Objective To assess parental permission for a neonate's research participation using the MacArthur competence assessment tool for clinical research (MacCAT-CR), specifically testing the components of understanding, appreciation, reasoning and choice. Study Design Quantitative interviews using study-specific MacCAT-CR tools. Hypothesis Parents of critically ill newborns would produce comparable MacCAT-CR scores to healthy adult controls despite the emotional stress of an infant with critical heart disease or the urgency of surgery. Parents of infants diagnosed prenatally would have higher MacCAT-CR scores than parents (...) of infants diagnosed postnatally. There would be no difference in MacCAT-CR scores between parents with respect to gender or whether they did or did not permit research participation. Participants Parents of neonates undergoing cardiac surgery who had made decisions about research participation before their neonate's surgery. Methods The MacCAT-CR. Results 35 parents (18 mothers; 17 fathers) of 24 neonates completed 55 interviews for one or more of three studies. Total scores: magnetic resonance imaging (mean 36.6, SD 7.71), genetics (mean 38.8, SD 3.44), heart rate variability (mean 37.7, SD 3.30). Parents generally scored higher than published subject populations and were comparable to published control populations with some exceptions. Conclusions The MacCAT-CR can be used to assess parental permission for neonatal research participation. Despite the stress of a critically ill neonate requiring surgery, parents were able to understand study-specific information and make informed decisions to permit their neonate's participation. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Justice Not GreedRichard A. HoehnJustice Not Greed Edited by Pamela Brubaker and Rogate Mshana Geneva: WCC Publications, 2010. 224 pp. $14.00The World Council of Churches (WCC) Advisory Group on Economic Matters (AGEM) advises the WCC and congregations on global economic issues. AGEM members from diverse backgrounds produced the papers in this volume. The introduction is by Rogate Mshana, WCC director for Peace, Justice, and Creation. Samuel Kobia, general (...) secretary of the WCC from 2004–9, introduces the rationale and role of AGEM in the global financial crisis. The book ends with a statement on just finance and the economy of life, adopted by the WCC Central Committee in September 2009. Justice Not Greed will be most useful in settings where there is interest in the intersection of ethics, the economic crisis, and Christianity in relation to the global economy, as well as among those who wish to follow the WCC. As expected [End Page 208] of conference papers, there is not a systematic development of an argument but overlapping ethical and economic analyses. All, however, are opposed to the status quo because of its manifest injustice, especially the impact on poor people.If one were to impose a thematic development, it might go something like this, allowing for individual differences among the authors. Decolonization has resulted in a lopsided, Western, capitalist economic system predicated on greed (Jan Pronk), described by other authors as a beast or a cancer (vivid but unhelpful metaphors since the crisis was caused by humans, not nature). The world lacks appropriate international structures. We need new global institutions, a new global financial architecture that is predicated on, or at least takes into account, justice. Congregations, the ecumenical movement, and the WCC could play a significant role in helping the United Nations move toward such a system.Several authors hope that the global crisis will provide a moment when such a change might become possible (e.g., Alexander Cobham’s “Blood-Stained Silver Lining”). Pamela K. Brubaker, Kim Yong-Bock, Roel Aalbersberg, Rienzie Perera, and Geevarghese Mor Coorilos examine questions related to the Bible, ethics, theology, a culture of “enough for all” (Musa Panti Filibus), the church as moral community, the ecumenical movement, and principles for an alternative economic system. Mariana Issa Zureikat argues for “econo-morals,” applying moral values to economic analyses. Thomas H. Kang advocates the capabilities approach of Amartya Sen and Martha Nussbaum. Marcos Arruda suggests an economy of world solidarity with the “gross happiness index” as a standard for measuring progress. While most chapters include economic analysis, John Dillon wades into some nitty-gritty causes of the current financial crisis, with a positive nod toward the (never adopted) Keynes plan for the Bretton Woods system of monetary management. Marie-Aimee Tourres lays out impacts on the developing world, as does Xiao Lian from a Chinese perspective. Most of these authors argue for such global solutions as a global reserve system and a global tax system.Justice Not Greed presents thoughtful, sometimes passionate papers that could form a basis for lively discussion. Yet real-world solutions often come down to the practice of democracy and political will. Unfortunately, it is not clear that the ecumenical movement possesses the will or the means to effect change because local organizing for political change is not a high priority at any level. [End Page 209]Richard A. HoehnChrist the Servant Lutheran ChurchCopyright © 2012 The Society of Christian Ethics... (shrink)

Increasingly, national governments across the globe are prioritizing investments in neuroscience. Currently, seven active or in-development national-level brain research initiatives exist, spanning four continents. Engaging with the underlying values and ethical concerns that drive brain research across cultural and continental divides is critical to future research. Culture influences what kinds of science are supported and where science can be conducted through ethical frameworks and evaluations of risk. Neuroscientists and philosophers alike have found themselves together encountering perennial questions; these questions are (...) engaged by the field of neuroethics, related to the nature of understanding the self and identity, the existence and meaning of free will, defining the role of reason in human behavior, and more. With this Perspective article, we aim to prioritize and advance to the foreground a list of neuroethics questions for neuroscientists operating in the context of these international brain initiatives. (shrink)

This paper explores one aspect of the political in the early Hegel, that of criminal action and its relationship to the concept of recognition in the System of Ethical Life. While it is clear that in this work Hegel thinks that criminal action plays an important role in the transformation of simple ethical communities, it is not clear that, for Hegel, the formal character of crime in the struggle for recognition is anything but negative. I attempt to show how this (...) role for crime leads Hegel to a legalistic conception of Right that has no solid connection with recognition as a social force. (shrink)

In the summer of 1997 one could scarcely enter a bookstore in Beijing without encountering Wang Xiaobo's pensive and defiant look on the cover of dozens of books displayed at the entrance. Wang had suddenly died in the spring of that year at the age of forty-five. Born in Beijing in 1952 to a family of intellectuals, he remained attached to China's capital despite periods of separation, such as during the Cultural Revolution, when he was sent to Yunnan to "learn (...) from the peasants" and taught in a "people-run-school" in Shandong, and also during the 1980s, when he studied in the United States . Wang always returned to Beijing, in the late 1970s to study economy and business at the People's University and in the late 1980s to teach there. After retiring in 1993, he devoted his time to writing: poetry, novels, essays, non-fiction, and a movie script. (shrink)

Nonadherence to treatment continues to be one of psychiatry's greatest challenges. To improve adherence and thus improve the care of patients, clinicians and patients' family members sometimes resort to hiding medication in food or drink, a practice referred to as covert/ surreptitious medication. The practice of covert drug administration in food and beverages is well known in the treatment of psychiatrically ill world-wide but no prevalence rates exist. Covert medication may seem like a minor matter, but it touches on legal (...) and ethical issues of a patient's competence, autonomy, and insight. Medicating patients without their knowledge is not justifiable solely as a shortcut for institutions or families wishing to calm a troublesome patient and thus alleviate some of the burdens of care giving. The paramount principle is ensuring the well-being of a patient who lacks the competence to give informed consent. Ethically, covert/surreptitious administration can be seen as a breach of trust by the doctor or by family members who administer the drugs. Covert medication contravenes contemporary ethical practice. Legally, treatment without consent is permissible only where common law or statute provides such authority. The practice of covert administration of medication is not specifically covered in the mental health legislation in developing countries. Many of the current dilemmas in this area have come to public attention because of two important developments in medical ethics and the law - the increasing importance accorded to respect for autonomy and loss of the parens patriae jurisdiction of the courts [parens patriae means 'parent of the country'; it permitted a court to consent or refuse treatment on behalf of an 'incapacity', or alternatively to appoint a guardian with such powers]. (shrink)

The increasingly foreshortening of bioethics known as narrative and even literary bioethics is analyzed in article. This analysis is realized on the material of Rudyard Kipling’s story «The miracle of Purun Bhagat». Deconstruction in its ethical aspect comes out in this case as method of the overcoming of logocentrism and becomes radicalization of ethics. The talk is about consideration of bioethics not simply as the science of survival but as radical ethics of the salvation of life. The text of the (...) story is interpreted as pharrmacon, remedy, sure remedy for human consciousness, society and nature. The result of the analysis is the idea of the consideration of conservative bioethics as radical ethics of salvation and science about spiritual-moral essence of human. This essence is consciousness, which is always moral consciousness in contradiction to intellect deprivated of moral dimension and leading humankind on the way of catastrophic progress to transhumanistic, posthuman future. (shrink)