trauma-generated patterns, which often involve denial of sameness and difference, the creation of complexity-reducing dualities, and the transformation of certainty into certitude, figure prominently in virtually all of the complaints for which patients seek analytic treatment. Analysts, she claims, are no more strangers to trauma than are their patients. Using in-depth clinical illustrations, Dr. Brothers demonstrates how a mutual desire to heal and to be healed from trauma draws patients and analysts into their analytic relationships. She recommends the reconceptualization of what has heretofore been considered transference and countertransference in terms of the transformation of experienced uncertainty. In her view the increased ability of both analytic partners to live with uncertainty is the mark of a successful treatment. Dr. Brothers’ perspective sheds fresh light on a variety of topics of great general interest to analysts as well as many of their patients, such as gender, the acceptance of death, faith, cult-like training programs, and burnout. Her discussions of these topics are enlivened by references to contemporary cinema and theatre. (shrink)

Psychopaths appear to be ‘creatures apart’ – grandiose, shameless, callous and versatile in their violence. I discuss biological underpinnings to their pale affect, their selective inability to discern fear and sadness in others and a predatory orienting towards images that make most startle and look away. However, just because something is biologically underpinned does not mean that it is innate. I show that while there may be some genetic determination of fearlessness and callous-unemotionality, these and other features of the personality (...) may arise from developmental failures in the interpersonal reception of their emotions, needs and their sense of self. One is unlikely to be able to own inner experiences if shamed for having them, or if, having them, one does not know how to regulate and soothe. So psychopaths may learn to attend away and suppress them. Rather than a fully inherited difficulty, they may have become unable to reflect on inner states, so meta-emotions and self-reflective emotions like guilt and shame do not fully arise. They retain enough sensitivity to know their difference, and hide. I suggest that psychopaths are characterised by a nested sense of self, arising from the surprising effect of shame on these seemingly shameless characters. They do not have an integrated sense of self across context or across time or in relation to a generalised social other. With a nested sense of self, diminished intensity and scope of affective experience (in both directly experienced and vicarious forms) they lack textured access to a personal, owned and integrated past. Thus they lack the kind of access to the past required for a motivationally compelling planning of the future. They lack the emotional investment in the future that enables us to overcome the motivation to act opportunistically and myopically. These individuals live strangely in time. They have a fugitive sense of self and live nimbly among many pasts. They present an elegant and coherent mask to the person they are addressing in the moment and generate possible futures without conviction. (shrink)

This open access book provides original, up-to-date case studies of “ethics dumping” that were largely facilitated by loopholes in the ethics governance of low and middle-income countries. It is instructive even to experienced researchers since it provides a voice to vulnerable populations from the fore mentioned countries. Ensuring the ethical conduct of North-South collaborations in research is a process fraught with difficulties. The background conditions under which such collaborations take place include extreme differentials in available income and power, as well (...) as a past history of colonialism, while differences in culture can add a new layer of complications. In this context, up-to-date case studies of unethical conduct are essential for research ethics training. (shrink)

This open access book offers insights into the development of the ground-breaking Global Code of Conduct for Research in Resource-Poor Settings (GCC) and the San Code of Research Ethics. Using a new, intuitive moral framework predicated on fairness, respect, care and honesty, both codes target ethics dumping – the export of unethical research practices from a high-income setting to a lower- or middle-income setting. The book is a rich resource of information and argument for any research stakeholder who opposes double (...) standards in research. It will be indispensable for applicants to European Union framework programmes, as the GCC is now a mandatory reference document for EU funding. (shrink)

The 1992 Convention on Biological Diversity (CBD) and its 2010 Nagoya Protocol brought about a breakthrough in global policy making. They combined a concern for the environment with a commitment to resolving longstanding human injustices regarding access to, and use of biological resources. In particular, the traditional knowledge of indigenous communities was no longer going to be exploited without fair benefit sharing. Yet, for 25 years after the adoption of the CBD, there were no major benefit sharing agreements that led (...) to significant funding streams for indigenous communities. This changed with the signing of the Rooibos Benefit Sharing Agreement in South Africa, described in this paper. As the authors report, the Rooibos Agreement is a superlative in two respects. It is the biggest benefit sharing agreement between industry and indigenous peoples to date. It is also the first industry-wide agreement to be formed in accordance with biodiversity legislation. This article is a co-production between traditional knowledge holders, the lawyer who represented their interests, the Co-Chair of the Nagoya Protocol negotiations, and an ethicist who analyzed the major challenges of this historic agreement. With no precedent in the benefit sharing world, the agreement stands as a concrete example of the ‘art of the possible.’ Although the rooibos case is unique in a number of aspects, the experience offers many transferable insights, including: patience; incrementalism; honesty; trust; genuine dialogue; strong legal support; a shared recognition that a fair, win-win deal is possible; government leadership; and unity amongst indigenous peoples. Such ingredients of success can apply well beyond southern Africa. (shrink)

Why should all human beings have certain rights simply by virtue of being human? One justification is an appeal to religious authority. However, in increasingly secular societies this approach has its limits. An alternative answer is that human rights are justified through human dignity. This paper argues that human rights and human dignity are better separated for three reasons. First, the justification paradox: the concept of human dignity does not solve the justification problem for human rights but rather aggravates it (...) in secular societies. Second, the Kantian cul-de-sac: if human rights were based on Kant’s concept of dignity rather than theist grounds, such rights would lose their universal validity. Third, hazard by association: human dignity is nowadays more controversial than the concept of human rights, especially given unresolved tensions between aspirational dignity and inviolable dignity. In conclusion, proponents of universal human rights will fare better with alternative frameworks to justify human rights rather than relying on the concept of dignity. (shrink)

There is a widespread view that well-learned skills are automated, and that attention to the performance of these skills is damaging because it disrupts the automatic processes involved in their execution. This idea serves as the basis for an account of choking in high pressure situations. On this view, choking is the result of self-focused attention induced by anxiety. Recent research in sports psychology has produced a significant body of experimental evidence widely interpreted as supporting this account of choking in (...) certain kinds of complex sensorimotor skills. We argue against this interpretation, pointing to problems with both the empirical evidence and the underlying theory. The experimental research fails to provide direct support for the central claims of the self-focus approach, contains inconsistencies, and suffers from problems of ecological validity. In addition, qualitative studies of choking have yielded contrary results. We further argue that in their current forms the self-focus and rival distraction approaches both lack the theoretical resources to provide a good theory of choking, and we argue for an expanded approach. Some of the elements that should be in an expanded approach include accounts of the features of pressure situations that influence the psychological response, the processes of situation appraisal, and the ways that attentional control can be overwhelmed, leading to distraction in some cases, and in others, perhaps, to damaging attention to skill execution. We also suggest that choking may sometimes involve performance-impairing mechanisms other than distraction or self-focus. (shrink)

The Blochian concept of cipher is discussed in some detail with a view to possible developments in the modern philosophy of nature. Parallels and differences are listed as to the Idealistic tradition in Germany preceding Bloch’s approach. It is found that within the framework of a strict process philosophy of the Blochian type, life forms and human (reflexive) life in particular show up as systemic parts of a nature that is projecting itself towards what has not yet become, hence a (...) strong similarity to Schelling’s approach. (shrink)

Schemas contribute to adaptation, filtering novelty though knowledge-expectancy structures, the residue of past contingencies and their consequences. Adaptation requires a balance between flexible, dynamic context-sensitivity and the cognitive efficiency that schemas afford in promoting persistent goal pursuit despite distraction. Affects can form and disrupt schemas. Transient affective experiences systematically alter selectivity of attentiveness to the directly experienced present environment, the internal environment, and to the stored experiences of memory. Enduring personal stylistic predispositions, like implicit motives and affective schemas, influence how (...) experience is perceived, responded to, and integrated; they shape memory and influence present experiential patterns, individually and intersubjectively. Such systematic influences are potential sources of error in the study of memory if not mapped; so far, individual personality differences have just been a source of complication in the literature on emotion-congruent perception and memory. I synthesize what findings there are about how personality differences, emotions, and affects contribute to the structuring and integration of perceptions and memories both directly and by way of hot, affectively-anchored schemas. Case studies from experimental and personality psychology highlight a conception of personality and affective experience relevant to memory research and cognitive science. (shrink)

This paper deals with the particularities of vagueness in law. Thereby the question of the law’s capacity for vagueness is closely related to the question of the impact of vagueness in law, since exaggerated vagueness combined with the elasticity of legal interpretation methodology may affect the constitutional principles of legal certainty, the division of powers, and the binding force of statute. To represent vagueness and the instability of legal concepts and rules, a Hyperbola of Meaning is introduced, opposing Heck’s metaphor (...) of a core and a periphery of meaning. Furthermore, evidence is provided that the use of vague legal concepts and the capability of legal methodology to affect the specific meaning of those concepts, may give rise to astonishing and irrational changes of meaning of the law. Finally the paper sets out in search of an added value of vagueness in law, and weighs several stated pros and contras of vagueness. The paper is written against a background of the German speaking realm. (shrink)

In the dialogue between Timothy F. Murphy and Cristina Richie about queer bioethics and queer reproduction in this journal, significant points of the emergent and extremely important discussions on lesbian, gay, bisexual, transgender and queer bioethics are raised. Richie specifies correctly that queer bioethics can either complement or contradict LGBT bioethics and the queer standpoint against heteroconformity and heterofuturity is decisive here. As the field of queer bioethics is such a recent and essential part of consideration for bioethics and as (...) it is still evolving, the objective of this intervention is to provide both an overview of important milestones of queer bioethics and to highlight that queer bioethics is not mono-logic and monolithic. To exemplify queer bioethic's ‘many-headed monsters’, queer reproduction is revisited and complemented by a European viewpoint. It is central to my argument and here I disagree with Richie that to be against heterofuturity does not necessarily mean to be against queer reproduction. However, I also argue that there are other reasons why queer reproduction should not be pursued at all costs. Finally, I discuss the most recent debates on race, class and citizenship, for example, queer necropolitics. These points still need to be addressed in queer bioethical agendas. (shrink)