Lack of guidance and regulation for authorizing medical cannabis for conditions involving the health and neurodevelopment of children is ethically problematic as it promulgates access inequities, risk-benefit inconsistencies, and inadequate consent mechanisms. In two virtual sessions using participatory action research and consensus-building methods, we obtained perspectives of stakeholders on ethics and medical cannabis for children and youth. The sessions focused on the scientific and regulatory landscape of medical cannabis, surrogate decision-making and assent, and the social and political culture of medical (...) cannabis. We found that evidence-gathering and data dissemination, pressures on clinical relationships, and the lack of integration of culturally diverse perspectives and Indigenous knowledges were key areas of concern. Participants emphasized the importance of utilizing adaptive study designs, highlighted the importance of trust-building between clinicians, patients and caregivers, and discussed barriers including historical and ongoing stigmatization of medical cannabis. We conclude that continued public consultation and strength-based research that integrate diverse perspectives are critical steps forward. (shrink)

For those who teach students in psychology, education, and the social sciences, the _Handbook of Demonstrations and Activities in the Teaching of Psychology, Second Edition_ provides practical applications and rich sources of ideas. Revised to include a wealth of new material, these invaluable reference books contain the collective experience of teachers who have successfully dealt with students' difficulty in mastering important concepts about human behavior. Each volume features a table that lists the articles and identifies the primary and secondary courses (...) in which readers can use each demonstration. Additionally, the subject index facilitates retrieval of articles according to topical headings, and the appendix notes the source as it originally appeared in _Teaching of Psychology_, the official journal of the Society for the Teaching of Psychology, Division Two of the American Psychological Association. Volume I consists of 97 articles about strategies for teaching introductory psychology, statistics, research methods, and the history of psychology classes. Divided into four sections, the book suggests ways to stimulate interest, promote participation, grasp psychological terminology, and master necessary scientific skills. (shrink)

This conceptual paper considers the practice implications of assisted dying for contemporary nursing practice within the United Kingdom in response to the publication of a parliamentary report leading to a private members’ bill that will form the basis of a debate and possible change in legislation. A recurring theme within the nursing research is how nurses should respond to patients expressing an interest or making a request for assisted dying. This paper explores contemporary evidence and argues that the procedure of (...) assisted dying is a complex (manifold) and puzzling (paradoxical) practice. The UK nursing profession may replicate recent healthcare catastrophes if the response to a proposal for assisted dying is based on a technical-rational stance, or if nurses merely coalesce around a single determinant such as patient autonomy. The paper presents two nursing communicative interventions that seek to address how to respond to a patient request for an assisted death that foregrounds the preferences and personhood of the patient whilst providing opportunities for enquiry-based approaches to enhance nursing responses to intractable suffering. (shrink)

Hegel is commonly understood to have required that the philosophy of history must be retrospective and therefore fundamentally conservative. Yet at the same time he is thought to have claimed that his system involved an absolute truth beyond which no philosophy could advance, and that it therefore marked the end of the history of philosophy. The two claims are evidently inconsistent, since a history of philosophy, which must be bound by constraints on the philosophy of history, could not legitimately comment (...) on philosophy's future. If this is the result of Hegel's metaphilosophy then he has contributed at least this much to his reputation for presumption and incoherence. However, I will argue that both claims are based upon misinterpretations that follow from inattention to Hegel's ontology, and that his metaphilosophy is more subtle and more critical than most interpreters have allowed. Though Hegel clearly requires that a philosophy draw its content from its time, he regards it as historically transcendent in its form, and as consequently playing a crucial role in the transition to the next historical epoch. The discussion begins with Hegel's views on the role of philosophy in history and proceeds to his conception of his place in the history of philosophy. (shrink)

The System of Ethics was published at the height of Fichte's academic career and marks the culmination of his philosophical development in Jena. Much more than a treatise on ethics narrowly construed, the System of Ethics presents a unified synthesis of Fichte's core philosophical ideas, including the principle I-hood, self-activity and self-consciousness, and also contains his most detailed treatment of action and agency. This volume brings together an international group of leading scholars on Fichte, and is the first of its (...) kind in English to offer critical and interpretive perspectives on this work, covering topics such as normativity, belief, justification, desire, duty, and the ethical life. It will be an essential guide for scholars wanting to deepen their understanding of Fichte's ethical thought, as well as for those interested in the history of ethics more broadly. (shrink)

In an essay entitled ‘The Nobility of Sight’, Hans Jonas argues that ‘[s] ince the days of Greek philosophy sight has been recognized as the most excellent of senses’ (Jonas, 1954, p.507). Seeking to account for the historical elevation of vision over other forms of sensory engagement with the world, Jonas contends that ‘[t]he unique distinction of sight consists in what we may call the image performance, where “image” implies three characteristics: (1) simultaneity in the presentation of a manifold; (2) (...) neutralization of the causality of sense-affection; (3) distance in the spatial and mental senses’ (ibid.). In the case of (1), what distinguishes sight from other senses is the fact that it can give us both dynamic and static reality: our eyes can survey a whole field of possible percepts as well as focus directly upon a fixed object (ibid., pp.508–9). In the case of (2), what further marks out vision is that it does not require the perceiver and the object of perception to be directly engaged — the ‘dynamic’ relation between the two is, in Jonas’ words, ‘neutralized’ (ibid., p.514). And in the case of (3), seeing’s inimitability is also guaranteed by its being ‘the only sense in which the advantage lies not in proximity but in distance: the best view is by no means the closest view’ (ibid., pp.517–8). (shrink)

“Unconscionable.” “Outrageous.” “Indefensible.” These are just some of the tamer descriptions for the billing practices of most hospitals, and also many physicians, that have recently come to the public's attention. Earlier this year, Time magazine published an extraordinary 24,000‐word exposé—the longest article it has ever published—detailing how even charitable hospitals routinely price‐gouge their patients.1 With characteristic flare for telling details, journalist Steven Brill documented ten‐fold markups of charges over costs at some prominent hospitals for common services like X rays and (...) lab tests, and one‐hundred‐fold mark‐ups on mundane supplies such as gauze pads and generic aspirin. Just as the buzz from Brill's article was abating, the Centers for Medicare & Medicaid Services released a comprehensive data set in May that galvanized local and national media across the country. This news tsunami caught hospital managers flat‐footed and tongue‐tied. Typical responses conceded that hospitals’ pricing practices are based neither on actual cost structures nor rational marketplace dynamics. Instead, hospitals attempted to deflect blame by noting that hardly anyone actually pays list prices, and they characterized their indefensible pricing as a symptom of a broken system that is beyond them to fix. There are two glaring faults in these standard defenses. (shrink)

National decline is typically blamed on special interests from the demand side of politics corrupting a country's institutions. The usual demand-side suspects include crony capitalists, consumer activists, economic elites, and labor unions. Less attention is given to government insiders on the supply side of politics - rulers, elected officials, bureaucrats, and public employees. In autocracies and democracies, government insiders have the motive, means, and opportunity to co-opt political power for their benefit and at the expense of national well-being. Many storied (...) empires have succumbed to such inside jobs. Today, they imperil countries as different as China and the United States. Democracy - government by the people - does not ensure government for the people. Understanding how government insiders use their power to subvert the public interest - and how these negative consequences can be mitigated - is the topic of this book by Mark A. Zupan. (shrink)

A central thesis of biocentrism is that all living things have intrinsic value. But when conflicts arise between the interests of humans and other organisms, this claim often has counterintuitive consequences. It would be wrong, for example, to swat pesky flies. Some biocentrists have responded by positing a taxonomy of interests in which human interests justifiably supersede those of other living things. I express doubts about whether this maneuver can succeed, and suggest that even if it does, it then commits (...) biocentrists to the claim that it is wrong not to harm living things, when doing so is necessary to advance nonbasic human interests, a position which runs counter to the biocentric attitude of respect for nature. As a result, biocentrists must adopt either a highly counterintuitive position or one that is contrary to their general outlook. I show that the introduction of the supererogatory may resolve not only this biocentric dilemma but other quandaries in environmental ethics. (shrink)

The participation of physicians in the atrocities of the Holocaust exposed vulnerabilities in medicine’s moral commitment to patients’ best interests that every health professional should recognize. Teaching about this history is challenging, as it is extremely complex and there are no common standards for what basic historical facts students in health professions training programs should learn. Nor is there guidance on how these historical facts can or should be related to contemporary ethical issues facing health professionals. To address these problems, (...) we propose a set of core historical facts about health professional involvement in the Holocaust that every student in a health professional training program should learn. We then identify three ethical lessons from the Holocaust that are pertinent today as physicians struggle to maintain their moral compass and earn the trust of patients and the public: 1) The lesson of commitment to science; maintaining balance between reason and skepticism in the search for truth, The lesson of clinical detachment; maintaining balance between necessary professional distance with a commitment to humanism and intimacy with patients, and 3) The lesson of competing loyalties; maintaining balance in upholding medicine’s multiple responsibilities, including to individual patients and the larger community. Embedding these facts and lessons into the education of health professionals is challenging yet critically important. Today’s physicians struggle with some of the same ethical tensions as did German physicians in the Nazi era, albeit in a much-attenuated fashion. Awareness of these tensions and taking active measures to maintain them in balance are necessary components of humanistic health care, which should be an integral part of health professional training programs. (shrink)

Rational Mysticism: Dispatches Jrom the Border between Science and Spirituality. John Horgan. Boston: Houghton Mifflin Company, 2003. 292 pp. $25.00 (cloth).

Over the last thirty years, personal debt loads have increased dramatically. Lower income earners borrow money to purchase basic goods and services, so their debt is frequently non-discretionary. The impact of non-discretionary personal debt on debtors can be as, if not more, harmful than government regulations that have been declared unconstitutional. In this regard, the impact of personal debt is tantamount to the impact of a civil rights violation. What separates the impact of unconstitutional state action from that of personal (...) debt is the assumption that only the latter are the result of consensual transactions. Consent, however, is not a dyadic phenomenon, it exists in gradations. The quality of consent is weakened when the agent is making choices in response to pressures, and the empiricalquestion of the extent to which a consent transaction is unforced is distinct from the normative question of whether a transaction is legitimate, or fair. It is necessary to devise a new taxonomy of language to clearly distinguish the empirical and normative questions. This elucidates the fact that lower income people are under more pressure to borrow money than are upper income individuals to pay progressive rates of income tax. To argue that the latter are ‘coerced,’ is to admit that the low income individual’s decision to borrow is similarly forced. This admission suggests that a significant portion of citizens of market-based economies (notably Canada and the U.S.) are being forced to endure harms tantamount to civil rights violations. The admission also suggests that free markets harbour forces that undermine individual autonomy, and the absence of corrective state regulation exacerbates the problem. (shrink)

Some critics have understood environmental egalitarianism to imply that human and animal lives are generally equal in value, so that killing a human is no more objectionable than killing a dog. This charge should be troubling for anyone with egalitarian sympathies. I argue that one can distinguish two distinct versions of equality, one based on the idea of equal treatment, the other on the idea of equally valuable lives. I look at a lifeboat case where one must choose between saving (...) a human and saving a dog, and using the work of Peter Singer and Tom Regan, I show why equality understood as equal treatment does not entail that lifeboat cases are moral toss-ups. But the view that all lives are equally valuable does entail this, and so egalitarians should reject this alternative account of equality. The upshot is that egalitarians need to be more careful about distinguishing between these two versions of equality. The failure to insist on this distinction has led many to believe that egalitarianism generally has counter-intuitive implications when in fact only one version of egalitarianism has this problem. (shrink)

Libertarians such as Nozick have argued that any redistributive tax scheme intended to achieve and maintain an egalitarian distributive pattern will violate self‐ownership. Furthermore, since self‐ownership is a central component of the idea of freedom, instituting an egalitarian distribution makes a society less rather than more free. All this turns on the claim, accepted by both libertarians and their critics, that a redistributive tax will violate self‐ownership because it must expropriate the fruit of a person’s labour. I show here that (...) there is no reason to accept this claim. The libertarian argument works only if the fruit of one’s labour must be understood to include everything that a person produces through his labour. But there is an alternative reading of the fruit of labour which identifies it with that subset of the total product of one’s labour which is due to his choices rather than luck. I argue that this reading is plausible, that there is nothing in the concept of self‐ownership which disallows it, and that if it is adopted, a redistributive tax need not automatically expropriate the fruit of one’s labour. Consequently there is no necessary inconsistency between redistributive taxation and self‐ownership, and so egalitarians can endorse the latter idea. (shrink)

The investigator seeks guidance related to a planned recruitment strategy of requiring participants to live within close proximity to the study site for the 32-week Phase II study examining the saf...

Synthetic biology has spawned a debate about how society and the international community should go about policy‐making, especially given the potential for both transformative benefits and existential threats. One of the significant contributions of “The Ethics of Synthetic Biology: Next Steps and Prior Questions,” by Kaebnick, Gusmano, and Murray, is its exploration of the difficulties of devel­oping policy that appropriately addresses the risks and benefits of synthetic biology. In this comment I want to develop this point further and emphasize how (...) the proper methodology for addressing synthetic biology's ethical and public policy issues are affected by the unpredictable and complex causal webs in synthetic biology (which have analogs in other new and emerging technologies). (shrink)

Evolvability is the capacity to create new adaptations, and especially new kinds of adaptations, through the evolutionary process. Evolvability is important both as a theoretical issue in biology and as a practical issue in evolutionary computation. But it is difficult to study evolvability, in part because it is difficult to..

Since 1991, over half the states have enacted laws that restrict or prohibit insurers’ use of genetic information in pricing, issuing, or structuring health insurance. Wisconsin was the first state to do so, in 1991, followed by Ohio in 1993, California and Colorado in 1994, and then several more states a year in each of the next five years. Similar legislation has been pending in Congress for several years. Also, a 1996 federal law known as the Health Insurance Portability and (...) Accountability Act prohibits group health insurers from applying “preexisting condition” exclusions to genetic conditions that are indicated solely by genetic tests and not by any actual symptoms. (shrink)

First Published in 2003. Routledge is an imprint of Taylor & Francis, an informa company.

Opponents of the Affordable Care Act have attempted to topple it in court by challenging the legality of two of its three legs. Three years ago, in NFIB v. Sibelius, Chief Justice Roberts narrowly upheld the constitutionality of the individual mandate, in a 5-to-4 decision that characterized the mandate as an optional tax rather than as a regulatory command. This year, on June 25, the health policy community exhaled a giant sigh of relief when the Supreme Court upheld the subsidy (...) leg of the ACA structure. In King v. Burwell, Justice Roberts again wrote the majority opinion, ruling as a matter of statutory interpretation that subsidies for insurance premiums are available not just through state-based exchanges but also through the federal exchange. (shrink)

As politicians revisit the merits of health insurance reform and courts deliberate its constitutionality, government regulators are busily working on the wonky details of implementation. The Affordable Care Act leaves vast swaths of regulation for various agencies to prescribe, most notably the Department of Health and Human Services. Infamously (or perhaps apocryphally, since I'm certainly not going to bother counting), the statute contains more than a thousand commands to the effect of, "the Secretary shall decide." This massive delegation of authority (...) is unavoidable in any attempt to comprehensively reform, yet preserve, our Byzantine health insurance system.Throughout this regulatory nativity, the government .. (shrink)

In 2018, the remarkable rescue of twelve young boys and their football coach trapped in a flooded cave in Thailand captured worldwide attention. The rescue required the boys to be dived out of the cave system while fully anaesthetized which presented unique practical and ethical challenges for the rescue team. Major departures from normal anaesthetic practice were required. Taking anaesthetized children underwater was unprecedented, complex, and dangerous. To do this underground in a flooded cave meant the risks were extreme. Using (...) a principlist approach, this essay will outline the rescue plan highlighting the ethical dilemmas faced by the rescue team. Informed consent and full disclosure of information are justifiably waived in emergency disaster scenarios. Beneficence as a guiding principle becomes a major challenge when all rescue options appear destined to cause likely fatalities of healthy young boys. Importantly, virtues and virtue ethics also have a vital role to play when confronting and dealing with ethical challenges in disaster scenarios—this will be discussed with particular reference to the cave rescue. (shrink)

. MAINTAINING DISCIPLINE IN DETAINEE OPERATIONS: A STUDY IN SMALL UNIT LEADERSHIP AND ETHICAL BEHAVIOR. Journal of Military Ethics: Vol. 11, No. 4, pp. 363-364. doi: 10.1080/15027570.2012.758409.

Translational science attempts to accelerate and increase the significance of research progressing from bench to bedside. Support from the NIH through its institutional grant program has increased the prominence and importance of translational science. The inclusion of a broadly based bioethics component to translational science presents an opportunity for bioethics scholars to address fundamental social issues, including the effects of translational science on public health, health equity, and human flourishing. Large-scale bioethical inquiries could examine research priorities, unintended consequences of research, (...) and access to and uptake of research discoveries. (shrink)