Over the past decade, there has been an extensive debate about whether researchers have an obligation to disclose genetic research findings, including primary and secondary findings. There appears to be an emerging (but disputed) view that researchers have some obligation to disclose some genetic findings to some research participants. The contours of this obligation, however, remain unclear. -/- As this paper will explore, much of this confusion is definitional or conceptual in nature. The extent of a researcher’s obligation to return (...) secondary and other research findings is often limited by reference to terms and concepts like “incidental,” “analytic validity,” “clinical validity,” “clinical relevance,” “clinical utility,” “clinical significance,” “actionability,” and “desirability.” These terms are used in different ways by different writers to describe obligations in different sorts of cases. -/- Underneath this definitional confusion is a general notion, supported by much of the literature, that findings only need to be disclosed when they surpass certain presumably objective or measureable thresholds, such as medical importance or scientific reproducibility. The problem is that there is significant variability in the way that these terms and concepts are used in the literature and, as such, in defining the scope of an obligation to return findings that surpasses the relevant thresholds. -/- The goal of this paper is to analyze the definitional muddle underlying the debate about returning genetic research findings, with the hope of answering a few questions. First, what is the range of definitions being used in this debate? Based on an extensive literature review, Part 1 will lay out a range of articulated definitions for each relevant term, with the goal of categorizing them into a handful of distinct types. Part 2 explains the definitional redundancy and confusion in the current literature, and, drawing from the terminological patterns identified in Part 1, outlines more cohesive building blocks to inform the development of future disclosure frameworks.Our minimum goal in articulating these conceptual building blocks is to promote clearer articulations of, and distinctions between, future disclosure frameworks. More ambitiously, we suggest which definitions and conceptualizations we consider most appropriate to use in future disclosure frameworks. Here, we seek to balance benefits to participants through the disclosure of important information with the minimization of undue burdens on individual researchers and the research enterprise more generally. -/- Our analysis builds upon the central philosophical distinction between concepts and conceptions. The basic idea is that the “concept” of X refers to the general (and relatively uncontroversial) structure/shape of X, while various “conceptions” of X are more particular, filled out, and controversial elaborations of the concept. In other words, “concepts” of X will be formal representations of X, while “conceptions” of X will be substantive interpretations of the key elements and relationships operating within that formal framework. (Implicit in this distinction is an important point about the nature of disagreement – namely, that in order for two or more parties to “disagree” about X as opposed to simply talk past one another, there must be at least enough shared agreement about X to know that the parties are referring to the same thing. A concept of X provides this point of common agreement, while competing conceptions of X mark the areas where disagreement arises.) In this paper, we will employ this distinction in a fundamental way to clarify exactly where the primary disagreements arise in the debate over disclosing genetic research findings. -/- We propose that, underlying all the seeming confusion and disagreement, there are three central and widely agreed upon concepts at work in this debate—validity, value, and volition. The first two concepts concern the nature of the information itself. An obligation to disclose only exists when findings are valid and have value but there are competing conceptions of how to determine or define validity and valuableness. The third concept—volition—pertains not to the information but rather to the person to whom it will be disclosed. Does that person want or not want the information, and what is the best way of determining this? Here, too, competing conceptions arise. Our key point, though, is that almost all of the ethical disagreement arises because of competing conceptions of these three concepts. Understanding and appreciating this key point can help to refocus the substantive debate by providing some common ground to start from in determining how best to interpret these shared concepts. This refocusing can, ideally, produce more productive debate and facilitate some progress in resolving it. (shrink)

As has been widely observed, histories of feminism have often been conceived via notions of generation where feminism is positioned as a kind of familial property, a form of inheritance and legacy which is transmitted through generations. Thus feminism and its history have been imagined as following a familial mode of social reproduction. Despite the dominance of this model, it has nonetheless been subject to critique, not least because of its reliance on teleological and progressive notions of history. Judith Roof, (...) for example, has called for new conceptualizations of temporality in an attempt to decouple histories of feminism from a generational model. This need to move away from a generational model is also underscored by what commentators such as Angela McRobbie have identified as a dispersal of feminism – a broad-scale circulation of feminist values in popular culture – as well as by the emergence of a certain kind of reflexivity whereby past and current feminist practices are increasingly subject to critique. For McRobbie such developments are understood as part of the articulation of a post-feminism in which feminism can no longer be passed on as it is positioned as having already passed away. However, in this article via an exploration of recent accounts of the passing of feminism it is suggested that what allows for a declaration of this passing is an attachment to feminism as a particular way of knowing as well as to a particular arrangement of the social. Indeed, it will be suggested that recent histories of feminism and commentaries on the state of contemporary feminism are driven not only by generational logics but also by these attachments – attachments which lose and fix both feminism and women in time. (shrink)

This chapter contains section titled: Cartesian Philosophy and the Conduct of Life Putting the Pieces of Descartes's Ethical Writings Together: Cartesian Virtue Ethics Key Texts The “Perfect Moral System” and the Morale Par Provision Cartesian Virtue Descartes's Virtue Ethics and His Metaphysics and Epistemology, Revisited Conclusion Notes References and Further Reading.

This research brings together insights from philosophy, political theory, and consumer research in conceptualizing and empirically examining the social dimension of negative and positive freedom in consumption. Drawing from ethnographic observations and interviews with Moroccan women regarding their shopping at the supermarket, the findings detail the roles of husbands, store employees, extended family members and friends as constrainer, protector, enabler, facilitator, indulger, and witness. The discussion explains a ‘domino effect’ in such innovative marketplaces, as these market and social actors together (...) enact positive and negative forms of freedom in consumption in ways that co-disrupt social traditions. Implications for business ethics emphasize the need for greater theoretical understanding and practical transparency and accountability regarding the shared, yet disparate responsibilities among businesses and consumers for the changes to social traditions that result in the joint enactment of women’s freedom in consumption. (shrink)

Abram Brummett and Christopher Ostertag offer critiques of my argument that clinical ethics consultants have expertise but are not “ethics experts”. My argument begins within our less-than-ideal world and asks what a justification of a clinical ethics consultation recommendation might look like under those conditions. It is a challenge to what could be called an “inflationary” position on ethics expertise that requires agreement on or rational proof of metaethical facts about the values at stake in clinical ethics consultation. Brummett and (...) Ostertag critique three distinct steps in the argument. Two of those I have a brief answer for, and an assessment of the third demonstrates that Brummett and Ostertag do not consider the premise upon which I based my account. Instead, they assert a counter-premise without argument, which at best results in a stalemate between our two accounts. However, the reasons supporting my premise still seem to me to be stronger, so I am in the end unconvinced by their critiques. (shrink)

The grounds for global solidarity have been theorized and conceptualized in recent years, and many have argued that we need a global concept of solidarity. But the question remains: what can motivate efforts of the international community and nation-states? Our focus is the grounding of solidarity with respect to global inequities in health. We explore what considerations could motivate acts of global solidarity in the specific context of health migration, and sketch briefly what form this kind of solidarity could take. (...) First, we argue that the only plausible conceptualization of persons highlights their interdependence. We draw upon a conception of persons as ‘ecological subjects’ and from there illustrate what such a conception implies with the example of nurses migrating from low and middle-income countries to more affluent ones. Next, we address potential critics who might counter any such understanding of current international politics with a reference to real-politik and the insights of realist international political theory. We argue that national governments – while not always or even often motivated by moral reasons alone – may nevertheless be motivated to acts of global solidarity by prudential arguments. Solidarity then need not be, as many argue, a function of charitable inclination, or emergent from an acknowledgment of injustice suffered, but may in fact serve national and transnational interests. We conclude on a positive note: global solidarity may be conceptualized to helpfully address global health inequity, to the extent that personal and transnational interdependence are enough to motivate national governments into action. (shrink)

Americans increasingly cite moral values as a factor in how they vote, but when we define morality simply in terms of a voter's position on gay marriage and abortion, we lose sight of the ethical decisions that guide our everyday lives. In our encounters with friends, family members, nature, and nonhuman creatures, we practice a nonutilitarian morality that makes sacrifice a rational and reasonable choice. Recognizing these everyday ethics, Anna L. Peterson argues, helps us move past the seemingly irreconcilable conflicts (...) of culture and refocus on issues that affect real social change. Peterson begins by divining a "second language" for personal and political values, a vocabulary derived from the loving and mutually beneficial relationships of daily life. Even if our interactions with others are fleeting and fragmentary, they provide a viable alternative to the contractual and atomistic attitudes of mainstream culture. Everyday ethics point toward a more just, humane, and sustainable society, and to acknowledge moments of grace in our daily encounters is to realize a different way of relating to people and nonhuman nature—an alternative ethic to cynicism and rank consumerism. In redefining the parameters of morality, Peterson enables us to make fundamental problems such as the distribution of wealth, the use of public land and natural resources, labor and employment policy, and the character of political institutions the preferred focus of debate and action. (shrink)

The Football Association has been under pressure to allow girls to play in mixed teams since 1978, following 12-year old Theresa Bennett’s application to play with boys in a local league. In 1991, over a decade after Bennett’s legal challenge, the FA agreed to remove its ban on mixed football and introduced Rule C4 in order to permit males and females to play together in competitive matches under the age of 11. More recently, following a campaign by parents, coaches, local (...) Members of Parliament and the Women’s Sport Foundation, the FA agreed to trial mixed football for the under-12 to under-15 age categories in order to establish, among other things, the risk of injury to players in sex-integrated competitions. A series of exponential changes ensued: between 2010 and 2014, the age at which mixed football was permitted increased from U11 to U16. In 2015, the FA announced the decision to raise the age limit on mixed football from U16 to U18 for the forthcoming 2015–2016 season. We critically examine th... (shrink)

Film Ethics considers a range of films and texts of film criticism alongside disparate philosophical discourses of ethics by Levinas, Derrida, Foucault, ...

Rhetorical argumentation is a craft: collective, processual, and circulating, and it partakes in the indeterminate evolution of public norms. Official apologies can illustrate how rhetorical modalities over time can reflect change in civic sensibilities and effect collective moral reflection and evolution. Rhetorical citizenship, understood as encompassing both critical production and reception of publicly circulating arguments, is a way of conceptualizing the interaction between the individual and the collective in the ongoing discursive formation of the community and the norms that inform (...) it. (shrink)

This paper explores Ronald Dworkin’s influential theory of constructive interpretation. It points out that this theory admits of two readings, which I call the “undemanding” and the “demanding” conceptions of constructive interpretation respectively. As I argue, Dworkin’s own presentation of the theory equivocates between these two conceptions, the former of which is utterly unproblematic, but the latter of which incorporates certain philosophical prejudices as to what it must mean for a practice to be purposive.

I argue that a particular epistemological approach, “ecological thinking,” helps to demonstrate that long-term care work is organized transnationally—through health, economic, labor, and immigration policies established primarily by governments, transnational corporations, other for-profit entities, and international lending bodies—to create and sustain injustice against the dependent elderly and those who care for them, and to weaken the care capacities of countries and their health systems, especially those of source countries. An ecological approach also helps to reveal the grounding of global responsibilities (...) and an alternative conception of justice for long-term care and global health equity more generally. (shrink)

New mechanisms to ensure that counter ter ror ism ac t ivit ies do not contravene international law or ethical values and principles will require careful design. Apart from the ethical and legal grounds, there are good practical rea-sons to design more effective counterter-rorism measures. Preventable harms to population health contribute to mistrust and instability and undermine the stated objectives of the intelligence services.

A core area of phonology is the study of phonotactics, or how sounds are linearly combined. Recent cross‐linguistic analyses have shown that the phonology determines not only phonotactics but also the articulatory coordination or timing of adjacent sounds. In this article, I explore how the relation between coordination and phonotactics affects speakers producing nonnative sequences. Recent experimental results (Davidson 2005, 2006) have shown that English speakers often repair unattested word‐initial sequences (e.g., /zg/, /vz/) by producing the consonants with a less (...) overlapping coordination. A theoretical account of the experimental results employs Gafos's (2002) constraint‐based grammar of coordination. In addition to Gafos's Alignment constraints establishing temporal relations between consonants, a family of Release constraints is proposed to encode phonotactic restrictions. The interaction of Alignment and Release constraints accounts for why speakers produce nonnative sequences by failing to adequately overlap the articulation of the consonants. The optimality theoretic analysis also incorporates floating constraints to explain why speakers are not equally accurate on all unattested clusters. (shrink)

Bryan W. Van Norden's Taking Back Philosophy is a long-awaited and much-needed manifesto on multicultural curricula in the academic discipline of philosophy, which has up to now been stubbornly persistent in its monolithic approach to the teaching of its own self-defined genealogy, its origin, its methodology, and its very essence. As Van Norden points out, philosophy has a serious diversity problem. Only a handful of graduate programs have full-time faculty teaching non-Western philosophy.1 No other discipline in the humanities or social (...) sciences, other than those specifically designated as Anglo-European area studies, has been so lopsided in its curricula and student makeup as the resolutely and decisively... (shrink)

The Cambridge Companion to Locke now joins the long list of titles available in this excellent series. As we have come to expect, the contributors to this Companion are distinguished and the result is comprehensive and eminently useful. This volume is one of the more accessible in the series, with most of the chapters pitched at a level accessible to advanced undergraduates and especially helpful to beginning graduate students. Many of the chapters will be of considerable interest to scholars; here (...) I myself think especially of Edwin McCann’s chapter on Locke’s philosophy of body, which considerably advances our understanding of the place of mechanism in Locke’s thought. In addition, the notes, selective bibliography, and index of passages cited will serve as resources for readers at all levels of expertise. (shrink)

: The model of moral reasoning used in Institutional Review Board review fails to uphold ethical ideals for research participants for it does not adequately acknowledge the particular context of research or of subjects, including their gender, their socioeconomic status, and the communities in which they lead their lives. The ethical review of research needs to take seriously the particularities of the research context as well as the situations of potential participants. A variety of conclusions are drawn for changes to (...) the system for ethical review. Most significant is a call for effective consultation with the various communities affected by research and greater reliance on subject representatives. Also proposed is national review for selected research. (shrink)

This article engages the crisis of measure currently being articulated within social and cultural theory and the associated claim that this crisis should compel an embrace of methods which seek to know the heterogeneous, the multiple, the complex and the vague. Taking the rise of immaterial forms of labour and value as paradigmatic of the crisis of measure, it questions the use of the figure of a domestically labouring woman who lacks ownership of her labour to illuminate this crisis, as (...) well as the structural equivalence currently being forced between ‘women’s work’ (especially the work of social reproduction) and productive activities. It does so with reference to the changing relationship between women and social reproduction, a changing relationship which suggests that at the heart of the crisis of measure is a restructuring of time. This article therefore adds fuel to the view that the relations of temporality are now a key ground for feminist theory. (shrink)

When anthropologists and other social scientists study health services in medical institutions, tensions sometimes arise as a result of the social scientists and health care professionals having different ideas about the ethics of research. In order to resolve this type of conflict and to facilitate mutual learning, we describe two general categories of research ethics framing: those of anthropology and those of medicine. The latter focuses on protection of the individual through the preservation of autonomy expressed through the requirement of (...) informed consent whereas the former focuses on broader political implications. After providing an example of a conflict, we outline four issues that characterize the occasional clashes between social scientists and medical staff: (1) a discrepancy in the way anthropologists perceive patients and medical staff; (2) ambiguity concerning the role of medical staff in anthropological research; (3) impediments to informed consent in qualitative research projects; and (4) property rights in data. Enhanced dialogue could serve to invigorate the ethical debate in both traditions. (shrink)

This article presents the first author's experiences as an Australian doctoral student undertaking a PhD by publication in the arena of the social sciences. She published nine articles in refereed journals and a peer-reviewed book chapter during the course of her PhD. We situate this experience in the context of current discussion about doctoral publication practices, in order to inform both postgraduate students and academics in general. The article discusses recent thinking about PhD by publication and identifies the factors that (...) students should consider prior to adopting this approach, in terms of university requirements, supervisors' attitudes, the research subject matter, intellectual property, capacity and working style, and issues of co-authorship. It then outlines our perceptions of the advantages and disadvantages of undertaking a PhD by publication. We suggest that, in general, the advantages outweigh the disadvantages. We conclude by reflecting on how the first author's experiences relate to current discussions about fostering publications by doctoral students. (shrink)

This research study used descriptive phenomenological methods to investigate and document the lived experience of altruism as described by moral exemplars. Six moral exemplars wrote descriptions of situations in which they engaged in spontaneous altruism. Altruism was defined for the purpose of this study as a motivational state with the ultimate goal of increasing another's welfare . These descriptions were then expanded and clarified through follow up interviews. The results of this descriptive phenomenological analysis produced two structures: the structure of (...) the lived experience of altruism as described by moral exemplars, and the structure of the lived experience of helping as described by moral exemplars. The differences between these two structures suggest that altruistically motivated pro-social behavior is more committed, extensive and effective than egoistically motivated helping, and results in a higher level of concern for the long-term well-being of the individuals helped. Although differentiated by primary motivations, altruistic or egoistic, both structures identify the motivating factors of empathy, personal historical life experiences, moral values, and personal identity as essential to the experience of assisting another individual in need. (shrink)

Much modern scholarship on Delphic oracles has revolved around the question of authenticity, where authenticity implies it is a fact that there was a consultation of the Delphic oracle, that a response was given and that the account of these events reports the occasion of the consultation and the response verbatim. This article challenges the usefulness and validity of this definition on two grounds. First, there is ample evidence that most Delphic oracles circulated orally for at least a generation before (...) being recorded in writing. Therefore, Delphic oracles should be examined through what we know about orality from Homeric studies. Second, all six hundred or so oracles attributed to Delphi are fulfilled. This observation suggests that Delphic tales are religious testimonia and should be read for what they tell us about the beliefs, though not necessarily the facts and details, of the communities who circulated them. This article, then, both provides an alternate definition of authenticity that takes into account the oral transmission of these tales by communities of believers and comments on the nature of the historical evidence these tales provide. (shrink)

About one-third of Australians use the services of complementary and alternative medicine (CAM); but debate about the role of CAM in public healthcare is vociferous. Despite this, the mechanisms driving CAM healthcare choices are not well understood, especially in rural Australia. From 2016 to 2018, 2,679 persons from the Goulburn Valley, northern Victoria, were surveyed, 28% (755) of whom reporting visiting CAM practitioners. A Generalized Linear Mixed Model was used to assess associations between various socio-demographic variables and the use of (...) CAM services. The strongest significant inverse (p < 0.05) association with CAM use overall was being unemployed, with markedly lower odds of using CAM than those employed full-time (OR 0.22 [0.12, 0.41]). The next strongest inverse relationship was being retired (OR 0.44 [0.30, 0.65]). The strongest positive associations were with English spoken at home (OR 2.38 [1.34, 4.24]), private health insurance (hospital cover) (1.57 [1.28, 1.91]), being Australian born (OR 1.61 [1.14, 2.28]), and female sex (1.25 [1.02, 1.52])). Females had significantly higher odds of using osteopathy than males (OR 1.98 [1.33, 2.96]) but there were no significant sex differences for chiropractic or massage. This is the first such study conducted solely for a rural Australian population. The drivers of CAM use differed from previous nation-wide studies and they varied across modalities. The factors identified here as being associated with CAM use could be used by CAM practitioners in developing person-centred services. Similarly, the findings are relevant to primary-care services in understanding what sectors of society might eschew conventional health care for CAM in rural regions, where health services are often limited. (shrink)

The intersection of national security, foreign policy, and health has been explored in a number of arenas, but little attention has been devoted to the ethical issues surrounding the global health impact of current counterterrorism policy and practice. In this essay, we’ll review a range of harms to population health traceable to counterterrorism operations, identify concerns involving moral agency and responsibility—specifically of humanitarian health workers, military medical personnel, and national security officials and operatives—and highlight two interrelated policy issues: the need (...) for a conception of national security that incorporates a cosmopolitan concern for health, and the need for shared health governance, including governance of activities affecting health. (shrink)

Recent social and cultural theory has emphasized that in risk culture the achievement of a reflexive self-identity is a key resource, for example, in terms of employment, citizenship and intimacy. Commentators on shifts in the organization of health have also stressed the significance of achieving a self-reflexive identity. So, for example, knowing, self-monitoring subjects have emerged as optimal citizens in relation to health. While there is certainly some critical commentary on these kinds of moves, nevertheless reflexive sexual subjects in relation (...) to health have received less critical attention. In this article, through an analysis of HIV antibody testing and, in particular, by looking at the making of reflexivity through the practice of testing, I consider the emergence of a heterosexuality defined in terms of reflexivity. In so doing I suggest that reflexivity should not be understood - as many commentators suggest - as an effect but rather as constitutive of risk culture. (shrink)

One finds in the systems of natural languages some explicit means of elaborating not only upon the directness of the causal relationship believed to exist between two events X and Y (i.e. some means of specifying just how inevitably event X gives or gave rise to event Y), but also some manner of indicating just who or what is understood to be the primary instigator of the caused event. The goal of the present paper is to explore these notions in (...) detail and arrive at a formal, logic-based means of capturing them. (shrink)

Elise Reimarus was among the leading women intellectuals of eighteenth-century Hamburg. Rarely acknowledged today, her surviving writings contribute to central literary and philosophical debates in Europe at the time. This paper traces Reimarus’s intervention in controversy surrounding Joseph Addison’s tragedy Cato (1713) and its dramatization of republican liberty and virtue. Long erased from the literary canon, Reimarus’s German translation and adaptation (ca. 1776) radicalizes Addison’s critique of Cato’s Stoic leadership style. By rewriting the love-plots and foregrounding the women characters’ private (...) lives, her Cato engenders an alternative “art of politics”—one that steers a consequentialist path toward the common good. (shrink)

As a modern academic Ulysses, the historical scientist is enticed by numerous plausible scientific theories that can explain the historical data in search of the truth. However, the predicament of her work is to inevitably crash onto the rocks and cliffs of uncertainty. The problem discussed in this paper is that several scientific models can be suitable to account for the same empirical observations. The risk of falling into speculation is looming, and exceedingly dangerous in science. This is also the (...) case in archaeological sciences, such as bioarchaeology. A bioarchaeologist frequently encounters traces of disease in ancient skeletons, and pertinent patterns may often result from equally probable different causes. This is a methodological issue commonly encountered in the interpretation of pathological patterns in human remains, and constitutes part of the problem known in bioarchaeology as the osteological paradox. During an informal trilogue, three characters discuss the osteological paradox, and attempt to define it in philosophical terms. The aim of this work is to present the problems of scientists with the philosophical approach to the debate between scientific realism and antirealism, focusing in particular on the so-called problem of underdetermination. Our original approach is to apply the distinction between ‘how-possibly’ models and ‘how-actually’ models by Alisa Bokulich to archaeological issues, integrating various fields of science with a multidisciplinary and omnivorous approach. The trilogue ends providing the historical scientist with reasons and means to believe in her ability to conceive of true and reliable scientific models to interpret the historical past. (shrink)

Philosophers and physicians alike tend to discuss the physician-patient relationship in terms of physician privilege and patient autonomy, stressing the duty of the physician to respect the autonomy and the variously elaborated rights of the patient. The authors of this article argue that such emphasis on rights was initially productive, in a first generation of debate on medical ethical issues, but that it is now time for a second generation effort that will stress the importance of the unique experiential aspects (...) of the physician-patient relationship — mutual trust, suffering and healing. We attempt here to initiate this second-generation discussion, presenting the first generation's philosophical background, criticizing it from the perspective of clinical experience, and seeking a synthesis in the relational qualities of patient and physician interacting in a medical context. (shrink)

This paper argues that Epicurus held a non-reductionist view of mental states that is in the spirit of Davidson's anomalous monism. We argue for this conclusion by considering the role that normative descriptions play in the peritropē argument from "On Nature" 25. However, we also argue that Epicurus was an indeterminist. We can know that atoms swerve because we can know that we make choices that are up to us and this is incompatible with the ancestral causal determination of mental (...) states by atomic processes. Epicurus escapes the traditional criticism of indeterminist libertarians because the swerve is not meant to explain how choices may be free. The anti-reductionist stance on the mental means that nothing about atomic processes could possibly explain any particular mental event. Moreover, because of the practical and therapeutic nature of Epicurean philosophy, it is not necessary that Epicurus provide an explanation of how the swerve subserves freedom of choice. We know all that we need to know for eudaimonia when we know that some choices are up to us. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Closing the Gaps in Pediatric HIV/AIDS Care, One Step at a TimeLisa V. Adams, Helga Naburi, Goodluck Lyatuu, Paul Palumbo, and C. Fordham von ReynFatuma's* doctors were completely perplexed. It was 2003 and she had returned to the DARDAR clinic in her hometown of Dar es Salaam, Tanzania three times that week with vague complaints of various pains and aches. Her doctors were considering whether these symptoms were due (...) to the initiation of her recent treatment with antiretroviral medications for her HIV infection or related to the last administration of the investigational tuberculosis (TB) vaccine that the DARDAR Health Study was evaluating. Fatuma's doctor, Dr. Lillian Mtei, consulted with Dartmouth's chief of Infectious Disease, Dr. Ford von Reyn, who happened to be in Dar that week on a site visit. Neither physician could determine the basis for her symptoms. Dr. Mtei returned to the exam room once more and this time emerged with the answer: Fatuma had just learned that her three year old daughter was HIV-infected, likely contracted from Fatuma during or shortly after she gave birth to her daughter. Fatuma believed that her HIV diagnosis was a death sentence for her daughter since antiretroviral therapy was not widely available for children.Dr. von Reyn, Dartmouth's lead clinical researcher in Africa and a father, knew too well the harsh reality of inequities in a resource-limited country. He turned to Dr. Mtei and said decidedly, "we need to do something about this."Thus the DARDAR Pediatric Program was born.Pediatric HIV: A Neglected DiseaseThe need for HIV treatment among children in Tanzania, as in most of sub-Saharan Africa, is compelling. At the end of 2009, approximately 160,000 children aged zero to fourteen in Tanzania were living with HIV (Joint United Nations Programme on HIV/AIDS [UNAIDS], 2011). Even with successful roll out of prevention of mother to child transmission programs in Tanzania, there were nearly 29,000 perinatal infections in 2009. As of December 2010, only 18% of these were enrolled in HIV treatment programs (UNAIDS, 2011; World Health Organization [WHO], 2011). Without antiretroviral therapy (ART), one-half of HIV-infected children will die before their second birthday. Since clinical research to determine efficacy and safety of new medical treatments is conducted almost exclusively in adults, provision of new medical treatments to [End Page 75] children always lags behind advances for adults. Furthermore, children are often underrepresented in programs for antiretroviral drugs for the following reasons: 1) they are not prioritized for care; 2) facilities lack infant diagnostic capabilities; 3) there is limited pediatric HIV training and consequently, a shortage of pediatric providers; and 4) pediatric antiretroviral formulations are frequently unavailable. The unacceptable delays in pediatric HIV drug development and treatment access led the international organization Drugs for Neglected Diseases initiative to publish an editorial in which they referred to pediatric HIV as a "neglected disease" (Lallemant, Chang, Cohen, & Pecoul, 2011).The Tip of the Iceberg: More than Just MedicinesWith a grant from the New York-based Foundation for the Treatment of Children with AIDS, the DARDAR Pediatric Program, a joint collaboration between Geisel School of Medicine at Dartmouth and Muhimbili University of Health and Allied Sciences, began seeing patients in May 2006. It was the first dedicated pediatric HIV Care and Treatment Center in Tanzania and operates in accordance with Tanzania's National AIDS Control Programme's guidance. Testing for both children and infants (the latter of which requires a more sophisticated assay) is available.The day the clinic opened we celebrated this collaborative effort that would provide HIV-infected children in Dar es Salaam access to antiretroviral treatment. One of our first patients was a six-year-old boy whose mother, like Fatuma, was a participant in our TB vaccine trial. She had been advised to bring her son to us for HIV screening. Her son looked healthy so she was surprised and understandably distraught when his test results indicated that not only was he HIV-infected, but his CD4 percentage was very low. His mother was reluctant to have him started on antiretrovirals given his general appearance and young age—and that he was... (shrink)

Explains what lying is and why people do it; then discusses trust, living responsibly, and the value of telling the truth.

Bourdieusian Prospects considers the ongoing relevance of Bourdieu's social theory for contemporary social science. Breaking with the tendency to reflect on Bourdieu's legacies, it brings established and emergent scholars together to debate the futures of a specifically Bourdieusian sociology. Driven by a central leitmotif in Bourdieu s oeuvre, namely, that his work not be blindly appropriated but actively interpreted, contributors to this volume set out to map the potentials of Bourdieusian inflected social science. While for many social scientists the empirical (...) and theoretical developments of the twenty-first century mark a limit point of Bourdieusian social theory, this collection charts both how and why a Bourdieusian sociology has a future, which is crucial for the ongoing development and roll out of an engaged, relevant and critical social science. ". (shrink)

In recent social theory, there has been an emphasis on the emergence of non-market, non-cash nexus or what are sometimes referred to as `traditional' forms of organization in the economic sphere. These are sometimes represented as vital to innovation and as constituting the cutting edge of socioeconomic change. In this article, my concern is to interrogate these new modes of organization. Its main argument is that such traditional forms may go hand in hand with a retraditionalization of gender in terms (...) of employment. The innovation and creativity associated with such new economic formations is therefore called into question. (shrink)

Within the social sciences the widespread impact of the social capital concept has prompted strong critique on the part of feminists, for it is a concept which appears to reinstate a version of social worlds which for the past thirty years or more feminist social scientists have sought to problematize and move beyond. Yet do these critiques go beyond the social capital paradigm? It is the contention of this article that they do not and in particular that such critiques fail (...) to problematize the association of women with collective social goods found in the social capital literature. It will be suggested further that this association relates to the use of a dualism of instrumentality versus freedom, whereby women are overwhelmingly associated with the latter. This article therefore delineates a gendered subtext operative within the social capital debates. Recognition of this subtext should lead feminists to disengage with the social capital concept, for this is a concept whose use will always trap women in the social-historical time of industrial society. (shrink)