Naloxone, which reverses the effects of opioids, was synthesized in 1960, though the hunt for opioid antagonists began a half-century earlier. The history of this quest reveals how cultural and medical attitudes toward opioids have been marked by a polarization of discourse that belies a keen ambivalence. From 1915 to 1960, researchers were stymied in seeking a “pure” antidote to opioids, discovering instead numerous opioid molecules of mixed or paradoxical properties. At the same time, the quest for a dominant explanatory (...) and therapeutic model for addiction was likewise unsettled. After naloxone’s discovery, new dichotomizing language arose in the “War on Drugs,” in increasingly divergent views between addiction medicine and palliative care, and in public debates about layperson naloxone access. Naloxone, one of the emblematic drugs of our time, highlights the ambivalence latent in public and biomedical discussions of opioids as agents of risk and relief. (shrink)

Neurosurgery for psychiatric disorders, also sometimes referred to as psychosurgery, is rapidly evolving, with new techniques and indications being investigated actively. Many within the field have suggested that some form of guidelines or regulations are needed to help ensure that a promising field develops safely. Multiple countries have enacted specific laws regulating NPD. This article reviews NPD-specific laws drawn from North and South America, Asia and Europe, in order to identify the typical form and contents of these laws and to (...) set the groundwork for the design of an optimal regulation for the field. Key challenges for this design that are revealed by the review are how to define the scope of the law, what types of regulations are required, and how to approach international harmonization given the potential migration of researchers and patients. (shrink)

In this essay, we suggest practical ways to shift the framing of crisis standards of care toward disability justice. We elaborate on the vision statement provided in the 2010 Institute of Medicine (National Academy of Medicine) “Summary of Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations,” which emphasizes fairness; equitable processes; community and provider engagement, education, and communication; and the rule of law. We argue that interpreting these elements through disability justice entails a commitment to both (...) distributive and recognitive justice. The disability rights movement's demand “Nothing about us, without us” requires substantive inclusion of disabled people in decision‐making related to their interests, including in crisis planning before, during, and after a pandemic like Covid‐19. (shrink)

Advancements in novel neurotechnologies, such as brain computer interfaces and neuromodulatory devices such as deep brain stimulators, will have profound implications for society and human rights. While these technologies are improving the diagnosis and treatment of mental and neurological diseases, they can also alter individual agency and estrange those using neurotechnologies from their sense of self, challenging basic notions of what it means to be human. As an international coalition of interdisciplinary scholars and practitioners, we examine these challenges and make (...) recommendations to mitigate negative consequences that could arise from the unregulated development or application of novel neurotechnologies. We explore potential ethical challenges in four key areas: identity and agency, privacy, bias, and enhancement. To address them, we propose democratic and inclusive summits to establish globally-coordinated ethical and societal guidelines for neurotechnology development and application, new measures, including “Neurorights,” for data privacy, security, and consent to empower neurotechnology users’ control over their data, new methods of identifying and preventing bias, and the adoption of public guidelines for safe and equitable distribution of neurotechnological devices. (shrink)

Abstract:Vulnerability is an important criterion to assess the ethical justification of the inclusion of participants in research trials. Currently, vulnerability is often understood as an attribute inherent to a participant by nature of a diagnosed condition. Accordingly, a common ethical concern relates to the participant’s decisionmaking capacity and ability to provide free and informed consent. We propose an expanded view of vulnerability that moves beyond a focus on consent and the intrinsic attributes of participants. We offer specific suggestions for how (...) relational aspects and the dynamic features of vulnerability could be more fully captured in current discussions and research practices. (shrink)

What happens at the end of a clinical trial for an investigational neural implant? It may be surprising to learn how difficult it is to answer this question. While new trials are initiated with increasing regularity, relatively little consensus exists on how best to conduct them, and even less on how to ethically end them. The landscape of recent neural implant trials demonstrates wide variability of what happens to research participants after an neural implant trial ends. Some former research participants (...) continue to receive support for their devices (e.g., battery and component replacements, software updates, etc.). Others, when safe, have their neural implants removed through surgical explantation. Still others continue to live with a deactivated neural implant embedded in their body. In the United States, there are no uniform requirements to provide services, of any kind, after an neural implant study ends, and other nations are similarly facing this challenge. The existence of a post-trial gap in an expanding neural implant research ecosystem invites obvious questions: What is owed to neural implant research participants post-trial, and why has providing it been so difficult to accomplish in practice? To take a step forward on this difficult issue, we assembled one group of stakeholders – researchers funded for neuroethics grants by the National Institutes of Health – to explore possible starting points on one topic: ethical guidance for post-trial care of research participants in neural implant trials. Based on shared concerns discussed in the expert workshop the current paper is a call to action. It reports the key areas of convergence from the meeting and highlights important next steps towards developing much needed guidance. (shrink)

In this paper the exclusive focus on large firms in the field of business ethics is challenged. Some of the idiosyncrasies of small firms are explained, and links are made between these and potential ethical issues. A review of the existing literature on ethics in small firms demonstrates the lack of appropriate research, so that to date we can draw no firm conclusions in relation to ethics in the small firm. Recommendations are made as to the way forward for small (...) firm business ethics research. Questions for investigation are suggested using micro, meso and macro perspectives. Much exploratory work needs to be done to lay the groundwork for this important area of social and commercial research in the future. (shrink)

In this paper we report on empirical research which investigates social capital of Small and Medium Sized Enterprises (SMEs). Bringing an international perspective to the work, we make a comparison between 30 firms located in West London and Munich in the sectors of food manufacturing/production, marketing services and garages. Here we present 6 case studies, which we use to illustrate the early findings from this pilot project. We identify differences in approach to associational membership in Germany and the U.K., with (...) a greater propensity to "belong" to an official group in Germany. We distinguish clear sectoral similarities across the countries, and indications that certain personality types will seek out engagement and find time beyond busy work life schedules, often merging work/home/leisure life and friends. Some of our cases illustrate that formal institutions, networks and mutual relationships can develop social capital for the SME, although we should take care not to assume a universal win-win situation for those who are engaged and contribute to the common good. Some of the obstacles to cooperation and civic engagement are outlined. (shrink)

"Social capital" can be considered to be the product of co-operationbetween various institutions, networks and business partners. It haspotential as a useful tool for business ethics. In this article weidentify categories pertinent to the measurement of social capital insmall and medium sized enterprises (SMEs). By drawing on three differentsectors, one business-to-business service, one business-to-customerservice, and one manufacturing, we have enabled the consideration ofsectoral differences. We find sector to play an important part inrelation to business practices and social capital. Our inclusion (...) of SMEsfrom Germany and the United Kingdom has called attention to cultural,institutional and economic aspects of two regions of Europe and how theycan influence SME social capital. Social capital is found to beinfluenced by context and, in particular, institutional arrangements. Inanalysing the data we note particular areas of interest from the pointof view of SMEs and social capital as being: formal engagement,networking within sectors, networking across sectors, volunteerism andgiving to charity, and finally a focus on why people engage. We concludethat there is a considerable amount of further research needed on socialcapital, SME''s and business ethics. (shrink)

This article provides a conceptual framework for studying the influence of mood on managerial ethical decision making. We draw on mood-congruency theory and the affect infusion model to propose that mood influences managerial ethical decision making through deliberate and conscious assessments of the moral intensity of an ethical issue. By accounting for proscriptive and prescriptive morality—i.e., harmful and prosocial behavior, respectively—we demonstrate that positive and negative mood may have asymmetrical and paradoxical effects on ethical decision making. Specifically, our analysis suggests (...) that individuals in a positive mood will be more likely to engage in prosocial behavior but less likely to refrain from activities that have harmful consequences for others, whereas individuals in a negative mood will be more likely to avoid activities that put others at risk or harm but at the same time less prone to engaging in activities that have positive consequences for others. Importantly, we account for the context within which managers make their decisions by examining how situational strength may moderate the influence of mood on managerial ethical decision making. Finally, we discuss how organizations can leverage the double-edged sword effect of mood on ethical decision making and prevent, control and manage the risk of unethical decision making on the part of managers. (shrink)

In this paper, we explore the experiences of EU migrants working in UK restaurants in the aftermath of the Brexit vote. We do so through a care ethics lens, which we bring together with the integrative approach to organisational silence to consider the ethical consequences of the organisational policies of political silence adopted by the restaurant chains in our qualitative empirical study. We develop the concept of political organisational silence and probe its ethical dimensions, showing how at the organisational level (...) it falls short of constituting a practice of caring for migrant workers in politically divisive and hostile times. We argue that organisational policies of political silence emphasise the exploitative nature of the business of (im)migration, which prioritises concern for profits over care for the needs of others. Organisations refuse caring responsibility for migrant workers, leaving care to the migrants themselves and their co-workers and managers. Whilst peer-care practices partially fill this politically silent care-vacuum, this leaves individuals to negotiate difficult tensions without institutional support at a time of increased uncertainty, complexity, hostility, violence, and vulnerability. Drawing lessons from our study and its aftermath, we call for a care manifesto to inform the business of (im)migration, which would need to include caring political responsibility towards migrant workers exercised through caring political organisational voice as well as silence. (shrink)

Do we mentally simulate olfactory information? We investigated mental simulation of odors and sounds in two experiments. Participants retained a word while they smelled an odor or heard a sound, then rated odor/sound intensity and recalled the word. Later odor/sound recognition was also tested, and pleasantness and familiarity judgments were collected. Word recall was slower when the sound and sound-word mismatched. Sound recognition was higher when sounds were paired with a match or near-match word. This indicates sound-words are mentally simulated. (...) However, using the same paradigm no memory effects were observed for odor. Instead it appears odor-words only affect lexical-semantic representations, demonstrated by higher ratings of odor intensity and pleasantness when an odor was paired with a match or near-match word. These results suggest fundamental differences in how odor and sound-words are represented. (shrink)

Background The use of tissue collected at a forensic post-mortem for forensic genetics research purposes remains of ethical concern as the process involves obtaining informed consent from grieving family members. Two forensic genetics research studies using tissue collected from a forensic post-mortem were recently initiated at our institution and were the first of their kind to be conducted in Cape Town, South Africa. Main body This article discusses some of the ethical challenges that were encountered in these research projects. Among (...) these challenges was the adaptation of research workflows to fit in with an exceptionally busy service delivery that is operating with limited resources. Whilst seeking guidance from the literature regarding research on deceased populations, it was noted that next of kin of decedents are not formally recognised as a vulnerable group in the existing ethical and legal frameworks in South Africa. The authors recommend that research in the forensic mortuary setting is approached using guidance for vulnerable groups, and the benefit to risk standard needs to be strongly justified. Lastly, when planning forensic genetics research, consideration must be given to the potential of uncovering incidental findings, funding to validate these findings and the feedback of results to family members; the latter of which is recommended to occur through a genetic counsellor. Conclusion It is hoped that these experiences will contribute towards a formal framework for conducting forensic genetic research in medico-legal mortuaries in South Africa. (shrink)

Olfaction has recently been highlighted as a sense poorly connected with language. Odor is difficult to verbalize, and it has few qualities that afford mimicry by vision or sound. At the same time, emotion is thought to be the most salient dimension of an odor, and it could therefore be an olfactory dimension more easily communicated. We investigated whether sounds imitative of an innate disgust response can be associated with unpleasant odors. In two experiments, participants were asked to make a (...) forced choice between a pseudoword including a disgust sound and a neutral pseudoword, for pleasant and unpleasant odors. Overall, participants chose more disgust pseudowords than neutral pseudowords for unpleasant odors, but this was not the case for pleasant odors. This effect was not driven by a general association between unpleasant sounds and unpleasant odors, but specifically the sounds [x/χ] and [f], thought to reflect physical responses to disgusting odors, as seen in the Polish fu! or the English ugh!. In line with growing evidence that language can encode odor, we provide the first experimental evidence for an association between the sound of a word and odor valence. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Healing Power of an Ethics ConsultLaura J. HoeksemaOur interdisciplinary team was inhaling and exhaling conflict, frustration, anger, confusion, guilt, and feelings of helplessness as we cared for a 21-year-old woman who was dying. We had regular disagreements about how our team should best care for her. She was receiving hospice care and had complex medical, psychosocial, physical, and emotional needs. She was frequently transitioning between hospice care at (...) home, living with different family members at different times, and hospice care in the hospital due to uncontrolled symptoms. This led to her having an inpatient hospice team made up of me—her physician—and a nurse, social worker, and chaplain and also an outpatient hospice team with a different physician, nurse, social worker, and chaplain. All of us cared for her regularly in our respective settings. Members of the two care teams advocated passionately for what they thought was best for her. At times, team members were advocating strongly for conflicting interventions. Every member of both teams experienced moral distress related to some aspect of her care.How could we move forward in a unified way to provide her with the best care possible when there was uncertainty and disagreement within the teams about whether we were providing her with ethically appropriate care?Several questions arose about her care:• What is our responsibility in protecting a vulnerable patient when there is concern she’s being taken advantage of by others?• How do we address concerns about possible opioid diversion? Was a dying patient not receiving the pain medication she needed because someone else was using it?• How do we address household members smoking in the presence of someone on oxygen?• Do we honor a dying patient’s wish to live in an environment that we’re concerned is unsafe for her and our staff?• When team members receive contradictory information from a patient, how do we develop a common understanding of the situation?• Was it appropriate for our team to spend hours and hours caring for her each day which prevented us from caring for other patients who also needed our support?• What is our responsibility in relation to supporting her family with their financial and legal concerns?We placed an ethics consult to help us think through the answers to these questions and address the intense moral distress of team members. After listening to us share our experiences, the ethicists acknowledged the complexities of caring for her and affirmed that we were doing a good job. This acknowledgment from someone not directly involved in caring for the patient was meaningful. Having colleagues, who weren’t impacted by the emotional intensity of caring for her, empathize with us helped us gain some perspective in the swirling tornado of our emotions.Moral distress was running rampant. Some team members were distressed that we were giving the patient too much autonomy to make decisions they felt put her at risk. Others felt we should restrict her autonomy significantly to protect her. Some were distressed by family members smoking near her when she was on oxygen. Others were distressed that the investment of time in caring for her was so great that we couldn’t care for other patients in ways they deserved. Team members were very passionate about their beliefs about what was right and wrong as we cared for her. [End Page 21]The ethics consultants addressed the conflicting ethical values and helped us feel more comfortable with the plan of care we developed together. We were asked thoughtful questions to help draw out sources of moral distress. We were given new ways of thinking about conflicting ethical values, which helped us understand the underlying reasons for the conflict our team was experiencing. Highlighting the ethical values that were in conflict and helping each of us understand that the specific aspects of her care that we found distressing were related to our personal values, helped decrease the intensity of disagreements and frustration. The ethicist’s ability to share this knowledge with our team was powerful. Our team realized that we weren’t frustrated or upset with each other. We came to understand that because of the... (shrink)

This article seeks to expand business and society research in a number of ways. Its primary purpose is to redraw two core corporate social responsibility theories, enhancing their relevance for small business. This redrawing is done by the application of the ethic of care, informed by the value of feminist perspectives and the extant empirical research on small business social responsibility. It is proposed that the expanded versions of core theory have wider relevance, value, and implications beyond the small firm (...) context. The theorization of small business social responsibility enables engagement with the mainstream of CSR research as well as making a contribution to small business studies in scholarly, policy, and practice terms. (shrink)

This article examines the nineteenth-century debate about scientific method between John Stuart Mill and William Whewell. Contrary to standard interpretations (given, for example, by Achinstein, Buchdahl, Butts, and Laudan), I argue that their debate was not over whether to endorse an inductive methodology but rather over the nature of inductive reasoning in science and the types of conclusions yielded by it. Whewell endorses, while Mill rejects, a type of inductive reasoning in which inference is employed to find a property or (...) cause shared by the observed members of a class, which is generalized to all its members, including the unobserved ones. Because of this, Whewell’s inductivism, unlike Mill’s, is able to yield theoretical hypotheses referring to unob-servables such as molecules and light waves. This is contrary to the claims of some critics of inductivism who argue that inductivism is unable to yield such hypotheses. Moreover, I suggest that Whewell’s view of induction conforms more closely than Mill’s view to the practice of scientists such as Kepler, Newton, and Fresnel, who do attempt to discover laws involving unobservables. (shrink)

In this paper I demonstrate that, contrary to the standard interpretations, William Whewell's view of scientific method is neither that of the hypothetico-deductivist nor that of the retroductivist. Rather, he offers a unique inductive methodology, which he calls "discoverers' induction." After explicating this methodology, I show that Kepler's discovery of his first law of planetary motion conforms to it, as Whewell claims it does. In explaining Whewell's famous phrase about "happy guesses" in science, I suggest that Whewell intended a distinction (...) between "inductions," which can be empirically verified, and "mere hypotheses"--or guesses--which cannot. Finally, I argue that Whewell's discoverers' induction is a view worthy of our attention today, because it avoids a number of problems faced by prominent alternative methodologies. (shrink)

We investigated family members’ lived experience of Parkinson’s disease aiming to investigate opportunities for well-being. A lifeworld-led approach to healthcare was adopted. Interpretative phenomenological analysis was used to explore in-depth interviews with people living with PD and their partners. The analysis generated four themes: It’s more than just an illness revealed the existential challenge of diagnosis; Like a bird with a broken wing emphasizing the need to adapt to increasing immobility through embodied agency; Being together with PD exploring the kinship (...) within couples and belonging experienced through support groups; and Carpe diem! illuminated the significance of time and fractured future orientation created by diagnosis. Findings were interpreted using an existential-phenomenological theory of well-being. We highlighted how partners shared the impact of PD in their own ontological challenges. Further research with different types of families and in different situations is required to identify services required to facilitate the process of learning to live with PD. Care and support for the family unit needs to provide emotional support to manage threats to identity and agency alongside problem-solving for bodily changes. Adopting a lifeworld-led healthcare approach would increase opportunities for well-being within the PD illness journey. (shrink)

This article investigates the relation between freedom, the public use of reason, and sensus communis, as discussed throughout Kant’s political writings and critical works. Kant’s discussion of the public use of reason, as put forth in "What Is Enlightenment?" is closely tied to his views on autonomy, most notably in the political sphere. However, Kant’s distinction between the public and private uses of reason relies upon sensus communis as discussed in the Critique of Judgment. The communicability achieved by sensus communis (...) has a relevance not restricted only to Kant’s explicitly political writings; sensus communis is also what we might call “transcendentally significant.” In this article, I argue that the public use of reason—a use of reason achieved by sensus communis—is vital for reason itself to follow its own normative demands. I conclude that sensus communis itself grounds reason’s use for its own critique. (shrink)

This article explores the influence of sadness in ethical decision-making and behavior. In three laboratory studies, we found that an incidental state of sadness reduced individuals’ propensity to engage in morally questionable behavior, including both unethical and selfish acts (Studies 1 to 3). We found this effect to be mediated by the role of sadness in prompting people to pay more attention to the negative consequences of morally questionable acts and perceive those consequences as more problematic (Studies 2 and 3). (...) This effect was consistent using different decision-making contexts and held when rewards to be gained from such behavior were relatively high. Several implications of these findings for business ethics and organizations are discussed. (shrink)

Rawls famously argues that the parties in the original position would agree upon the two principles of justice. Among other things, these principles guarantee equal political liberty—that is, democracy—as a requirement of justice. We argue on the contrary that the parties have reason to reject this requirement. As we show, by Rawls’ own lights, the parties would be greatly concerned to mitigate existential risk. But it is doubtful whether democracy always minimizes such risk. Indeed, no one currently knows which political (...) systems would. Consequently, the parties—and we ourselves—have reason to reject democracy as a requirement of justice in favor of political experimentalism, a general approach to political justice which rules in at least some non-democratic political systems which might minimize existential risk. (shrink)

In the nineteenth century, William Whewell claimed that his confirmation criterion of consilience was a truth-guarantor: we could, he believed, be certain that a consilient theory was true. Since that time Whewell has been much ridiculed for this claim by critics such as J. S. Mill and Bas van Fraassen. I have argued elsewhere that, while Whewell's claim that consilience can guarantee the truth of a theory is clearly wrong, consilience is indeed quite useful as a confirmation criterion (Snyder 2005). (...) Here I will show that, even when consilience gives evidence for a theory that turns out to be false, there is an important sense in which consilience shows that the theory has captured something correct about the natural-kind structure of the physical world. Whewell was therefore correct to claim that consilience provides a "criterion of reality" (Whewell [1847] 1967, vol. 2, 68). Consilience provides this by giving justification for the claim that we have really `cut nature at its causal joints', to adapt Plato's famous phrase. Because of this, consilience can play a role in an argument for scientific realism. (shrink)