Meat is a multi-billion-dollar industry that relies on people performing risky physical work inside meat-processing facilities over long shifts in close proximity. These workers are socially disempowered, and many are members of groups beset by historic and ongoing structural discrimination. The combination of working conditions and worker characteristics facilitate the spread of SARS-CoV-2, the virus that causes COVID-19. Workers have been expected to put their health and lives at risk during the pandemic because of government and industry pressures to keep (...) this “essential industry” producing. Numerous interventions can significantly reduce the risks to workers and their communities; however, the industry’s implementation has been sporadic and inconsistent. With a focus on the U.S. context, this paper offers an ethical framework for infection prevention and control recommendations grounded in public health values of health and safety, interdependence and solidarity, and health equity and justice, with particular attention to considerations of reciprocity, equitable burden sharing, harm reduction, and health promotion. Meat-processing workers are owed an approach that protects their health relative to the risks of harms to them, their families, and their communities. Sacrifices from businesses benefitting financially from essential industry status are ethically warranted and should acknowledge the risks assumed by workers in the context of existing structural inequities. (shrink)

Background: The literature and research on nursing ethics and advocacy has shown that generally very few nurses and other clinicians will speak up about an issue they have witnessed regarding a patient advocacy concern and that often advocacy in nursing is not learned until after students have graduated and begun working. Objective: To evaluate the effectiveness of narrative pedagogy on the development of advocacy in student nurses, as measured by the Protective Nursing Advocacy Scale. Design: We tested the hypothesis that (...) use of a narrative pedagogy assignment related to ethics would improve student nurse’s perception of their advocacy role as measured by the Protective Nursing Advocacy Scale using a quasi-experimental nonrandomized study using a pre-test, intervention, post-test design. Data collection occurred during class time from October 2012 to December 2012. The Protective Nursing Advocacy Scale tool was administered to students in class to assess their baseline and was administered again at the completion of the educational intervention to assess whether narrative pedagogy was effective in developing the nursing student’s perception of their role as a patient advocate. Ethical considerations: Students were informed that their participation was voluntary and that the data collected would be anonymous and confidential. The survey was not a graded assignment, and students did not receive any incentive to participate. The institutional review board of the college determined the study to be exempt from review. Setting: School of Nursing at a small liberal arts college in the Northeastern United States. Participants: A consecutive, nonprobability sample of 44 senior-level nursing students enrolled in their final nursing semester was utilized. Findings: Results indicated significant differences in student nurse’s perception of their advocacy role related to environment and educational influences following an education intervention using an ethics digital story. Conclusion: Using the Protective Nursing Advocacy Scale, we were able to measure the effectiveness of narrative pedagogy on nursing student’s perception of the nurse’s advocacy role. (shrink)

Randomized controlled trial trial designs exist on an explanatory-pragmatic spectrum, depending on the degree to which a study aims to address a question of efficacy or effectiveness. As conceptualized by Schwartz and Lellouch in 1967, an explanatory approach to trial design emphasizes hypothesis testing about the mechanisms of action of treatments under ideal conditions, whereas a pragmatic approach emphasizes testing effectiveness of two or more available treatments in real-world conditions. Interest in, and the number of, pragmatic trials has grown substantially (...) in recent years, with increased recognition by funders and stakeholders worldwide of the need for credible evidence to inform clinical decision-making. This increase has been accompanied by the onset of learning healthcare systems, as well as an increasing focus on patient-oriented research. However, pragmatic trials have ethical challenges that have not yet been identified or adequately characterized. The present study aims to explore the views of key stakeholders with respect to ethical issues raised by the design and conduct of pragmatic trials. It is embedded within a large, four-year project that seeks to develop guidance for the ethical design and conduct of pragmatic trials. As a first step, this study will address important gaps in the current empirical literature with respect to identifying a comprehensive range of ethical issues arising from the design and conduct of pragmatic trials. By opening up a broad range of topics for consideration within our parallel ethical analysis, we will extend the current debate, which has largely emphasized issues of consent, to the range of ethical considerations that may flow from specific design choices. Semi-structured interviews with key stakeholders, across multiple jurisdictions, identified based on their known experience and/or expertise with pragmatic trials. We expect that the study outputs will be of interest to a wide range of knowledge users including trialists, ethicists, research ethics committees, journal editors, regulators, healthcare policymakers, research funders and patient groups. All publications will adhere to the Tri-Agency Open Access Policy on Publications. (shrink)

DBS Think Tank IX was held on August 25–27, 2021 in Orlando FL with US based participants largely in person and overseas participants joining by video conferencing technology. The DBS Think Tank was founded in 2012 and provides an open platform where clinicians, engineers and researchers can freely discuss current and emerging deep brain stimulation technologies as well as the logistical and ethical issues facing the field. The consensus among the DBS Think Tank IX speakers was that DBS expanded in (...) its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. After collectively sharing our experiences, it was estimated that globally more than 230,000 DBS devices have been implanted for neurological and neuropsychiatric disorders. As such, this year’s meeting was focused on advances in the following areas: neuromodulation in Europe, Asia and Australia; cutting-edge technologies, neuroethics, interventional psychiatry, adaptive DBS, neuromodulation for pain, network neuromodulation for epilepsy and neuromodulation for traumatic brain injury. (shrink)

Port-wine birthmarks (PWBs) are caused by somatic, mosaic mutations in the G protein guanine nucleotide binding protein alpha subunit q (GNAQ) and are characterized by the formation of dilated, dysfunctional blood vessels in the dermis, eyes, and/or brain. Cutaneous PWBs can be treated by current dermatologic therapy, like laser intervention, to lighten the lesions and diminish nodules that occur in the lesion. Involvement of the eyes and/or brain can result in serious complications and this variation is termed Sturge-Weber syndrome (SWS). (...) Some of the biggest hurdles preventing development of new therapeutics are unanswered questions regarding disease biology and lack of models for drug screening. In this review, we discuss the current understanding of GNAQ signaling, the standard of care for patients, overlap with other GNAQ-associated or phenotypically similar diseases, as well as deficiencies in current in vivo and in vitro vascular malformation models. (shrink)

The progression of research and scholarly inquiry does not occur in isolation and is wholly dependent on accurate reporting of methods and results, and successful replication of prior work. Without mechanisms to correct the literature, much time and money is wasted on research based on a crumbling foundation. These guidelines serve to outline the respective responsibilities of researchers, institutions, agencies, and publishers or editors in maintaining the integrity of the research record. Delineating these complementary roles and proposing solutions for common (...) barriers provide a foundation for best practices. (shrink)

In ‘The nature of moral judgments and the extent of the moral domain’, Fraser criticises findings by Kelly et al. that speak against the moral/conventional distinction, arguing that the experiment was confounded. First, we note that the results of that experiment held up when confounds were removed . Second, and more importantly, we argue that attempts to prove the existence of a M/C distinction are systematically confounded. In contrast to Fraser, we refer to data that support our view. We (...) highlight the implications for the moral/conventional theory. (shrink)

Certain researchers in the field of moral psychology, following Turiel, argue that children and adults in different cultures make a distinction between moral and conventional transgressions. One interpretation of the theory holds that moral transgressions elicit a signature moral response pattern while conventional transgressions elicit a signature conventional response pattern. Four dimensions distinguish the moral response pattern from the conventional response pattern. 1. HARM/JUSTICE/RIGHTS – Subjects justify the wrongness of moral transgressions by stating that they involve a victim that is (...) harmed, whose rights have been violated or who has been subject to an injustice. Conventional transgressions do not involve a victim that is harmed, whose rights have been violated or who has been subject to an injustice. 2. AUTHORITY – Subjects judge moral transgressions as wrong independent of structures of authority while the wrongness of conventional transgressions can be changed by an authority. 3. GENERALIZABILITY – Subjects judge moral transgressions as generalizably wrong, i.e., independent of time and place, while conventional transgressions’ wrongness depends on time and place. 4. SERIOUSNESS – Subjects judge moral transgressions as more seriously wrong than conventional transgressions. Others have criticized this view for a diversity of reasons. Relevant for our purposes is that, first, there appear to be cultural differences in what constitutes a moral transgression and second, it is unclear what the exact hypotheses are, surrounding this supposed moral/conventional distinction. I will present planned and ongoing experimental research that investigates two specific problems we encountered in the moral-conventional literature. First of all, we cannot draw reliable conclusions from previous work about the generalizability of the wrongness of different kinds of transgressions. In previous experiments, differences in time and place are often but not always confounded with a variety of other differences. For example, Huebner et al. ask participants if the depicted act would be OK for someone who lived elsewhere where everyone else did this. Moreover, when varying time and/or place, participants are likely to assume that other things differ as well. In our study, we vary time and/or place in a variety of scenarios in order to investigate what assumptions participants make when confronted with the generalizability question. Second, it is an open question as to what extent any transgression will universally elicit one of the two signature response patterns. In our study, we make use of existing differences in participants’ value hierarchy to test this. For one and the same scenario, we compare the response of participants for whom authority is an important value with the results of participants for whom authority is not an important value, in order to see if there are differences in the two groups’ response patterns. References: Haidt J., Koller S. & Dias M. 1993. Affect, culture and morality, or is it wrong to eat your dog? Journal of Personality and Social Psychology 65:613-628. Huebner B., Lee, J.L. & Hauser, M.D. 2010. The Moral-Conventional Distinction in Mature Moral Competence. Journal of Cognition and Culture 10: 1-26. Kelly D., Stich S., Haley K.J., Eng S.J. & Fessler D.M.T. 2007. Harm, Affect, and the Moral/Conventional Distinction. Mind & Language 22:117-131. Nichols S. 2004. Sentimental Rules: on the Natural Foundations of Moral Judgment. Oxford University Press. Stich S., Fessler, D.M.T. & Kelly D. 2009. On the Morality of Harm: A response to Sousa, Holbrook and Piazza. Cognition 113:93-97. Turiel E. 1983. The Development of Social Knowledge. Morality & Convention. Cambridge University Press. (shrink)

Responsibility is impossible because there is no responsibility-maker and there needs to be one if people are morally responsible. The two most plausible candidates, psychology and decision, fail. A person is not responsible for an unchosen psychology or a psychology that was chosen when the person is not responsible for the choice. This can be seen in intuitions about instantly-created and manipulated people. This result is further supported by the notion that, in general, the right, the good, and virtue rest (...) on the exercise of a capacity rather than the capacity itself. It is also supported by the notion that negligence is not a responsibility-maker. ​ A person is not responsible for a choice that does not reflect his psychology or that does reflect it when he is not responsible for the psychology. This can be seen by considering intuitions regarding acts that are unconnected or arbitrarily connected to a person’s psychology. It can also be seen intuitions about acts that result from a manipulated psychology. The problem with choice as a foundation can be further seen in that an infinite or self-created person would not be responsible despite these superhuman choice-related features. (shrink)

Objective To study how doctors care for their patients, both medically and as fellow humans, through observing their conduct in patient–doctor encounters. Design Qualitative study in which 101 videotaped consultations were observed and analysed using a Grounded Theory approach, generating explanatory categories through a hermeneutical analysis of the taped consultations. Setting A 500-bed general teaching hospital in Norway. Participants 71 doctors working in clinical non-psychiatric departments and their patients. Results The doctors were concerned about their patients' health and how their (...) medical knowledge could be of service. This medical focus often over-rode other important aspects of the consultations, especially existential elements. The doctors actively directed the focus away from their patients' existential concerns onto medical facts and rarely addressed the personal aspects of a patient's condition, treating them in a biomechanical manner. At the same time, however, the doctors attended to their patients with courteousness, displaying a polite and friendly attitude and emphasising the relationship between them. Conclusions The study suggests that the main failing of patient–doctor encounters is not a lack of courteous manners, but the moral offence patients experience when existential concerns are ignored. Improving doctors' social and communication skills cannot resolve this moral problem, which appears to be intrinsically bound to modern medical practice. Acknowledging this moral offence would, however, be the first step towards minimising the effects thereof. (shrink)

Philosophy of history; the idea of the not-being and the history, by K. M. Jamil.--Philosophy of history, by Khwaja Ashkar Husain.--Philosophy of history, by A. H. Kamali.--Philosophy of history, by B. H. Siddiqi.--Philosophy of history: explanation in history, by Kazi A. Kadir.

Narrative ethics taps into an inherent human need to tell our own stories centred on our own moral values and to have those stories heard and acknowledged. However, not everyone’s words are afforded equal power. The use of narrative ethics in bioethical decision-making is problematized by a disparity in whose stories are told, whose stories are heard, and whose stories are believed. Here, I conduct an analysis of narrative ethics through a critical theory lens to show how entrenched patterns of (...) narrative neglect in medicine are harming not only our capacity to make use of narrative ethics but also our capacity to deliver effective healthcare. To illustrate this point, I use three examples where the patient’s gender affects how their stories unfold: autism, weight, and pain management. From these, I argue that the use of narrative ethics without the application of a critical theory lens risks the exacerbation of what Miranda Fricker refers to as “testimonial injustice,” the prima facie harm experienced by individuals whose credibility is undermined by others’ prejudices. Finally, I suggest that narrative ethics can be a powerful tool for mitigating oppressive practices in medicine if we couple it with critical analysis that enables us to understand the power dynamics at play in storytelling. (shrink)

Immediately after the publication of Darwin's book on the origin of species, Engels, having familiarized himself with it, wrote to Marx on December 12, 1859: "All in all, Darwin, whom I am reading right now, is superb. Teleology had hitherto not yet been destroyed in one of its aspects, and now this has been done. Moreover, hitherto there has never been so sweeping an attempt to prove historical development in nature, especially with such success." Soon Marx enlarged upon the evaluation (...) of Darwinism. In his letter of December 19, 1860, he commented that this theory "provides a foundation in natural history for our views." It is therefore no accident that Engels, in developing the principles of dialectical materialism and problems of the dialectics of nature, interested himself so deeply and comprehensively in the theory of evolution. (shrink)

Many philosophers believe that there is a causal condition on perception, and that this condition is a conceptual truth about perception. A highly influential argument for this claim is based on intuitive responses to Gricean style thought experiments. Do the folk share the intuitions of philosophers? Roberts et al. (2016) presented participants with two kinds of cases: Blocker cases (similar to Grice’s case involving a mirror and a pillar) and Non-Blocker cases (similar to Grice’s case involving a clock and brain (...) stimulation). They found that a substantial minority agreed that seeing occurs in the Non-Blocker cases, and that in the Blocker cases significantly less agreed that seeing occurs. They thus hypothesized that folk intuitions better align with a no blocker condition than with a causal condition. This paper continues this line of enquiry with two new experiments. The paper investigates the generality and robustness of Roberts et al.’s findings by expanding the sense modalities tested from only vision to audition and olfaction as well. The paper also uses Gricean style thought experiments as a case study for investigating the “reflection defense” against the negative project in experimental philosophy. Our results replicate and extend Roberts et al.’s study and support their hypothesis that folk intuitions better align with a no blocker condition. They also provide an empirical reason to doubt the reflection defense. (shrink)

This monograph aims to mathematically codify the notion of "moral systems" and define a sensible distance between them. It consists of three parts, aimed at an audience with varying interests and mathematical backgrounds. The first part steers philosophical, formally defining moral systems and several related concepts. The second part studies black box algorithms, including questions of inference and metric construction. The third part explores the technical construction of metrics amongst conditional probability distributions.

In the wider ecumenical movement, bearing witness to each other in true friendship is a creative gesture inspired by the Holy Spirit. It cuts across religious and denominational divides. The friendship between Gandhi and CF Andrews is invoked as an example of East and West bearing witness to each other. In ancient Asian religious context, mutual witnessing is extended to all sentient beings. From the Orthodox tradition three themes are highlighted as contributing to the Spirit-movement for mutual witness and healing (...) of divisions, namely, Theosis or divinization, the Perfecting work of the Holy Spirit and the Eighth Day. Humanity and the whole creation are involved in the process of divinization. Our mutual relationship is defined by this journey together. The Holy Spirit is continually renewing the creation which is pneumatodynamic, or energized by the Spirit from the beginning to the eschaton. Human beings as leaders and priests of creation are to respond to and cooperate in the perfecting work of the Spirit. The more we rely on the power of the Holy Spirit, the more united and reconciled in Christ we become. (shrink)