This article examines the involvement of neonatal nurses in ethical issues, achieved through a survey of Australian neonatal nurses. The aim was to discover if nurses were involved in ethical decisions, to examine various categories of neonates and the concerns that nurses felt about them, and to determine the extent to which nurses saw themselves as advocates. A response rate of 65% was achieved from nurses in two states who worked in intensive care and special care nurseries. The findings show (...) that nurses were more likely to be involved in clinical decision making than in ethical decision making, showed the greatest concern for infants who had an uncertain prognosis, and saw themselves as advocates for their patients. The issues surrounding these findings are examined. (shrink)

One barrier to optimal pain management in the neonatal intensive care unit (NICU) is how the healthcare community perceives, and therefore manages, neonatal pain. In this paper, we emphasise that healthcare professionals not only have a professional obligation to care for neonates in the NICU, but that these patients are intrinsically worthy of care. We discuss the conditions that make neonates worthy recipients of pain management by highlighting how neonates are (1) vulnerable to pain and harm, and (2) completely dependent (...) on others for pain management. We argue for a relational account of ethical decision-making in the NICU by demonstrating how an increase in vulnerability and dependence may be experienced by the healthcare community and the neonate’s family. Finally, an ethical framework for decisions around neonatal pain management is proposed, focussing on surrogate decision-making and the importance of compassionate action through both a reflective and an affective empathy. As empathy can be highly motivating against pain, we propose that, in addition to educational programs that raise awareness and knowledge of neonatal pain and pain management, healthcare professionals must cultivate empathy in a collective manner, where all members of the NICU team, including parents, are compassionate decision-makers. (shrink)

Despite its focus on consent the new Human Tissue Act 2004 allows for testing without consent where a relative could benefitIn recognition of the fact that genetic test results in people can have implications for close relatives, the new Human Tissue Act 2004 allows for a direction to access a person’s tissue so that testing can be carried out for the benefit of a relative, without the consent of that person. Clinical practice governed by common law and statute, before this (...) act, acknowledged that the disclosure, without consent, of the results of a genetic test, is ethically permissible in extreme situations for the benefit of a relative. New testing for the benefit of a relative without donor consent challenges the principle that informed or adequate consent should be obtained before a genetic test with considerable predictive powers is carried out. The debate surrounding the analogous situation of HIV testing concluded that in very rare cases, disclosure of an HIV result without consent may be justified, but testing without consent is a professional misconduct. This part of the legislation is controversial and deserves further debate. The Human Tissue Authority should take measures to limit the potential harm that can be caused by this provision.IntroductionAfter much debate, the new Human Tissue Act 2004 was passed by parliament in November 2004. Implementation of this act may be staggered, but it will be fully operational in May 2006. This act has several provisions that have implications in clinical practice for the use of stored tissue or samples containing cells. These provisions allow the Human Tissue Authority to permit access to human tissue for the purpose of obtaining scientific or medical information about a person for the benefit of another family member, without the consent of the donor . …. (shrink)

We present a comprehensive study of the axiom schemas IΣ - n , BΣ - n (induction and collection schemas for parameter free Σ n formulas) and some closely related schemas.

BackgroundInnovations in technology have contributed to rapid changes in the way that modern biomedical research is carried out. Researchers are increasingly required to endorse adaptive and flexible approaches to accommodate these innovations and comply with ethical, legal and regulatory requirements. This paper explores how Dynamic Consent may provide solutions to address challenges encountered when researchers invite individuals to participate in research and follow them up over time in a continuously changing environment.MethodsAn interdisciplinary workshop jointly organised by the University of Oxford (...) and the COST Action CHIP ME gathered clinicians, researchers, ethicists, lawyers, research participants and patient representatives to discuss experiences of using Dynamic Consent, and how such use may facilitate the conduct of specific research tasks. The data collected during the workshop were analysed using a content analysis approach.ResultsDynamic Consent can provide practical, sustainable and future-proof solutions to challenges related to participant recruitment, the attainment of informed consent, participant retention and consent management, and may bring economic efficiencies.ConclusionsDynamic Consent offers opportunities for ongoing communication between researchers and research participants that can positively impact research. Dynamic Consent supports inter-sector, cross-border approaches and large scale data-sharing. Whilst it is relatively easy to set up and maintain, its implementation will require that researchers re-consider their relationship with research participants and adopt new procedures. (shrink)

Dynamic Consent is both a model and a specific web-based tool that enables clear, granular communication and recording of participant consent choices over time. The DC model enables individuals to know and to decide how personal research information is being used and provides a way in which to exercise legal rights provided in privacy and data protection law. The DC tool is flexible and responsive, enabling legal and ethical requirements in research data sharing to be met and for online health (...) information to be maintained. DC has been used in rare diseases and genomics, to enable people to control and express their preferences regarding their own data. However, DC has never been explored in relationship to historical collections of bioscientific and genetic heritage or to contexts involving Aboriginal and Torres Strait Islander people.In response to the growing interest by First Peoples throughout Australia in genetic and genomic research, and the increasing number of invitations from researchers to participate in community health and wellbeing projects, this article examines the legal and ethical attributes and challenges of DC in these contexts. It also explores opportunities for including First Peoples' cultural perspectives, governance, and leadership as a method for defining DC on cultural terms that engage best practice research and data analysis as well as respect for meaningful and longitudinal individual and family participation. (shrink)

Over the past 25 years, there has been growing recognition of the importance of studying the Ethical, Legal and Social Implications of genetic and genomic research. A large investment into ELSI research from the National Institutes of Health Human Genomic Project budget in 1990 stimulated the growth of this emerging field; ELSI research has continued to develop and is starting to emerge as a field in its own right. The evolving subject matter of ELSI research continues to raise new research (...) questions as well as prompt re-evaluation of earlier work and a growing number of scholars working in this area now identify themselves as ELSI scholars rather than with a particular discipline. Due to the international and interdisciplinary nature of ELSI research, scholars can often find themselves isolated from disciplinary or regionally situated support structures. We conducted a workshop with Early Career Researchers in Oxford, UK, and this paper discusses some of the particular challenges that were highlighted. While ELSI ECRs may face many of the universal challenges faced by ECRs, we argue that a number of challenges are either unique or exacerbated in the case of ELSI ECRs and discuss some of the reasons as to why this may be the case. We identify some of the most pressing issues for ELSI ECRs as: interdisciplinary angst and expertise, isolation from traditional support structures, limited resources and funding opportunities, and uncertainty regarding how research contributions will be measured. We discuss the potential opportunity to use web 2.0 technologies to transform academic support structures and address some of the challenges faced by ELSI ECRs, by helping to facilitate mentoring and support, access to resources and new accreditation metrics. As our field develops it is crucial for the ELSI community to continue looking forward to identify how emerging digital solutions can be used to facilitate the international and interdisciplinary research we perform, and to offer support for those embarking on, progressing through, and transitioning into an ELSI research career. (shrink)

Innovations in information technologies have facilitated the development of new styles of research networks and forms of governance. This is evident in genomics where increasingly, research is carried out by large, interdisciplinary consortia focussing on a specific research endeavour. The UK10K project is an example of a human genomics consortium funded to provide insights into the genomics of rare conditions, and establish a community resource from generated sequence data. To achieve its objectives according to the agreed timetable, the UK10K project (...) established an internal governance system to expedite the research and to deal with the complex issues that arose. The project’s governance structure exemplifies a new form of network governance called ‘pop-up’ governance. ‘Pop-up’ because: it was put together quickly, existed for a specific period, was designed for a specific purpose, and was dismantled easily on project completion. In this paper, we use UK10K to describe how ‘pop-up’ governance works on the ground and how relational, hierarchical and contractual governance mechanisms are used in this new form of network governance. (shrink)

ABSTRACT:The notion of stakeholder salience based on attributes (e.g., power, legitimacy, urgency) is applied in the family business setting. We argue that where principal institutions intersect (i.e., family and business); managerial perceptions of stakeholder salience will be different and more complex than where institutions are based on a single dominant logic. We propose that (1) whereas utilitarian power is more likely in the general business case, normative power is more typical in family business stakeholder salience; (2) whereas in a general (...) business context legitimacy is socially constructed; for family stakeholders, legitimacy is based on heredity; and (3) whereas temporality and criticality are somewhat independent in general-business urgency, they are linked in the family business case because of family ties and family-centered non-economic goals. We apply this theoretical framework to position and integrate the contributions to this special section ofBusiness Ethics Quarterlyon “Stakeholder Theory, Ethics, Corporate Social Responsibility, and Family Enterprise.”. (shrink)

In this paper we study the model theory of extensions of models of first-order Peano Arithmetic by means of the arithmetized completeness theorem applied to a definable complete extension of PA in the original model. This leads us to many interesting model theoretic properties equivalent to reflection principles and ω-consistency, and these properties together with the associated first-order schemes extending PA are studied.

Disillusioned with college, Everett takes a position teaching philosophy to kids at an innovative summer enrichment academy on an island off the New England coast. The academy is run by fellow student Juniper’s Aunt Laura, and at Laura’s recommendation, Everett uses as his curriculum an exploration of the concept of happiness as described by ten of history’s most significant philosophers. This idea is sparked by a collection of readings saved by Laura’s grandmother, a teacher who originally owned the mansion in (...) which the academy is housed. But along with those readings is a set of clues that lead to a rare historic work by an ancient Greek philosopher—a codex—that is hidden in the mansion. So Everett sets to work preparing the readings for his students while simultaneously solving the clues with Juniper to find the codex. -/- What Everett doesn’t know, however, is that he and Juniper are not the only ones on the hunt for the codex, and the stakes are high. The book is extremely valuable, and there are plenty of people who would like to get their hands on the money it would bring at auction, including the people who are funding Laura’s academy. The question of rightful ownership and the mystery of the codex’s location deepen as Everett and Juniper solve the riddles to find the keys that will open whatever safe contains the ancient text. And all the while, Everett finds himself falling for Juniper. -/- He’s also working through the collection of philosophical readings about happiness, taking each one in turn and presenting it in clear, concise, modern English to his students, who are eager to discover how to lead a happy life. Everett is equally eager to make the same discovery, and he carefully considers each philosopher’s thinking on the matter, applying the concepts to his own life in an effort to understand them in the context of a young person in the real world struggling to figure out what he wants to do with his future. -/- As Everett gains clarity on what he wants out of life, however, the mystery of the codex takes a dark turn, and everything he thought he knew is turned upside down. Who will end up with the codex? What will happen to the academy? And will Everett be able to take everything that he has learned—both the good and the bad—to build a life for himself that will bring him the most happiness? -/- There is an accompanying guidebook for this novel. (shrink)

There is longstanding consensus on the need to include pregnant women in research. The goal of clinical research is to find highly regulated, carefully controlled, morally responsible ways to generate evidence...

The Onion, with its unique brand of deadpan satirical humor, has become a familiar part of the American scene. The newspaper has a readership of over a million, and it reaches millions more with its spin-off books and The Onion News Network. The Onion has shown us that standard ways of thinking about the news have their grotesque and silly side, and this invites philosophical examination. Twenty-one philosophers were commissioned to figure out just what makes the Onion so truthful and (...) insightful. Are the Onion writers truly cynical, or just cynically faking it? Does the Onion really have a serious point of view on religion? On sex? On politics? Who cares what Area Man thinks? If everyone’s so dumb, how come so many Onion readers keep on laughing at how dumb they are? (shrink)

Gloria is a typical twenty-one-year-old living in post-World War II America, spending her time making fashionable clothing for herself and going out with her boyfriend, when her brother Stanley goes missing. While on her way to speak with his friends at the Delta Psi fraternity house at Princeton University, she discovers the body of one of his fellow students. The young man has been murdered, and Gloria’s worry for her brother deepens into a terrible fear for his safety. -/- Stanley (...) is a member of the Dreamcatcher Committee, which eminent philosopher John Dewey has tasked with locating the next greatest philosopher—the thinker who can solve the problem of how to establish both peace and justice in society. That person will receive a dreamcatcher from Dewey that has been handed down through several generations of notable philosophers. The only problem is that, not only is Stanley missing, but the dreamcatcher seems to be as well. -/- So Gloria and the committee members embark on a search for both her brother and the dreamcatcher, following a trail of clues laid out by Stanley himself. Their search leads them to explore the philosophical theories of an array of thinkers and writers who all had different ideas about how to achieve a society that is both peaceful and just. But the person who has the most profound and influential theory is not who they think, and the answer provides them with the whereabouts of both the dreamcatcher and Stanley in a fascinating twist that none of them could have foreseen. -/- This novel is part of an innovative philosophy curriculum that uses engaging stories to introduce students to important philosophical concepts. In this story, a teen named Gloria discovers that her brother has gone missing. When another student from his university is found murdered, Gloria and the members of a committee tasked with identifying the next great philosopher find themselves following a trail of clues in the search for answers. Along the way, they explore several philosophical theories for establishing a just, peaceful society. But the person who has the most profound theory is not who they think, leading them to the answers they’re seeking in a twist that none of them could have foreseen. -/- . (shrink)

We may consider the possibility of man's freedom from two points of view: From the point of view of the metaphysical problem of “ free-will “; from the point of view of the meaning and conditions of felt freedom. The first point of view is the more familiar, and I propose to discuss it here only by way of preparing for a consideration of the second.

Nobody understands TJ, so when he finds an abandoned cabin in the woods, it feels to him like a haven from society. But that night, TJ starts having unusually vivid dreams that take him back to the middle of the nineteenth century, where he learns about the American philosophical movement known as Transcendentalism and where he is introduced to a man living in an identical cabin, this one on the shore of Walden Pond: Henry David Thoreau. TJ soon learns that (...) his classmate Ivy is sharing the dream with him; she enters it as Louisa May Alcott, and he is a teen who is spending the summer with the Alcott family. Together they must solve the mystery of a murdered woman in the woods near Thoreau's cabin, and along the way, they meet such eminent and influential figures as Ralph Waldo Emerson, Amos Bronson Alcott, Margaret Fuller, William Ellery Channing—and of course Thoreau. -/- Solving the murder mystery in the dream requires TJ and Ivy to learn about the beliefs and principles of the Transcendentalists, which reveal to them the foremost social struggle of the day: the abolition of slavery. They also discover the philosophers' views on women's rights and the relationship of humans to the natural world and to one another—and, in a fundamental way, to the idea of God. This information provides just what TJ and Ivy need to solve a mystery back in their waking lives of a missing painting related to the strange cabin in the woods. As he works through the mysteries, TJ finds himself embracing Transcendentalism, and it gives him a new perspective on his real life and how he ultimately wants to live it. (shrink)

Second Life, an on-line, interactive environment in which users create avatars through which they have virtual experiences, is a contemporary experiment in utopia. While most often it is used for social networking, it also is used for commercial and educational purposes, as well as for political activism. Here, we share the results from a course that uses Second Life as a tool for examining social justice. We examine the notion of utopia, present the results of a pre- and post-survey designed (...) to measure the effectiveness of our Second Life course, and relate insights gleaned from the centerpiece assignment of the course that required students to construct proposals for how $200 best could be spent in Second Life to promote social justice. Finally, we demonstrate how Second Life can be a helpful classroom tool for examining John Rawls’s influential utopian work, A Theory of Justice. (shrink)

This work is designed to show that there is an implicit connection between Ockham's academic and political careers in his theory of conscience. ;Thomas Aquinas offers a theory of moral responsibility according to which the conscientious individual has knowledge of the rightness of her act which does not preclude her doing otherwise. His account of the will, however, proves that this state of affairs never obtains. Ockham's alternative presupposes that we freely choose our own ends. He is therefore entitled to (...) assert that conscience is the knowledge of one's own acts as right or wrong. ;The libertarian metaphysics underlying Ockham's ethics is tested by the problem of unfulfilled prophecy. Thomas Bradwardine argues that the Antichrist is free not to come because it is possible for God to undo the past. Thomas Buckingham argues for the possibility that the prophecy never meant that the Antichrist was going to come. Meanwhile, Ockham is left with the possibility that God lied. Ockhamist John of Mirecourt shows why this 'heretical' solution is the only way to save the faith. Ockham's theory of conscience provides a sound basis for interpreting his treatise on heresy. Heresy is disobedience, not to authority, but to the truth. Since the condemnation of heresy is itself a paradigm instance of this kind of perversity, freedom of speech prevails by default. Ockham's conception of a community united by this realization provides an answer to twentieth-century speech-regulation advocates. ;Ockham thought that it is through our obedience to the truth that Jesus's promise to be with his disciples 'always, to the end of the age' will be fulfilled. According to Walter Burley, 'I promise you a Christian' converts with 'A Christian is promised to you by me.' According to Ockham, in contrast, it is an opaque construction. This account of the logic of indefinite promises implies that no individual can claim to be one of the disciples to whom Jesus was referring. ;I hope to leave the reader in a better position to appreciate the sense in which the claim that Ockham's two careers are united by his nominalism may be considered correct. (shrink)

(2006). Was there no evolutionary thought in the middle ages? The case of William of Ockham. British Journal for the History of Philosophy: Vol. 14, No. 2, pp. 225-244.

Odour-sound correspondences provide some of the most fascinating and intriguing examples of crossmodal associations, in part, because it is unclear from where exactly they originate. Although frequently used as similes, or figures of speech, in both literature and poetry, such smell-sound correspondences have recently started to attract the attention of experimental researchers too. To date, the findings clearly demonstrate that the majority of non-synaesthetic individuals associate orthonasally-presented odours with various different sound properties, e.g., pitch, instrument type, and timbre, in a (...) non-random manner. What is more, these auditory-olfactory associations exhibit a number of features that are common to other crossmodal associations, such as their consistency over time, and their bidirectionality. However, the psychological mechanism underpinning these associations in the general population remain unclear, with a number of distinct hypotheses having been put forward over the years. In this chapter, we consider auditory-olfactory associations in art and science, focusing on poetry, music composition, and performance. First, we provide examples of the use of auditory-olfactory synaesthetic metaphors in poetry, from William Shakespeare through to Romanticism, illustrating how crossmodal associations have appeared in literature for centuries. Then, we move on to focus on music composition and performance, describing a number of examples where auditory stimuli have been purposely matched with crossmodally corresponding olfactory and/or visual stimuli. Considering the scientific study of smell-sound correspondences, we review the key psychophysical studies demonstrating that, beyond the artistic context, robust and non-random crossmodal associations are also triggered in the majority of the general population. We discuss a number of hypotheses that have been put forward over the years to account for such associations, focusing on the idea that certain correspondences between olfactory and auditory stimuli are mediated by the emotional character of the component stimuli. (shrink)

The ability to resist distracting stimuli whilst voluntarily focusing on a task is fundamental to our everyday cognitive functioning. Here, we investigated how this ability develops, and thereafter declines, across the lifespan using a single task/experiment. Young children (5–7 years), older children (10–11 years), young adults (20–27 years), and older adults (62–86 years) were presented with complex visual scenes. Endogenous (voluntary) attention was engaged by having the participants search for a visual target presented on either the left or right side (...) of the display. The onset of the visual scenes was preceded – at stimulus onset asynchronies (SOAs) of 50, 200, or 500 ms – by a task-irrelevant sound (an exogenous crossmodal spatial distractor) delivered either on the same or opposite side as the visual target, or simultaneously on both sides (cued, uncued, or neutral trials, respectively). Age-related differences were revealed, especially in the extreme age-groups, which showed a greater impact of crossmodal spatial distractors. Young children were highly susceptible to exogenous spatial distraction at the shortest SOA (50 ms), whereas older adults were distracted at all SOAs, showing significant exogenous capture effects during the visual search task. By contrast, older children and young adults' search performance was not significantly affected by crossmodal spatial distraction. Overall, these findings present a detailed picture of the developmental trajectory of endogenous resistance to crossmodal spatial distraction from childhood to old age and demonstrate a different efficiency in coping with distraction across the four age-groups studied. (shrink)

Objective Futile treatment, which by definition cannot benefit a patient, is undesirable. This research investigated why doctors believe that treatment that they consider to be futile is sometimes provided at the end of a patient9s life. Design Semistructured in-depth interviews. Setting Three large tertiary public hospitals in Brisbane, Australia. Participants 96 doctors from emergency, intensive care, palliative care, oncology, renal medicine, internal medicine, respiratory medicine, surgery, cardiology, geriatric medicine and medical administration departments. Participants were recruited using purposive maximum variation sampling. (...) Results Doctors attributed the provision of futile treatment to a wide range of inter-related factors. One was the characteristics of treating doctors, including their orientation towards curative treatment, discomfort or inexperience with death and dying, concerns about legal risk and poor communication skills. Second, the attributes of the patient and family, including their requests or demands for further treatment, prognostic uncertainty and lack of information about patient wishes. Third, there were hospital factors including a high degree of specialisation, the availability of routine tests and interventions, and organisational barriers to diverting a patient from a curative to a palliative pathway. Doctors nominated family or patient request and doctors being locked into a curative role as the _main_ reasons for futile care. Conclusions Doctors believe that a range of factors contribute to the provision of futile treatment. A combination of strategies is necessary to reduce futile treatment, including better training for doctors who treat patients at the end of life, educating the community about the limits of medicine and the need to plan for death and dying, and structural reform at the hospital level. (shrink)