The “lone” clinical bioethicist working in a large, multisite hospital faces considerable challenges. While attempting to build ethics capacity and sustain a demanding range of responsibilities, he or she must also achieve an acceptable level of integration, sustainability, and accountability within a complex organisational structure. In an effort to address such inherent demands and to create a platform towards better evaluation and effectiveness, the Clinical Ethics Group at the Joint Centre for Bioethics at the University of Toronto is implementing the (...) Hub and Spokes Strategy at seven hospitals. The goal of the Hub and Spokes Strategy is to foster an ethical climate and strengthen ethics capacity broadly throughout healthcare settings as well as create models in clinical bioethics that are excellent and effective. (shrink)

With the rapid development of genetic research and applications in health care there is some agreement among funding and regulatory bodies that the public(s) need to be equipped to deal with the choices that the new technologies will offer them, although this does not necessarily include a role for the public in influencing their development and regulation. This paper considers the methods and purpose of public consultations in the area of genetics including large-scale surveys of opinion, consensus conferences and focus (...) groups. Consultation has been undertaken to enable the researchers/policy makers to see what the public do not know and plan more public education to make up the deficiency, to check on areas of concern so that public education can be used to address them or to gain a public mandate for a planned policy. An alternative and more recent approach is to find out what the public(s) do know and understand and to see how experts can learn from them in order to get a fuller view of technology in use. (shrink)

My main goal here is to develop a functional analysis of cheating and corruption in sports, and to differentiate cheating within the broader category of corruption. Whereas officials can act corruptly, they cannot cheat. In contrast, sports participants, since they occupy two roles, can do both. I argue that although acts of cheating are acts of corruption, not all corrupt acts by competitors are acts of cheating. I also respond to some skeptical challenges and criticisms of the concept of ‘cheating’ (...) by providing some opposing arguments and a provisional definition. I argue that cheating in sports occurs in the context of a complex institutional practice. It transpires due to some failing in the efforts and/or limitations of sports officials to prohibit it. In central cases it consists in both the functional and ethical violation of the constitutional norms of a sport in the service of obtaining unearned victory for the cheater. (shrink)

In recent literature on the philosophical foundations of socialism a growing number of theorists have endorsed the claim that freedom as non-domination is a fundamental normative commitment undergirding socialist politics. On this sort of view, a broad range of traditional socialist claims can be explained and justified by reference to freedom as non-domination. In this paper, I argue that even if these theorists are right that opposition to domination is a core socialist normative commitment, it is not clear that that (...) opposition is best understood in terms of a commitment to a particular conception of freedom. Instead, socialist opposition to domination can be more fruitfully understood as flowing from a commitment to a relational conception of equality, according to which relationships with a substantially egalitarian character have a special value. I argue, first, that a relational egalitarian construal of socialist opposition to domination can retain all of the benefits of the freedom as non-domination construal, and, secondly, that a relational egalitarian account will have benefits that a freedom as non-domination approach will lack. I conclude that there are still significant benefits to retaining a place for equality in our considered account of the normative foundations of socialism. (shrink)

Deep ethical interpretivism has been the standard view of the nature of sport in the philosophy of sport for the past seventeen years or so. On this account excellence assumes the role of the foundational, ethical goal that justice assumes in Ronald Dworkin’s interpretivist model of law. However, since excellence in sports is not an ethical value, and since it should not be regarded as an ultimate goal, the case for the traditional account fails. It should be replaced by the (...) shallow interpretivist model that I begin to sketch out and defend here. (shrink)

We explore the meaning and implications of Bourdieu’s construct of the field of power and integrate it into a wider conception of the formation and functioning of elites at the highest level in society. Corporate leaders active within the field of power hold prominent roles in numerous organizations, constituting an ‘elite of elites’, whose networks integrate powerful participants from different fields. As ‘bridging actors’, they form coalitions to determine institutional settlements and societal resource flows. We ask how some corporate actors (...) (minority) become hyper-agents, those actors who ‘make things happen’, while others (majority) remain ‘ordinary’ members of the elite. Three hypotheses are developed and tested using extensive data on the French business elite. Social class emerges as persistently important, challenging the myth of meritocratic inclusion. Our primary contribution to Bourdieusian scholarship lies in our analysis of hyper-agents, revealing the debts these dominants owe to elite schools and privileged classes. (shrink)

Introduction: This article discusses ethical, legal and social issues raised by the collection, storage and use of DNA in forensic databases. Review: The largest and most inclusive forensic database in the world, the UK National DNA database, leads the worldwide trend towards greater inclusivity. The performance of the NDNAD, criteria for inclusion, legislative framework and plans for integrating forensic databases across Europe are discussed. Comparisons are drawn with UK biobank that has started collecting DNA samples linked to medical records and, (...) unlike the NDNAD, requires informed consent from volunteers, allows withdrawal of samples and only includes adults. The potential uses of research into genes associated with violent and ‘antisocial’ behaviour are discussed in the context of an increasing degree of surveillance in the UK. Conclusion: It should not be assumed that the benefits of forensic databases will necessarily override the social and ethical costs, regardless of changes to the criteria for inclusion or the permitted uses of samples and profiles. The expansion of forensic databases raises issues of relevance to the medical profession. (shrink)

Are sociologists always critical about genetics? Are philosophers always more supportive? This is the impression of many sociologists in the United Kingdom who argue that contemporary British philosophers criticise genetic technologies and applications in ways that scientists and medical doctors can deal with. They emphasise matters like informed consent, but pay less or no attention to the wider social consequences of technologies, practices and policies. Philosophers in their turn may see sociologists as irrationally hostile to science and medical practice. Some (...) of them refuse to criticise genetics, arguing that there is nothing to criticise. Others feel that their criticisms are in fact more accurate than the concerns raised by sociologists. And yet others point out that the impression of uncritical support can only be true of a certain specific group. Philosophers have so many internal disagreements among themselves that the generalisation can hardly be justified. In this paper an attempt is made by a sociologist and a philosopher to understand how sociological and philosophical perspectives on bioethics may differ in discussions about genetics. The paper, which proceeds in dialogue form, is based on our email correspondence on the advantages and disadvantages of genetic technologies and their applications, and on the idea of social consequences as understood by scholars from two different disciplines. (shrink)

concepts are defined as concepts that cannot be experienced directly through the sensorimotor modalities. Explaining our understanding of such concepts poses a challenge to neurocognitive models of knowledge. One account of how these concepts come to be represented is that sensorimotor representations of grounded experiences are reactivated in a way that is constitutive of the abstract concept. In the present experiment, we investigated how sensorimotor information might constitute GOD-related concepts, and whether a person’s self-reported religiosity modulated this grounding. To do (...) so, we manipulated both the state of the body and the state of stimuli in two tasks that required conceptual categorization of abstract words. Linear Mixed Effects model fitting procedures were used to determine which manipulated factors best predicted response latency and accuracy in both tasks. We successfully replicated previous research demonstrating faster categorization of GOD-related words when they were presented at the top of the screen. Importantly, results demonstrated that the kneeling posture manipulation enhanced this effect, as did religiosity, as participants who scored higher in religiosity showed a greater effect of the posture manipulation on the speed with which word categorization occurred when those words were presented in the higher visuospatial presentation condition. Overall, we interpreted our findings to suggest that directly manipulating sensorimotor information can facilitate the categorization of abstract concepts, supporting the notion that this information in part constitutes the representation of abstract concepts. (shrink)

The past decade has seen profound changes in the relationship between humanitarian and political action. The political determinants of humanitarian crises are now acknowledged, so too is their chronicity, and the limits of relief aid as a form of intervention are thus more fully understood. In 1994, in the refugee camps of Goma, Zaire, there was widespread manipulation of aid resources by armed groups implicated in the genocide in Rwanda. This experience highlighted a wider concern that, rather than doing good, (...) emergency aid can fuel violence. The apparent consensus that humanitarian assistance can somehow stand outside politics gave way to calls for tighter linkage between aid and political responses to crises. (shrink)

In this paper, I defend a general theory of competition and contrast it with a corresponding general theory of cooperation. I then use this analysis to critique mutualism. Building on the work of Arthur Applbaum and Joseph Heath I develop an alternative adversarial model of competitive sport, one that helps explain and is partly justified by shallow interpretivism, and argue that this model helps shows that the claim that mutualism provides us with the most defensible ethical ideal of sport is (...) false. By replacing that view with an understanding of sporting adversarial ethics we can appreciate that the ethics of sport are more complex than has been commonly recognized. (shrink)

Objectives—The development of predictive genetic tests provides a new area where consumers can gain knowledge of their health status and commercial opportunities. “Over-the-counter” or mail order genetic tests are most likely to provide information on carrier status or the risk of developing a multifactorial disease. The paper considers the social and ethical implications of individuals purchasing genetic tests and whether genetic information is different from other types of health information which individuals can obtain for themselves.Design—The discussion is illustrated by findings (...) from a questionnaire survey of university students as potential consumers. Topics covered included what health tests they had already used, expectations of genetic tests, willingness to pay, who should have access to the results and whether there need to be restrictions on such tests.Sample—Six hundred and fifteen first-year students in the universities of Leuven, Cardiff, Central Lancashire, Vienna and Nijmegen studying either medicine or a non-science subject.Results—Students were enthusiastic about genetic tests and had high expectations of their accuracy and usefulness but most thought they should be available through the health service and a minority thought that some tests, for example for sex selection, should not be available at all. There were few differences in responses by sex or subject of study but some by country. The paper also considers ethical and social issues outside the scope of a questionnaire survey of this type.Conclusion—To address some of these issues the sale of genetic tests to individuals can be made subject to ethical guidelines or codes of practice, for example to protect vulnerable groups, but there are fundamental social and ethical questions which such guidelines cannot address. (shrink)

The idea of individual responsibility for action is central to our conception of what it is to be a person. Behavioural genetic research may seem to call into question the idea of individual responsibility with possible implications for the criminal justice system. These implications will depend on the understandings of the various agencies and professional groups involved in responding to violent and anti-social behaviour, and, the result of negotiations between them over resulting practice. The paper considers two kinds of approaches (...) to the question of responsibility and ‘criminal genes’ arising from a sociological and philosophical perspective respectively. One is to consider the social context and possible practical implications of research into ‘criminal genes’ which will later be examined through interviews and discussions with a range of experts including lawyers and social workers. A second and different kind of approach is to ask whether the findings of behavioural genetics ought to have implications for attributions of responsibility. Issues of genetic influence are central to both approaches. (shrink)

ABSTRACTIn this article, I begin to develop and defend a reformed concept of ‘cheating’ as ‘wrongful competitive norm violating’. I then use this to reject Oliver Leaman’s view that cheating is som...

Biobanks that are run on an opt-in basis depend on people having the motivation to give and to trust in those who control their samples. Yet in the UK trust in the healthcare system has been in decline and there have been a number of health-related scandals that have received widespread media and public attention. Given this background, and the previous public consultations on UK Biobank, the paper explores the way people express their trust and mistrust in the area of (...) medical and genetic information through discussions in six focus groups held in different areas of Britain. The themes that emerged in the discussion were the special character of genetic data; the ease with which information spreads; the public/private divide in genetic research; the potential of genetic information to harm people; choice, consent and lack of control; and the difficulty of establishing trustworthy governing arrangements. The expert agenda of policy-makers and medical ethics does not address the broader concerns expressed by participants. It seems that public consultation and the language of openness and transparency may not be sufficient to establish trust in the governance of genetic databases. Donors will be asked to give freely without any return but the participants' perception of those using the samples is that they are motivated by success and profit rather than healthcare priorities. In this context altruism seems naive and even dangerous. In order to place their trust well people need evidence of a relationship with obligations and expectations on both sides. (shrink)

Much of the current genetic research into aggressive and violent behaviour focuses on young people and might appear to offer the hope of targeted prediction and intervention. In the UK data is collected on children from various agencies and collated to produce ‘at risk of offending’ identities used to justify intervention. Information from behavioural genetic tests could conceivably be included. Regulatory frameworks for collecting, storing and using information from DNA samples differ between the health service and the police particularly in (...) the need for consent and the treatment of children. This paper draws on discussions with professionals involved with ‘problem’ young people to consider their views on the utility of genetic research for tackling violent/aggressive behaviour and the impact an identification of genetic susceptibility might have on their clients. (shrink)

This volume contains essays which cover a range of aspects in the debate over genetic testing. It looks at both the advantages and disadvantages involved in knowing or not knowing whether one is a carrier of certain genetic traits.

In this article I develop my argument for a shallow interpretivist theory of sport by showing that whereas it applies to all oppositional sports, the standard theory of sport for the past twenty ye...

Trying to separate out nature and nurture as explanations for behaviour, as in classic genetic studies of twins and families, is now said to be both impossible and unproductive. In practice the nature-nurture model persists as a way of framing discussion on the causes of behaviour in genetic research papers, as well as in the media and lay debate. Social and environmental theories of crime have been dominant in criminology and in public policy while biological theories have been seen as (...) outdated and discredited. Recently, research into genetic variations associated with aggressive and antisocial behaviour has received more attention in the media. This paper explores ideas on the role of nature and nurture in violent and antisocial behaviour through interviews and open-ended questionnaires among lay publics. There was general agreement that everybody’s behaviour is influenced to varying degrees by both genetic and environmental factors but deterministic accounts of causation, except in exceptional circumstances, were rejected. Only an emphasis on nature was seen as dangerous in its consequences, for society and for individuals themselves. Whereas academic researchers approach the debate from their disciplinary perspectives which may or may not engage with practical and policy issues, the key issue for the public was what sort of explanations of behaviour will lead to the best outcomes for all concerned. (shrink)

For the legal system to function effectively people are generally viewed as autonomous actors able to exercise choice and responsible for their actions. It is conceivable that genetic traits associated with violent and antisocial behaviour could call into question an affected individual’s responsibility for acts of criminal violence. Evidence concerning genes associated with violent and antisocial behaviour has been introduced in criminal courts in USA and Italy, either alone or with associated environmental factors. One example of a ‘genetic defence’ is (...) based on low levels of monoamine oxidase A activity, with a prevalence of around thirty percent in Caucasian males. In countries with trial by jury it is particularly relevant to consider the views of publics on criminal liability and the significance they assign to evidence citing genetic influences on behaviour. This article draws on largely qualitative research looking at participants’ explanations of, and assigning of responsibility for, violent and antisocial behaviour where environmental or genetic influences are claimed. Genetic factors were not viewed deterministically by participants but were considered by most to be irrelevant to personal responsibility. Notions of human agency, free will and choice were crucial to explanations of problem behaviours and ensured that offenders could be held responsible despite evidence on environmental and genetic factors. (shrink)

Within academic circles, the “deficit” model of public understanding of science has been subject to increasing critical scrutiny by those who favor more constructivist approaches. These suggest that “the public” can articulate sophisticated ideas about the social and ethical implications of science regardless of their level of technical knowledge. The seminal studies following constructivist approaches have generally involved small-scale qualitative investigations, which have minimized the pre-framing of issues to a greater or lesser extent. This article describes the Gene Week Project, (...) sponsored by the Wellcome Trust, which attempted to extend this work to a large-scale consultation on genetics and health through the medium of a local daily newspaper. Readers were invited to respond to a set of open-ended questions that accompanied stimulus material published each day for five consecutive weekdays. The articles were written with the intention of extending the limited range of discourses around genetics and biotechnology that are usually presented by the popular media. Responses raised overarching issues about the place of emerging health technologies in society reminiscent of previous open-ended consultations in this field. The paper ends with a critical discussion about the potential of this method to contribute to the further development of open-ended public consultations. (shrink)

Analysis of microtubule proteins from several sources has revealed a molecular complexity consistent with the proposed multi‐functional nature of tubulin and microtubule‐associated proteins (MAP). Less certain is the actual range of functions attributable to microtubules and how the variability exhibited by the microtubule proteins translates into functional specificity. In spite of the conceptual difficulties, an exciting picture of structure/function integration is emerging from the study of microtubules.

It is the task of theology in every age to discover formulations of belief which are both traditionally and genuinely meaningful. The Book of Acts presents Jesus Christ, absent since his ascension, yet powerfully present in a complex of ways, which may be catalytically provocative for the thinking of faith today.

ABSTRACTBernard Suits and other formalists endorse both the logical incompatibility thesis and the view that rule-breakings resulting in penalties can be a legitimate part of a game. This is what Fred D’Agostino calls ‘the problem of penalties’. In this paper, I reject both Suits’ and D’Agostino’s responses to the problem and argue instead that the solution is to abandon Suits’ view that the constitutive rules of all games are alike. Whereas the logical incompatibility thesis applies to games in which players’ (...) actions are perfectly controlled, it does not apply to sports. This insight not only justifies the rejection of formalism as a theory about the nature of sport but it also helps explain the greater normative complexity of sports, which in turn leads to the idea that in sports ‘cheating’ should be interpreted as a genus. (shrink)

The organ shortage is commonly presented as having a clear solution, increase the number of organs donated and the problem will be solved. In the light of the Northern Ireland Assembly’s consultation on moving to an opt-out organ donor register this article focusses on the social factors and complexities which impact strongly on both the supply of, and demand for, transplantable organs. Judging by the experience of other countries presumed consent systems may or may not increase donations but have not (...) met demand. Donation rates have risen considerably in all parts of the UK recently but there is also an increasing demand for organs. Looking at international donation rates and attitudes, future demand for organs and education on donation, the question is whether the organ shortage could ever be met. The increase in longevity, in rates of diabetes and obesity and in alcohol related liver disease all contribute both to increased demand for transplants, and re-transplants, and a reduction in the number of usable organs. It is unlikely that demand could ever be met, since, if supply was unlimited, the focus would move to financial resources and competing demands on the health care budget in a publicly funded health system. These factors point to the need to focus on ways of reducing, or at least stabilizing, demand where lifestyle factors contribute to the underlying disease. (shrink)

Public policy analysis, a profession aimed at knowledge transfer, gives advice concerning public decisions. It can also recommend styles of reasoning, for citizens as well as analysts, to decrease the likelihood of misutilization of knowledge. These recommendations are more appropriate for an early stage of discourse reasoned proposal selection, than for the later stage of persuasion.

According to the Higher-Order Thought (HOT) theory of consciousness, conscious states are just those states that are the object of a suitable higher-order thought to the effect that one is in that state. These higher-order thoughts perform this role by providing subjects with a particular type of _awareness_. However, HOT theorists have tended to offer two alternative formulations of this awareness when stating the basic claims of HOT theory. According to what I call the _state formulation_ of HOT theory, HOTs (...) provide subjects with an awareness of _mental states_, and a mental state is conscious only if the subject is aware of that state. According to what I call the _oneself formulation_ of HOT theory, HOTs provide subjects with an awareness of _themselves as being in a mental state_, and a mental state is conscious only if the subject is aware of themselves as being in that state. In this paper I explore the dialectical significance and legitimacy of HOT theorists’ current practice of employing both formulations. I argue that there is some reason for HOT theorists to adopt the oneself formulation, rather than the state formulation. However, this appears to weaken HOT theory considerably, by abandoning the idea that when our mental states are conscious, we are aware of those states themselves. Against this objection I argue that adopting the oneself formulation does not require abandoning the basic idea lying behind the state formulation and that this is consistent with the reasons for favouring the oneself formulation. (shrink)

Ethical issues surrounding research are complex and multifaceted. There are issues concerning: the methods used, the intended purpose, the foreseen and unforeseen effects, the use and dissemination of findings, and, not least, what is and what fails to be researched. - In this article we break down the issues into two main categories: (I) how the research itself is done; and (II) how it is determined by and in turn affects a wider context. In the first section we discuss familiar (...) issues such as the need for methodologically sound investigation, appropriate protections for the human subjects of research, as well as issues arising in collaborative research. The second set of issues is less well investigated and, indeed, particularly difficult to address; these are issues that extend well beyond the control of the researcher(s) or, quite often, any one individual or organization. We discuss the selection of research topics, research funding, publication and, finally, the role of external ethical guidelines and their institutional setting. (shrink)

Berenicen statim ab urbe dimisit invitus invitam.As for Berenice, he immediately dismissed her from the city against his will, against her will. Suetonius' laconic description of Titus' dismissal of his consort, the Herodian Berenice, after his accession to the Principate has attracted the attention of readers across the centuries. The biographer's use of polyptoton, invitus invitam, to describe the mental states of the Roman princeps and Judaean princess has been read as particularly moving. Perhaps most notably, Racine turned the emperor's (...) banishment of his lover into the central dilemma of his tragedy Bérénice. At the start of his preface to the text of the play, the dramatist amalgamates this sentence with another from earlier in the chapter, retaining the striking repetition, ‘Titus reginam Berenicen cui etiam nuptias pollicitus ferebatur, statim ab Urbe dimisit invitus invitam’. Racine claims that this account of the dismissal of Berenice provides appropriate subject matter for tragic poetry and, to support his case, he compares Virgil's treatment of the separation of Aeneas and Dido to the situation of Titus and Berenice. Suetonius is not normally read as a literarily sophisticated writer, but we should take a cue from Racine's response to this sentence. In this article, I argue that Suetonius himself chose to compare Titus and Berenice with Dido and Aeneas by an allusion in this sentence to Virgil's Aeneid and to Catullus' translation of the Coma Berenices. Within a rather matter-of-fact presentation of the relationship between the Flavian emperor and his Herodian consort, Suetonius evoked a more dramatic model. (shrink)