Ethical decision making in medicine has recently seen calls to move towards less prescriptive- based approaches that consider the particularities of each case. The main alternative call from the literature is for better understanding of phronesis concepts applied to decision making. A well-cited phronesis-based approach is Kaldjian’s five-stage theoretical framework: goals, concrete circumstances, virtues, deliberation and motivation to act. We build on Kaldjian’s theory after using his framework to analyse data collected from a three-year empirical study of phronesis and the (...) medical community. The data are a set of narratives collected in response to asking a medical community what making ethically wise decisions means to them. We found that Kaldjian’s five concepts are present in the accounts to some extent but that one of the elements, motivation, is constructed as playing a different, though still crucial role. Rather than being an end-stage of the process as Kaldjian’s framework suggests, motivation was constructed as initiating the process and maintaining the momentum of taking a phronesis-based approach. The implications for medical ethics decision-making education are significant as motivation itself is a highly complex concept. We therefore theorise that motivation is required for leading in, continuing and completing the actions of the ethical decision taken. Appreciating the central importance of motivation through the whole of Kaldjian’s framework has implications for cultivating the virtues of phronesis and courage to take the right course of action. (shrink)

Volume 20, Issue 3, March 2020, Page 73-74.

Contemporary clinical ethics was founded on principlism, and the four principles: respect for autonomy, nonmaleficence, beneficence and justice, remain dominant in medical ethics discourse and practice. These principles are held to be expansive enough to provide the basis for the ethical practice of medicine across cultures. Although principlism remains subject to critique and revision, the four-principle model continues to be taught and applied across the world. As the practice of medicine globalizes, it remains critical to examine the extent to which (...) both the four-principle framework, and individual principles among the four, suffice patients and practitioners in different social and cultural contexts. Using the four-principle model we analyze two accounts of surrogate decision making – one from the developed and one from the developing world – in which the clinician undertakes medical decision-making with apparently little input from the patient and/or family. The purpose of this analysis is to highlight challenges in assessing ethical behaviour according to the principlist model. We next describe cultural expectations and mores that inform both patient and clinician behaviors in these scenarios in order to argue that the principle of respect for persons informed by culture-specific ideas of personhood may offer an improved ethical construct for analyzing and guiding medical practice in a globalized and plural world. (shrink)

Multinational companies commonly and increasingly undertake their research in low and middle-income countries through commercial clinical research organizations (CROs). The involvement of these scientific middle men complicates the application of the theories of justice. We examine those complexities, and conclude that while the difficulties are not immune to analysis in terms of these theories, the theories have to be deployed in new ways in order to be useful in the new commercial world.

BackgroundMedical ethics has recently seen a drive away from multiple prescriptive approaches, where physicians are inundated with guidelines and principles, towards alternative, less deontological perspectives. This represents a clear call for theory building that does not produce more guidelines. Phronesis (practical wisdom) offers an alternative approach for ethical decision-making based on an application of accumulated wisdom gained through previous practice dilemmas and decisions experienced by practitioners. Phronesis, as an ‘executive virtue’, offers a way to navigate the practice virtues for any (...) given case to reach a final decision on the way forward. However, very limited empirical data exist to support the theory of phronesis-based medical decision-making, and what does exist tends to focus on individual practitioners rather than practice-based communities of physicians.MethodsThe primary research question was: What does it mean to medical practitioners to make ethically wise decisions for patients and their communities? A three-year ethnographic study explored the practical wisdom of doctors (n = 131) and used their narratives to develop theoretical understanding of the concepts of ethical decision-making. Data collection included narrative interviews and observations with hospital doctors and General Practitioners at all stages in career progression. The analysis draws on neo-Aristotelian, MacIntyrean concepts of practice- based virtue ethics and was supported by an arts-based film production process.ResultsWe found that individually doctors conveyed many different practice virtues and those were consolidated into fifteen virtue continua that convey the participants’ ‘collective practical wisdom’, including the phronesis virtue. This study advances the existing theory and practice on phronesis as a decision-making approach due to the availability of these continua.ConclusionGiven the arguments that doctors feel professionally and personally vulnerable in the context of ethical decision-making, the continua in the form of a video series and app based moral debating resource can support before, during and after decision-making reflection. The potential implications are that these theoretical findings can be used by educators and practitioners as a non-prescriptive alternative to improve ethical decision-making, thereby addressing the call in the literature, and benefit patients and their communities, as well. (shrink)

This paper presents a cross-sectional study that demonstrates how King Abdulaziz University has responded to the lockdown imposed by the Ministry of Education in Saudi Arabia due to the Covid-19 pandemic. The purpose of this study was to examine the perceptions of students and faculty towards assessment that had to take place online due to physical or social distancing rules and lockdowns. A descriptive mixed-method study was conducted with two different self-administered questionnaires that were developed for students and faculty, respectively. (...) A total of 547 responses were received from undergraduate students and 213 from faculty. The main finding suggests the need for a multilevel approach to the problems of cheating and plagiarism, including raising student awareness and ethics, training teachers to detect cheating methods, and institutions activating their code of practice and applying severe sanctions on those who engage in such practices. (shrink)

Drawing on 2 years of field research conducted between 2008 and 2010 in London’s Kurdish community, I discuss the practical and ethical challenges that confront researchers dealing with violence against women committed in the name of ‘honour’. In examining how feminist methodologies and principles inform my research, I address issues of researcher positioning and the importance of speaking with, rather than for, marginalised groups. I then explore the difficulties of operationalising this position when dealing with honour-based violence. Using the interview (...) data from the 2008–2010 study and a case study of the trial of Mehmet Goren (who was convicted in 2009 of murdering his daughter Tulay for supposedly dishonouring their family), I discuss the socio-cultural norms and values underlying honour codes, examining both the position of men and women in relation to the maintenance of family honour and the regulation of women’s sexuality and conduct. In particular, I explore the difficulties inherent in obtaining and understanding victims’ own personal narratives, especially in legal settings, while simultaneously showing how it is only through empowering women to speak for themselves that we will be able to bring about the deep societal changes needed to eradicate honour-based violence. (shrink)

In fact, it can be easily said that during the Prophet's time and in the early periods after him, women were visibly active in the fields of science, commerce, and politics. Because at the time of the revelation of the Qur'an, not only men but also women were making great efforts to learn and teach the Prophet's message as in many other fields. In the first period, many female Companions, especially Prophet 'A'isha and other Ummah-i Believers, made serious efforts to (...) learn the hadiths and pass them on to future generations. The woman, like the man, is Allah's caliph on earth. There is no difference between men and women in terms of honor, dignity and value in the sight of Allah. Both have separate rights and duties. During the Jahiliyyah period, girls were buried alive after birth, but the birth of Islam and the Age of Bliss (the Age of the Prophet) marked the beginning of a happy era for women. Muslim women companions actively participated in education, religious discussions, trade and warfare. In conclusion, Islam aimed to liberate women from the violence of the age of ignorance. It emphasized women's freedom of property, work, learning knowledge and family happiness. (shrink)

Communication between road users is a major key to coordinate movement and increase roadway safety. The aim of this work was to grasp how pedestrians (Experiment A), cyclists (Experiment B), and kick scooter users (Experiment C) sought to visually communicate with drivengers when they would face autonomous vehicles (AVs). In each experiment, participants (n= 462,n= 279, andn= 202, respectively) were asked to imagine themselves in described situations of encounters between a specific type of vulnerable road user (e.g., pedestrian) and a (...) human driver in an approaching car. The human driver state and the communicative means of the approaching car through an external Human-Machine Interface (eHMI) were manipulated between the scenarios. The participants were prompted to rate from “never” to “always” (6-point Likert scale) the frequency with which they would seek eye contact with the human driver either in order to express their willingness to cross or to make their effective decision to cross. Our findings revealed that a passive human driver in an AV with no visual checking on the road triggered a decline in vulnerable road users’ desire to communicate by eye contact (Experiments A–C). Moreover, the results of Experiment C demonstrated that the speed screen, the text message screen, and the vibrating mobile app eHMI signals diminished kick scooter users’ desire to communicate visually with the human driver, with some age-based differences. This suggested a better comprehension of the approaching car’s intentions by the kick scooter users, driven by the features of the eHMI. (shrink)

This article explores how the type of consent given for organ donation should affect the judgement of a patient's overall benefit with regards to donation of their organs and the pre-mortem interventions required to facilitate this. The findings of a qualitative study of the views of 10 healthcare professionals, combined with a philosophical analysis inform the conclusion that how consent to organ donation is given is a reliable indicator only of the strength of evidence about views on donation and subsequent (...) willingness to undergo pre-mortem interventions. It is not an indicator of the strength of actual desire to donate. Clinical management of living patients prior to donation after circulatory death must therefore respect the values, wishes and beliefs of the potential donation after circulatory death donor. Our participants, however, suggested that the information currently provided is sufficient to authorise donation and that this consent, however provided, was sufficient to proceed with pre-mortem interventions. Respect for autonomy underpinned this ‘all or nothing’ approach. Although the legal requirements for donation authorisation and the protection of patients without capacity are clear, practice and policy regarding consent in donation after circulatory death may be based on donation following brainstem death where the patient is already dead when the family is approached. Custom and practice in donation after circulatory death may need to be revised to protect the interests of the dying potential donor. (shrink)

The ‘right not to know’ (RNTK) can be used by patients as a safeguard against the effects that certain medical information can have on their well-being. At first glance, one might reason it suitable for a patient to enact their RNTK. However, although Davies states that RNTK gives people the ability to both protect themselves from self-perceived harm and exercise their autonomy, I will argue that ‘not knowing’ hinders patients’ ability to exercise their existential freedom and represents what Sartre calls (...) an instance of ‘bad faith’. Davies argues that the RNTK takes precedence over many related issues and objections associated with a patient’s decision to implement such a resolution.1 Fundamentally, the RNTK gives patients power to protect themselves from subjective harm and to exercise their autonomy. In most cases, objectors of RNTK cite the negative impact on the patient’s state of health, which affects not only the patient but also those persons who would also be negatively affected by patient health outcomes. For the majority of objectors, patients have moral obligations to lessen the degree of burden on others, which refusal can initiate. However, Davies concludes, ‘…the burden placed on others is not sufficiently significant …. (shrink)

Research on interpersonal trauma tends to focus on the effects of traumatic encounters on those one who directly undergo the experience. In this paper, I seek to understand the experiences of the friends and family of the one who has undergone trauma, a paradigmatic case being the relatives of veterans (O’Nell, 1999). I argue that one way we can understand the experiences of friends and relatives is through Pauline Boss’ concept of _ambiguous loss_ (Boss, 1986, 2007). The kind of ambiguous (...) loss relevant for our purposes is when a family member is physically present but psychologically absent, for example, in the case of a relative with advanced dementia. This is what I purport happens in some instances of traumatic experience. I argue that third-person traumatic encounter can be experienced as a loss due to the changes in the person who has undergone the traumatic encounter and that this, in turn, causes changes in the person experiencing the loss and their relationship with their traumatised family member. I argue that first-person traumatic encounter is a transformative experience (Paul, 2014), i.e., an experience which causes personal and epistemic changes in the subject undergoing it, and that third-person traumatic encounter can also be a transformative experience. (shrink)

This paper examines the problematisation of sex-selective abortion (SSA) in UK parliamentary debates on Fiona Bruce's Abortion (Sex-Selection) Bill 2014–15 and on the subsequent proposed amendment to the Serious Crime Bill 2014–15. On the basis of close textual analysis, we argue that a discursive framing of SSA as a form of cultural oppression of minority women in need of protection underpinned Bruce's Bill; in contrast, by highlighting issues more commonly articulated in defence of women's reproductive rights, the second set of (...) debates displaced this framing in favour of a broader understanding, drawing on postcolonial feminist critiques, of how socio-economic factors constrain all women in this regard. We argue that the problematisation of SSA explains the original cross-party support for, and subsequent defeat of, the policies proposed to restrict SSA. Our analysis also highlights the central role of ideology in the policy process, thus making politics visible in policymaking. (shrink)

Objective: There is lack of information on the presentation of eating disorders (EDs) in Saudi Arabia using gold standard clinical tools. The present study aimed to provide data on the presentation of EDs in Saudi Arabia using clinically validated measures.Method: Hundred and thirty-three individuals (33 male) with a mean age of 22 years (2.63) completed three measures: the Eating Disorder Examination (EDE), a semi-structured interview, the Eating Disorder Examination Questionnaire (EDE-Q), a self-report measure, and the Depression Anxiety and Stress Scale (...) (DASS-21) to measure comorbid symptoms.Results: Individuals in Saudi Arabia reported higher levels of restraint, eating concern and shape concern and a higher global score, but lower levels of weight concern on the EDE-Q compared to the EDE. Female participants reported a higher global score, alongside significantly higher scores on the restraint, shape concern and weight concern subscales than males. The most common ED subtype was other specific feeding or ED. Compared with Western community samples, symptom severity in this purposive sample obtained from community settings was significantly higher in this sample.Discussion: Individuals with eating, weight and shape concerns in Saudi Arabia may feel more comfortable expressing their symptoms on a self-report tool compared with a face to face interview. However, it is possible that a self-report measure may over-estimate the severity of symptoms. The data suggest that clinicians in Saudi Arabia should regularly screen for EDs in all genders. It is also important to note that ED symptoms are a cause for concern in young people in Saudi Arabia. (shrink)

Prince of philosophers -- The emergence of Islam -- Boy genius -- Court physician -- A traveling philosopher -- Death of an intellectual -- A lasting legacy.

This article intends to review William Dembski's recent monograph entitledBeing as Communion: A Metaphysics of Information, in which he establishes an entire information-centric metaphysics. This viewpoint is compared with al-Ghazālī’s perspective, a Muslim philosophical theologian from the Medieval period. It is concluded that what Dembski defines as information, which for him is the ontological basis of the natural world, seems remarkably close to al-Ghazālī’s notion of God's will and omnipotence. This article is an explorative comparison of their metaphysical frameworks that (...) are discussed in light of modern scientific developments, highlighting their differences and similarities. (shrink)

Abstract: Retama raetam (RR) is a traditional medicinal plant belongs to fabaceae family which grows in North Africa and East Mediterranean region. Locally, RR is used in several diseases including diabetes mellitus and hypertension. Thus, this study aims to investigate certain behavioral and central effects of methanolic extract of RR seeds in experimental animals (male Albino adult mice of 20 – 35 gm). Three exploratory behavioral models are used in this study, open field, elevated plus maze and light-dark box models, (...) in addition, picrotoxin induced seizure model in mice. In elevated plus-maze test of anxiety, a dose of 25 mg/kg of RR induced a significant increase in number of open arms entries and time spent on open arms of the maze compared to the control. In light-dark model, time spent on light area and number of light-dark transitions are significantly increased after treatment with 25 mg/kg RR extract of seeds. Open field model also revealed a significant increase in general motor activity of the mouse after 25 mg/kg of RR. On the other hand, a dose of 50 mg/kg of RR significantly induced a profound central and peripheral analgesic responses. In summary, this study concludes that RR seeds have a profound anxiolytic-like effect and analgesic response with delay in latency time of seizure induced by picrotoxin in mice. (shrink)

This study reviews and synthesizes the contemporary business literature that focuses on the role of corporate social responsibility to enhance firm value. The main objective of this review is to proffer a precise understanding of what has already been investigated and the findings of those investigations regarding the value-enhancing capabilities of CSR for public firms. In addition, this review identifies gaps in the existing literature, evaluates inconsistent findings, discusses possible data sources for empirical researchers, and provides direction for exploring other (...) promising avenues in future studies. The thrust of the CSR literature largely acknowledges the value-enhancing capabilities of firms’ social and environmental activities. However, the predominance of inconsistent theoretical grounds in major CSR-benefits-related areas suggests that there is ample room for future research to contribute to the extant literature. Anecdotal evidence, the prevalence of theoretical arguments, and the availability of large cross-sectional firm-level data suggest that future research will enrich the literature by investigating the real insights behind several unanswered questions, by establishing implicit understandings regarding recognized findings, and by developing new theories in this emerging field. (shrink)

Despite the vast scholarship on Ibn Khaldun, little attention has been devoted to his views on war - views of considerable contemporary significance because he remains one of the few authoritative figures across a broad swath of the Islamic political spectrum. The first part of this article identifies jihad as a crucial element of a broader imperative for Ibn Khaldun: establishing empires of sufficient size, diversity and cosmopolitanism to sustain the kind of civilization he views as necessary for human excellence. (...) The second part of the article demonstrates that for Ibn Khaldun the good military commander, like the good religious guide, is a model for the good or artful statesman in general. In the process, Ibn Khaldun's study of war and empire emerges as one of the most innovative articulations of Realpolitik in Islamic political thought. (shrink)

Although the Mukhtasar Siyasat al-Hurub has attained iconic status in the Islamic military canon, it has never received a full-length analysis. Almost all extant references, moreover, focus on its technical aspects rather than its political subtext. That subtext has a twofold purpose. First, to valorize reason by emphasizing the centrality of deliberation in jihad. Second, to ensure that such valorization nevertheless does not lose sight of (a) the uncertainties of war, which militate against replacing faith in supernatural forces with an (...) equally unwarranted faith in science; or (b) the existence of evil in the world, which precludes any hope of perpetual peace. As such, the Mukhtasar articulates a distinctive Islamic approach that diverges both from a more optimistic Western tradition extending from early Christianity to the Enlightenment, and from an alternative-- but currently resurgent-- Islamic outlook on the proper scope and conduct of jihad. (shrink)

_Misapprehensions of culture and religion are used for the early marriages of women in Pakistan, which generates few significant challenges for women to pursue their higher education. The present study identifies such challenges for married women in higher education. These challenges are relevant to women’s post-marriage lifespan in rural Pakistan. Building upon Fredrickson’s (2001) and Hobfoll’s (2001) theories focused on post marriages issues, the study has developed open-ended questions for collecting in-depth information. Therefore, 43 in-depth interviews with married women were (...) conducted and through qualitative data analysis using NVIVO software, the study has highlighted that early marriages of girls have become a cultural norm, and education priorities of the girls are insignificant for parents to decide the marriage date. Married women pursuing education at marriage do not get any support from husbands and in-laws as the patriarchal norms prohibit women from stepping out from home. In these circumstances, women may get subject to the victim of many unlawful practices, including intimate partner violence (IPV). Thus, the present study findings imply that married women's participation in higher education is negligible due to weak legislation on women’s rights and strong illegitimate tribal practices._. (shrink)

The idea of the subject as a construct, of various external influences, was not new to the cultural and literary circles in the 1980s when DeLillo published White Noise. In the second half of the twentieth century, post-structuralist and postmodern theories unsettled the established ideas of the humanist tradition like the concept of the subject. The idea that the subject is constituted by external factors posed a challenge to the modernist notion of the subject as authentic and independent consciousness. Influenced (...) by post-structuralist and postmodern theories, novelists in post-war America, especially during and after the 1980s, portrayed their protagonists (the subjects) as textual constructs rather than authentic heroic figures we often find in modernists’ works of art. DeLillo engages with technological developments and sociocultural changes in post-war America and explores how such developments/changes influence an individual’s subjectivity. Critics have described Jack Gladney, the protagonist of White Noise, as a late-modernist displaced to negotiate the postmodern landscape. This study, which is purely of scholarly interest, attempts to show how Gladney vacillates between the notions of modernist authentic subject and the de-centred postmodern subject created textually. This article also attempts to explore how DeLillo’s fiction engages with the idea of the subject during the 1980s. (shrink)

On the outside wall and in the vestibule of the ‘House of Publius Paquius Proculus’ in Pompeii (building I.7.1) three graffiti containing the name Cucuta can be found. The first simply readsCucuta(CIL4.8065 [outside wall]). The second tells us that Cucuta was an attendant of the Emperor Nero (CIL4.8066 [outside wall]):Cu(cuta) | Cucuta Ner(onis).From the third we learn that Cucuta was a financial secretary (a rationibus) of Nero (CIL4.8075 [vestibule]):Cucuta ab ra[t]ioni[b]us | Neronis Augusti. While the meaning and significance of these (...) graffiti may seem apparent—that one of Nero's attendants scratched his name on the wall and vestibule pillar as he waited for the emperor to return from a meeting—the closeness betweenCucuta(an otherwise unattested name) andcicuta(hemlock) raises a key question: should we readCucutaasCicutaand therefore understand the third graffito in particular as a joke about Nero's rumoured fondness for killing family, friends and his senatorial enemies with poison? In other words, is it Poison, and not a person, that keeps Nero's finances in order? And, if so, can theCucutagraffiti give us an alternative insight into the plethora of wall inscriptions found outside building I.7.1 greeting Publius Paquius Proculus and recommending him for office? (shrink)

Bien que les minorités sexuelles et de genre courent un risque accru de problèmes de santé, on dispose de peu de données sur les interactions patient-prestataire de soins. Dans cette étude, nous avons exploré les perspectives des patients LGBTQ et leurs rencontres avec les médecins afin d’améliorer notre compréhension des expériences patient-médecin. À l’aide d’une sélection ciblée de patients LGBTQ auto-identifiés, nous avons réalisé quatorze entrevues semi-structurées en profondeur sur des sujets comme l’orientation sexuelle et l’identité de genre, ainsi que (...) leur rôle perçu dans la relation patient-fournisseur. Un codage utilisant une approche modifiée de la théorie ancrée a été effectuée pour générer des thèmes. Nous avons identifié trois grands thèmes qui démontrent la complexité des expériences vécues par les patients LGBTQ. La première, le manque de confiance, identifie la méfiance et la perte de la relation médecin-patient résultant d’une mauvaise communication des médecins ou d’un jugement porté sur eux, ou du fait que les médecins font des suppositions sur le genre, utilisent des pronoms incorrects et ne reconnaissent pas l’hétérogénéité dans la communauté transgenre. Un deuxième thème, être vulnérable, décrit les défis et les craintes liés au réconfort des patients face à la divulgation de leur orientation sexuelle ou de leur identité de genre. Un dernier thème, la discrimination sélective, met en relief la discrimination raciale ou ethnique qui crée un fardeau supplémentaire en plus de la maladie et de l’identité stigmatisée. Nos résultats révèlent les besoins complexes des personnes aux multiples identités stigmatisées lorsqu’il s’agit d’établir des relations avec les prestataires. En utilisant une perspective intersectionnelle qui tient compte de la pluralité des identités des patients, les prestataires peuvent aider à améliorer leurs relations avec les patients LGBTQ. L’intégration d’une formation intersectionnelle pour les étudiants en médecine et les résidents pourrait grandement profiter aux patients LGBTQ et à leurs médecins. (shrink)

Tacit knowing as a concept and legitimate topic of scholarship came up in philosophical research in the second half of the 20th century in the form of some influential works by Michael Polanyi (although similar concepts had been discussed before). Systematic epistemological studies on the topic are still scarce, however. In this article, I support the thesis that tacit knowing pervades all our common major divisions of knowledge and that it therefore must not be neglected in epistemological research. By this (...) approach I am simultaneously giving a systematic back-up for Polanyi's claim that the tacit component is found in all knowledge. (shrink)

There have recently been a number of high profile political incidents, and legal cases, that raise questions about hate speech. At the same time, the tensions, and perceived conflicts, between religion and sexuality have become controversial topics. This paper considers the relationship between religious freedom, free speech and equality through an analysis of recent case law in Great Britain, Canada and the United States. The paper starts with a discussion of how conflicts between these values arise in areas such as (...) hate speech and explores the differences between the European and US approach to this issue. In Council of Europe member states there is an increasing use of the criminal law to regulate hate speech. This paper argues that criminalisation of hate speech poses a distinct risk to the values of free speech and proposes alternative non-legal responses such as a greater use of cultural policy. The paper also explores a range of cases where the religion and sexual orientation conflict has arisen in areas such as the workplace. An analysis of these cases suggests that although there is no perfect resolution of this issue, it is possible to develop a set of principles that encourage a balance between the values of religious freedom, free speech and equality even in difficult situations where there is a conflict between religion and sexuality. The paper concludes with some practical recommendations for managing the tensions or conflicts between religious freedom, free speech and equality in liberal democracies. (shrink)

The intention of this paper is to examine the impact of corporate social responsibility disclosure on financial performance in a case study of listed Pharmaceutical firms in Pakistan. For this case study, the panel data of 10 years from 2005 to 2014 are obtained through content analysis of annual reports. Quantitative tools were used to measure variables studied in which index was developed and used scoring methodology. Further, brand equity is introduced as a mediator between CSRD and financial performance. The (...) results of content analysis revealed that GSK Pakistan laboratories involved in greater level of disclosure as compared to other pharmaceutical firms. The average rate of disclosure of listed pharmaceutical firms is increasing annually. Among four themes, the results showed that pharmaceutical firms mostly disclose information regarding community involvement. The results of regression which were significant shows that brand equity act as mediator between the corporate social responsibility disclosure and financial performance. (shrink)

Recruitment challenges in clinical research are widespread, particularly for traditionally under-represented groups. Referral relationships—in which research partners and clinical partners agree to collaborate on selected research studies or programmes, with the expectation that the clinical partners refer appropriate patients as potential participants—may help alleviate these challenges. Referral relationships allow research partners access to expanded and more diverse pools of participants by increasing the engagement of medical providers, leveraging providers’ connections with patients and providing structural support for study participation. Clinical partners (...) can also benefit from the resources offered by research involvement, and patients may benefit from improved access to studies. Yet despite their potential, referral relationships can raise ethical concerns. Here, we discuss ethical considerations for referral relationships in clinical research to address these concerns. When establishing relationships, fair participant selection should guide the sites and studies involved. When defining the terms of a relationship, partners should build trust and respect, collaborating so that health centres or hospitals and communities benefit from their research involvement with the mitigation of associated burdens. When implemented, referral relationships should continue to honour fair participant selection, reduce misunderstanding or miscommunication about research and protect patients’ privacy and confidentiality. Overall, when conducted ethically, referral relationships can help address study recruitment challenges and promote fair access to research opportunities. (shrink)

This paper argues that, although no resistance or revolution is permitted in the Kantian state, very tyrannical regimes must not be obeyed because they do not qualify as states. The essay shows how a state ceases to be a state, argues that persons have a moral responsibility to judge about it and defends the compatibility of this with Kantian authority. The reconstructed Kantian view has implications for how we conceive authority and obligation. It calls for a morally demanding definition of (...) the state and asserts that the primary personal responsibility is not to evaluate the morality of every single law but to evaluate the moral standing of the polity.Send article to KindleTo send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle. Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply. Find out more about the Kindle Personal Document Service.Kant, the State, and RevolutionVolume 18, Issue 1Reidar Maliks DOI: https://doi.org/10.1017/S1369415412000271Your Kindle email address Please provide your Kindle email.@free.kindle.com@kindle.com Available formats PDF Please select a format to send. By using this service, you agree that you will only keep articles for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services. Please confirm that you accept the terms of use. Cancel Send ×Send article to Dropbox To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Dropbox. Kant, the State, and RevolutionVolume 18, Issue 1Reidar Maliks DOI: https://doi.org/10.1017/S1369415412000271Available formats PDF Please select a format to send. By using this service, you agree that you will only keep articles for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services. Please confirm that you accept the terms of use. Cancel Send ×Send article to Google Drive To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Google Drive. Kant, the State, and RevolutionVolume 18, Issue 1Reidar Maliks DOI: https://doi.org/10.1017/S1369415412000271Available formats PDF Please select a format to send. By using this service, you agree that you will only keep articles for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services. Please confirm that you accept the terms of use. Cancel Send ×Export citation. (shrink)

Nuh Ha Mim Keller, a contemporary Muslim theologian, argues against the compatibility of evolution and Islam. In this article we intend to critically evaluate his position in which he advances three separate arguments. First, he criticizes the science of evolution. Second, he demonstrates the metaphysical problems with naturalism and the role of chance in the enterprise of evolution. Third, he contends that evolution and the creationist narrative in Islamic scripture is irresolvable. Given these points, Keller concludes that believing in human (...) evolution takes one outside the fold of Islam (kufr). After reviewing each of these points we argue that his claims are unwarranted because of other possibilities which Keller may have not considered. In effect, we argue that believing in evolution doesn't necessarily or definitively entail kufr. (shrink)

An introduction to the political philosophy of Kant, exploring how he developed his views in a context shaped by controversies following the French revolution. It provides new information on his followers and critics as they engaged in high stakes political debates on freedom's relation to the state at this key turning point in history.