ObjectivesTo describe reporting of informed consent in pragmatic trials, justifications for waivers of consent and reporting of alternative approaches to standard written consent. To identify factors associated with (1) not reporting and (2) not obtaining consent.MethodsSurvey of primary trial reports, published 2014–2019, identified using an electronic search filter for pragmatic trials implemented in MEDLINE, and registered in ClinicalTrials.gov.ResultsAmong 1988 trials, 132 (6.6%) did not include a statement about participant consent, 1691 (85.0%) reported consent had been obtained, 139 (7.0%) reported a (...) waiver and 26 (1.3%) reported consent for one aspect (eg, data collection) but a waiver for another (eg, intervention). Of the 165 trials reporting a waiver, 76 (46.1%) provided a justification. Few (53, 2.9%) explicitly reported use of alternative approaches to consent. In multivariable logistic regression analyses, lower journal impact factor (p=0.001) and cluster randomisation (p<0.0001) were significantly associated with not reporting on consent, while trial recency, cluster randomisation, higher-income country settings, health services research and explicit labelling as pragmatic were significantly associated with not obtaining consent (all p<0.0001).DiscussionNot obtaining consent seems to be increasing and is associated with the use of cluster randomisation and pragmatic aims, but neither cluster randomisation nor pragmatism are currently accepted justifications for waivers of consent. Rather than considering either standard written informed consent or waivers of consent, researchers and research ethics committees could consider alternative consent approaches that may facilitate the conduct of pragmatic trials while preserving patient autonomy and the public’s trust in research. (shrink)

Using data from 88 countries, we test hypotheses linking a country’s economic freedom and cultural values with the propensity and timing of decisions to impose stringent policies to combat the spread of Covid-19, as well as society’s compliance with those restrictive measures. Our analysis supports hypotheses that a country’s economic freedom and cultural dimensions of individualism and masculinity predict early implementation of stringent policies. After accounting for endogeneity, we find that individualism also helps explain residents’ compliance with stringent measures. These (...) findings illustrate how institutions and cultural values influence government policies and societal compliance. (shrink)

In this paper, I will present a problem for reductive accounts of knowledge-undermining epistemic luck. By “reductive” I mean accounts that try to analyze epistemic luck in non-epistemic terms. I will begin by briefly considering Jennifer Lackey's (2006) criticism of Duncan Pritchard's (2005) safety-based account of epistemic luck. I will further develop her objection to Pritchard by drawing on the defeasible-reasoning tradition. I will then show that her objection to safety-based accounts is an instance of a more general problem (...) with reductive accounts of epistemic luck. In short, they face a dilemma: they can either fail to vindicate the intuitive verdicts about cases or they can illicitly appeal to the epistemic vocabulary they are trying to reduce. The upshot is that we can only understand epistemic luck in terms of the assessment of the subject's reasons and we can't give a reductive account of that. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:74 Feminist Studies 46, no. 1. © 2020 by Feminist Studies, Inc. Jennifer L. Holland “Survivors of the Abortion Holocaust”: Children and Young Adults in the Anti-Abortion Movement During the last three decades of the twentieth century, children across the United States regularly encountered adults who both hailed them as survivors of a holocaust and pleaded with them not to perpetrate one. These adults were not talking about (...) war, at least not in a traditional sense. They were talking about legal abortion. Children and young adults often heard this pitch in school presentations like one made in the mid-1970s by a California anti-abortion group, United Parents Under God, in which pictures of aborted fetuses (whose “feet will never kick a football... run on a playground... or play hopscotch”) and their imagined lost life stories were the centerpiece. Next to pictures of aborted fetuses were pictures of two prematurely born infants of color (the only people of color in the presentation) who were supposedly in danger under Roe v. Wade. With murder hovering in the air, activists asked their teen audience, “Is someone you love next?” According to these California anti-abortion activists, young people were physically and intellectually vulnerable to pro-choice views because they inhabited “atheistic” classrooms “where evil can no longer be called ‘evil.’” “You are quite literally ‘trapped’ in a completely ‘pagan’ situation in our secular society and schools and we must reach you anyway we can,” they continued. In the so-called “pro-life” worldview, liberals were brainwashing children and young people through the media, public schools, and many other institutions. Jennifer L. Holland 75 “Women’s liberal abortion speakers,” political scientists, “who typically work for the STATE” and for whom the “ends justify the means,” and new “secular-science textbooks”—all were trying to frighten teenagers to “into killing [their] OWN OFFSPRING,” activists said. Anti-abortion women, “ordinary women... who LOVE you” according to the California presentation, sought to protect children while feminist “witches... distort [ed] God’s purposes of sexuality.”1 In order to counteract what they viewed as corruption, anti-abortion activists had to wage a counter -battle, politicizing children in order to make them innocent again. In practice, that meant bringing the abortion wars—with their attendant graphic imagery and discussions of immorality, murder, and “holocausts ”—into the haven of childhood. From the movement’s early days, anti-abortion activists waged their fight in the name of innocent young people; abortion, they said, was a genocide of children. While these activists were certainly not the only US movement to use the supposed vulnerability of children to elicit public support for their cause, they also did something different. For the anti-abortion movement, children and young adults were more than just endangered innocents; they were also potential perpetrators. Young people, it seemed, were more liberal than their elders, having allegedly been reared in and indoctrinated by liberal culture. They seemed, in short, to be a potentially pro-choice generation. Thus, adult activists spoke more to and about young people at the end of the century. Adults needed young people to speak for fetuses as “Survivors of the Abortion Holocaust,” but they also needed to convert and save America through them. The anti-abortion narrative of childhood vulnerability offered the restoration of social hierarchies as a solution to the problem of abortion. It was “women’s liberal abortion speakers” and feminist “witches” who were the sources of societal indoctrination. Pro-choice women separated sex and reproduction, thus undermining women’s role in society and changing their relationships with men. More subtly, anti-abortion 1. United Parents Under God, “That They May Live: A Presentation on Abortion,” n.d., folder 1, United Parents Under God Ephemeral Materials, Wilcox Collection of Contemporary Political Movements, Kansas Collection, Kenneth Spencer Research Library, University of Kansas. This publication was probably created in the early to mid-1970s because the few citations contained within are from between 1970 and 1973. 76 Jennifer L. Holland activists—who were almost always white—mourned the loss of past racial hierarchies while also envisioning theirs as a civil rights movement. In the California presentation mentioned above, activists explicitly compared abortion to mandated... (shrink)

In this paper, I provide the framework for an account of group assertion. On my view, there are two kinds of group assertion, coordinated and authority-based, with authority-based group assertion being the core notion. I argue against a deflationary view, according to which a group’s asserting is understood in terms of individual assertions, by showing that a group can assert a proposition even when no individual does. Instead, I argue on behalf of an inflationary view, according to which it is (...) the group itself that asserts, a conclusion supported by the fact that paradigmatic features of assertion apply only at the level of the group. A central virtue of my account is that it appreciates the important relationship that exists between most groups and their spokespersons, as well as the consequences that follow from this relationship. My view, thus, provides the framework for distinguishing when responsibility for an assertion lies at the collective level, and when it should be shouldered by an individual simply speaking for herself. (shrink)

Introduction -- From paideia to humanism -- Pietism and the problem of human craft (Menschen-Kunst) -- The harmonious harp-playing of humanity: J. G. Herder -- Ethical formation and the invention of the religion of art -- The rise of the Bildungsroman and the commodification of literature -- Authorship and its resignation in Goethe's Wilhelm Meister -- "The Bildung of self-consciousness itself towards science": Hegel.

There is reason for genuine puzzlement about Hume's aim in ‘The Natural History of Religion’. Some commentators take the work to be merely a causal investigation into the psychological processes and environmental conditions that are likely to give rise to the first religions, an investigation that has no significant or straightforward implications for the rationality or justification of religious belief. Others take the work to constitute an attack on the rationality and justification of religious belief in general. In contrast to (...) these views, I argue that Hume aims to establish two important claims in ‘The Natural History of Religion’. First, almost all popular religions, including popular monotheism, are deeply superstitious. Second, superstitious monotheism is incompatible with the variety of theism supported by the argument from design. This incompatibility puts significant pressure on the rational acceptability of popular religions. (shrink)

Numerous laws have passed to move away from criminalising youth who trade sex. Specialised courts have also been established to support youth. Despite proponents' contention that specialised, trauma-informed courts are less punitive than typical interventions, research is limited. This article explores one specialised dependency court's efforts to assist youth ‘at risk’. Drawing on interviews and ethnographic observations, I argue that laws and trauma-informed court interventions intensify the supervision of youth and families while inadvertently concealing the gendered-racialised effects of child welfare (...) system involvement. Ethnographic findings contribute to sociolegal and anti-carceral feminist research on carceral control beyond the criminal legal system. This work also explores the ethics of carceral-trauma entanglements that accompany decriminalisation’s afterlife. (shrink)

In this paper, I will argue that there is a deep connection between home-based care, technology, and the self. Providing the means for persons to receive care at home is not merely a kindness that respects their preference to be at home: it is an important means of extending their selfhood and respecting the unique selves that they are. Home-based technologies like telemedicine and robotic care may certainly be useful tools in providing care for persons at home, but they also (...) have important implications for sustaining selfhood in ways that are of value to individuals and those who care for them. I will argue, by appealing to Hilde Lindemann’s notion of “holding” persons’ identities in place, that technological interventions are not only useful tools for improving and sustaining health and good care at home, but that they may also help to extend our personal identities and relational capacities in ways that are practically and ethically good. Because of these important goods, I will claim that there is a prima facie moral duty to do this “holding” work and that it is best done by family members and loved ones who are well suited to the job because of their history and relationship with the individual that needs to be “held” in place. (shrink)

Ethicists, regulators and researchers have struggled with the question of whether incidental findings in genomics studies should be disclosed to participants. In the ethical debate, a general consensus is that disclosed information should benefit participants. However, there is no agreement that genetic information will benefit participants, rather it may cause problems such as anxiety. One could get past this disagreement about disclosure of incidental findings by letting participants express their preferences in the consent form. We argue that this freedom of (...) choice is problematic. In transferring the decision to participants, it is assumed that participants will understand what they decide about and that they will express what they truly want. However, psychological findings about people's reaction to probabilities and risk have been shown to involve both cognitive and emotional challenges. People change their attitude to risk depending on what is at stake. Their mood affects judgments and choices, and they over- and underestimate probabilities depending on whether they are low or high. Moreover, different framing of the options can steer people to a specific choice. Although it seems attractive to let participants express their preferences to incidental findings in the consent form, it is uncertain if this choice enables people to express what they truly prefer. In order to better understand the participants' preferences, we argue that future empirical work needs to confront the participant with the complexity of the uncertainty and the trade-offs that are connected with the uncertain predictive value of genetic risk information. (shrink)

Political corporate social responsibility (PCSR) calls for firms to implement and engage in deliberative democracy processes and structures, addressing governance gaps where governments are unwilling or unable to do so. However, an underlying assumption that the implementation of PCSR will enrich democratic processes in society has been exposed and challenged. In this conceptual article, we explore this challenge by developing a framework to reveal the dynamics of firms’ deliberative democratic processes and structures (meso level), and those at nation state (macro (...) level). Using existing cases as illustrative examples, we demonstrate that despite the public good premise of PCSR theory toward thickening the overall democracy in a society, corporate democratization at meso level can have the opposite effect and may actually erode macro-level democratic control of society and the economy. These findings imply a need for multilevel analysis in PCSR research and greater consideration of state-level public institutions and the responsibilities of business firms toward those institutions. Furthermore, we contribute to the PCSR literature by identifying the disruptive mechanisms associated with these dynamics and outline two alternative perspectives to allow firms to continue to take on political responsibilities. (shrink)

Emotional arousal and negative affect enhance recall of central aspects of an event. However, the role of discrete emotions in selective memory processing is understudied. Undergraduates were asked to recall and rate autobiographical memories of eight emotional events. Details of each memory were rated as central or peripheral to the event. Significance of the event, vividness, reliving and other aspects of remembering were also rated for each memory. Positive affect enhanced recall of peripheral details. Furthermore, the impairment of peripheral recall (...) was greatest in memories of anger, not of fear. Reliving the experience at retrieval was negatively correlated with recall of peripheral details for some emotions (e.g., anger) but not others (e.g., fear), irrespective of similarities in affect and intensity. Within individuals, recall of peripheral details was correlated with less belief in the memory's accuracy and more likelihood to recall the memory from one's own eyes (i.e., a field perspective). (shrink)

Commentators often claim that medical research subjects are coerced into participating in clinical studies. In recent years, such claims have appeared especially frequently in ethical discussions of research in developing countries. Medical research ethics is more important than ever as we move into the 21st century because worldwide the pharmaceutical industry has grown so much and shows no sign of slowing its growth. This means that more people are involved in medical research today than ever before, and in the future (...) even more will be involved. However, despite the pressing need for reflection on research ethics, it is important to carefully identify the concerns we have about research. Otherwise we run the risk that the moral language we use, and which we hear other people use, may do our moral thinking for us. We argue that many recent claims about the occurrence of coercion in medical research are misguided and misuse the word "coercion." We try to identify the real problems, and urge people to attend carefully to the implications of their descriptions of moral problems in research. (shrink)

Book synopsis: The aim of this collection of papers is to present different philosophical perspectives on the mental, exploring questions about how to define, explain and understand the various kinds of mental acts and processes, and exhibiting, in particular, the contrast between naturalistic and non-naturalistic approaches. There is a long tradition in philosophy of clarifying concepts such as those of thinking, knowing and believing. The task of clarifying these concepts has become ever more important with the major developments that have (...) taken place over the last century in the human and cognitive sciences - most notably, psychology, sociology, linguistics, neurophysiology, AI, and cognitive science itself. In all these sciences, there is a need to delineate the domain of the mental and to elucidate the key concepts and underlying assumptions. This need is widely recognized, but approaches and answers vary significantly. Some stress the representational features involved in most of our mental processes, others the inferential dimension; some stress the necessity of using empirical data, others the need to refine ideas before pursuing and drawing on empirical research. The papers collected in this volume are grouped into four parts, on language and thought, on knowledge, belief and action, on intentionality, and on naturalism. The volume will be welcomed by all those engaged and interested in debates about the mental in philosophy and the human and cognitive sciences. (shrink)

Internet-based health research is increasing, and often offers financial incentives but fraudulent behavior by participants can result. Specifically, eligible or ineligible individuals may enter the study multiple times and receive undeserved financial compensation. We review past experiences and approaches to this problem and propose several new strategies. Researchers can detect and prevent Internet research fraud in four broad ways: through the questionnaire/instrument ; through participants' non-questionnaire data and seeking external validation through computer information,, and 4) through study design. These approaches (...) each have pros and cons, and raise ethical, legal, and logistical questions, given that ethical tensions can emerge between preserving the integrity of research vs. protecting the privacy and confidentiality of study respondents. While past discussions concerning the ethics of online research have tended to focus on the participants' ability to trust the researchers, needs now arise to examine researchers' abilities to trust the participants. This analysis has several critical implications for future practice, policy, and research. (shrink)

How to characterize the relationship between science and technology has been a sensitive issue for historians of technology. This essay uses a recent and controversial piece by Paul Forman as a springboard for reexamining the concept of applied science and asks whether “applied science” remains a useful term. Scholars have often taken “applied science” to mean the subordination of technological knowledge to scientific knowledge—and thus the subordination of history of technology to history of science. This essay argues that the historical (...) moment for sensitivity on the subject of applied science has passed, that even in instances where technology can accurately be described as subordinate to science it need not follow that its history is subordinate, and that the concept can be useful in addressing issues in the history and contemporary practice of engineering education. (shrink)

In this paper I shall first expose a weakness shared by several philosophical discussions of self-deception: I shall show that these discussions have failed to give it a complete analysis. The apparent phenomenon of self-deception is all too familiar, and yet its adequate characterization in general terms is wanting. More exactly, I shall argue that to understand self-deception statically, as these accounts have done, has been—and must be—to fail to give a characterization of it as a state of mind, sufficient (...) to distinguish it from other mental states not born of self-deception. (shrink)

This volume argues that educational problems have their basis in an ideology of binary opposites often referred to as dualism, and that it is partly because mainstream schooling incorporates dualism that it is unable to facilitate the thinking skills, dispositions and understandings necessary for autonomy, democratic citizenship and leading a meaningful life. Bleazby proposes an approach to schooling termed social reconstruction learning, in which students engage in philosophical inquiries with members of their community in order to reconstruct real social problems, (...) arguing that this pedagogy can better facilitate independent thinking, imaginativeness, emotional intelligence, autonomy, and active citizenship. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Journal of the History of Ideas 61.2 (2000) 285-304 [Access article in PDF] Vacher de Lapouge and the Rise of Nazi Science Jennifer Michael Hecht * In the literature on the history of the Shoah the existence of a tradition of explicit anti-morality has been generally ignored. 1 This article argues that the materialist anthropology of the late nineteenth and early twentieth centuries waged a direct attack on (...) morality, which was described as inherently linked to religion. Strict materialism also denied any human access to the eternal except through biological lineage, linking the past, present, and future. This concern with procreation, which culminated in a desire to change the racial content of the world, led anthropology to aim its attack on morality on restrictive sexual mores and the injunction not to kill. Still, anti-morality was not conjured up in order to further eugenics; it was an independent idea and an explicit response to the loss of God. The anthropologist who best illustrates this scientific anti-morality is Georges Vacher de Lapouge, the French inventor of "anthroposociology." The present article explicates Lapouge's anti-morality and establishes a connection between his racial theories and those of a coterie of German colleagues. Most notable among these German colleagues was Hans Günther, whose vision had a role in shaping Nazi racial policy, in particular the Nazi interest in head measurements. Scholars investigating the origins of German racism have discovered French influence but have focused on Gobineau and his almost anti-scientific literary racism. This article argues that Lapouge and his scientific racism were also important.The relative significance of ideology in the "Final Solution" is the subject of some debate. This article seeks not to enter that debate but rather to reevaluate the nature of the ideology. It seems clear that whatever may have been the relative importance of ideas to, for instance, mundane careerism and conformity, the [End Page 285] ideas did play a role. 2 Within that context it will be demonstrated that Lapouge's anthroposociology helped to legitimate racialist utopianism. The scientific status of anthroposociology was deliberately engaged as propaganda for the regime, even after the specifics of its injunctions were no longer of much interest to the programmers of genocide.Whatever made people enact and accept genocide as daily routine, the idea of it came from somewhere, and somehow "the moral sensitivities" of the people were dulled. 3 Increasingly, historians stress that along with older forms of anti-Semitism, new scientific doctrines had a direct effect on events. There are a number of studies on the role of science in National Socialist doctrine, but they tend to be more about the role of doctors and the medical model of society than they are about anthropology. 4 Those that do deal with anthropology tend to mention Lapouge as an interesting forerunner but consistently fail to recognize his direct influence on Nazi doctrine. 5Lapouge's contribution to racism was a quantitative, well-written race theory that was replete with the language and tools of science. It was particularly appealing because it described a collection of human groups which sounded too scientific and clinical to be political. The value-laden descriptions of these clinical types (based on head shape) were easily transferred to known "racial" or social groups--with the simple claim that this or that group tended to have this or that head shape. Lapougian race theory was convincing because it was alien and yet confirmed familiar suspicions. It was thus highly instrumental in vitalizing dormant or mild prejudice. These ideas (and the endless columns of measurements and descriptions of head shapes) have grown so foreign to present day beliefs that they have become somewhat invisible to our eyes. Because of this, historians have not fully appreciated one of the important factors contributing to the "respectability" and credibility of a genocidal doctrine.In studying people who were guilty of unparalleled cruelty, historians expected to find moral agony and found instead a bureaucratic, mechanistic, banality. [End Page 286] In considering scientific racism, on the other hand, historians... (shrink)

Market incentives in capitalist economies and public health requirements are contradictory. In the COVID-19 pandemic, market-rewarded self-interested behavior has been exposed as a source of mortality and morbidity. Profit-motivated behaviors can keep people from accessing necessities for health thereby harming individuals and possibly damaging population health. The profit motive can also undermine healthcare system capacity by maldistributing goods that are inputs to healthcare. Furthermore, because profit-seeking is economically rational in capitalism, capitalist imperatives may be incompatible with public health. The ways (...) markets misallocate resources provide a rationale for state responsibility for health, which is a public good. (shrink)

Feelings associated with grief are regularly described as painful, but in what respect are they to be understood as pain? The acute pain of easily located tissue damage has long been the paradigm of pain in scientific and philosophical analysis, a dominance serving to obscure features the pain of grief might share not only with chronic pain but with some depressive suffering. Two examples of such commonalities are explored (ways pain feelings are experienced as in and of the body; and (...) are often recessed to the background of consciousness). These features are introduced to illustrate how a preliminary search for additional pain paradigms might proceed, and in so doing to offer some support for the proposal that pain endured as part of grieving may be real pain, not merely 'pain'. (shrink)

Among the ideas and themes in Burton’s Anatomy of Melancholy with apparent bearing on the treatment of depression in our own times, four are the subject of the present chapter. First, these herbal and other remedies were to be taken as part of a broader regimen of which no single part could be omitted. The regulation of exercise, fresh air, sleep, diet, evacuation, and feelings, believed to together keep the bodily humors in healthy balance, demanded habits and practices that were (...) essential accompaniments to one another and to other measures. This was eclectic and holistic healing, only effective when combined. Second, adhering to this regimen was, for the most part, the individual’s own responsibility: it was an extensive self-help program. Third, it was preventive medicine, thought to ward off the symptoms of melancholy before they became entrenched and difficult to treat. And, finally, underlying and reinforcing these practical recommendations were ideas about the causes of, and remedies for, melancholy that are consonant with some recent challenges to the application of mainstream conceptions of disease in today’s medicine when it comes to the treatment of depression. Inasmuch as he seems to eschew “common cause” etiological models, Burton’s account corresponds more closely to the network-based models beginning to be proposed for disorders of mood or affect. (shrink)

This paper applies a relational and familial ethic to address concerns relating to nursing home deaths and advance care planning during Covid‐19 and beyond. The deaths of our elderly in nursing homes during this pandemic have been made more complicated by the restriction of visitors even at the end of life, a time when families would normally be present. While we must be vigilant about preventing unnecessary deaths caused by coronavirus outbreaks in nursing homes, some deaths of our elders are (...) inevitable. Thus, it is essential that advanced care planning occurs in a way that upholds the familial and relational aspects of elders’ lives that often matter to them the most. We invoke concepts from feminist ethicists like Hilde Lindemann and Eva Kittay and introduce Avery Weisman and Thomas Hackett’s concept of “appropriate death” to suggest better ways of planning for those deaths of our elderly that cannot be avoided. Our hope is to allow for deaths that are as meaningful as possible for both the elderly and the family members who survive them. (shrink)

There is growing interest in the processes by which entrepreneurial opportunities are cocreated between entrepreneurs and their stakeholders. The longitudinal case study of de novo firm Wakefield Seafoods seeks to understand the underlying dynamics of phenomena that play out over time as stakeholders emerge and their contributions become essential to the opportunity formation process. The king crab data show that under conditions of uncertainty, characterized by incomplete or missing knowledge, entrepreneurial processes of experimentation, failure, and learning were effective in forming (...) and exploiting an opportunity. Moreover, contrary to existing literature that either emphasizes heroic entrepreneurs or downplays their value, this article shows that both the vision of the entrepreneur and the stakeholder contributions are critical. This detailed examination of process data shows that the cumulative actions made by entrepreneurs in concert with their stakeholders formed an opportunity that coalesced into a new market. (shrink)