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)

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)

The implementation of online technologies to promote wellbeing is increasingly becoming a worldwide priority. This study includes secondary analyses of data and examined drop-out rates in an online guided self-help intervention for patients with anorexia nervosa. Specifically, rates of drop-out at end of treatment (i.e. six-week assessment), as well as intervention adherence (minimum of four of six online guided sessions) and differences between completers and drop-outs were examined. Motivation to change and associated patient variables were assessed as predictors of drop-out (...) using structural equation modelling. Ninety-nine patients were randomised to the intervention arm of the trial. Data were available for 82 individuals, 67 of whom completed the six-week assessment and attended a minimum of four online sessions. No significant differences were found between completers and drop-outs at baseline. At the end of the first week of participation, drop-outs from the six-week assessment or the intervention reported less satisfaction with their work with the mentor delivering online guidance. Greater confidence in own ability to change and higher controlled motivation (willingness to change due to pressure from others) predicted lower drop-out rates from the six-week assessment. Stronger alliance with the therapist at the treatment centre and lower psychological distress were associated with greater autonomous motivation (self-directed motivation) and importance and ability to change. Data demonstrate that a novel online guided self-help intervention for patients with anorexia nervosa is feasible. Early satisfaction with the program and external pressure to change have a protective role against drop-out rates. (shrink)

In recent years, business ethics and economic scholars have been paying greater attention to the development of commons organizing. The latter refers to the processes by which communities of people work in common in the pursuit of the common good. In turn, this promotes commons organizational designs based on collective forms of common goods production, distribution, management and ownership. In this paper, we build on two main literature streams: the ethical approach based on the theory of the common good of (...) the firm in virtue ethics and the economic approach based on the theory of institutions for collective action developed by Ostrom’s research on common-pool resources to avert the tragedy of the commons. The latter expands to include the novel concepts of new commons, “commoning” and polycentric governance. Drawing on the analysis of what is new in these forms of organizing, we propose a comprehensive model, highlighting the integration of two sets of organizing principles—common good and collective action – and five problem-solving processes to explain the main dimensions of commons organizing. We contribute to business ethics literature by exploring the convergence between the ethical and economic approaches in the development of a commons organizing view. (shrink)

It is widely accepted that knowledge of certain of one’s own mental states is authoritative in being epistemically more secure than knowledge of the mental states of others, and theories of self-knowledge have largely appealed to one or the other of two sources to explain this special epistemic status. The first, ‘detectivist’, position, appeals to an inner perception-like basis, whereas the second, ‘constitutivist’, one, appeals to the view that the special security awarded to certain self-knowledge is a conceptual matter. I (...) argue that there is a fundamental class of cases of authoritative self-knowledge, ones in which subjects are consciously thinking about their current, conscious intentional states, that is best accounted for in terms of a theory that is, broadly speaking, introspectionist and detectivist. The position developed has an intuitive plausibility that has inspired many who work in the Cartesian tradition, and the potential to yield a single treatment of the basis of authoritative self-knowledge for both intentional states and sensation states. (shrink)

BackgroundClinical ethics support aims to support health care professionals in dealing with ethical issues in clinical practice. Although the prevalence of CES is increasing, it does meet challenges and pressing questions regarding implementation and organization. In this paper we present a specific way of organizing CES, which we have called integrative CES, and argue that this approach meets some of the challenges regarding implementation and organization.MethodsThis integrative approach was developed in an iterative process, combining actual experiences in a case study (...) in which we offered CES to a team that provides transgender health care and reflecting on the theoretical underpinnings of our work stemming from pragmatism, hermeneutics and organizational and educational sciences.ResultsIn this paper we describe five key characteristics of an integrative approach to CES; 1. Positioning CES more within care practices, 2. Involving new perspectives, 3. Creating co-ownership of CES, 4. Paying attention to follow up, and 5. Developing innovative CES activities through an emerging design.ConclusionsIn the discussion we compare this approach to the integrated approach to CES developed in the US and the hub and spokes strategy developed in Canada. Furthermore, we reflect on how an integrative approach to CES can help to handle some of the challenges of current CES. (shrink)

One of Mark Textor’s main aims in Brentano’s Mind is to refute Brentano’s claim that intentionality – the capacity our mental acts have for being of, about, or directed on something – is the mark of the mental. I defend the view that Brentano analysed intentionality in terms of intentional inexistence (and so wasn’t an intentionality primitivist as Textor suggests). And I argue that we can regard intentionality as being the mark of the mental, but only if we give a (...) non-relational analysis of the idea of intentional inexistence. Textor objects to an analysis of intentionality in terms of intentional inexistence for failing to account for the relationship between the object our mental act is directed on, and the ‘immanent’ or ‘inexistent’ object which all mental acts contain. I claim that this problem doesn’t arise if the object our mental act is directed on just is the immanent/ inexistent object. I argue that Brentano (at least sometimes) seems to identify the two. I then offer my own view of intentionality according to which our mental acts are directed on immanent/ inexistent objects, and that ‘directedness’ should be understood non-relationally. (shrink)

First published in 2000. Routledge is an imprint of Taylor & Francis, an informa company.

Externalist representationalism is touted as a superior rival to naïve realism, and yet a careful analysis of the externalist representationalist's analysis of our ordinary perceptual experiences shows the view to be far closer to naïve realism than we might have expected. One of the central advertised benefits of representationalist views in general is that they are compatible with the idea that ordinary, illusory and hallucinatory perceptual experiences are of the same fundamental kind. Naïve realists are forced to deny the ‘common (...) fundamental kind claim’ and adopt disjunctivism. However, I argue that externalist representationalism is also a version of disjunctivism. Consequently, one of the main rivals to naïve realism turns out not to be a rival at all. (shrink)

In A Treatise of Artificial Magnets, John Michell observes, Not being aware of this property [i.e. the equality of attraction and repulsion], he [Gilbert] concluded from some experiments he had made, not very irationally [sic], that the Needle was not attracted by the magnet, but turned into its position by, what he calls, a disponent virtue […]. For Michell, the disponent virtue 1 is the underlying cause of magnetic phenomena in Gilbert’s treatment. He is not alone. Ridley and Carpenter also (...) read Gilbert’s magnetism as positing a disponent virtue.2 I agree. In this paper, I show what it would entail to treat Gilbertian magnetism as... (shrink)

While committed to the view that Buddhist Reductionism offers the best account of the Abhidharma distinction of the two truths, Siderits (2009) argues that Buddhist Reductionism has the surprising consequence of making itself inexpressible. This inexpressibility follows from the semantic insulation between conventional and ultimate discourses that Siderits argues is required in order to preserve classical logic for both types of discourse, avoiding contradiction and bivalence failure. I argue that inexpressibility is a problematic consequence that threatens to constitute a reductio (...) of Buddhist Reductionism. (shrink)

Locke's political theory centres on juridical matters of law, right, consent and legitimacy. Despite his concern to differentiate politics from family and posit a free and equal post-familial individual as political subject, this apparently abstract political theory is itself conveyed through a narrative of family. Locke rejects patriarchal absolutism that casts the king as a patriarchal father by thinking politics through alternative conceptions of father, sons and brothers. As such, Locke did not in fact help muster liberalism by instantiating a (...) vivid public-private divide that insulated the political imagination from ideas of family. (shrink)

In order to move towards an Ethic of Accounting, one must start by defining the function and role of the accountant. This in turn depends to a great extent on the identity of the client or whatever party the Accountant owes his loyal agency to. The issue is one of cardinal importance, and it is perceived as such by the accountants themselves. Loeb for instance says that the client-identity issue is overriding importance now, and will become even more crucial in (...) the immediate years ahead. The question of what constitutes ethical behaviour on the part of the accountant will depend then upon the relation within which such ethical behaviour will have to be deployed.The main question raised in this paper will therefore be, is the accountant primarily engaged by one client (whether an individual or a corporation) to act as their agent, deal with their problems by loyally advancing their interests to the best of his professional competence, although within the limits imposed by law and morality? Or is the public sector to be considered the principal target of the accountant's resolute professionalism and unswerving loyalty? (shrink)

Background: The concept of dignity can be divided into two main attributes: absolute dignity that calls for recognition of an inner worth of persons and social dignity that can be changeable and can be lost as a result of different social factors and moral behaviours. In this light, the nursing profession has a professional dignity that is to be continually constructed and re-constructed and involves both main attributes of dignity. Objectives: The purpose of this study was to determine how nurses (...) described nursing’s professional dignity in internal medicine and surgery departments in hospital settings. Research design: The research design was qualitative. Ethical considerations: This study was approved by the ethics committees of the healthcare organizations involved. All the participants were provided with information about the purpose and the nature of the study. Participants: A total of 124 nurses participated in this study. Method: The data were collected using 20 focus group sessions in different parts of Italy. The data were analysed by means of a conventional inductive content analysis starting from the information retrieved in order to extract meaning units and sorting the arising phenomena into conceptually meaningful categories and themes. Results: Nursing’s professional dignity was deeply embedded in the innermost part of individuals. Regarding the social part of dignity, a great importance was put on the values that compose nursing’s professional identity, the socio-historical background and the evolution of nursing in the area considered. The social part of dignity was also linked to collaboration with physicians and with healthcare assistants who were thought to have a central role in easing work strain. Equally important, though, was the relationship with peers and senior nurses. Conclusion: The organizational environments under scrutiny with their low staffing levels, overload of work and hierarchical interactions did not promote respect for the dignity of nurses. To understand these professional values, it is pivotal to comprehend the role of different health professions in their cultural milieu and the evolution of the nursing profession in diverse countries. (shrink)

The prevalence and negative impact of brain disorders are increasing. Clinical Neuropsychology is a specialty dedicated to understanding brain-behavior relationships, applying such knowledge to the assessment of cognitive, affective, and behavioral functioning associated with brain disorders, and designing and implementing effective treatments. The need for services goes beyond neurological diseases and has increased in areas of neurodevelopmental and psychiatric conditions, among others. In Europe, a great deal of variability exists in the education and training of Clinical Neuropsychologists. Training models include (...) master’s programs, continuing education courses, doctoral programs, and/or post-doctoral specialization depending on the country, with no common framework of requirements, although patients’ needs demand equal competencies across Europe. In the past five years, the Standing Committee on Clinical Neuropsychology of the European Federation of Psychologists’ Association has conducted a series of surveys and interviews with experts in the field representing 30 European countries. The information, along with information from the existing literature, is used in presenting an overview of current and relevant topics related to policy and guidelines in the training and competencies in Clinical Neuropsychology. An option for the way forward is the EuroPsy Specialist Certificate which is currently offered in Work- and Organizational psychology and Psychotherapy. It builds upon the Basic Certificate and complements national standards without overriding them. General principles can be found that can set the basis for a common, solid, and comprehensive specialty education/training, sharpening the Neuropsychologists’ competencies across Europe. The requirements in Clinical Neuropsychology should be comparable to those for the existing specialty areas in the EuroPsy model. Despite the perceived challenges, developing a Specialist Certificate appears a step forward for the development of Clinical Neuropsychology. Recommendations are proposed towards a shared framework of competencies by the means of a common level of education/training for the professionals in Europe. Benchmarking training standards and competencies across Europe has the potential of providing protection against unqualified and ethically questionable practice, creating transparency, raising the general European standard, and promoting mobility of both Clinical Neuropsychologists and patients in Europe, for the benefit of the professional field and the population. (shrink)

The authors of this volume elucidate the remarkable role played by religion in the shaping and reshaping of narrative forms in antiquity and late antiquity in a variety of ways. This is particularly evident in ancient Jewish and Christian narrative, which is in the focus of most of the contributions, but also in some “pagan” novels such as that of Heliodorus, which is dealt with as well in the third part of the volume, both in an illuminating comparison with Christian (...) novels and in an inspiring rethinking of Heliodorus's relation to Neoplatonism. All of these essays, from different perspectives, illuminate the interplay between narrative and religion, and show how religious concerns and agendas shaped narrative forms in Judaism and early Christianity. A series of compelling and innovative articles, all based on fresh and often groundbreaking research by eminent specialists, is divided into three large sections: part one deals with ancient Jewish narrative, and part two with ancient Christian narrative, in particular gospels, acts, biographies, and martyrdoms, while part three offers a comparison with “pagan” narrative, and especially the religious novel of Heliodorus, both in terms of social perspectives and in terms of philosophical and religious agendas. Like the essays collected by Marília Futre Pinheiro, Judith Perkins, and Richard Pervo in 2013, which investigate the core role played by narratives in Christian and Jewish self-fashioning in the Roman Empire, the present volume fruitfully bridges the disciplinary gap between classical studies and ancient Jewish and Christian studies, offers new insights, and hopefully opens up new paths of inquiry. Contributions by (in alphabetical order): Cathryn Chew, Mark J. Edwards, Erich Gruen, Vincent Hunink, David Konstan, Karen King, Dennis MacDonald, Laura S. Nasrallah, Judith Perkins, Richard Pervo, Ilaria Ramelli, Lautaro Roig Lanzillotta, Svetla Slaveva-Griffin, and Lawrence Wills. (shrink)

Le droit culturel international a été renforcé grâce à l'adoption par l'Unesco de la Convention sur la protection et la promotion de la diversité des expressions culturelles. Ce texte relie la culture à la coopération internationale, au développement et aux droits de l'homme. Sa mise en oeuvre devient un véritable défi, et son suivi se révèle une nécessité. La diversité culturelle, déjà objet d'étude de l'anthropologie, doit à présent devenir un concept politique et être mis en pratique. La culture doit (...) être envisagée comme vecteur de la vie politique, économique et sociale, tant au niveau national qu'au niveau des rapports entre les différentes aires culturelles. Réfléchir à la problématique de l'Autre, gérer l'acculturation et la cohabitation culturelle devient une question politique, et la gestion des rapports entre culture, communication, société et politique requiert la construction de théories spécifiques et adaptées.The international cultural right has been strengthened with the adoption by the Unesco Convention on the Protection and Promotion of the Diversity of Cultural Expressions. This text connects culture international cooperation, development and human rights. Its implementation is a challenge, and its follow-up reveals a necessity. Cultural diversity, already an object of study of anthropology, has now become a political concept and be put into practice. Culture should be considered as a vector of political, economic and social, both nationally and relationships between different cultural areas. Consider the problem of the Other, managing acculturation and cultural cohabitation becomes a political issue, and the management of the relationship between culture and communication, society and politics requires the construction of specific theories and adapted. (shrink)

Consumption--the flow of physical materials in human lives--is an important ethical issue. Be it fair trade coffee or foreign oil, North Americans' consumption choices affect the well-being of humans around the globe, in addition to impacting the natural world and consumers themselves. In this book, Laura Hartman seeks to formulate a coherent Christian ethic of consumption.

There are three main intersections between transhumanism and the future of work, related to the different meanings of transhumanism: 1. the radical meaning of the transformation of the human condition towards perfection beyond humanity conceived as a limitation ) in the context of the devaluation of the human being1: towards perfection «beyond» the human range in the workplace; 2. the intermediate meaning of enhancement as the quantitative and qualitative increase of human capacities 2: towards perfection «in» humans in the workplace; (...) 3. the use of emerging technologies 3 in order to enhance «human work». (shrink)

In this paper, we examine the drivers involved in an alternative business model: cross-sector social partnerships between for-profit, predominantly multinational corporations and nonprofit organizations. We explore these cross-sector social partnerships from the perspective of these primary stakeholders, examining the questions of power differentials and the definitions and determinants of success. In order more deeply to understand these drivers, we review the evolution of the concept of “value” and the perception of the value that each stakeholder brings to the partnership. We (...) then describe and offer the results of an empirical, qualitative study of 18 CSSPs, where we analyze each partner's representations of success, outcomes sought and distinctions in determinants of value within the partnerships. (shrink)

This study examines how the self-reported cheating behaviors of students from a single large institution serving primarily adult students in online courses differ from those previously reported in large-scale studies of academic integrity among traditional-age college students. Specifically, the research presented here demonstrates that students at a large online university are no more likely to engage in most forms of cheating than the traditional-age students in residential institutions studied by Donald McCabe in his seminal research on academic integrity. Relatedly, our (...) study finds that students’ age decreases the likelihood of engaging in cheating behaviors. Moreover, traditional-age undergraduates in our study were no more likely to engage in cheating behaviors than the undergraduate students McCabe surveyed. Our study offers a unique contribution to the extant literature on academic integrity, as we believe this is the largest survey of student attitudes, beliefs, and behaviors from a single institution. The research presented here confounds the common perception that cheating is more prevalent and easier to accomplish in online learning and assessment. (shrink)

This article is an expansion of comments I was honored to present at a celebration of the life and work of Anne Donchin at the June 2016 meeting of the International Network on Feminist Approaches to Bioethics in Edinburgh. It is obviously far from comprehensive, but I hope it gives readers a glimpse of an Anne of whose depths many of us were not fully aware. One of the most difficult parts of talking about someone who has died is highlighting (...) the positive without overdoing it to the extent that their friends and loved ones find themselves rolling their mental eyes a bit, since most of us—no matter how wonderful—are a little less than perfect. But my problem here is that the more I have found out... (shrink)

There is increasing global pressure to ensure that pregnant women are responsibly and safely included in clinical research in order to improve the evidence base that underpins healthcare delivery during pregnancy. One supposed barrier to inclusion is the assumption that pregnant women will be reluctant to participate in research. There is however very little empirical research investigating the views of pregnant women. Their perspective on the benefits, burdens and risks of research is a crucial component to ensuring effective recruitment. The (...) Research In Pregnancy Ethics study set out to ascertain the views of pregnant women about research participation using an inductive thematic analysis. We conducted semi-structured interviews with 20 women who had participated in a double-blind randomised placebo controlled trial in Wellington while pregnant. Our results show that at least some pregnant women recognise the value and importance of research during pregnancy. The women we interviewed were deeply invested in the research process and outcomes. Key motivations for participating were altruism, playing a valuable civic role and the importance of research. The main perceived burdens related to inconvenience and time commitment. For some women, possible randomization to the placebo arm was regarded as a burden or disadvantage. (shrink)

O objetivo deste trabalho é apresentar as críticas feitas por neurocientistas às pesquisas que buscam diferenças cognitivas entre homens e mulheres presentes no cérebro, principalmente, utilizando o respaldo da neuroimagem. Desde o início dos anos 2000, a preocupação com a utilização da neurociência para justificar estereótipos de gênero e a falta de critério dos responsáveis para diferenciar as expressões “sexo” e “gênero” têm envolvido diversas neurocientistas no debate mais profundo entre natureza e cultura apresentado por essas pesquisas. Além disso, é (...) imperativo pensarmos no impacto desses resultados, considerando que eles fornecem argumentos para os diversos discursos sociais e contribuem muito para o entendimento das habilidades humanas. (shrink)

From the earliest application of modern randomized controlled trials in medical research, scientists and observers have deliberated the ethics of randomly allocating study participants to trial control arms. Adaptive RCT designs have been promoted as ethically advantageous over conventional RCTs because they reduce the allocation of subjects to what appear to be inferior treatments. Critical assessment of this claim is important, as adaptive designs are changing medical research, with the potential to significantly shift how clinical trials are conducted. Policy-makers are (...) swiftly moving to encourage greater use of adaptive designs. In 2016, the newly enacted 21st Century Cures Act instructed the Food and Drug Administration to help product sponsors incorporate adaptive methods into proposed clinical trial protocols and applications for investigational drugs and also biological products. In this article, we review the ethical justifications commonly offered for adaptive designs, explore these arguments in the context of actual trials, and contend that clinical equipoise is a useful standard for adaptive-trial ethics. We distinguish between theoretical and clinical equipoise and explain why ethical arguments related to adaptive trials tend to focus on the former. Yet we contend that theoretical equipoise can be an unreliable standard for adaptive ethics. While we contend that clinical equipoise is the most critical principle for the primary ethical concerns posed by adaptive trials, we suggest ethical approaches to deal with some additional concerns unique to adaptive designs. (shrink)